Methods: During 2010, a stratified random sample of 80 hospitals was selected from the public and private health sectors in four South African provinces. All nurses working in intensive care, theatre, casualty, maternity and general medical and surgical wards on the survey day completed a self-administered questionnaire after obtaining informed consent. In addition to demographic information, the questionnaire focused on the prevalence of moonlighting and participants’ intention to leave their primary jobs in the 12 months following the survey. Survey data were analysed using STATA version 10.
Results: Survey participants (n=3 784) were predominantly middle-aged (median 42 years). The prevalence of moonlighting in the previous year was 34.1% [95%CI: 32.6–35.6]. Overall, 1 133 participants (31.5%) indicated that they planned to leave their primary jobs, ranging from a low of 23.4% among nursing auxilliaries to 39% of all nurses working in Gauteng, the wealthiest and most urbanised province in South Africa. 15.5 % of all survey participants indicated that they planned to go overseas in the 12 months following the survey. Among this group, 18.1 % of moonlighters, compared to 14.3% of non-moonlighters planned to go overseas, but this difference was not statistically significant. The odds ratio of moonlighters planning to go overseas compared to non-moonlighters was 1.32 [95% CI: 0.81- 2.16], but this was not statistically significant (p=0.266).
This study provides empirical information on whether moonlighting influences nurses’ decisions to leave their primary jobs. There is the need for strategies to reduce turnover among South African nurses.
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