Temp nurses go digital: Examining gig care in US nursing homes.

Abstract

Nursing homes in the United States have long struggled with a shortage of nurses, which has now been exacerbated by the COVID-19 crisis. In response to the shortage, nursing homes have increasingly used temporary services to fill nursing vacancies. Existing studies have examined the care provided by temporary nurses from traditional staffing agencies; however, at the time of writing, no studies have examined care provided by their counterparts from digital gig platforms. This article reports the findings from 15months of fieldwork (6/2019-8/2019; 6/2020-5/2021) at two US nursing homes, both characterised by high gig-nurse usage. I asked the following questions: how nurses engage in and perceive gig services, and how the use of gig services affects the work environment and everyday care. The findings indicate that gig services (1) offer gig nurses monetary incentives at the expense of exaggerating the budget deficit of nursing homes, (2) increase gig nurses' working autonomy while creating a loophole in managerial oversight, (3) lead to an uneven distribution of duties between gig nurses and nursing home staff, which demoralises the latter. Taken together, gig services, while empowering the gig nurses, have resulted in the precarisation of nursing home staffing and care environments.