Utilization of supplemental agency nurses in an Army medical center.

The purpose of this study was to describe the perceived impact of supplemental agency nurses upon the quality of patient care, unit cohesiveness, and morale of permanently assigned personnel at an Army medical center. The study population consisted of 28 agency nurses and 138 permanently assigned nursing staff. The study was descriptive and exploratory in nature, utilizing the method of content analysis. Major themes that emerged from data analysis included economic, professional nursing, and patient care issues. Perceptions were that agency nurses provided the institution with necessary labor, but that the agency nurses had greater flexibility of hours and control over their practice. Permanently assigned nursing staff reported that the use of agency services hindered continuity of patient care, at times reduced the quality of care, negatively affected morale among personnel, and impacted adversely upon the time available for mission-related training.