Using Supplemental Nursing Staff to Fill Gaps

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Travel nurses, float pools, seasonal contract nurses and other temporary nurse arrangements are crucial to the healthcare system because they fill staffing gaps across the country, particularly during the COVID-19 pandemic. Supplemental nursing staffs are used during periods of high patient admissions or nurse shortages.

Researchers have found that supplemental nurses provide quality care similar to nurses working in permanent positions. A study in the Journal of Nursing Administration (JONA) disputed the misconception that supplemental nursing staffing had a negative impact on quality of care and cost efficiency. In fact, the study, titled “Hospital Employment of Supplemental Registered Nurses and Patients’ Satisfaction With Care,” found poor work environments had a larger impact on quality of care than supplemental nursing staff did.

“The employment of [supplemental registered nurses], even in substantial proportions, does not appear to be associated with patients’ overall satisfaction with care or their appraisals of the quality of nurse communication,” researchers found. “Our findings contribute to a growing research base suggesting that the use of [supplemental registered nurses] is safe and satisfactory to patients and offers hospitals a reasonable strategy for ensuring that adequate nurse staffing is available to hospitalized patients at all times.”

Indeed, DNP-educated nurses working as hospital executives should be prepared to welcome supplemental nurses during times of critical staffing needs such as the COVID-19 pandemic. By earning a doctor of nursing degree, including through an online DNP program, nurse executives can fulfill nurse manager job duties and help supplemental nurses make a smooth transition for quality patient care.

Types of Supplemental Nursing Staffing

Supplemental staffing plays a significant role in hospitals to ensure patient needs are met. Several types of supplemental nurses can be found working in hospitals:


Registered nurses (RN) who work in a PRN position perform a wide spectrum of nursing duties depending on the assignment. PRN, which is the abbreviation for the Latin phrase pro re nata, means nurses work when there is need, such as during high patient occupancy times. The Latin phrase means “when circumstances require.”

Unlike staff RNs, PRN nurses work an unpredictable schedule, depending on the hospital’s staffing needs. Some PRNs work on an on-call status while others work a set schedule. Working under a PRN status also means nurses can work for multiple hospitals at the same time. PRN is also called Per Diem.

Travel nurse

Travel nurses work as part of a hospital’s regular staff for the duration of their assignments. Travel nurses typically must have a minimum of 12 months of acute clinical care experience. Many hospitals hire travel nurses for short blocks of time, but long-term travel contracts are also available.

Locum Tenens

A locum tenens agreement represents a temporary contract between a healthcare facility and provider. Unlike a PRN or travel nurse position, locum tenens positions require the clinician to live in the same general area as the medical facility.

Locum tenens, the Latin phrase for place holder, was once reserved for physicians who filled in for other physicians. It is now used for nurse practitioners and other advanced practice nurses. For a locum tenens role, clinicians work in extended full- or part-time positions filling in for other similarly situated clinicians.

Float pool

Nurses who work in a hospital’s float pool work between multiple areas, including ICU, labor and delivery and medical and surgical. Float-pool nurses are typically hospital staff members who choose to work in a continually changing atmosphere.

Nurses who work in the float pool permanently are typically very flexible and adept at many types of care. In some cases, hospitals rotate staff nurses through the float pool.

Seasonal nurses

Seasonal contracts are common in locations where the population fluctuates periodically, such as in Arizona and Florida. Seasonal nurses are also used to support departments during months when patient counts are high, such as flu season. Seasonal contracts typically last three to six months.

Supplemental Nursing Staffing During a Pandemic

As the COVID-19 pandemic continues, some hospitals have had to shift how they use supplemental staffing. Part of the nurse manager job duties is determining where staffing levels need to increase and decrease. In some cases, supplemental staffing jobs were cut due to a decrease in elective medical procedures, which are not considered emergencies and are scheduled in advance. In the cases of COVID treatment, supplemental nursing staffing is on the rise.

Georgia Reiner, a senior risk specialist at the Nurses Service Organization (NSO) insurance company, told Minority Nurse that travel nurses have been in the highest demand in hard-hit areas that include New York and Washington state, and in specific specialty areas including critical care and med/surg.

“Travel nurses are in high-demand across the United States as hospitals work to treat surges of coronavirus (COVID-19) patients,” Reiner said. “This crisis arrived at a time when nurse staffing was already a concern due to a multitude of factors, including the growing health care demands of an aging population and nurses aging out of the workforce. Therefore, the demand for travel nurses seems to be primarily driven by a need to build up hospital capacity to handle the influx of COVID-19 patients.”

For nurse executives who are determining staffing levels during the pandemic, understanding how supplemental nursing staffing can help is essential to quality care. At Duquesne University, RNs who attend the online DNP program are prepared to take on a multitude of responsibilities including fulfilling RN-to-patient staffing ratios and safe staffing.

About Duquesne University’s Online DNP Program

Duquesne University’s online DNP program trains RNs for clinical leadership positions. The university’s curriculum encourages positive changes and professional accountability in healthcare. Students learn how to build on existing experiences and knowledge and implement evidence-based practices in clinical settings.

The online DNP program offers three DNP tracks:

  • Clinical Leadership DNP
  • Post-Bachelor’s Executive Nurse Leadership DNP
  • Post-Master’s Executive Nurse Leadership DNP

Duquesne University’s online DNP program also allows students to continue working and maintain family responsibilities while earning an advanced degree. For more information, contact Duquesne University now.



Hospital Employment of Supplemental Registered Nurses and Patients’ Satisfaction With Care: JONA

What Does a PRN Job Position Mean in a Hospital Setting?: Chron

What is a Travel Nurse?:

New to Locum Tenens? A Definition From Barton Associates: Barton Associates

Types of Supplemental Staffing: BluePipes

Float Nursing: Career Nightmare Or Advantage?: Onward Healthcare

What Is a Seasonal Nurse?: ZipRecruiter

The Risks to Travel Nurses During the Pandemic: Minority Nurse