What to Know Before Hiring Agency or Per Diem Nurses

Bringing in extra nurses sounds like a quick fix when staffing’s tight. But if you want that process to actually help instead of creating more work, there are a few things you need to get clear on first.

Whether you’re filling a last-minute shift or trying to cover long-term leave, here’s what you need to know before hiring agency or per diem nurses to save time, money, and a whole lot of frustration.

Confirm Experience and Licensure Early

Before you bring anyone into your facility, check that they have up-to-date credentials. That includes active licenses in your state, relevant certifications, and experience in your specific unit type.

Agency nurses often jump between facilities, so not all experience is a perfect match. Make sure the nurse’s background aligns with the level of care your patients need—don’t assume just because someone has years of nursing under their belt that they’re ready to hit the ground running in your department.

Understand the Cost Differences

Per diem nurses and agency nurses come with different costs. Agency nurses usually have agency fees built into their hourly rate, while per diem nurses might come at a slightly lower cost—but with less flexibility or coverage.

You’ll want to weigh the value of guaranteed availability versus budget limitations. Knowing these differences can help avoid last-minute surprises when finance reviews the billing breakdown.

Know Who Handles Onboarding

Some hospitals have full orientation plans in place for temporary nurses, while others skip it entirely. That can cause real confusion on shift one.

Decide who’s responsible for basic onboarding—like showing them where supplies are, how to log into charting systems, or reviewing patient safety protocols. Even short-term nurses need a quick rundown to avoid safety issues or miscommunication with permanent staff.

Clarify Scheduling Expectations

Per diem and agency nurses often work odd hours, weekends, or nights—but they’re not always available on short notice. Don’t assume someone can pick up a shift at 6 a.m. tomorrow just because they’re labeled “flexible.” Check availability up front and agree on how much notice they need. That’ll help you avoid scrambling to fill a spot when someone doesn’t respond in time.

Ask About Cultural Fit

Technical skills are important, but personality and communication matter too. Temporary nurses will interact with patients, families, and staff—and that experience needs to be positive.

If possible, ask questions about their work style or talk to references about how they’ve handled challenging situations in the past. A good fit keeps morale steady and supports a better patient experience.

Confirm Background Check Procedures

Make sure you have a system in place to handle background checks for agency or per diem nurses. Healthcare background checks include several elements, including license verification, abuse registry checks, and past employment validation.

If you don’t plan for them, they can take forever—or worse, get skipped. That’s a problem, because these checks are mandatory for all healthcare hires. Not doing them can put your facility at risk of compliance violations or liability issues.

Be Ready Before You Hire

If you want hiring to go smoothly, understanding what to know before hiring agency or per diem nurses is important. Not all temporary staff are the same, and the decisions you make upfront can impact patient care, team morale, and your bottom line. Make sure you’re working with experienced professionals, handling compliance the right way, and setting them up with the info they need to succeed.