How a Nurse Beat Burn-Out by Going Per-Diem

Dr. Margarita David

Updated March 29, 2021

Published February 4, 2021

Dr. Margarita David is a doctorally-prepared registered nurse and founder of the Dr. Registered Nurse Success Academy, LLC. Dr. David also holds a Bachelor’s in Business Management & Administration, Bachelor’s in Nursing, and a Master’s in Nursing Education and Leadership.

No matter how much you love your work, long shifts, understaffing, increased patient acuity and weekend work commitments can cause any nurse to feel stress and burnout. While burnout can impact your well-being, it can also lead to errors that negatively affect patient safety. Additionally, work-related stress can have an impact on a nurse's home life as they carry the stress home. If it's right for you, transitioning from full-time to a per-diem position can offer more flexibility and work-life balance. In this article, we spoke with Elizabeth Castro, BSN, RN, to discuss how she beat burnout by going per-diem.

Question: How long have you been a registered nurse? Which settings have you worked in?
A: “I have been a registered nurse for over 10 years and have worked in many different settings. I first started working in surgical services, but realized that it was not for me after a short period. I then transferred to a busy medical-surgical unit. I worked three 12-hour shifts. Once I felt comfortable caring for patients with various disease processes, I began to pick up more shifts. My ultimate goal since being in nursing school was to work in the critical care setting, so I wanted to make sure I gained as much experience as possible.”

Q: Were you working on a full-time basis? How many hours a week did you work?
A: “I worked on a full-time basis—40 hours a week in three days—and every other weekend. However, about two years after working in the medical-surgical unit, I transferred to the stepdown unit. In this unit, instead of having six patients at one time, it dropped to four. Although there were fewer patients, the patients were sicker and required more care. I figured transferring to the stepdown unit was one step closer to critical care. With fewer patients, I would be able to pick up more time as I would not be as tired. I was definitely wrong there.”

Q: Did anything change once you transferred to the stepdown unit?
A: “The unit was going through many changes, including management. Every time I came to work, we were understaffed by either nurses or nursing assistants. At the same time, the acuity of the patients increased. Patients were sicker and required more hands-on care. Eventually, it became mandatory to pick up overtime to fill the many needs that existed. Instead of working 40-hour weeks, I was working 60-hour weeks.

I remember escaping to the bathroom for one minute to take a breather while my portable, unit-assigned phone rang nonstop. I was continuously tired, even on the few days I had off. My mental health was declining, and my family felt it too. When I got home, I went straight to the shower and went directly to bed without eating dinner because I was exhausted. This went on for a long time. After experiencing this for about 10 months, I realized that I was burned out.

It is important to recognize the symptoms of burnout to know when it is time for a change. These might include loss of purpose, frustration, fatigue, anxiety and negative attitudes towards the job and coworkers.”

Related: 16 Signs that You May Be Burned Out

Q: What changes did you make to decrease your burnout symptoms?
A: “While others enjoyed being able to pick up extra shifts and working as much overtime as possible, my priority was my physical and mental health. A nurse should not feel like they have to burn themselves out to meet a unit's needs. I realized the needs of the unit didn't match what I could physically and mentally do. As a result, I decided to decrease my stress by focusing on the things that I can control, like my time. This was when I decided to transition from a full-time to a per-diem position. I ended up finding a per-diem position in another hospital, as my unit manager wouldn't approve my change to a per diem status.

Once I went per diem, I was able to have more control of my time without being obligated to work mandatory overtime. I was also able to work only the required shifts to keep the per-diem status, which can be between 50-60 hours every six-week schedule. I gained more days off, allowing me more sleep, rest, time with family and friends and better work-life balance.”

Related: 15 Ways To Deal with Burnout

Q: What advice do you have for other nurses that are feeling burned out at work?
A: “How can we take care of others if we neglect ourselves? Listen to your body and mind, and you need to do what is best for you. When debating if you need to go from full-time to per diem, as a result of feeling burned out, ask yourself these questions:

  • Am I with my current work environment?

  • Am I neglecting my personal needs to satisfy work needs?

  • Do I have a good work-life balance?

  • Do I feel mentally and physically drained?

If you answered yes to any of these questions, it may be time for a change, even if it is a temporary one.”

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