From this study, permanent nurses described agency nurses as competent with general nursing care but lack specialty specific competence. This lack of competence translates to permanent staff nurses taking complex and sicker patients. It is also important for hospitals to recognise this, as permanent staff nurses repeatedly taking complex and sicker patients can lead to their burnout. Permanent nurses also reported workplace disadvantages experienced by agency nurses. An issue that needs to be addressed by the organisations and agency providers is the lack of orientation provided to agency nurses. This study identified that orientation can be inconsistent and insufficient especially when there is a significant workload in the nursing unit. Moreover, agency nurses skipped their entitled meal-breaks to finish their jobs. This is an important occupational health and safety issue putting agency nurses and patients at risks.
The isolation of agency nurses from permanent nurses was also reported in this study. The atmosphere of isolation leads to agency staff nurses not talking to permanent staff, which raises a significant issue for teamwork and communication. It was discussed that nursing depends on effective communication to provide safe nursing care. The lack of communication between agency and permanent staff nurses can lead to agency nurses missing vital information regarding their patients leading to poor nursing care. This can result in job dissatisfaction not just for agency nurses but also for permanent staff nurses.
Casual employment such as agency nursing is a powerful human resource strategy as this gives the capacity to ‘top-up’ as demands arise. Agency nursing will be a part of the modern nursing workforce, and policies for their effective integration using evidence-based strategies and contemporary research need to be considered by organisations as part of their commitment in the nurses’ retention in the profession and provision of quality patient care.