Factors influencing job satisfaction among nurses with permanent and temporary employment

https://doi.org/10.61873/SFJO4531 pISSN 1011-6583 • eISSN 2945-1922 https://rcpp-ie.com REVIEW OF CLINICAL PHARMACOLOGY AND PHARMACOKINETICS, INTERNATIONAL EDITION | 39(3): 119-128 (2025) Received: 09 August 2025 | Revised: 24 September 2025 | Accepted: 30 September 2025 | Published: 22 October 2025 Open Access | RESEARCH REPORT Factors influencing job satisfaction among nurses with permanent and temporary employment Apostolos Kolokythas1, Maria Noula2, Monica Nikitara2, Zoe Roupa2 1Knappschaft Clinics, University Hospital, Bochum, Germany 2Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus *Corresponding author: Apostolos Kolokythas, Knappschaft Clinics, University Hospital, Bochum, Germany. Tel.: +49-1742156164; e-mail: Apostolos.kolokyth[email protected] ABSTRACT Background: Job satisfaction is a fundamental factor affecting nurse well-being, retention, and healthcare system performance. Aim: This study explores the determinants of job satisfaction among nurses, with particular emphasis on the differences between temporary agency nurses and those in permanent positions in North Rhine-Westphalia, Germany. Methodology: A cross-sectional study was conducted to assess job satisfaction among nurses working under both temporary agency and permanent employment contracts. Data were collected from a sample of 195 nurses using the Job Satisfaction Survey (JSS), a standardized instrument designed to measure multiple domains of job satisfaction. The survey included items related to supervision, salary, promotion opportunities, work relationships, and benefits. Statistical analyses were performed to identify and compare job satisfaction levels between the two employment groups. Results: Temporary nurses reported consistently higher satisfaction than permanent nurses across most domains of the Job Satisfaction Survey. Supervision was the most positively rated factor (97.9% of temporary vs. 72.2% of permanent nurses), while pay (73.0% vs. 11.1%) and benefits (51.8% vs. 9.3%) also showed large disparities. Promotion opportunities were rated lowest by both groups (7.1% vs. 3.7%), and satisfaction with co-worker relationships remained stable across groups (63.1% vs. 63.0%). The most pronounced contrast was observed in overall job satisfaction: 61.7% of temporary nurses reported being satisfied compared with only 5.6% of permanent nurses. Regression analysis confirmed that permanent employment was negatively associated with satisfaction, whereas higher educational attainment predicted higher satisfaction with pay and overall job satisfaction. Conclusion: The findings reveal significant and counterintuitive differences in job satisfaction between temporary and permanent nurses. Contrary to expectations, temporary nurses consistently reported higher satisfaction across most domains of work life. Addressing issues related to compensation, career progression, and job stability is essential to enhance satisfaction and reduce turnover. Healthcare organizations should implement targeted strategies that acknowledge the distinct needs of both employment groups and foster a supportive working environment. KEYWORDS temporary agency nurses, travel nurses, job satisfaction, work environment, nursing workforce Publisher note: PHARMAKON-Press stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Copyright: © 2025 by the authors. Licensee PHARMAKON-Press, Athens, Greece. This is an open access article published under the terms and conditions of the Creative Commons Attribution (CC BY 4.0) license. 1. INTRODUCTION Nurses’ job satisfaction constitutes one of the key How to cite this article: Kolokythas A., Noula M., Nikitara M., Roupa Z.: Factors influencing job satisfaction among nurses with permanent and temporary employment. Rev. Clin. Pharmacol. Pharmacokinet. Int. Ed. 39(3): 119-128 (2025). DOI: 10.61873/SFJO4531 120 REVIEW OF CLINICAL PHARMACOLOGY AND PHARMACOKINETICS, INTERNATIONAL EDITION 2025 indicators of quality in healthcare systems, as it is directly linked to care effectiveness, staff retention, work performance, and the overall well-being of healthcare professionals. The constant evolution of working conditions, the global shortage of nursing staff, and the need for greater flexibility within healthcare organizations have contributed to the increasing prevalence of temporary or flexible forms of employment. Temporary employment contracts refer either to fixed-term work arrangements, through direct agreements with hospitals or via staffing agencies and are associated with specific challenges as well as opportunities for professionals in the field [1]. At the international level, temporary employment has increased significantly in recent years, particularly following periods of economic crisis or heightened pressure on healthcare systems, such as during the COVID-19 pandemic. At the same time, the growing demand for mobility and flexibility in the modern workforce has led many professionals to opt for temporary positions, either as a deliberate career strategy or as a necessary alternative. This shift has a direct impact on their job satisfaction, as