The nursing profession offers diverse career paths beyond traditional hospital employment, with temporary roles becoming increasingly common. Locum nursing represents a flexible option for Registered Nurses (RNs) and Advanced Practice Registered Nurses (APRNs) seeking variety and autonomy. The term “locum” is derived from the Latin phrase locum tenens, which translates to “place holder,” accurately describing the function of this role in healthcare staffing. This career path involves temporarily filling immediate staffing needs in various clinical environments.
Defining the Locum Nurse Role
A locum nurse is a temporary healthcare professional hired by hospitals, clinics, or other medical facilities to fill sudden or planned staffing gaps. These assignments maintain continuity of patient care when permanent staff are unavailable or while a facility searches for a long-term hire. Locum nurses provide the same level of care and perform the same duties as their permanent counterparts, requiring them to integrate rapidly into existing clinical teams.
The scope of practice can be broad, ranging from general medical-surgical floors to highly specialized units, depending on the nurse’s training and experience. They are expected to quickly become familiar with facility protocols and patient populations, often with minimal orientation. This temporary staffing model helps facilities manage fluctuations in patient volume and staffing shortages without interrupting service.
Key Differences from Other Nursing Roles
Locum nursing is distinct from both travel nursing and per diem nursing, primarily in contract duration and logistical requirements. Travel nurses typically commit to contracts ranging from four to thirteen weeks and often receive housing stipends because they relocate across state lines. Locum assignments, especially for Advanced Practice Registered Nurses (APRNs), can range significantly in length, from a single day to a full year.
Per diem, or “as-needed” nurses, generally work within commuting distance of their homes, picking up shifts day-to-day to cover unexpected absences. This work is local and focuses on shift-based availability rather than a defined contract. Locum nurses, however, are frequently hired for specialized, longer-term coverage needs requiring a specific skill set for the duration of the gap.
Advantages of Locum Nursing
One appealing aspect of locum work is the high degree of flexibility in scheduling, allowing nurses to choose when and where they work. This autonomy provides a work-life balance difficult to achieve in traditional staff positions, enabling nurses to take breaks between contracts as desired. Locum professionals are also exposed to a diverse array of clinical settings, patient populations, and operational systems, which broadens their professional experience.
Gaining experience in new environments helps locum nurses diversify their skill set. This career path often comes with the potential for higher hourly wages compared to permanent staff positions, reflecting the specialized, temporary nature of the coverage.
Challenges and Considerations
The flexibility of locum work is balanced by several career and logistical challenges that require careful management. Locum nurses often lack employer-provided benefits, such as health insurance, paid time off, and retirement contributions, which are standard for permanent staff positions. The intermittent nature of the work can also lead to an unpredictable income stream for those who do not secure back-to-back assignments.
A significant practical difficulty is the need to quickly adapt to new electronic health record (EHR) systems at each facility. Locum professionals must be prepared to navigate diverse systems like Epic, Cerner, or Meditech with minimal training, as orientation may last only a few hours or days.
Requirements for Becoming a Locum Nurse
To begin a career as a locum nurse, a professional must possess a current, unencumbered nursing license, typically at the Registered Nurse (RN) level or higher. Many facilities prefer nurses to have at least two years of specialized clinical experience before accepting locum assignments, ensuring they can function independently. Essential certifications, such as Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS), are required for integration into acute care settings.
Navigating state licensure is important, as a license is required in every state where the nurse intends to practice. The Nurse Licensure Compact (NLC) facilitates multistate practice by allowing a nurse to practice in other NLC states with a single license. Many nurses partner with specialized locum agencies to manage the complex credentialing and licensing process across multiple jurisdictions. Locum nurse practitioners often require a valid Drug Enforcement Administration (DEA) registration if their duties involve prescribing controlled substances.
Compensation and Contract Structure
Compensation for locum nurses is typically structured to reflect the temporary nature of the work and the absence of traditional employee benefits. Pay rates are often negotiated based on the specialty, the urgency of the staffing need, and the geographic location of the assignment. Locum professionals are frequently classified as independent contractors, reporting their income on a 1099-NEC form, rather than as W-2 employees.
This independent contractor status means the nurse is self-employed and responsible for paying all income taxes, including self-employment taxes for Social Security and Medicare, usually through quarterly estimated payments. The 1099 classification allows for greater tax reduction opportunities, such as deducting specific business-related expenses like travel, continuing education, and licensing fees.