Understanding nurses' dual practice:

A scoping review of what we know and what we still need to ask on nurses holding multiple jobs

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

BACKGROUND:
Mounting evidence suggests that holding multiple concurrent jobs in public and private (dual practice) is common among health workers in low- as well as high-income countries. Nurses are world's largest health professional workforce and a critical resource for achieving Universal Health Coverage. Nonetheless, little is known about nurses' engagement with dual practice.

METHODS:
We conducted a scoping review of the literature on nurses' dual practice with the objective of generating hypotheses on its nature and consequences, and define a research agenda on the phenomenon. The Arksey and O'Malley's methodological steps were followed to develop the research questions, identify relevant studies, include/exclude studies, extract the data, and report the findings. PRISMA guidelines were additionally used to conduct the review and report on results.

RESULTS:
Of the initial 194 records identified, a total of 35 met the inclusion criteria for nurses' dual practice; the vast majority (65%) were peer-reviewed publications, followed by nursing magazine publications (19%), reports, and doctoral dissertations. Twenty publications focused on high-income countries, 16 on low- or middle-income ones, and two had a multi country perspective. Although holding multiple jobs not always amounted to dual practice, several ways were found for public-sector nurses to engage concomitantly in public and private employments, in regulated as well as in informal, casual fashions. Some of these forms were reported as particularly prevalent, from over 50% in Australia, Canada, and the UK, to 28% in South Africa. The opportunity to increase a meagre salary, but also a dissatisfaction with the main job and the flexibility offered by multiple job-holding arrangements, were among the reported reasons for engaging in these practices.

DISCUSSION AND CONCLUSIONS:
Limited and mostly circumstantial evidence exists on nurses' dual practice, with the few existing studies suggesting that the phenomenon is likely to be very common and carry implications for health systems and nurses' welfare worldwide. We offer an agenda for future research to consolidate the existing evidence and to further explore nurses' motivation; without a better understanding of nurse dual practice, this will continue to be a largely 'hidden' element in nursing workforce policy and practice, with an unclear impact on the delivery of care.
Original languageEnglish
Article number14
Pages (from-to)14-30
Number of pages16
JournalHuman resources for health
VolumeVol. 16
Issue numbern.º 1
DOIs
Publication statusPublished - 22 Feb 2018

Fingerprint

nurse
Nurses
Publications
income
Health
Nursing
nursing
health
Universal Coverage
evidence
Health Manpower
Public Sector
Private Practice
Salaries and Fringe Benefits
earning a doctorate
South Africa
salary
Research
health professionals
magazine

Keywords

  • Casualization of work
  • Human resources for health
  • Moonlighting
  • Multiple job-holding
  • Nurses
  • Nurses dual practice
  • Private health sector

Cite this

@article{63aa0eb0d1134f3ebf81dd8a02febdf6,
title = "Understanding nurses' dual practice:: A scoping review of what we know and what we still need to ask on nurses holding multiple jobs",
abstract = "BACKGROUND:Mounting evidence suggests that holding multiple concurrent jobs in public and private (dual practice) is common among health workers in low- as well as high-income countries. Nurses are world's largest health professional workforce and a critical resource for achieving Universal Health Coverage. Nonetheless, little is known about nurses' engagement with dual practice.METHODS:We conducted a scoping review of the literature on nurses' dual practice with the objective of generating hypotheses on its nature and consequences, and define a research agenda on the phenomenon. The Arksey and O'Malley's methodological steps were followed to develop the research questions, identify relevant studies, include/exclude studies, extract the data, and report the findings. PRISMA guidelines were additionally used to conduct the review and report on results.RESULTS:Of the initial 194 records identified, a total of 35 met the inclusion criteria for nurses' dual practice; the vast majority (65{\%}) were peer-reviewed publications, followed by nursing magazine publications (19{\%}), reports, and doctoral dissertations. Twenty publications focused on high-income countries, 16 on low- or middle-income ones, and two had a multi country perspective. Although holding multiple jobs not always amounted to dual practice, several ways were found for public-sector nurses to engage concomitantly in public and private employments, in regulated as well as in informal, casual fashions. Some of these forms were reported as particularly prevalent, from over 50{\%} in Australia, Canada, and the UK, to 28{\%} in South Africa. The opportunity to increase a meagre salary, but also a dissatisfaction with the main job and the flexibility offered by multiple job-holding arrangements, were among the reported reasons for engaging in these practices.DISCUSSION AND CONCLUSIONS:Limited and mostly circumstantial evidence exists on nurses' dual practice, with the few existing studies suggesting that the phenomenon is likely to be very common and carry implications for health systems and nurses' welfare worldwide. We offer an agenda for future research to consolidate the existing evidence and to further explore nurses' motivation; without a better understanding of nurse dual practice, this will continue to be a largely 'hidden' element in nursing workforce policy and practice, with an unclear impact on the delivery of care.",
keywords = "Casualization of work, Human resources for health, Moonlighting, Multiple job-holding, Nurses, Nurses dual practice, Private health sector",
author = "G Russo and I Fronteira and Jesus, {Tiago S} and James Buchan",
year = "2018",
month = "2",
day = "22",
doi = "10.1186/s12960-018-0276-x",
language = "English",
volume = "Vol. 16",
pages = "14--30",
journal = "Human resources for health",
issn = "1478-4491",
publisher = "Springer Verlag",
number = "n.º 1",

}

Understanding nurses' dual practice: A scoping review of what we know and what we still need to ask on nurses holding multiple jobs. / Russo, G; Fronteira, I; Jesus, Tiago S ; Buchan, James.