the temporary nature of employment affects their sense of stability, belonging, career advancement opportunities, and the quality of interpersonal relationships in the workplace [2,3]. Job satisfaction is a multidimensional concept that encompasses an employee’s perception of their working conditions, relationships with colleagues and management, compensation, opportunities for training and advancement, as well as the overall recognition of their professional role. For nurses in particular, job satisfaction is closely linked to the moral fulfilment derived from caring for others, clinical autonomy, and professional recognition. Temporary employment conditions may either hinder or enhance these dimensions, depending on the nature and quality of the employment relationship [4,5]. Despite the increasing reliance on temporary staffing models, scholarly attention to job satisfaction among temporary agency nurses remains relatively limited compared to studies focusing on full-time or permanently employed nurses. The majority of existing literature tends to generalize findings across various types of employment, thereby obscuring the unique experiences and concerns of temporary agency nurses [6,7]. As healthcare systems continue to expand the use of flexible staffing solutions, it becomes essential to understand how temporary employment affects the well-being and job satisfaction of nurses, as well as which organizational interventions can mitigate potential negative impacts [8]. Several theoretical frameworks are useful for analyzing job satisfaction among temporary nurses. Herzberg’s Two-Factor Theory distinguishes between hygiene factors (e.g., pay, job security, working conditions) and motivators (e.g., recognition, responsibility, advancement) as determinants of job satisfaction. In temporary nursing contexts, the absence of certain hygiene factors, such as employment stability and benefits, may be offset by motivators like assignment variety and flexible scheduling (Herzberg, 1966). Similarly, the Job Demands–Resources (JD-R) model has been applied in nursing research to examine how job demands, such as workload, time pressure, and emotional labor, interact with job resources, including social support, autonomy, and constructive feedback, to influence job satisfaction and the risk of professional burnout [9,10]. 2. METHODOLOGY 2.1. Research design The research adopts a comparative cross-sectional approach, providing a precise delineation of the research problem and methods used to investigate temporary employment as a work model in nursing practice. This method allows for the simultaneous analysis of characteristics, behaviours, and performances of different groups or systems and examines how various variables influence outcomes and their interactions. One of the key advantages of this approach is its ability to observe phenomena within a defined timeframe, facilitating the evaluation of relationships between variables without the influence of time or progression. The methodological choice ensures the accuracy and reliability of findings, reflecting the scientific formulation of the research problem. The study was conducted in Germany, specifically within the federal state of North RhineWestphalia, with data collection occurring between July 2023 and February 2024. A pilot study was conducted during the initial three months to refine the methodology and identify potential issues. The selection of this region provides a focused understanding of temporary employment in nursing, enabling a comparison of the specific conditions and practices in the area. The study's timeframe ensured the collection of a sufficient volume of data to support comprehensive analysis. 2.2. Data collection process The data collection process commenced after approval was granted by the Boards of Directors of the collaborating temporary staffing agencies. Dur- FACTORS INFLUENCING JOB SATISFACTION AMONG NURSES WITH PERMANENT AND TEMPORARY… 121 ing on-site visits to the affiliated healthcare facilities, the researcher personally distributed sealed envelopes containing the questionnaire, an informed consent form, and an information sheet detailing the study’s objectives and guarantees of anonymity and confidentiality. Participants completed the questionnaires autonomously and anonymously, returning the sealed envelopes to a locked collection box placed within the hospitals. A total of 195 questionnaires were distributed and all were returned, resulting in a 100% response rate. The average completion time did not exceed 10 minutes. The procedure was designed to ensure data integrity, confidentiality, and compliance with ethical research standards. 2.3. Research tool This study was conducted using a structured questionnaire specifically designed to provide an indepth analysis of temporary staffing as a work model in nursing practice. The questionnaire was accompanied by a letter that included: (i) a brief introduction presenting the title of the study, (ii) the researcher's contact details and relevant information for completing the questionnaire, (iii) information regarding the participant consent process, (iv) details about the confidentiality of personal data, emphasizing that the questionnaires were anonymous, responses would be used exclusively for academic purposes, and no individual data would be disclosed to any organization or individual outside of the study's results, ensuring complete data security, (v) information about the participant's rights and how they would be informed throughout the study, and (vi) clarification of the voluntary nature of participation. 