Why working as a per diem OT is worth it

Why working as a per diem OT is worth it

Are you tired from working at the same job for 40 hours every week? Are you tired of the drama? If so, PRN OT might be for you.

Working per diem can be confusing and sometimes difficult to justify unless the pay outweighs the benefits.  I’ve worked as a PRN OT for 8 years being single, married, and with a family.  

Per Diem vs full time occupational therapy

While working approximately 35-40 hours per week, I was able to support a family with only one source of income.

I’m convinced that working per diem can work for almost everyone. In this article, I’ll address commonly asked questions, the benefits of working per diem, the disadvantages, and when it’s worth it. 

What is a PRN OT?

Per diem means “as needed,” but most OTs who work per diem are able to choose their hours and have a regular schedule. Per diem OTs, in many cases, get paid more than full time employees and are able to work when they want and may leave when they want depending on their employer.

Some Per Diem OTs only work one or two days per week, while others may work 5 days per week. Many facilities will put restrictions on how many days a per diem employee can work per week, but they often break this rule when more help is needed.

Since most per diems don’t work a regular schedule and are usually the first to be called off, many per diem OTs will work at 2-3 locations in order to work more hours.

Are PRN OTs able to work 40 hours per week?

Many PRN OTs are able to work 40 hours per week if they have more than one job. As a per diem employee, you take the risk of being the first employee to be called off, but if you’re working at 2-3 facilities, it’s usually not hard to find extra work.

When I was working per diem I had 3 jobs. When I got called off, I would call another facility to see if they needed any help. In most cases, the other facility would appreciate my call and put me on their schedule.

This didn’t always happen, but it was nice to be able to fall back on 2 other jobs if needed.

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How often do PRNs get called off?

This really depends on the facility. I’ve worked at some facilities that would call off PRN employees once a year, and I’ve worked at other locations that would call me off once per week. It really depends on how your facility schedules employees and the patient caseload.

How much do PRN OTs make?

When I graduated OT school and started working full time in acute care I found that PRN employees at my job were making $17 more per hour and working 5 days/week. 

Most PRN jobs have an average pay rate between $45-55/hour with the highest rates above $60/hour.

Why every new grad should be working PRN

Has anyone told you that as a new grad you should be working full time for a few years before attempting PRN work? Most people think new grads shouldn’t start PRN right away, assuming that most new OTs need a few years of experience in order to take on the responsibility of PRN.

In most cases, that’s simply not true. More experience will make you a better therapist. Working PRN forces you to be flexible, take on challenging case loads, and work in various settings. 

It also can be more interesting to have 2-3 jobs rather than the monotony of working at one.

Removing the income ladder

Working PRN can also boost your pay as a new grad. Instead of starting at the bottom of the pay scale, working per diem puts you at the top. 

Some occupational therapists have to work 10-15 years to get the pay equivalent to per diem.  As a new grad, you can do it right out of OT school.  

How much experience do I need before working per diem?

In general, I would recommend working full time for at least 3-6 months before attempting PRN. If you’re working in a specialty like hand therapy, I would plan on working at least one year.

It’s best to work per diem at your current job.  If you only have 6 months of experience, you can probably work per diem at a rehab or nursing home, but some settings (acute care) may not hire you, because they don’t have confidence in your skill level. 

After you have 1-2 years of per diem experience, you can start branching out to other jobs.

Pros of working Per diem

OT per diem Pros and Cons

Here are a few reasons why it might be worth it to work per diem or shift to a per diem position from your current job. 

  • Increased pay
  • Work when you want
  • Less monotonous
  • Less work drama
  • Don’t have to work holidays
  • Higher starting pay for new grads
  • Increased flexibility
  • Able to work more than 40 hours

Cons of working Per diem and how to mitigate risk  

The cons of working PRN include

  • First to be called off
  • No health insurance
  • No PTO
  • Limited benefits
  • Asked to work extra shifts
  • Increased flexibility
  • No set schedule

Health Insurance

While there are lots of cons to working PRN, it’s not as bad as you might think.  You’ll usually have to pay for your own health insurance, but if your pay is 25% more, it’s not an issue.

For me, I opted out of health insurance and purchased a health sharing plan for my family.  It was so much more affordable than regular health insurance, but I understand it’s not for everyone.


Losing PTO wasn’t a problem when I was making more money as a PRN OT.  Instead of taking a long week off, I took multiple short weeks off. 

For example, I would request to be off Friday thru Monday, so I only lost 2 days of pay. Once or twice a year, I would take off for a week or more, and it never seemed to be an issue.

Limited benefits

Most PRN employees have limited benefits, but I’ve found that most benefits offered aren’t all that great.  Dental insurance and other insurances don’t usually save you that much compared to paying for it on your own. 

There’s actually many dentists that offer their own plans and it can be cheaper than traditional dental insurance plans.

You’ll also lose 401k benefits, but I’ve found that investing in a IRA is in many cases more beneficial. 

No set schedule

With PRN, you’re also expected to be called off, pick up extra shifts, and you don’t have a set schedule, but if you work 2-3 jobs you’ll almost always have a place to work. It’s also easy to tell your boss you can’t work if your other facility already has you scheduled.

When is it worth it to work per diem? 

When is per diem OT worth it

Working per diem is worth it when you’re making 25-30% more than full time.  For example, if your full time pay is $36-40 per hour, you should try to aim for a PRN rate of $45-55 per hour.

You should also only work per diem if you’re able to get the hours you need.  If your job only allows you to work 2 days per week with the chance of getting called off, you will need another job.  

When PRN is worth it

  • 25-30% more in pay
  • Working 2-3 jobs
  • Able to work at least 2 days per week
  • You have a 2nd job with benefits

Working Part-time and PRN

Most part time employees are expected to work 24 hours per week.  If you’re working part-time and getting benefits, a second (PRN) job can really boost your income. 

You might think working per diem is great, but you worry about being called off or losing benefits.  In this case, you should see if your employer will allow you to work part-time with benefits, so you can do PRN on the side. 

If your employer won’t allow you to work part time with benefits, see if you can get a part time job somewhere else and work per diem at your current job.  


Working 40 hours at the same job every week can be stressful, monotonous, and full of drama.  Working per diem can feel like an escape and it pays more.

I understand per-diem isn’t for everyone, but I hope this helped you learn a few different ways to make per diem more of a reality.  Subscribe below to learn more OT tips and tricks.