Supplemental Staffing and the Changing Structure of Nurse Employment. Executive Summary

摘要

The exploratory study focuses on the growth and decline of supplemental nursing agencies between 1975 and 1982 as a means to understand nurse labor market behavior. Recurring themes in the history of nursing provided the research framework: the dominant role of hospitals in the nurse labor market, hospital resistance to nurses' efforts to gain professional control, and the tendency for nurses to pursue strategies that perpetuate their semi-professional status. The research involved samples of hospitals and agencies in two San Francisco East Bay counties and interviews with hospital managers, agency directors and labor representatives and a survey of 450 nurses during 1981-1983. Through agency employment, nurses unintentionally contributed to increased stratification within their ranks. This allowed hospitals to make fundamental changes in their staffing policies in response to cost containment pressures and the general economic recession: reduction in RN staff, efforts to increase the productivity of fewer employees and internalizing supplemental staffing through exp anded per diem pools.