2.4. Study population The study involved a sample of 195 nurses who were employed under fixed-term temporary staffing contracts or had transitioned back to permanent employment. These nurses worked in various healthcare facilities, providing a diverse and representative sample within the nursing sector. Participants were selected based on their employment status, specifically focusing on those with temporary or permanent contracts. This categorization allowed for a comparative analysis of the effects of temporary staffing versus permanent employment on various work-related outcomes. By examining both groups, the study aimed to provide a nuanced understanding of the differences in experiences and practices between temporary and permanent nursing staff. The choice of this sample enhances the specialization and reliability of the study, offering critical insights into the impact of temporary staffing on nursing practice, job satisfaction, and the quality of care provided, within the context of different contractual work arrangements. 2.5. Instrument of the survey The primary instrument utilized in this study was designed to systematically assess job satisfaction among nurses. The questionnaire incorporated the Job Satisfaction Survey (JSS), a well-established and validated tool specifically developed for measuring multiple dimensions of job satisfaction within healthcare settings. The JSS evaluates a broad range of factors, including working conditions, compensation, supervision, professional relationships, opportunities for advancement, and recognition. By employing the JSS, the study enabled a detailed and reliable assessment of the key aspects that influence nurses’ satisfaction with their work environment. The questionnaire also collected essential socio-demographic data such as age, gender, level of education, years of professional experience, and type of employment contract, to allow for subgroup analyses and to explore associations between these variables and job satisfaction outcomes. The use of this validated scale ensured the consistency and comparability of the data, providing a robust methodological framework for analyzing the differences in job satisfaction between nurses with permanent and temporary employment contracts. 2.6. Statistical analysis Quantitative variables were reported as means with standard deviations (SD) and medians with interquartile ranges (IQR), whereas categorical variables were presented as absolute and relative frequencies. The comparison of proportions was performed using chi-square tests and Fisher’s exact tests. For the comparison of continuous variables between two groups, Student’s t-tests and MannWhitney U tests were employed, depending on the data distribution. Multiple linear regression analyses were conducted, with the Job Satisfaction Scale (JSS) subscales as the dependent variables. A stepwise selection method was applied with an entry criterion of p=0.05 and a removal criterion of p=0.10. Adjusted regression coefficients (β) and their associated standard errors (SE) were computed from the regression models. Logarithmic transformations were utilized where appropriate for the multiple linear regression analyses. All reported p-values are two-tailed, with statistical significance set at p<0.05. Statistical 122 REVIEW OF CLINICAL PHARMACOLOGY AND PHARMACOKINETICS, INTERNATIONAL EDITION 2025 analyses were performed using SPSS software (version 26.0). 3. RESULTS A total of 195 nurses participated in the study, of whom 54 (27.7%) were employed on permanent contracts and 141 (72.3%) worked under temporary staffing arrangements. The demographic and professional characteristics of the participants are presented in Table 1. Statistically significant differences were identified between permanent and temporary nurses in terms of age, educational background, and professional experience. Older nurses were more likely to have transitioned to permanent contracts, with more than half of those over 51 years of age employed permanently (p<0.01), whereas younger age groups were overwhelmingly represented among temporary staff. Educational attainment was another influential factor: 81.3% of academic degree holders were permanently employed compared with only 18.8% of those without higher qualifications (p<0.001). Similarly, nurses with more than 20 years of experience were significantly more likely to hold permanent positions (p<0.001). By contrast, gender distribution (p=0.612), marital status (p=0.744), and parental status (p=0.695) did not differ significantly between groups. Notably, working in rotating shifts appeared to act as a barrier to permanent employment. Only 24.9% of shift workers were permanently employed, compared to 75.1% in temporary roles (p=0.003). Table 1. Sample’s