In my first years as a nurse practitioner I worked more than full-time. I picked up extra shifts and took on PRN positions in addition to a full-time job. I busted my booty to save money to buy a house, a much needed vehicle upgrade, and overall establish myself as a working adult in a successful career. Then, in 2012, I founded ThriveAP which became my side-gig. Seven years later and counting, the day-in and day-out operations of ThriveAP have become a more than full-time commitment and I have adjusted my schedule working as a nurse practitioner in the emergency department accordingly. I maintain PRN positions with a few local hospitals and work seeing patients one or two days a week. 

Working PRN as a nurse practitioner has been an interesting experience. With work-life balance and flexibility in one’s career a natural concern for NPs, a number of my nurse practitioner colleagues have asked me about my experience making up my schedule of exclusively part-time positions. As an advanced practice provider who has done this for a few years now, I have learned that there are definite pros and cons to ditching full-time employment for freelancing with PRN opportunities. Here are a few things to consider if you find this transition tempting

Working PRN may affect your pocketbook

Nurse practitioners holding PRN positions are often employed as 1099 workers. This means that you are responsible for paying certain taxes that are typically covered by your employer or automatically deducted from your paycheck as a standard W-2, full-time employee. Make sure to calculate your earnings appropriately based on the tax status of your new position and budget accordingly. 

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In addition to tax considerations, NPs on a flexible work arrangement likely won’t receive benefits. Will your employer cover health insurance? Professional licensing costs? Continuing education? What about malpractice insurance? Understand how much replacing these perks will cost if you don’t receive them through an employer. Some employers compensate PRN nurse practitioners at a higher hourly rate to make up for a lack of benefits, others do not. 

Prepare for unpredictability

Working PRN certainly offers the benefit of a flexible schedule. You can say goodbye to counting vacation days and PTO hours. If you like, you just may avoid working holidays, weekends, overnights, and other undesirable shifts altogether. This newfound flexibility may come at a cost. With PRN status, you are subject to the whims of an employer’s needs. In my experience, there are months with plenty of shifts to be had, and others with few at all. If you’re relying on your PRN income, you must plan ahead for leaner months by working available shifts during times of need or adjusting your budget. Following these patterns can lead to anxiety when shifts are slim and working more than you originally intended when there’s work to be had. Your PRN job may not be quite as accommodating of your ideal schedule as planned. 

Fewer administrative obligations

One perk of going PRN is that less is generally expected of you in your role as an NP. You won’t likely be expected to attend most meetings. Work taken home with you after hours can be non-existent. While you need to maintain a standard of excellence in patient care, of course, taking on duties outside of this description typically doesn’t befall those NPs who are there to fill-in gaps in the schedule. 

Read your employment contract closely

Even if you’re only picking up one shift a month, it’s essential to review your employment agreement closely. Some employers place more guidelines around working PRN than others. These contractual obligations can significantly affect the scheduling freedoms you’re allowed. Employers may specify that PRN nurse practitioners work their fair share of holidays or weekends despite a very part-time status. Or, for example, they may specify that PRN providers work a minimum number of shifts each month. Make sure you’re OK with the stipulations outlined in your employment agreement

Overall, working several PRN positions rather than one full or part-time job had allowed me the scheduling freedom I sought as a nurse practitioner. It has allowed me to pursue other professional endeavors in conjunction with patient care. While the decision has some financial downsides and can be unpredictable at times, freelancing by picking up a number of PRN positions can be a viable option for NPs seeking schedule flexibility and balance. 

Have you worked exclusively PRN? How was your experience? 


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1 thought on “Should You Ditch Your Full-Time NP Job for Freelancing?”

  1. I’ve been an NP for 18 years. My first 10 years were in family practice. I left family practice when I finally accepted that I was terribly burnt out. Since then, for the last 6 + years, I’ve mostly been doing locums assignments that last anywhere from a few days to several months. I love all the experience I’ve gained from doing locums work, all the people I’ve met, and places I’ve explored. I’ve worked from Alaska to Maine.
    I eventually created my own company to maximize tax savings. I didn’t have health insurance for quite a few years but I’m in good health so that wasn’t an issue. I was just concerned about what would happen if I had an accident. I’m now a member of a health share which is very affordable and will cover any emergency.
    Next on my horizon is creating my own functional medicine practice.
    My career has been quite a journey. I’m grateful for all I’ve learned. And I’m grateful I recognized my need for change back when I was getting burnt out. I hear of and see so many NPs who are overwhelmed and unhappy in their careers. It’s so important to stand up for yourself and not accept terrible working conditions.

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