In: Human resources for health, Vol. Vol. 16, No. n.º 1, 14, 22.02.2018, p. 14-30.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Understanding nurses' dual practice:

T2 - A scoping review of what we know and what we still need to ask on nurses holding multiple jobs

AU - Russo, G

AU - Fronteira, I

AU - Jesus, Tiago S

AU - Buchan, James

PY - 2018/2/22

Y1 - 2018/2/22

N2 - BACKGROUND:Mounting evidence suggests that holding multiple concurrent jobs in public and private (dual practice) is common among health workers in low- as well as high-income countries. Nurses are world's largest health professional workforce and a critical resource for achieving Universal Health Coverage. Nonetheless, little is known about nurses' engagement with dual practice.METHODS:We conducted a scoping review of the literature on nurses' dual practice with the objective of generating hypotheses on its nature and consequences, and define a research agenda on the phenomenon. The Arksey and O'Malley's methodological steps were followed to develop the research questions, identify relevant studies, include/exclude studies, extract the data, and report the findings. PRISMA guidelines were additionally used to conduct the review and report on results.RESULTS:Of the initial 194 records identified, a total of 35 met the inclusion criteria for nurses' dual practice; the vast majority (65%) were peer-reviewed publications, followed by nursing magazine publications (19%), reports, and doctoral dissertations. Twenty publications focused on high-income countries, 16 on low- or middle-income ones, and two had a multi country perspective. Although holding multiple jobs not always amounted to dual practice, several ways were found for public-sector nurses to engage concomitantly in public and private employments, in regulated as well as in informal, casual fashions. Some of these forms were reported as particularly prevalent, from over 50% in Australia, Canada, and the UK, to 28% in South Africa. The opportunity to increase a meagre salary, but also a dissatisfaction with the main job and the flexibility offered by multiple job-holding arrangements, were among the reported reasons for engaging in these practices.DISCUSSION AND CONCLUSIONS:Limited and mostly circumstantial evidence exists on nurses' dual practice, with the few existing studies suggesting that the phenomenon is likely to be very common and carry implications for health systems and nurses' welfare worldwide. We offer an agenda for future research to consolidate the existing evidence and to further explore nurses' motivation; without a better understanding of nurse dual practice, this will continue to be a largely 'hidden' element in nursing workforce policy and practice, with an unclear impact on the delivery of care.

AB - BACKGROUND:Mounting evidence suggests that holding multiple concurrent jobs in public and private (dual practice) is common among health workers in low- as well as high-income countries. Nurses are world's largest health professional workforce and a critical resource for achieving Universal Health Coverage. Nonetheless, little is known about nurses' engagement with dual practice.METHODS:We conducted a scoping review of the literature on nurses' dual practice with the objective of generating hypotheses on its nature and consequences, and define a research agenda on the phenomenon. The Arksey and O'Malley's methodological steps were followed to develop the research questions, identify relevant studies, include/exclude studies, extract the data, and report the findings. PRISMA guidelines were additionally used to conduct the review and report on results.RESULTS:Of the initial 194 records identified, a total of 35 met the inclusion criteria for nurses' dual practice; the vast majority (65%) were peer-reviewed publications, followed by nursing magazine publications (19%), reports, and doctoral dissertations. Twenty publications focused on high-income countries, 16 on low- or middle-income ones, and two had a multi country perspective. Although holding multiple jobs not always amounted to dual practice, several ways were found for public-sector nurses to engage concomitantly in public and private employments, in regulated as well as in informal, casual fashions. Some of these forms were reported as particularly prevalent, from over 50% in Australia, Canada, and the UK, to 28% in South Africa. The opportunity to increase a meagre salary, but also a dissatisfaction with the main job and the flexibility offered by multiple job-holding arrangements, were among the reported reasons for engaging in these practices.DISCUSSION AND CONCLUSIONS:Limited and mostly circumstantial evidence exists on nurses' dual practice, with the few existing studies suggesting that the phenomenon is likely to be very common and carry implications for health systems and nurses' welfare worldwide. We offer an agenda for future research to consolidate the existing evidence and to further explore nurses' motivation; without a better understanding of nurse dual practice, this will continue to be a largely 'hidden' element in nursing workforce policy and practice, with an unclear impact on the delivery of care.

KW - Casualization of work

KW - Human resources for health

KW - Moonlighting

KW - Multiple job-holding

KW - Nurses

KW - Nurses dual practice

KW - Private health sector

UR - https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-018-0276-x

U2 - 10.1186/s12960-018-0276-x

DO - 10.1186/s12960-018-0276-x

M3 - Review article

VL - Vol. 16

SP - 14

EP - 30

JO - Human resources for health

JF - Human resources for health

SN - 1478-4491

IS - n.º 1

M1 - 14

ER -