Image of Kristin E. Smith, Ph.D., MPH
Kristin E. Smith, Ph.D., MPH

Secondary employment among nurses and direct care workers not only reveals inequities in the job market; it also has direct health implications for nursing home residents, according to a new investigation.

Due to low wages and limited hours, about 6% of personal care aides, nursing aides, licensed practical nurses and licensed nurses hold second jobs, reported Kristin E. Smith, Ph.D., MPH, of Dartmouth College and colleagues. 

Many of these workers move across health settings from their first to second jobs, and 15% of second jobs for personal care and nursing aides are in other essential occupations, the study team reported.

“The COVID-19 pandemic is shining the spotlight on inequalities throughout our society, particularly in healthcare systems, where we are now seeing real-life implications for loved ones in nursing homes, who are such a vulnerable population,” Smith said. 

Federal and state-level initiatives could help correct the problem by raising wages through bonuses that are higher than unemployment benefits, Smith and colleagues said. This could decrease the need for second jobs among essential care workers while also reducing COVID-19 exposure and transmission, they concluded.

Data came from the 2010 to 2019 Current Population Survey. Other findings demonstrated that:

  • Nurses with children and Black nurses were more likely to hold second jobs than white nurses.
  • Female and married nurses were less likely to have a second job.
  • Nurses had higher wages than direct care workers and worked 30% more hours.
  • White direct care workers were more likely to have second jobs than Asian, American Indian and Alaskan Native workers.
  • Black direct care workers were less likely to have a second job when work hours were excluded from the analysis.
  • Hispanic workers were less likely to have a second job than their non-Hispanic counterparts.
  • Direct care workers with more education were more likely to have a second job.
  • Low wages and limited hours were linked to holding a second job for direct care workers.
  • Lower hours were most strongly correlated with second-job holding among nurses.

The study was published in the journal Medical Care Research and Review.