Us and them: Experiences of agency nurses in intensive care units

Objective: This qualitative case study describes the work experiences of agency nurses from their perspective. It explores their interactions with intensive care unit managers to whom they report in their designated intensive care units and their relationships with fellow permanent nurses. Methods: A qualitative study was undertaken in three intensive care units at a public hospital in South Africa. Face-to-face interviews were used to collect data from eleven agency nurses. Thematic analysis of the data was undertaken. Findings: The challenges of agency nursing work were haphazard clinical allocation, a lack of self-efficacy and competence, and feelings of exclusion. Positive aspects of the agency nurse experience included feedback and support from permanent nurses and intensive care unit managers and occurrences of belonging and acceptance. Conclusion: The findings of this study point to the importance of agency nurse relationships with managers and fellow permanent nurses. To ensure patient care is not compromised, managers and nurse managers have a responsibility to ensure a welcoming, inclusive and nurturing environment for all staff tasked with intensive care unit responsibilities. (C) 2019 Elsevier Ltd. All rights reserved.