Gigification of Nursing Services in the United States, the United Kingdom, and Canada: Legal, Ethical, and Policy Implications

ObjectiveTo examine the legal, ethical, and policy issues associated with gig work in nursing across the United States, the United Kingdom, and Canada.MethodsNarrative review and cross-country comparative analysis.ResultsSixteen studies were included. While the term "gig work" is not generally applied to nursing in both the United Kingdom and Canada, the availability of flexible, temporary, short-term work is common, manifesting primarily through either bank nursing or agency nursing mediated by various digital platforms. The phenomenon of internal banking was observed across all three countries. Despite the increasing trend of gig work, legal ambiguities exist regarding the classification of nurses as employees or independent contractors which has significant ramifications for liability and accountability. With the short-term nature of gig work, patient safety concerns also exist, particularly for nurses navigating new healthcare contexts. Compounding these challenges, many gig platforms lack standardized mechanisms to verify nurses' credentials or enforce compliance with scope-of-practice regulations. Ethically, this regulatory vacuum perpetuates systemic inequities, as gig nurses may face substandard wages, exclusion from benefits, and exploitative contractual terms.ConclusionWhile gig work offers nurses unprecedented autonomy and flexibility, its unchecked growth risks normalizing precarious labor conditions, eroding workplace protections, and raising patient safety concerns. To sustainably integrate the gig model, legislators must close classification loopholes. Healthcare institutions should implement registries for vetted gig workers and enforce standardized onboarding protocols to maintain care quality. Simultaneously, gig platforms require regulatory oversight to mandate real-time credential verification, wage guarantees, and scope-of-practice safeguards.