The gig economy’s labor model and its algorithmic management technologies now have a foothold in one of the largest labor sectors in the country: health care. On-demand nursing companies such as CareRev, Clipboard Health, ShiftKey, and ShiftMed have promised hospitals more control and nurses more flexibility. Through original interviews with 29 “gig” nurses and nursing assistants, this brief finds that these apps encourage nurses to work for less pay, fail to provide certainty about scheduling and the amount or nature of work, take little to no accountability for worker safety, and can threaten patient well-being by placing nurses in unfamiliar clinical environments with no onboarding or facility training. On-demand nursing platforms are also using the Uber playbook to lobby state legislatures in an attempt to exempt themselves from existing labor regulations. In the wake of the COVID-19 pandemic, nurses have fled the profession as a result of poor working conditions, creating what some have incorrectly identified as a “nursing shortage.” As gig nursing platforms falsely promise to empower workers and meet their needs, it is up to legislators, policymakers, civic leaders, and community organizations to act to solve the real problems at the root of this crisis.
I know this industry and this article is very misleading. These companies do not use credit rating or debt to determine shift availability or wages. The article just says they “could” while claiming the criteria are opaque. They are not. They all have documentation that describes how rates are set. What’s more, many states set minimum rates for these jobs. The “algorithm” for setting the pay rate are based on bonuses given for nurses that are willing to work multiple shifts at the same location specifically to encourage facility affinity to support continuity of care or to ensure coverage during holidays, weekends, etc.
Most of these platforms do have live interviews in addition to background check, credential verification with state boards, and vaccination verification. Onboarding to a facility is accomplished with online learning courses for fire and safety, floor procedures, and care plans. Per diem nurse agencies have existed for decades to deal with variability in patient census and uncertainty around schedule has been a part of that since the beginning and is not unique to digital agencies.
It does not put negative pressure on wages for full time employees and no facility would fill a shift with an agency nurse instead of with a full time nurse because the full time nurse costs less. These agencies are only used when there aren’t a sufficient number of full time nurses on staff to meet patient/staff ratios, which is often. Every single facility that uses an agency has openings for full time nurses that they struggle to fill.