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  1. Jordan, Barbara BSN, RN

Article Content

To the Editor:


Nurses have a variety of career options in today's health care market. They can work in an array of settings and for different employers. Dr. Jo Manion's article, "Emergence of the Free Agent Nurse Workforce" in the Fall 2002 (26:5, pp. 68-78) Nursing Administration Quarterly, is thought provoking and timely. She describes the attributes and characteristics that are necessary qualities of successful free agent nurses. Traditionally, nurses have not considered themselves free agents. They have worked in settings in which the employment policies have been made for them. Travel and agency nurse positions have the appeal of financial incentives, autonomy, and flexibility. Nurses are being drawn to these positions, as their needs are not always being met in their current work environments. To become successful free agents, nurses do need to broaden their skills and knowledge to increase their marketability. Some nurses are drawn to the benefits of agency nursing but they do not take the initiative in developing their knowledge and skills. This article should be given to every nurse who partners with a nursing agency.


Dr. Manion also encourages health care organizations to learn to work with free agents. Free agents can be used to support the organization during times of census fluctuation and leaves of absence. The use of free agents or temporary staff is not a new concept. Businesses have been using independent contractors for years. A more recent employment method is the use of a professional employer organization. 1 These organizations offer businesses the ability to outsource their human resource functions. Some health care organizations are exploring the use of outsourcing. In whatever manner health care organizations choose to use temporary staff, they should be proactive in partnering with the temporary staffing agencies.


Agencies vary in their applicant screening processes, hiring practices, and annual competency assessment. In Great Britain, a concern regarding the lack of regulations for nursing agencies has led to the proposal of the Employment Agencies Act. 2 Health care organizations need to know the standards under which the temporary staffing agencies operate. Some agencies hire nurses who have 1 year of clinical experience. These nurses are expected to be highly functional in a temporary position. This can be very difficult for a novice nurse. Agency nurses are expected by the hospital to perform at the same level as permanent staff with little to no orientation.


In addition to providing nurses guidance in the advancement of free agency, I propose collaboration between health care organizations and temporary staffing agencies. They should partner in the development of mutual standards and competencies for nurses. The San Gabriel Valley Nurse Executive Council in Los Angeles met with representatives from agencies to develop guidelines for agency nurses. 3 This council developed a standardized competency tool that could be used in all area hospitals. The use of guidelines and standards assists organizations and agencies in having a common ground. It also reduces redundancy of efforts.


Health care organizations that embrace the new world of temporary staffing and lead the effort in partnership will be in the forefront of new employment options. There is very little information in the literature to guide nurse administrators in the use and effects of temporary staff. Dr. Manion's article should encourage nurse leaders to look to their institutions practices and share their experiences.




1. Meyer H. Don't get stung by a sweet outsourcing deal. Business Health. 1997;15:34-38. [Context Link]


2. Quick change artists. Nurs Times. 1999;95:24-26. [Context Link]


3. Willard J. Travel and registry nurses help fill staffing gaps. Nurs Manage. 2000;31:46-47. [Context Link]