Should I stay or should I go? Agency nursing work in the UK

Abstract

There are competing perspectives as to whether agency represents the desire to be a ‘free agent’ in terms of greater flexibility and control, or whether it represents a reluctant retreat from permanent employment. This paper explores the reasons why nurses in the UK work on an agency basis through surveys of two nursing agencies and asks: to what extent do supply-side preferences contribute to the decision for nurses to work on an agency basis? How does working on an agency basis affect the work-life balance and career aspirations of nurses? Two surveys were conducted; one with a ‘generalist’ nurse agency; and one with a ‘specialized’ agency, in order to examine the impact of rare/specialized skills on pecuniary motives. It is found that while nurses who also have a permanent job are more likely to report pecuniary factors as influencing the decision to work through agencies, nurses who solely work agency are more likely to emphasize work-life balance issues and escaping ‘office politics’ as key factors. Importantly, the findings point to the continued appeal of agency work as a means to exit the nursing workplace, suggesting that government reforms to increase the appeal of nursing as a profession have only partially addressed the concerns of nurses.