The Rise of a Gig or Contract Nursing Workforce

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

In their 2023 book Culture Shock, Gallup researchers identified a significant threat to employers in the future: a workforce that will increasingly want gig or contract work. Nurse leaders began talking with me about this trend a few years ago. New graduates were entering practice, finishing residency programs, asking to convert to part-time, seeking travel assignments, or working per diem. The trend has continued with broad implications for continuity of care, teamwork, and skyrocketing onboarding costs.

I am often asked whether this is just a life stage for Generation Z nurses or a permanent change in how nurses view their work and careers. While we can’t be sure this trend will continue, most workforce experts believe it will. From the work of Jean Twenge and others, we know that younger staff today are more entrepreneurial, less loyal to organizations, and want flexibility in their work. The current government workforce job cuts and corporate downsizing are likely to fuel the beliefs of Generation Z that they need to take personal responsibility for their careers.

New data from Hallmark-Pulse-Survey-Results-2025 indicates that most health system leaders now see this trend and are beginning to design employment strategies (albeit challenging) to respond to it. Consider the following from their survey of 1200 leaders looking at emerging workforce trends:

97% planned to increase the use of flexible work options (float pool, gig style, per diem, contract) in the next year, with almost 50% planning a 30% increase.
92% have an internal resource pool or float pool.
A growing percentage have 50% or fewer full-time staff.
67% indicated burnout was the top challenge they face in 24/7 staffing.
89% are under pressure to reduce staffing costs.
94% use a platform to manage their gig or flexible staffing.
50% indicate that implementing flexible staffing is either difficult or extremely difficult.
The number of unfilled shifts due to lack of available staff ranges from 10+% to 25+%.
95% worry about staffing shortages and the impact of mandated ratios on the care of patients.
95% understand that providing nurses with more work-life balance would improve the quality of care.
98% see the relationship between nurse engagement and patient satisfaction.
Leaders believe more than 50% of their workforce would prefer gig or flexible work.
98% see increased requests over the past two years from nurses for gig or flexible work arrangements.
78% believe that gig or flexible work arrangements are very important or extremely important to improving nurse engagement, and 96% see them as a key workforce strategy moving into the future.

Nurses are clearly communicating their preferred work arrangements, and employers are listening. Many leaders are having challenges embracing this trend because it impacts teamwork and patient care continuity. Units and departments will struggle to maintain core teams, and most will move into a teaming environment. The manager’s role becomes even more important as they provide critical ballast for the team. Whether you agree or disagree with the changes in how nurses now view their careers, to future-proof your leadership, you will need to learn to accept it.

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