When it comes to staffing healthcare facilities, one of the most important decisions administrators face is how to hire nurses. The two primary options are hiring a nurse directly or working with a nursing agency to provide temporary or permanent staffing solutions.
Each option comes with its own set of advantages and challenges, which makes it essential for healthcare organizations to evaluate both carefully. We have compiled this blog to discuss the differences between hiring nurses through a nursing agency vs. direct hire.
We will cover everything from costs to flexibility so that you can make the right decision for your staffing needs.
Understanding The Two Options: Direct Hire Vs. Nursing Agency
Direct Hiring
This is when a healthcare facility hires nurses as permanent employees or on a long-term contract. These nurses are integrated into the facility’s culture, receive full benefits, and are expected to follow the organization’s specific policies and procedures.
Nursing Agencies
Nursing agencies serve as middlemen, providing healthcare facilities with temporary or contract nurses. These nurses are employed by the agency, not the healthcare facility, and are typically brought in to meet short-term staffing needs or fill in for absentee nurses.
Each option offers distinct benefits and drawbacks, and understanding these can help determine the best fit for a facility’s needs.
Cost Of Hiring Nurses Directly Vs. Through An Agency
One of the most significant factors to consider when choosing between hiring directly or using an agency is cost. While both methods can provide high-quality nursing care, the associated costs can vary widely. So, let’s take a look at the comparison of the cost of hiring nurses directly vs. through an agency.
Direct Hiring Costs
Hiring nurses directly may appear to be the more cost-effective option in the long term. However, while you avoid agency fees, direct hiring comes with its own financial commitments, such as:
- Recruitment and Onboarding: Recruiting nurses directly requires time and money, from advertising job openings to conducting interviews. Additionally, healthcare facilities must invest in onboarding procedures, such as orientation and training programs, to familiarize new hires with the facility’s culture and procedures.
- Salaries and Benefits: When you hire a nurse directly, you are responsible for paying their salary, providing healthcare benefits, offering paid time off, and contributing to retirement plans. These benefits increase the total compensation package and contribute to the overall cost.
- Legal and Administrative Costs: Direct hires require paperwork, tax withholdings, and compliance with local labor laws, which may involve administrative overhead.
- Staffing Flexibility: With direct hiring, you can end up with either too many or too few nurses during peak and off-peak periods, leading to unnecessary staffing costs or potential understaffing.
While these costs may seem substantial, direct hires can be more cost-effective over time, particularly for long-term needs. The ability to control wages and benefits may allow a facility to maintain a sustainable and predictable staffing budget.
Nursing Agency Costs
Nursing agencies provide flexibility, but this comes at a price. Healthcare facilities typically pay more when hiring through an agency due to the added services and overhead costs that agencies incur. Some of the expenses associated with agency hires include:
- Agency Fees and Markups: Nursing agencies typically charge a premium above the nurse’s hourly wage to cover administrative costs, recruitment, and marketing efforts. These fees can vary based on the nurse’s experience and specialization.
- Temporary Assignments: Agency nurses are often used for short-term assignments, meaning you’ll pay a higher rate for their services compared to permanent employees who may receive lower wages but with added benefits.
- Lack of Long-Term Benefits: While you don’t need to provide benefits like health care or retirement plans for agency nurses, the agency’s higher hourly rates typically offset the money saved from not offering benefits.
Despite these higher upfront costs, nursing agencies offer significant advantages in terms of flexibility and convenience, making them a valuable resource for short-term or fluctuating staffing needs.
4 Major Differences Between Agency Nurses And Direct Hires
While both agency nurses and direct hires are licensed professionals, there are key differences between agency nurses and direct hires that can influence a healthcare facility’s decision.
1. Commitment And Continuity Of Care
Direct hires are seen as an integral part of the healthcare team, as they are expected to stay long-term or at least for the duration of their contract. This continuity of care is a clear benefit for patients, as they are treated by the same nursing staff over time.
