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...
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doaj-49adce922d2a424b878724001cd06dfd2020-11-25T01:14:21ZengBMCHuman Resources for Health1478-44912018-02-0116111610.1186/s12960-018-0276-xUnderstanding nurses’ dual practice: a scoping review of what we know and what we still need to ask on nurses holding multiple jobsGiuliano Russo0Inês Fronteira1Tiago Silva Jesus2James Buchan3Centre for Primary Care and Public Health, Queen Mary University of LondonGHTM, Instituto de Higiene e Medicina Tropical, Nova University of LisbonGHTM, Instituto de Higiene e Medicina Tropical, Nova University of LisbonGHTM, Instituto de Higiene e Medicina Tropical, Nova University of LisbonAbstract 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.http://link.springer.com/article/10.1186/s12960-018-0276-xNurses dual practiceMultiple job-holdingMoonlightingHuman resources for healthPrivate health sectorNurses |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Giuliano Russo Inês Fronteira Tiago Silva Jesus James Buchan |
spellingShingle |
Giuliano Russo Inês Fronteira Tiago Silva Jesus James Buchan Understanding nurses’ dual practice: a scoping review of what we know and what we still need to ask on nurses holding multiple jobs Human Resources for Health Nurses dual practice Multiple job-holding Moonlighting Human resources for health Private health sector Nurses |
author_facet |
Giuliano Russo Inês Fronteira Tiago Silva Jesus James Buchan |
author_sort |
Giuliano Russo |
title |
Understanding nurses’ dual practice: a scoping review of what we know and what we still need to ask on nurses holding multiple jobs |
title_short |
Understanding nurses’ dual practice: a scoping review of what we know and what we still need to ask on nurses holding multiple jobs |
title_full |
Understanding nurses’ dual practice: a scoping review of what we know and what we still need to ask on nurses holding multiple jobs |
title_fullStr |
Understanding nurses’ dual practice: a scoping review of what we know and what we still need to ask on nurses holding multiple jobs |
title_full_unstemmed |
Understanding nurses’ dual practice: a scoping review of what we know and what we still need to ask on nurses holding multiple jobs |
title_sort |
understanding nurses’ dual practice: a scoping review of what we know and what we still need to ask on nurses holding multiple jobs |
publisher |
BMC |
series |
Human Resources for Health |
issn |
1478-4491 |
publishDate |
2018-02-01 |
description |
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. |
topic |
Nurses dual practice Multiple job-holding Moonlighting Human resources for health Private health sector Nurses |
url |
http://link.springer.com/article/10.1186/s12960-018-0276-x |
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