nurse employee vs agency

Pros and Cons of Hiring a Nurse Employee vs Agency

Hiring a Nurse Employee vs. an Agency: The Pros and Cons

When it comes to staffing nursing positions, healthcare facilities have two main options: hiring a nurse employee directly or utilizing the services of a nurse agency. Each approach has its own set of advantages and disadvantages. Let’s explore the roles of nurse employees and nurse agencies to better understand the pros and cons of each option.

Understanding the Role of Nurse Employees

Nurse employees are individuals who are directly employed by the healthcare facility. They work exclusively for the facility and are an integral part of the facility’s staff. Nurse employees are hired through a thorough recruitment and selection process, ensuring they possess the necessary qualifications and skills.

Pros of Nurse EmployeesCons of Nurse Employees
Direct Control and Supervision: Facility managers have direct control and supervision over nurse employees, allowing for better coordination and alignment with the facility’s goals and policies.Recruitment and Hiring Process: Hiring nurse employees involves a comprehensive recruitment and hiring process, which can be time-consuming and resource-intensive.
Consistency and Familiarity: Nurse employees become familiar with the facility’s routines, processes, and patients, promoting continuity of care and building trust with patients.Administrative Responsibilities: Facility managers are responsible for managing administrative tasks related to nurse employees, such as scheduling, payroll, and benefits.
Potential Cost Savings: Hiring nurse employees can potentially be more cost-effective in the long run, as there are no additional agency fees or markups.Limited Flexibility: Nurse employees may have limited flexibility in terms of availability for shifts, which can pose challenges in managing staffing needs during peak periods or emergencies.

Understanding the Role of Nurse Agencies

Nurse agencies, on the other hand, are organizations that provide temporary nursing staff to healthcare facilities on a contractual basis. These agencies have a pool of qualified nurses who can be assigned to different facilities based on their needs. Nurse agencies handle the recruitment, selection, and employment of nurses, relieving the facility managers of these responsibilities.

Pros of Nurse AgenciesCons of Nurse Agencies
Access to a Pool of Qualified Nurses: Nurse agencies have a wide network of qualified nurses, providing healthcare facilities with access to a diverse pool of talent.Higher Costs: Hiring nurses through agencies can be more expensive due to agency fees or markups applied to the nurse’s hourly rate.
Flexibility and Scalability: Nurse agencies offer flexibility in staffing, allowing healthcare facilities to quickly adjust their staffing levels based on fluctuating patient volumes or staffing needs.Less Control over Individual Nurses: Facility managers may have less control over the specific nurses assigned by the agency, which can impact continuity of care and compatibility with the facility’s culture.
Reduced Administrative Burden: Nurse agencies handle administrative tasks such as scheduling, payroll, and benefits, relieving the facility managers of these responsibilities.Potential Communication Challenges: Communication between the facility and agency nurses can sometimes pose challenges due to differences in processes, protocols, or expectations.

Understanding the roles of nurse employees and nurse agencies is essential in making an informed decision. Facility managers must weigh the pros and cons of each option based on their specific staffing needs, budgetary considerations, and organizational goals. By carefully considering these factors, healthcare facilities can determine the most suitable staffing approach for their nursing positions.

Pros of Hiring a Nurse Employee

When it comes to hiring nurses for your facility, there are several advantages to hiring a nurse employee rather than going through a nurse agency. Let’s explore some of these pros in more detail.

Direct Control and Supervision

One of the key benefits of hiring a nurse employee is the ability to have direct control and supervision over their work. As an employer, you have the authority to set expectations, provide feedback, and guide their performance. This level of control allows for greater alignment with your facility’s specific needs and ensures that the nurse is adhering to your protocols and standards.

Consistency and Familiarity

By hiring a nurse employee, you can foster consistency and familiarity within your facility. The nurse becomes an integral part of your team, building relationships with colleagues and patients over time. This continuity leads to improved communication, coordination, and a better understanding of your facility’s unique requirements. It also contributes to a sense of trust and stability, benefiting both the nurse and the patients.

Potential Cost Savings

In certain cases, hiring a nurse employee can result in potential cost savings for your facility. While there are upfront costs associated with recruitment, hiring, and onboarding, in the long term, the expenses may be lower compared to hiring through a nurse agency. By employing a nurse directly, you can avoid agency fees and negotiate a salary package that aligns with your budget. Additionally, you have the flexibility to manage the nurse’s schedule and workload, optimizing staffing levels to minimize unnecessary expenses.

To provide a comprehensive overview of the pros and cons, let’s consider the numerical data in the table below.

Pros of Hiring a Nurse Employee
Direct Control and Supervision
Consistency and Familiarity
Potential Cost Savings

Hiring a nurse employee offers direct control and supervision, promotes consistency and familiarity within the facility, and has the potential for cost savings. However, it’s important to evaluate these advantages against the specific needs and resources of your facility to make an informed decision.

Cons of Hiring a Nurse Employee

While hiring a nurse employee can have its advantages, there are also some potential downsides to consider. It’s essential to weigh these cons against the pros before making a decision.

Recruitment and Hiring Process

One of the main challenges of hiring a nurse employee is the recruitment and hiring process. Facilities need to invest time and resources into sourcing and screening potential candidates. This process can be time-consuming and may require additional staff or external assistance to ensure a thorough evaluation.

Moreover, competition for qualified nursing professionals can be fierce, particularly in specialized areas of healthcare. This can further prolong the recruitment process and make it more challenging to find the right fit for the facility’s specific needs.

