SUPPLEMENTAL STAFFING AND THE CHANGING STRUCTURE OF NURSE EMPLOYMENT.
Contributors: University of California, Berkeley.
Published: 1985
Number of pages: 334
Subjects: Sociology, Industrial and Labor Relations.
Description: This study focuses on the experience with supplemental nursing agencies as a vehicle for understanding patterns in nurse labor market behavior. Agencies expanded during the nurse shortage of the late 1970s as hospitals sought to meet their staffing needs and nurses perceived an opportunity to improve the conditions of their work. The subsequent decline of agencies was associated with the effects of general economic recession and hospital responses to policy reforms to contain hospital cost inflation.

Several recurring themes in the history of nursing provided the framework for this exploratory study. These themes include the dominant role of hospitals in the nurse labor market, hospital resistance to efforts by nurses to gain professional control over nursing practice 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 included interviews with hospital managers, agency directors and labor representatives and a survey of 450 nurses during 1981-1983.

Research findings revealed that agency employment did not meet nurses' expectations for greater autonomy. Through agency employment, nurses unintentionally contributed to increased stratification within their ranks. This gave hospitals the flexibility to make fundamental changes in their staffing policies in response to pressures to contain costs: reduction of RN staff, efforts to increase the productivity of a fewer number of employees and integration of supplemental staffing into hospital employment through expanded use of per diem nurses. Such changes in hospital staffing policy decrease the relative number of staff positions that offer fringe benefits, potential upward mobility and full employment protection.

While this study is concerned with nursing and health policy, the issues underlying this specific case have broader social policy relevance. The study illustrates the importance of viewing social sector programs and institutions not only as providers of services but also as major employers. Given this dual role, social policy planners must understand the causes of labor market behavior within the sector and assess alternative policy reforms for their labor market implications as well as effects on service levels and quality.
Notes: Source: Dissertation Abstracts International, Volume: 46-09, Section: A, page: 2829.

Thesis (PH.D.)--UNIVERSITY OF CALIFORNIA, BERKELEY, 1985.

School code: 0028.