per diem staff

Nurse Staffing Solution: What To Expect From Per Diem Staff

The world of health care is one of balance, especially when it comes to nurse staffing. You need to employ and schedule enough health care professionals (HCPs) to cover the needs of your patients, but you don’t want so many staff that there isn’t enough work to keep everyone working. Depending on your facility’s or service’s specialties, you may also not know how many patients you’ll have from month to month or even day to day. 

If you are using staffing agencies and registries for the first time, you’ll likely want to know what to expect from per diem staff before shifts, during, and after.

Before the Shift

All health care professional or nurse staffing agencies require their health care providers to go through a basic orientation before they are able to sign up for any shifts. This typically involves online courses and quizzes to test their knowledge and understanding of necessary topics like infection control and HIPAA regulations. Credible staffing agencies also require background checks and immunizations records, just like health care facilities and services do when they hire staff.

As someone in charge of staffing your facility or services, it’s up to you to decide what to expect from per diem staff before they can sign up for one of your shifts.


For many facilities needing nurse staffing solutions and for any HCPs, this orientation is more than enough to qualify per diem staff to start picking up shifts. However, some facilities and services require that per diem staff attend a facility-specific orientation first. The orientation may be a video, learning materials that cover information about your facility’s policies, or a formal on-site orientation.

Health Requirements

You know your patient demographics better than any staffing agency, and any per diem staff who accept shifts from you should reflect that. A good nurse staffing registry will work with you on making sure your shifts are covered by the HCPs you need. For example, perhaps you have a patient population that speaks mainly Spanish, and you would like to request nursing staff who are fluent in English and Spanish.

There may be other health-related requirements you may consider based on current issues. With COVID-19 being such a concern for many skilled nursing facilities and places who work closely with the elderly and those at high risk, some facilities may request proof of a negative COVID-19 test. During flu season, you may request only staff who have proof of getting a flu vaccine and require that those without wear masks during their shifts.

Staff Education

If this is your facility’s or service’s first time working with a nursing registry to hire per diem staff, a useful and vital step in ensuring those staff members fill shifts successfully is education for your full-time and part-time staff. Some of your staff may also have never worked with agency nurses and may be unfamiliar with how they work, or they may be worried about what it means for them and their jobs.

As part of a regular in-service training or staff meeting, let your staff know about your decision to use a nurse staffing agency. Explain what is expected of your staff when they work with per diem staff and that you are using per diem nurses not to replace them but to help them. Working in a new facility for the first time can be overwhelming, and successful patient care is a result of all health professionals working together.

At the Start of the Shift

When an HCP shows up to a shift for the first time at a new facility, there will always be a learning curve. While many tasks and responsibilities in the nursing field remain the same depending on the specialty, the basics of how exactly to do those tasks will be different.

If there is no formal facility-specific orientation, or even if there is, the per diem staff will need to know several important pieces of information. They will need this knowledge to know how to safely provide the best quality patient care in your facility or for your service organization. You can help them by making sure that you and the supervising staff know how to answer questions when they come up.

Daily Operations

Many tasks that your full-time and part-time staff do throughout the day become second nature. When a per diem HCP first shows up to a shift, there are details to how to perform these responsibilities that they have to learn. There are several basic resources they will need to know in order to perform their regular duties:

  • Which floors, rooms, or patients they are assigned to and how the facility is laid out
  • Where supplies are kept
  • How to log in to charting and medical record software
  • How to use your facility’s software
  • Who to contact if they have questions and how to contact them

Many facilities in a specific specialty will use the same software systems or ones that are very similar. For example, the electronic medical record you use at your facility for nursing staff to administer medications may likely be the same one used at other facilities that a per diem nurse has used many times before. 

Regardless, make sure a per diem staff member knows how to use it correctly. When they step away from the computer, do they log off, or does the software have a privacy screen setting? All HCPs are trained in being HIPAA compliant and just need to know what tools are available to them.

Emergency and Safety Procedures 

As someone new to the facility, an HCP will want to know what to do in an emergency. Point out where they can find equipment like fire extinguishers and information like escape routes. If something happens during their shift that requires an incident report, make sure they know how to respond and who to contact.

How to Share Information

How you share this information with each new per diem staff is up to you. Some facilities have a book or binder with resources that per diem nurses can look at to familiarize themselves with your policies or use as a reference. 

Depending on which shifts you need filled, you may have the supervising manager on that shift available to answer questions or go over necessary information when the staff shows up. During night shifts when administrators may not be on-site, have a chain of command and a clear point of contact that is communicated to per diem staff, so they know who to contact or ask questions.

During the Shift

When a per diem HCP shows up for their first shift at your facility, they are like any of your full-time staff when they walked onto the job for the first time. They will likely be slower to do tasks compared to one of your full-time or part-time staff members or an HCP who has worked for your facility before.

With this in mind, you may consider assigning per diem staff patients or units with lower acuity patients and scheduling full-time staff with units that require more facility knowledge to provide the best patient care. Enabling your HCP staff to be successful during their shift as much as possible will make sure your patients receive quality care.

After the Shift

When a nurse is ready to leave the facility at the end of their shift, they will need to close out their shift on their agency’s app or sign out in a book. The method will vary depending on the nurse staffing agency, but someone will need to verify that they worked the shift before they can leave. 

Usually, this means they need a signature from a supervisor, if available, or a fellow coworker, if allowed by their agency. Think of this like signing off on time cards at the end of every pay cycle. A per diem HCP’s pay cycle begins and ends that same shift, and you are signing off on their time card.

Depending on the agency service, you and the HCP may then be asked to provide feedback on how the shift went. This could be through the agency’s software or by email or phone. Feedback when necessary is an important part of the process to ensure that the per diem staff and your facility both get any concerns resolved or acknowledge a job well done.

At Clipboard Health, you’ll receive a personal account manager who will help you fill your shifts. Fill out a short form to get started hiring staff today!