While locum and gig nurses could help ease the Nursing workforce shortage in the short term, more needs to be done for these temporary roles to create a lasting, sustainable impact.
Locum and gig Nursing have been around for over a century, yet they are not widely embraced in Singapore, where full-time and permanent Nursing employment is the norm. However, ageing populations, changing patient expectations, evolving models of care, and rising manpower costs are pushing healthcare organisations to adopt more dynamic staffing models.
As a result, healthcare organisations are increasingly turning to more flexible workforce solutions such as gig and locum nurses to ensure adequate staffing levels and maintain quality care. These nurses bring with them diverse experiences from different clinical environments, team dynamics and workplace cultures, contributing positively to knowledge sharing and innovation, especially in primary healthcare settings.
Temporary nurses also play an essential role in expanding healthcare access by providing flexible care that meets patient needs not only in hospitals but also in the community, outside typical clinical settings. During the pandemic, for instance, locum and gig nurses were instrumental in keeping many vaccination centres running smoothly.
One might expect that such part-time and temporary employment models would take off after the pandemic—much like other gig work. But that has not happened. Why?
The Problem Doesn’t Lie with the Nurses
The truth is, many nurses are in favour of flexible work arrangements. Younger and single nurses value the opportunity to pursue personal interests, while married nurses with children appreciate the flexibility to devote more time to family responsibilities. Those pursuing further education also benefit from flexible shifts that allow them to balance work and academic commitments more effectively.
Recent research conducted by our team at the Alice Lee Centre for Nursing Studies (NUS Nursing), National University of Singapore Yong Loo Lin School of Medicine, corroborates these observations. The study, which gathered responses from 111 registered nurses working in temporary clinical roles, found that they are generally satisfied and motivated at work.
Beyond flexible scheduling and work-life balance, many also cited job autonomy as a key reason for choosing locum and gig Nursing over full-time, permanent positions. Unlike traditional Nursing roles, where assignments are typically fixed, these temporary nurses have more control over their professional experiences. They can select assignments that match their clinical interests and expertise, or rotate between departments or specialties to develop a broader set of skills that address diverse patient needs.
As one participant shared, “Compared to the full-time position where I would be attached to one department, I get to see different patients from different disciplines as a gig nurse. This adds flavour to my clinical Nursing experience.”
Besides having the freedom to explore different Nursing specialties and focus on preferred areas of clinical practice, many are also glad to be free from duties unrelated to bedside and patient care—and to be able to take breaks and end work on time.
Yet, despite these seemingly favourable conditions for locum and gig Nursing in Singapore, there is no evidence that more nurses are taking up such roles. Instead, our research found that many of these nurses do not intend to stay in temporary positions.
One wonders why. After all, many reported that providing direct bedside care gives them a strong sense of job satisfaction and fulfilment. The study also noted that temporary nurses are offered competitive compensation packages—comparable to, or even exceeding, those of their full-time counterparts.
Hard Truths about Locum and Gig Work
So what is the other side of the story?
Turns out—the absence of work benefits, such as sick leave and bonuses, as well as uncertainties in Nursing assignments that result in pay volatility, give nurses pause when considering locum and gig Nursing. One respondent confided, “Unstable income, if the place has enough staff then they won’t ask you to come.”
Another participant who worked at the COVID-19 vaccination facilities added, “It was very, very busy at the start of COVID. Then when the situation stabilised, assignments became less.”
But job and remuneration stability is only part of the story. The bigger obstacle preventing nurses from pursuing locum and gig work is the lack of career advancement opportunities and professional development pathways.
Temporary nurses often play supporting roles to full-time nurses in clinical settings. Sometimes, these include taking on routine tasks that are typically delegated to enrolled nurses. They are also seldom given opportunities to manage cases independently. As a result, they are unable to hone their clinical skills, particularly in managing complex cases.
The absence of rank differentiation among temporary roles also means these nurses receive little structural support for career progression or opportunities for professional development. To make matters worse, locum and gig Nursing is often discounted from formal clinical experience—making it difficult for temporary nurses to eventually transition back to full-time work.
Agency for Making Locum and Gig Nursing Viable
Healthcare is changing—and so is our Nursing workforce. The views and expectations of younger nurses towards work are different from those of earlier generations. As they will make up the majority of the Nursing workforce in time, it is crucial to take a holistic approach to address their needs.
As the study revealed, work flexibility and work-life balance rank high among their career considerations. It is therefore not unreasonable to imagine that more will choose locum and gig work over full-time, permanent employment.
Furthermore, the growing emphasis on lifelong learning suggests that future nurses will have a stronger inclination to take career breaks throughout their professional lives to pursue further qualifications, while using temporary Nursing as a source of income.
However, current human resource management policies for temporary nurses across various healthcare organisations remain basic, offering limited, if any, growth opportunities and professional development. Between losing these nurses who prefer locum and gig work altogether and restructuring the support available for temporary nurses, there is strong incentive to close the gaps in existing Nursing development pathways.
Perhaps, the solution lies in establishing a robust and structured career model that supports nurses’ growth—whether they choose to navigate between gigs or transition between permanent and temporary employment to suit their life stages and career aspirations.
