Locum vs. Permanent CRNA:
Which Is Right
for Your Facility?

When a CRNA position opens at your facility, whether through a retirement, a resignation, or new volume, you have to decide whether to bring in a locum to cover the gap, launch a permanent search, or do both. It sounds simple, but it's one of the most consequential staffing decisions a facility leader makes, with real effects on budget, continuity of care, and team morale.

This article breaks down both options, when each makes sense, and why the right answer is almost always a mix of the two.

Understanding the Real Cost of Each

The sticker price of locum tenens is high, typically $250–$350+ per hour for a CRNA depending on specialty, location, and urgency. Add housing, travel, and agency fees, and the all-in cost of a locum CRNA can run $20,000–$35,000 per week. That number creates real sticker shock for finance departments.

The comparison that matters is the locum rate against the total cost of an unstaffed OR. Cancelled cases, delayed procedures, diverted patients, and overtime for remaining staff all carry their own costs, and they hit your revenue line directly. A fair financial model has to account for both sides.

When Locum Makes Clear Sense

Immediate coverage needs

If a CRNA gives two weeks' notice on a Monday, you can't fill that position permanently by the following Monday. Credentialing alone takes 4–8 weeks at most facilities. Locum tenens exists for this gap. It keeps your ORs running while you conduct a thoughtful permanent search instead of a panicked one.

Seasonal or variable volume

Some facilities have predictable volume surges, such as orthopedic surgery centers that spike in spring and fall or hospitals that see volume climb in certain quarters. Locum CRNAs are a legitimate, cost-effective way to manage variable demand without overstaffing your permanent roster.

Evaluating fit before committing

A locum engagement can work as an extended working interview. Some of the best permanent hires start as locum placements, since both sides get to evaluate chemistry, clinical style, and cultural fit before committing long-term.

When Permanent Placement Should Be the Priority

Predictable, ongoing volume

If you have consistent case volume that requires a dedicated CRNA, permanent placement is almost always the better long-term investment. Given the cost difference between a locum and a permanent hire, a permanent CRNA pays for their own recruiting fee within months, and the savings compound over a full-time tenure.

Building a cohesive anesthesia team

CRNAs who work together consistently develop communication patterns, clinical rhythms, and institutional knowledge that translate directly into better patient outcomes and smoother OR workflow. High locum turnover disrupts this. If team culture and continuity matter at your facility, permanent placement is worth prioritizing.

Rural and critical access settings

In rural facilities where CRNAs often work as the sole or primary anesthesia provider, continuity is a patient safety issue. A permanent provider committed to the community is worth a longer, more deliberate search than a revolving door of locums.

The Decision Framework

The Hybrid Approach: How Most Facilities Should Think About This

For most facilities, the most effective strategy is running both tracks at once. Engage a locum to cover immediate clinical needs while running a focused permanent search in parallel. Set a clear internal deadline for the permanent search, typically 60–90 days, and hold to it.

This approach keeps your ORs running, avoids the panic that leads to poor permanent hires, and builds in cost discipline, because you know the locum clock is running while the permanent search progresses.

What it requires is a recruiting partner who can move quickly on both tracks, understands the difference between locum and permanent CRNA candidates, and knows how to close offers in a competitive market.