Upon graduation from PT school, I was one of very few to go straight into a PRN position. Many of my friends went for salaried roles in their chosen fields initially, but over time, started to look into PRN roles for their pay and flexibility. I fielded lots of questions as they considered the jump, and ultimately many friends did make the switch as other aspects of their life changed. Here are a few things to consider to better navigate choosing one or more PRN jobs as a physical therapist or healthcare professional.
- Q: Is there mentoring?
I did find that as I took on PRN roles in acute, inpatient rehab, and outpatient settings, there is definitely less mentoring from other experienced therapists across the board. This is only natural and happens for a few reasons, but ultimately in a PRN position, you are filling an increase in demand or filling in for someone who is out of office on that particular day, so the work is pretty independent. That said, I want to make clear that nearly every therapist I've ever worked with while I was in a PRN position (let's just say I covered a lot of locations) was always helpful, willing to answer my questions, give advice, point me in the right direction or even give me a proactive "heads ups" on difficult patients. In my opinion, at the end of my first year of practice in PRN roles across three settings, I felt as though I learned exponentially more than I would have had I stayed full-time in one setting at one location. The lack of direct one-on-one mentoring with a consistent person did not bother me, but I know that, understandably, it can bother other new grads. - Q: Can I hold multiple PRN jobs?
The short answer to this is yes, definitely. I've held two PRN positions for the majority of my career. Those considering taking on multiple roles need to ensure perfect understanding of the scheduling methods of each job, balance any weekend requirements to meet the needs of both positions, and keep up to date with any online trainings or in-person skill check offs required for each job (independently, without one or more managers constantly reminding you). In my case, I started working full-time hours as a PRN in inpatient care, then added one day per week in an outpatient setting until I was full time in outpatient, over the course of a couple of years. I chose this way because I enjoyed both positions, and holding both roles allowed me time to decide if I wanted to take an inpatient or outpatient position more full-time after the fact. - Q: How many PRN jobs is too many PRN jobs?
I held two PRN positions - one covered 8 area hospitals, and one covered a single outpatient therapy clinic. I found myself to be adept at switching to the policies and procedures at each place of work with ease (I would find out the night before which hospital I was working at the next morning for the hospital system, while my outpatient day of the week and location were consistent). Others would find this to be real struggle. My advice is to always start with one and make sure you can manage all aspects of it before adding another. One OT I worked with held FOUR PRN positions at one time! Not exactly what I would recommend, but she made it work! - Q: How does PRN work with healthcare?
Healthcare benefits are typically not included in a PRN position, which is in part why the pay tends to be a little higher compared to salaried positions. If you plan to keep your current position with healthcare benefits, and simply add on a weekender PRN position or something similar, then you're set! If you are considering switching fully to a PRN position, then you'll want to investigate healthcare benefit options. Are you married? If so, you can look into whether getting on your spouse's benefits would be worth the switch to a PRN position (I was on my husband's benefits). Alternatively, you can always search the government's health insurance marketplace for plans and decide whether that cost would be offset by the slightly higher pay in the PRN world. - Q: What is the difference between being an hourly contractor versus a salaried employee?
One of the biggest differences that first comes to mind is that if the place of work does not need you for a full day, you go home. In the inpatient setting, there were days when the hospital census had dipped, and I was either called off the morning of work or sent home at lunch due to the lack of need (and you are not paid if called off, and once you clock out). Ultimately, this did not happen too often, but it is worth knowing that PRNs will be the first to go. In the outpatient world, I was paid for the hours I worked. If a patient cancelled in the morning or at the end of the day, I would come in later or go home earlier and not be paid for those missed hours (if a patient canceled in the middle of the day, my employer did continue to pay me if I had more patients to see afterward).
In a salaried role, you have guaranteed hours and are paid for full days of work; it is up to your employer if they allow you to go home early and still be paid if not needed, or if they want you to remain on-site through your scheduled hours. (Confusingly, if census is really low, some hospitals will ask salaried therapists to take PTO in order to go home early - not a great practice and one that ultimately becomes problematic). Lastly, there are typically no formal benefits to a PRN position, meaning no PTO, no health insurance, and obviously no guaranteed hours; a salaried role can typically expect all of that and sometimes more. - Q: Why choose a PRN role?
The benefits of PRN are plentiful - choose your own days and hours, remove availability as needed and receive higher hourly pay. The role is a little more independent than a staff therapist role in that there are no other administrative responsibilities beyond maintaining the safety regulations (online trainings, skills checks, CPR, etc.) of the facility. You can learn a lot in a short amount of time, especially so if you cover more than one location, and there is a chance that you get to meet many more coworkers and learn from their help and advice. If someone is on the fence about applying for a PRN position and has a plan for benefits and health insurance, I would recommend giving it a try!
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