Taking The PRN Plunge: Is It Right For Your Career?

Taking the PRN PlungeRespiratory therapists often take a few PRN shifts to make a little extra money. In “Taking the PRN Plunge,” RTs discuss the good and the bad that comes along with it.

Hospitals need clinicians 24/7, and keeping all the staffing balls in the air often depends on hiring PRN workers who can take on an extra shift or two when needed. For practitioners like respiratory therapists that can mean extra money, and many therapists have worked PRN jobs over the course of their careers. If you’ve yet to take the PRN plunge but are giving it serious consideration, you’re probably wondering how it will affect your full-time job and your home and family life. AARC members who have been there, done that, share their experience.

Tim Toney, CRT: The Experience You Get is Great

When Toney first got out of RT school, he was assigned to a small community hospital in Ft. Riley, KS. There were no ventilator patients and RTs did little more than perform PFTs, neb treatments, and ABGs. He wanted more, so he took a PRN position at a hospital about 90 minutes away where he could gain some experience in ventilator care, the ER, trauma, and other key areas of respiratory care. “When I left that assignment I found that I had more experience than most of my peers who had been in the field 3-10 years longer than I had been,” says the therapist.

Marlyce Campbell, CRT: Safety Could be a Concern

Like most people who take on a PRN position, Campbell did it because she needed the extra money. The fact that the PRN hospital utilized RTs in the ER was a big plus too because she wanted to get more involved in ER care, and since she only worked one weekend a month it didn’t impact her full-time job or life all that much.

But now, as a manager of RT, she isn’t so sure about the PRN concept. “I get concerned that now that everyone works the 12-hour shift, they work PRN at other places a lot,” she says. “This could become a problem in terms of getting burned out, not getting enough sleep, and not providing safe patient care.” She’s seen these problems in her own department. “One time I found out one of my employees was working 12-hour shifts for 20 straight days! That is not safe for them or the patient.”

MaryAnn Couture, MS, RRT-NPS, RRT-ACCS: Pluses and Minuses to Taking the PRN Plunge

Couture sees advantages and disadvantages for PRN work. “When times were good a few years ago, our hospital was allowed to hire new grads as per diem, with the promise that as positions opened they would be fast-tracked to a full-time job,” she says. “But in recent political times, when the hospitals were not receiving as much state funding, there was a major switch. Our facility now requires a two-shift commitment per week, or the equivalent of a part-time scheduled job.”

Several senior staff members who were going back to school to earn advanced degrees were caught in the crosshairs, shocked to find out they would have to commit to 16 hours per week to keep their jobs. “That led to a sudden loss of an experienced person, who did not need weeks of training, to be replaced by new hires who would take about three months before they were independent,” says Couture.

Julie St. Amant, BA, RRT: A Few Quick Rules

St Amant believes PRN work can help to broaden a therapist’s horizons and expose him to different ways of operating. And it is, of course, a great way to make a little extra money. But she has several caveats for anyone who takes on one of these positions. “Don’t talk poorly about either place you work. Don’t talk about patients or other staff issues. Treat the PRN job seriously don’t sign up for shifts then back out.” She also advises RTs to refrain from saying things like : “at ________ we do it this way” or “you are doing it wrong.” On her to-do list: represent your hospital well and recommend treatments and ways of doing things that might be positive changes at either job.

Janelle Gardiner, DHSc, RRT, AE-C: It Helps Me Connect with My Students

An associate professor at a major university, Gardner works PRN at a couple of rural hospitals and, like other educators, does it to keep current in the field. But she also enjoys the contact with patients. “I can be heard saying, ‘I want to be able to tell my students what respiratory therapists do at the bedside because I actually still do it, not because I used to ten years ago,’ ” she says. The hospitals also keep her up-to-date on protocols and evidence-based practices, which helps her educate her students because she’s familiar with many of the things they are being exposed to in their clinical rotations. “I am better able to relate to what they are telling me and questions they ask,” says the educator. 

Carrie Hammond, RRT: Running Uphill

Hammond was actually working one PRN job when she found she would need a second PRN job to make ends meet. But even after she went full-time at one of the hospitals, she still came up short at the end of the month and needed the PRN job to keep going. She arranged her schedule so that she was working the PRN job the same day of each week, but it still wasn’t the best of situations. “Since I was flipping nights and days, it got really difficult and I felt like I was running an uphill battle,” says the RT.

