Key Responsibilities and Required Skills for Agency Nurse

🎯 Role Definition

An Agency Nurse (per diem / travel nurse) is a licensed registered nurse (RN) or licensed practical nurse (LPN) contracted through a staffing agency to provide high-quality, short-term clinical care across hospitals, clinics, long-term care, and community health settings. The Agency Nurse must rapidly integrate into new teams, follow facility policies, deliver patient-centered care, maintain precise documentation in electronic medical records (EMR), and comply with state licensure and agency credentialing requirements. This role demands clinical versatility, strong communication, and the ability to thrive in fast-paced, variable environments.

📈 Career Progression

Typical Career Path

Entry Point From:

Certified Nursing Assistant (CNA) transitioning to LPN or RN
Recently licensed RN with clinical acute care rotations
Experienced LPN or Med‑Surg nurse seeking flexible/agency work

Advancement To:

Charge Nurse or Shift Supervisor
Nurse Manager or Assistant Nurse Manager
Clinical Nurse Specialist, Nurse Educator, or Infection Control Nurse
Senior Travel Nurse or Per Diem Coordinator

Lateral Moves:

Home Health Nurse or Hospice Nurse
Telemetry/Step‑down nurse or Clinic Nurse
Case Manager or Utilization Review Nurse

Core Responsibilities

Primary Functions

Perform thorough patient assessments on admission and throughout the shift, synthesizing subjective complaints and objective findings to identify changes in clinical status and escalate concerns to the interdisciplinary team.
Administer prescribed medications, including IV medications, controlled substances, and titratable drips, following the five rights of medication administration and agency/facility policy.
Initiate, manage, and discontinue IV lines and peripheral/central access as appropriate; monitor infusion rates, compatibility, and infiltration/complication signs.
Provide comprehensive wound care including assessment, dressing changes, negative pressure therapy support, and documentation of wound progression consistent with best practices and facility protocols.
Develop, implement, and revise individualized patient care plans in collaboration with physicians, advanced practice providers, and allied health professionals to meet short-term and discharge goals.
Perform frequent clinical monitoring of vital signs, telemetry, lab results, and hemodynamic parameters; recognize and intervene in acute changes, initiating rapid response when required.
Accurately document all nursing care, interventions, assessments, and patient responses in the facility’s EMR (Epic, Cerner, Meditech, or equivalent) in a timely, legible, and legally compliant manner.
Provide patient and family education on diagnosis, medication administration, self-care techniques, wound care, and discharge instructions tailored to health literacy levels.
Conduct safe patient transfers, ambulation assistance, fall prevention measures, and use of assistive devices to minimize risk and support rehabilitation goals.
Participate in interdisciplinary rounds, consults, and care conferences to coordinate patient-centered care, update plan-of-care, and support safe disposition and continuity of care.
Manage admissions, discharges, and transfers efficiently while ensuring accurate medication reconciliation, durable medical equipment orders, and follow-up arrangements.
Perform point-of-care testing, obtain blood and wound cultures, and assist with specimen collection, labeling, and transport per facility protocols to support diagnostic accuracy.
Adhere to universal precautions, infection prevention strategies, and isolation procedures; participate in facility surveillance and reporting of healthcare-associated infections.
Provide acute and end-of-life care including pain and symptom management, comfort measures, and family support consistent with palliative care principles.
Respond to emergency situations (code blue, stroke alerts, rapid response) as a competent resuscitation team member, applying ACLS/BLS protocols and facility emergency procedures.
Facilitate safe medication reconciliation at transitions of care, identifying discrepancies, and communicating changes to prescribers and pharmacy staff.
Mentor and precept new agency staff or orient permanent hires when requested, demonstrating best practices and modeling clinical judgment and documentation standards.
Maintain professional compliance with state nursing licensure, agency credentialing, background checks, immunizations, and mandatory trainings to be eligible for assignments.
Triage phone calls and walk-in encounters, prioritize workload based on acuity, and coordinate with case management for early discharge planning or placement needs.
Monitor and document pain assessments, implement multimodal pain management strategies, and evaluate response to analgesics and adjunct therapies.
Conduct medication titration and infusion management (e.g., vasopressors, insulin drips), reporting values promptly and following approved protocols or prescriber orders.
Support behavioral health patient safety initiatives by following de-escalation techniques, safe room protocols, and reporting incidents according to policy.
Ensure proper handling, storage, and documentation of controlled substances, participating in narcotic counts and investigations as required by facility policy.
Travel efficiently between multiple client facilities as assigned, maintain flexible availability for evening, night, weekend, and holiday shifts, and manage timekeeping and credential submission to the agency.