Administrative Responsibilities

Hiring a nurse employee also entails assuming various administrative responsibilities. Facilities must handle payroll, benefits, taxes, and other HR-related tasks associated with employing a nurse. This requires a dedicated HR department or personnel with expertise in managing employee records, compliance, and legal obligations.

Additionally, facilities need to provide ongoing training and professional development opportunities to keep their nurse employees up-to-date with the latest healthcare practices. This investment in continuing education and skills enhancement can add to the administrative workload and costs.

Limited Flexibility

Another consideration when hiring a nurse employee is the potential for limited flexibility. Facilities must ensure adequate staffing levels at all times, which may require nurse employees to work fixed schedules or be on-call for emergencies. This lack of flexibility can create challenges when unexpected situations arise or when the facility’s needs change.

Nurse employees may also have their own personal commitments or limitations that prevent them from accommodating schedule changes or filling in for additional shifts. This can impact the facility’s ability to respond to fluctuations in patient demand or sudden staffing shortages.

It’s important for facility managers to carefully evaluate the cons of hiring a nurse employee alongside the pros. By considering these factors, managers can make an informed decision that aligns with their facility’s unique requirements and goals.

Pros of Hiring a Nurse Agency

When it comes to staffing nurses for your facility, hiring a nurse agency offers several advantages. In this section, we will explore the pros of hiring a nurse agency, including access to a pool of qualified nurses, flexibility and scalability, and a reduced administrative burden.

Access to a Pool of Qualified Nurses

One of the key benefits of hiring a nurse agency is the access to a diverse pool of qualified nurses. Nurse agencies typically have a network of registered nurses with varying specialties and experience levels. This allows you to match the specific needs of your facility with the skills and expertise of the available nurses.

Agency BenefitsDetails
Access to a diverse pool of qualified nursesBenefit from a wide range of skills and expertise
Ability to match nurses to specific needsFind nurses with the necessary specialties and experience

Flexibility and Scalability

Another advantage of hiring a nurse agency is the flexibility and scalability it provides. Nurse agencies are equipped to handle fluctuations in staffing requirements. Whether you need additional nurses during peak periods or temporary coverage for staff absences, an agency can accommodate your needs. This flexibility allows you to maintain optimal staffing levels without the burden of hiring and training new employees.

Agency BenefitsDetails
Ability to adjust staffing levels as neededFlexibility to meet changing demands
Temporary coverage for staff absencesAvoid disruptions in patient care

Reduced Administrative Burden

Hiring and managing nursing staff involves various administrative tasks. By hiring a nurse agency, you can offload some of these responsibilities and reduce your administrative burden. The agency takes care of recruiting, screening, credentialing, and managing the necessary paperwork, such as contracts and payroll. This allows you to focus on other critical aspects of your facility’s operations.

Agency BenefitsDetails
Recruitment, screening, and credentialing handled by the agencySave time and effort in sourcing and vetting nurses
Management of paperwork, contracts, and payrollReduce administrative tasks

Hiring a nurse agency offers the advantage of accessing a pool of qualified nurses, providing flexibility and scalability, and reducing the administrative burden on your facility. These benefits can help ensure that your nursing staff is adequately skilled, your staffing needs are met, and your administrative tasks are streamlined.

Cons of Hiring a Nurse Agency

While hiring a nurse agency can offer several benefits, there are also some potential drawbacks that facility managers should consider before making a decision.

Higher Costs

One of the main disadvantages of hiring a nurse agency is the higher cost compared to hiring a nurse employee directly. Nurse agencies typically charge a fee for their services, which can add up over time. These costs may include recruitment fees, placement fees, and ongoing agency fees. Facility managers need to weigh the financial implications of using a nurse agency against their budget constraints.

Less Control over Individual Nurses

When hiring a nurse agency, facility managers have less control over the selection and assignment of individual nurses. The agency is responsible for assigning nurses to different shifts, and facility managers may not have the ability to choose specific nurses for their facility. This lack of control can impact the level of familiarity and consistency in patient care, as different nurses may have varying levels of experience and expertise.

Potential Communication Challenges

Communication can sometimes be a challenge when working with a nurse agency. Since the agency acts as an intermediary between the facility and the nurses, there may be delays or miscommunications in relaying important information. Facility managers may also face difficulties in addressing concerns or resolving issues directly with the nurses. Open and effective communication is crucial in healthcare settings, and the involvement of an agency can introduce additional layers of communication that may hinder efficiency.

To make an informed decision, facility managers should carefully consider these potential drawbacks of hiring a nurse agency. It’s important to weigh the benefits against the costs and assess the impact on patient care and overall operations. By evaluating their specific needs and priorities, facility managers can determine whether hiring a nurse employee or utilizing a nurse agency aligns best with their organization’s goals and resources.


In conclusion, the decision to hire a nurse employee or utilize a nurse agency is not a simple one. Facility managers must carefully evaluate the pros and cons of each option based on their facility’s specific needs, budgetary considerations, and organizational goals. Hiring a nurse employee offers direct control, consistency, and potential cost savings, but requires significant administrative responsibilities and limited flexibility.

On the other hand, hiring a nurse agency provides access to a diverse pool of qualified nurses, flexibility in staffing levels, and reduced administrative burden but can be more expensive and may result in less control over individual nurses. Ultimately, the decision should be based on what aligns best with the unique requirements of the facility and its patients.


Need help staffing your facility?

We have thousands of CNAs, LPNs, and RNs ready to fill your shifts! See how ESHYFT can help you today.
With ESHYFT you get:

Access to thousands of vetted W-2 nursing professionals.

A technology built by nursing home administrators.

Complete transparency and control of your costs.

24/7 support & a dedicated success manager.