Chia Yu Lien

Nursing homes in the United States have long struggled with nursing shortages, which the COVID-19 crisis has exacerbated. In response, nursing homes have increasingly used temporary services to fill vacancies. Existing studies have examined care provided by temporary nurses from traditional staffing agencies, yet no study has examined care provided by their counterparts from digital gig platforms. This dissertation pioneers empirical research on the use of gig nurses in U.S. nursing homes. I pursue five interrelated objectives in two nursing homes: (1) to describe the historical, legal, and economic contexts gig nursing has been created and sustained; (2) to examine the pattern of the supply and demand of gig care work in nursing homes; (3) to understand if, how, why, and when nurses engage in gig work; (4) to determine how gig work is perceived by gig nurses and other nursing home personnel; and (5) to investigate the extent to which gig work affects the work environment and everyday care. Through historical study, ethnographic research, and gig work mapping, this dissertation investigates how the reorganization of nursing labor via digital platforms shapes nursing home care.