Going agency-free: using PRN coverage to build your own staff
Agency dependence is expensive and hard to escape. Here's a practical path that uses PRN coverage to stabilize now and build a team of your own.
It may sound odd coming from a staffing company, but here it is: the goal should be for you to need us less. NurseStat's stated aim is to help facilities become less dependent on agencies and, ultimately, agency-free. This guide covers why agency dependence is so hard to shake and lays out a practical path out of it.
Why agency dependence is costly
Agency staff can be a lifeline when you're short. The trouble starts when a stopgap becomes the plan.
- Premium costs add up. Agency rates typically run higher than what you pay your own staff. When agency use becomes routine, that premium turns into a permanent line in your budget.
- Continuity suffers. A rotating cast of unfamiliar faces doesn't know your residents' routines, preferences, or baselines. For residents living with dementia, constant new faces can be unsettling.
- Your team feels it. Staff end up orienting someone new shift after shift, and that wears on morale.
- Keeping the good ones can be expensive. Many agency contracts include a buyout or conversion fee if you hire one of their clinicians directly, which makes it costly to keep the people who fit best.
Why it's hard to escape
Agency dependence tends to feed itself. You're short-staffed, so you bring in agency help. Agency costs squeeze the budget you'd otherwise put toward recruiting, retention, and raises. Stretched staff burn out and leave, and the gaps get filled with more agency help.
Breaking that cycle rarely happens all at once. It takes a steady plan.
A practical path
1. Use PRN coverage to stabilize first. You can't build a team while you're scrambling to fill tomorrow's schedule. Start by getting dependable coverage for your gaps. With NurseStat, you can post shifts one at a time or in bulk, and many shifts get requests within the hour. For a last-minute hole, mark the shift urgent and the first qualified clinician is confirmed automatically. NurseStat also sometimes adds incentive pay, which it pays for itself, to help fill last-minute shifts.
2. Get to know the clinicians who come through your doors. Every PRN shift is a chance to see someone work. With NurseStat, multiple qualified clinicians can request the same shift, and you choose who works. Pay attention to who your residents respond to, who your charge nurses trust, and who fits your culture. If someone isn't a fit, a do-not-return list keeps them off your schedule at one location or all of them.
3. Direct-assign the ones who fit. When you find clinicians you want back, you can assign shifts directly to anyone who has worked for you before. Seeing the same people again builds continuity for residents, and it gives both sides a real sense of whether a longer relationship makes sense.
4. Hire them, with no buyout fee. This is where the path turns. When a NurseStat clinician is someone you'd like on staff, and they're interested too, you can hire them with no buyout fee. They already know your building, your residents, and your team. In effect, you've both had a long working interview.
5. Keep PRN for true gaps. Going agency-free doesn't mean never needing help. Call-offs, leaves, census swings, and open positions will still happen. The difference is that outside coverage becomes a tool you reach for on purpose, for gaps you can't reasonably staff yourself, instead of the thing holding up your schedule.
Measure your progress
Pick a starting point and watch the trend. Which units, shifts, and roles lean hardest on outside help? Those are the places where recruiting and retention efforts will pay off first. As you hire and keep good people, the goal is to see outside hours in those areas shrink over time.
Tools that support the plan
A few NurseStat features make this easier to run day to day:
- Admin and Scheduler user roles, so the right people can manage posting and scheduling
- One login across multiple facilities, if you oversee more than one building
- Weekly invoices and a PBJ-formatted hours report with CSV export, so you can see where outside hours are going
- Exportable credential documentation for audits and surveys
- Workers' comp, which NurseStat carries on its clinicians
And when you need to talk something through, a real person answers the phone.
Start the conversation
If you're ready to steady your schedule now and build toward a team of your own, we'd like to help. Visit For Facilities or contact us, or call or text (859) 748-9600, seven days a week.