Secondary Functions

Participate in quality improvement projects, chart audits, and patient safety committees as requested by the facility or agency.
Assist with supply inventory management, equipment checks, and reporting of maintenance needs to ensure a safe clinical environment.
Support patient satisfaction initiatives by responding thoughtfully to patient/family feedback and documenting service recovery when applicable.
Attend mandatory in‑service trainings, competency assessments, and update certifications (BLS, ACLS, PALS) to remain practice-ready.
Collaborate with unit leadership to suggest workflow improvements and share frontline observations that enhance efficiency and care delivery.
Provide occasional telehealth triage, patient follow-up calls, and community outreach education when integrated into assignment requirements.

Required Skills & Competencies

Hard Skills (Technical)

Active and unrestricted RN or LPN license in the state(s) of practice; compact license proficiency preferred.
Strong clinical assessment and critical thinking skills for acute, med‑surg, telemetry, ED, ICU, or long‑term care environments.
Proficiency with electronic medical records (EMR) systems such as Epic, Cerner, Meditech, Allscripts, or similar.
Medication administration expertise including IV push, PCA management, insulin dosing, and controlled substance handling.
IV therapy and phlebotomy skills, including insertion, maintenance, and recognition of complications.
Wound care and ostomy management skills with familiarity in dressing selection and documentation.
Telemetry monitoring and interpretation of basic cardiac rhythms; ACLS/BLS certification where applicable.
Infection control best practices, sterile technique, and isolation precautions (COVID-19, MRSA, C. diff).
Emergency response skills: BLS, ACLS, basic airway management, and familiarity with rapid response/code procedures.
Experience with medication reconciliation, discharge planning workflows, and coordination with case management.
Competence in point-of-care testing and specimen collection with adherence to lab handling procedures.
Time management and prioritization tools for managing heavy caseloads and patient acuity.

Soft Skills

Excellent verbal and written communication with patients, families, multidisciplinary teams, and agency coordinators.
Flexibility and adaptability to rapidly changing clinical settings, processes, and documentation systems.
Strong problem-solving and clinical judgment under pressure; ability to de-escalate and manage crisis situations.
Cultural sensitivity and patient-centered bedside manner to support diverse populations and health equity.
Teamwork and collaboration: proven ability to work with physicians, therapists, social workers, and ancillary staff.
Professionalism and reliability: punctuality, accountability for assignments, and consistent follow-through.
Attention to detail in documentation, medication administration, and regulatory compliance.
Emotional resilience and self-care strategies to manage stress associated with transient assignments.
Customer-service orientation to represent the staffing agency professionally and improve patient satisfaction.
Coaching and mentoring skills for precepting new staff or orienting facility teams to agency processes.

Education & Experience

Educational Background

Minimum Education:

Active nursing license (RN or LPN) issued by the state board of nursing. Graduation from an accredited nursing program (ADN or diploma for RN; approved LPN program).

Preferred Education:

Bachelor of Science in Nursing (BSN) preferred for many hospitals and specialty assignments.
Additional certifications relevant to specialty (e.g., CCRN, OCN, Med-Surg Certification).

Relevant Fields of Study:

Nursing (ADN, BSN, LPN programs)
Critical Care Nursing specialties
Emergency or Trauma Nursing certifications

Experience Requirements

Typical Experience Range:

1–5 years of clinical nursing experience; many agency roles require a minimum of 1–2 years in acute care or the specialty area being staffed.

Preferred:

2+ years of relevant experience in the unit specialty (e.g., ICU, ED, Med‑Surg, Telemetry, OR, LTC).
Prior agency/per diem or travel nursing experience demonstrating adaptability, rapid orientation, and reliable performance.
Demonstrated competency in EMR documentation, IV/med administration, and emergency/critical care procedures.