Jonnie Korinko, RRT: What’s Your End Game?

Korinko currently works 2-3 days a week at her PRN job and 3-4 days a week at her full-time job. It’s a grueling schedule that she would hesitate to recommend to others. “We have several employees at my PRN job that only work one shift every other week. That is totally doable for many people and easy to commit to,” she says. “I, however, work significantly more than that.” Why does she do it? For her, it’s all about her end game. “I just bought a house less than a year ago and it needs a lot of work, so my PRN money goes there,” she says.

Tod Waldron, BS, RRT-NPS: Connections Could Come in Handy

Extra money was certainly Waldron’s motivation for working PRN. When his kids were young the additional pay helped to pay for things they needed, and now that they are in college those needs have been multiplied. “I work PRN every other weekend. My bosses have been okay with it as long as the full-time job is the priority,” he says. While he does it mainly for the money, he also says a PRN job helps to keep him in touch with other ways of doing things and other types of equipment. “Also, with the job market as it is, you never know when having another connection might come in handy,” says Waldron.

Lisa Pisarek, BS, RRT, CPFT: Tough on Family Life

Pisarek started out working PRN at a local hospital, then took on a part-time position in a physician practice doing PFTs. The PFT job is now full time, but she still has the PRN job at the hospital and says the physicians at her practice love the fact that she is keeping up with hospital care. But that doesn’t mean she’s working PRN out of choice. “I have two boys in college and my husband was laid off several times over the past few years. It was, and still is, financially necessary,” she says. While working more than one job does make her a more well-rounded therapist, she says it’s been tough on family life and social activities. “If I won the lottery, I would probably leave the PRN job,” says Pisarek.

Ed Borza, RRT-NPS, RRT-ACCS, CPFT, AE-C: Give It a Try

As an educator, Borza’s main motivation for doing PRN work is to maintain his clinical skills. “I am able to still apply my knowledge as an RT to patient care and I keep up with changes in technology and clinical practice,” he says. That makes him a better educator for students who will soon be working in hospitals themselves. He encourages his recent grads to give it a try as well. “For newcomers to the field, having two or even three jobs can speed your development as a clinician and also expose you to more opportunities,” says Borza. ”In the long run, it’s all about growing and learning as an RT.”

Stephanie Nail, RRT-ACCS, RPFT: Attitude Counts

When Nail’s hospital cut RT hours to 36 per week, she and many others in the department had little choice but to turn to PRN work. “My boss was okay with us working at other facilities because her bottom line looked great with zero overtime. We had a set schedule and there were no issues.” For her, it wasn’t really a problem. Her husband was working as a traveling nurse at the time and her kids were grown and on their own. Working PRN seemed better than sitting home alone.

She believes having the right attitude is everything when it comes to making the most of a PRN job (or any job, for that matter). “I have worked shifts in 35-bed facilities up to 500-bed facilities. I always went in with the attitude that someone there needed my skill set or that I was getting an opportunity to learn something new,” she says. “I’ve been blessed to still love what I do after all these years.”

John Cefaratt, BS, RRT-NPS: Don’t Get Burned Out

As a member of an air medical transport team that works two 24 hour shifts per week, Cefaratt says he has lots of free time to put towards a PRN position and generally works 3-4 shifts per pay period. “Working in the hospital gives me clinical experience to further treat my patients with the latest procedures and treatment modalities,” he says. “Being that I have so many days off in a row I can easily cover PRN shifts and still be rested and ready to work at my full-time job.” He’d recommend PRN work to other RTs who can stay committed to their full-time jobs, not burn themselves out, and gain something beneficial from the PRN position that they can take back to their full-time job.

Joel Livesay, MS, RRT, RVT: I Do It to Stay Current

As a department chair at a community college, Livesay works PRN to stay current in the field, and working at one of the largest teaching hospitals in the area affords him easier movement with his students around the various units, since they already know him. The hospital would like him to work two weekends per month, but his manager is great about letting him limit it to one. “The extra cash is nice but not worth the time away from the family and hobbies,” says Livesay.