However, the downside of direct hires is that they may not always be available when the healthcare facility faces unexpected staffing shortages. Nurses who are already part of the team may not have the flexibility to fill sudden gaps in shifts or handle surges in patient numbers.
On the other hand, agency nurses are typically employed for short-term assignments, which means they are used when a healthcare facility experiences fluctuating demands such as seasonal patient surges, vacations, or short-term illness.
While agency nurses may not provide the same long-term continuity of care as direct hires, they excel in providing much-needed flexibility and adapting quickly to varying staffing needs.
Furthermore, experienced agency nurses often bring fresh perspectives, having worked in various healthcare settings, and they can adapt quickly to different environments, benefiting both the facility and the patients.
2. Flexibility And Adaptability
Directly hired nurses offer stability, but they lack the flexibility that healthcare facilities sometimes require in fast-paced environments. When an unexpected surge in patient numbers occurs, a direct-hire nurse may not be available immediately to fill the gap.
This could lead to overburdening existing staff or relying on overtime, which can be both costly and unsustainable.
One of the major advantages of nursing agencies is their ability to provide flexible staffing solutions. Nursing agencies can quickly mobilize nurses to fill sudden vacancies, whether due to illness, vacation, or an unexpected surge in patient numbers.
This adaptability allows healthcare facilities to avoid the costs and stress associated with overstaffing or understaffing. Nursing agencies have a pool of qualified nurses available at a moment’s notice, making them highly effective in responding to the dynamic nature of healthcare needs.
3. Quality And Specialization Of Nurses
When hiring nurses directly, healthcare facilities have the advantage of designing their recruitment process to find individuals who align with the organization’s culture and needs.
Direct hires can be selected based on their expertise in specific areas of care. While direct hires can specialize in particular areas of care, there are limitations in quickly scaling up specialized expertise across a wide range of areas. For example, if a hospital needs specialized care in critical care, pediatrics, or geriatrics, they may not always have the right nurse available on the team, and the process of recruiting specialized staff can take time.
Nursing agencies have a broader pool of specialized nurses with diverse skill sets, making it easier to source professionals for specific short-term needs. Whether a hospital needs critical care nurses, pediatric specialists, or geriatric experts, agencies can quickly provide highly qualified professionals.
Nursing agencies also offer access to a wider range of experience, as their nurses often work in different settings and have been exposed to various patient care challenges. This versatility is a key advantage of agency nurses. They can be brought in for niche roles that might otherwise require prolonged recruitment and onboarding for direct hires.
4. Training And Integration
Direct hires typically go through comprehensive orientation and training programs that are specific to the healthcare facility. These nurses are integrated into the facility’s culture, policies, and procedures, which can enhance their effectiveness and understanding of patient care protocols.
However, the extensive training and integration required for direct hires can be time-consuming. When a facility needs to add new staff quickly, direct hires might not be able to start immediately and will require additional time for orientation and adjustment.
Although agency nurses may not go through the same in-depth orientation as direct hires, they typically come with a wealth of experience and are often able to adapt quickly to different healthcare settings. Many agencies provide their nurses with some level of orientation, but it is usually more limited than what a direct hire would receive.
However, the flexibility and speed with which agency nurses can step into a role make them ideal for situations where immediate care is needed. Given that agency nurses often work in diverse settings, they are accustomed to quickly adapting to new environments. This agility enables them to provide high-quality care with minimal ramp-up time.
While they may not be as thoroughly integrated as direct hires, their adaptability makes them a valuable asset for short-term staffing needs.
Final Verdict: Which Option Is Right For Your Healthcare Facility?
Choosing between direct hire and nursing agency staff depends on your facility’s unique needs. If your organization has consistent patient volumes and requires long-term staff, direct hires might be the more cost-effective and stable option.
If you experience fluctuating staffing needs, such as seasonal surges in patient numbers or temporary absences due to vacations or illness, a nursing agency might be a better solution. Agencies provide quick staffing solutions without long-term commitment.
The best option is to get in touch with the best nursing staffing agency, such as Allied Health Services, for trustworthy and highly professional nurses.
