Working PRN
Pulse editor
Sunday, December 14, 2008
With the economy in recession and unemployment numbers rising, more health care workers are picking up extra shifts or working two jobs. Unlike workers in many other job sectors, nurses and therapists can usually find extra work in their field by working part time or PRN.
PRN stands for “pro re nata,” a Latin phrase meaning “as needed” or “as the situation arises.”
Photos by BARRY WILLIAMS / Special
Bibi Ramlall, a nurse in the mother/infant unit at Gwinnett Medical Center, looks on as Marlhy Patino holds her newborn daughter, Valeria Zelaya-Patino. Ramlall also works PRN shifts at Northside Hospital.
Theresa Cruz lectures during a health science class at Chattahoochee High School in Alpharetta. Cruz also works on a PRN basis at Gwinnett Medical Center in Lawrenceville.
Bibi Ramlall updates patients’ records at Gwinnett Medical Center. ‘I don’t mind working the extra hours and it is great money,’ she said.
The PRN arrangement benefits workers and employers. Working PRN can be a lifeline for nurses and therapists who need to make more money. When hospitals need to cover essential shifts, PRN workers can fill those slots.
Hiring PRN workers is considered a more cost-
effective way to meet staffing needs than hiring extra full-time employees, travel nurses or agency nurses, said Meredith Northcutt, director of recruitment at Gwinnett Health System in Lawrenceville. While PRN workers usually are paid higher hourly rates than full-time employees, they don’t get benefits. They also contract with employers to work a certain number of hours or shifts.
“Some shifts are always harder to fill than others. Most hospitals are glad to get the skilled help and don’t mind that a nurse has a full-time job elsewhere,” said Helen Allen, RN-C.
Allen works full time at The Birth Place at Emory Johns Creek Hospital and on a PRN basis in the mother/infant unit of the Women’s Pavilion at Gwinnett Medical Center in Lawrenceville.
“It’s always good to have a little extra money,” she said. “I think the biggest portion of clinicians work PRN for economic reasons.”
‘I still love it’
But there are other benefits to the arrangement, she added.
“My husband says that I would go to work even if they didn’t pay me,” Allen said with a laugh. “I’ve been a nurse for 30 years and practiced in obstetrical for most of that time — and I still love it.”
Allen worked for Emory Dunwoody Medical Center until it closed in 2006, and switched to labor and delivery at Emory Johns Creek Hospital two years ago. She has also worked PRN at Gwinnett Medical Center for about 10 years.
“There are different levels of PRN,” she said. “I’m committed to work one weekend a month (an eight-hour shift on Saturday and a 12-hour shift on Sunday) and take eight hours on call a month.”
Using a staffing computer program, she can schedule herself .
Allen likes the pay and the challenge of sharpening her skills in two places. “I’m attached to people in both departments and would hate to leave either, but the pace is very different in the two hospitals,” she said.
Gwinnett is a much busier hospital, with about 500 deliveries a month.
“I see more babies and more procedures by working both units,” Allen said. “Sometimes I get good ideas from one hospital that I share with another.”
Flexibility a plus
A nurse for 11 years and the mother of four children, Bibi Ramlall, BSN, started her career working per diem in New York for Medical Concepts, a medical staffing agency.
“I worked three 12-hour shifts every week wherever I was needed, and picked up overtime when we had extra bills to pay,” Ramlall said.
Ramlall and her husband made the arrangement work for their family.
“My husband worked nights and I worked during the days,” she said. “It was hard for him to be home with the kids and get four hours sleep and then go to work, but he did it.”
About 18 months ago, Ramlall took a full-time job in the mother/infant unit at Gwinnett Medical Center, working two 12-hour shifts on the weekend and an eight-hour shift on Wednesdays.
“It allows me the flexibility to be home for the kids when they come home from school every day,” she said, “and I like the bond I’ve formed with my co-workers. We’re like a little family.”
Ramlall still works PRN shifts at Northside Hospital.
“I don’t mind working the extra hours and it is great money. I just let the agency know on what days I’m available,” she said. “Nursing is a good career in any economy, and when times are tough, people can always use their skills to pick up extra hours.”
A nursing career offers employment options for almost any situation, Theresa Cruz, RN, has learned.
“Nursing gives you unlimited possibilities,” she said.
Cruz left a career in penal corrections to attend nursing school at age 31. After she graduated in 1985, Cruz worked nights in a nursing home. She moved to Georgia with her husband and children in 1991 and took a PRN position with Gwinnett Medical Center.
“I stayed home to raise my children and worked PRN because we didn’t need the benefits,” she said.
Making extra money
That changed 13 years ago when her husband had a massive heart attack and died. Suddenly, she needed benefits and a work schedule that a single mother could manage.
“A friend said that she had the perfect job for me. Chattahoochee High School was looking for a health science teacher,” Cruz said. “I looked into it, was hired, went back for my certification and it worked. I had the same schedule and holidays as my children.”
She continued to work PRN at Gwinnett Medical, switching from the neonatal intensive care unit to the mother/infant unit. Her supervisor worked around her teaching schedule.
“I didn’t want to quit working at the hospital because I didn’t know if I would like teaching,” Cruz said. “My passion is medicine and working PRN keeps me current on the latest drugs and procedures.
“It makes me a better teacher. My students take my elective courses because they have an interest in a health care career, and I’m able to bring real stories back from the workplace.”
Cruz is only required to work one weekend per pay period, but often works two or three weekends a month.
“It’s a totally different [from] teaching. I like that and I’m saving all my extra money for retirement,” Cruz said. “The nice thing about PRN is that you are more in control of your schedule.”
Not every supervisor posts PRN jobs, but most hospitals have those slots, and nurses often find out about them by asking supervisors or co-workers, she said.
“Of course, when the census goes down, PRN positions usually get sent home first, and if there are no slots available, you don’t work,” Cruz said. “I’ve noticed that there’s more competition for all nursing shifts now, and that’s definitely because of the economy.”