Article
Nursing on short notice? Determinants and developments of temporary nursing in German hospital
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Authors
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Helge Schnack
- Abteilung Rehabilitation und Prävention, Department für Versorgungsforschung, Carl von Ossietzky Universität Oldenburg, Deutschland
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Johanna Sophie Lubasch
- Oldenburger Forschungsnetzwerk für Notfall und Intensivmedizin, Department für Versorgungsforschung, Carl von Ossietzky Universität Oldenburg, Deutschland
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Arno Stöcker
- Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Universität zu Köln, Deutschland
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Ann-Kathrin Löhr
- Abteilung Rehabilitation und Prävention, Department für Versorgungsforschung, Carl von Ossietzky Universität Oldenburg, Deutschland
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Lena Ansmann
- Lehrstuhl für Medizinische Soziologie, Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Universität zu Köln, Deutschland
| Published: | September 10, 2024 |
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Outline
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Background: Hospitals in Germany are still struggling to fill nursing vacancies, which can have a variety of effects on the hospital, patient care, and hospital staff. As a result, hospitals are increasingly relying on temporary nursing staff to fill short-term vacancies. Temporary nursing, also known as agency nursing, is a practice, in which nurses are employed by a commercial organization to work in hospitals (or other healthcare facilities) for a limited period of time. Despite its rising importance, the use of temporary nurses in hospitals has rarely been investigated from an organizational perspective.
Objective: This study examines the utilization of temporary nurses in German hospitals and how the use of temporary nurses is associated with organizational and environmental hospital characteristics.
Methods: A secondary data analysis of longitudinal quantitative data from all general hospitals in Germany between 2015 and 2020 was carried out. As a data source, structured quality reports were used („Qualitätsberichte der Krankenhäuser“) and combined with spatial data on hospital locations (peripheral vs. central location). Due to the hierarchical data structure (time points clustered in hospitals), a multilevel regression analysis (random intercept model) was performed.
Results: A total of n=7992 observations from n=1208 general hospitals were included in the analysis. The results indicate a significant increase in temporary nursing in hospitals, especially during 2019-2020 compared to 2015. Non-profit hospitals utilized temporary nurses less frequently than public hospitals. Additionally, hospitals located in central and peripheral areas used temporary nurses less frequently than those located in very central areas.
Implication for research: Overall, the study revealed that hospitals are increasingly relying on temporary nurses to provide patient care. In addition, hospitals utilize temporary nurses in varying ways depending on organizational (e.g., ownership) or environmental characteristics (e.g., location). According to organization theory, this can be explained by the fact that hospitals adapt their organizational strategies differently to their context: hospitals located in very central areas depend more on temporary nurses, possibly due to the higher competition between hospitals and a higher turnover rate of nurses in urban areas.