characteristics by group Εmployment type P Permanent staff (Ν=54; 27.7%) Temporary staff (Ν=141; 72.3%) Ν % Ν % Age (years) 21 – 30 5 21.7 18 78.3 0.023+ 31 – 40 16 23.5 52 76.5 41 – 50 17 23.6 55 76.4 Over 51 16 50.0 16 50.0 Sex Female 34 29.3 82 70.7 0.626+ Male 20 25.3 59 74.7 Married No 19 21.1 71 78.9 0.057+ Yes 35 33.3 70 66.7 Children No 25 26.0 71 74.0 0.612+ Yes 29 29.3 70 70.7 Education Secondary school education 8 13.1 53 86.9 <0.001+ High school 33 28.0 85 72.0 Academic degree 13 81.3 3 18.8 Professional skills Graduate nurse 26 35.6 47 64.4 0.056+ Specialized graduate nurse 28 23.0 94 77.0 Years of work Up to 10 13 18.1 59 81.9 0.045+ 11-20 25 36.8 43 63.2 Over 20 16 29.1 39 70.9 Working in shifts No 9 64.3 5 35.7 0.003++ Yes 45 24.9 136 75.1 +Pearson’s chi-square test ++Fisher’s exact test FACTORS INFLUENCING JOB SATISFACTION AMONG NURSES WITH PERMANENT AND TEMPORARY… 123 Health-related quality of life, assessed through the SF-12, revealed no significant differences between the two groups (Table 2). Permanent nurses reported a mean physical health score of 52.0, while temporary nurses averaged 53.1 (p=0.220). Mental health scores were likewise comparable, averaging 42.7 for permanent and 43.8 for temporary nurses (p=0.336). These findings suggest that observed differences in job satisfaction cannot be attributed to disparities in physical or mental health. Clear differences were identified in job satisfaction outcomes (Table 2). Temporary nurses reported significantly higher mean scores across most domains of the Job Satisfaction Survey (JSS), including pay (p<0.001), supervision (p<0.001), benefits (p<0.001), contingent rewards (p=0.022), operating conditions (p<0.001), nature of work (p<0.001), communication (p<0.001), and overall job satisfaction (p<0.001). Mean satisfaction with pay was 16.9 (SD=2.3) among temporary nurses compared with 12.4 (SD=2.7) among permanent staff, while supervision averaged 20.1 (SD=2.2) versus 17.9 (SD=2.8), respectively. Benefits were also more positively evaluated by temporary nurses (15.6, SD=2.8) compared with permanent nurses (12.3, SD=2.3). By contrast, promotion opportunities showed no significant differences (p=0.425), and satisfaction with co-worker relationships was nearly identical between groups (p=0.960). Table 2. Descriptive statistics of SF-12 and job satisfaction scale, by group. Εmployment type P Permanent staff Timeshare staff Mean (SD) Median (IQR) Mean (SD) Median (IQR) Physical health 52 (6.2) 53 (49.3 – 56.8) 53.1 (5.1) 53.1 (49.6 – 56.8) 0.220+ Mental health 42.7 (6.2) 42.4 (38.9 – 47.1) 43.8 (7) 43.5 (39.8 – 48.4) 0.336+ Pay 12.4 (2.7) 12.5 (10 - 15) 16.9 (2.3) 17 (15 - 18) <0.001++ Promotion 11.5 (2.4) 11.5 (10 - 13) 11.3 (2.6) 11 (10 - 13) 0.425++ Supervision 17.9 (2.8) 18 (15 - 20) 20.1 (2.2) 20 (18 - 22) <0.001++ Benefits 12.3 (2.3) 12 (11 - 14) 15.6 (2.8) 16 (13 - 18) <0.001++ Contingent rewards 12.6 (2.6) 12 (11 - 14) 14.6 (3) 15 (13 - 17) <0.001++ Operating conditions 12.3 (2.7) 12 (11 - 14) 14.8 (2.9) 15 (13 - 17) <0.001++ Coworkers 16.4 (2.3) 16 (15 - 18) 16.4 (2.2) 16 (15 - 18) 0.960++ Nature of work 15.7 (2.8) 15.5 (14 - 18) 18.2 (3.9) 19 (16 - 21) <0.001++ Communication 15.6 (1.8) 15 (15 - 17) 17 (2.4) 17 (16 - 18) <0.001++ Total Job Satisfaction 128.9 (8.5) 129 (122 - 135) 146.9 (9.3) 147 (141 - 153) <0.001++ +Student’s t-test ++Mann-Whitney test The multiple linear regression analysis further clarified these associations (Table 3). Employment type emerged as the strongest predictor, with permanent employment significantly and negatively associated with satisfaction across multiple domains, including pay (p<0.001), supervision (p<0.001), benefits (p<0.001), contingent rewards (p<0.001), operating conditions (p<0.001), nature of work (p<0.001), communication (p<0.001), and overall job satisfaction (p<0.001). Educational attainment exerted a positive influence, as nurses with specialized graduate qualifications reported higher satisfaction with pay (p=0.002) and overall job satisfaction (p=0.029). Shift work was significantly associated with lower satisfaction in promotion opportunities (p=0.029). Professional experience had a more nuanced effect: nurses with more than 20 years of experience reported slightly higher satisfaction with co-worker relationships (p=0.030), while those with 11–20 years did not differ significantly from nurses with fewer than 10 years of experience (p=0.808). These associations remained robust in the multivariate regression model, underscoring employment type as the most consistent predictor of job satisfaction. 124 REVIEW OF CLINICAL PHARMACOLOGY AND PHARMACOKINETICS, INTERNATIONAL EDITION 2025 Table 3. Multiple linear regression results, for job satisfaction scales, in a stepwise method. Dependent variables Independent variables β+ SE++ P Pay Employment type (Permanent vs Timeshare staff) -0.135 0.012 <0.001 Professional skills (Specialized graduate nurse vs Graduate nurse) 0.033 0.011 0.002 Promotion Working in shifts (Yes vs No) -0.029 0.013 0.029 Supervision Employment type (Permanent vs Timeshare staff) -0.051 0.009 <0.001 Benefits Employment type (Permanent vs Timeshare staff) -0.103 0.013 <0.001 Contingent rewards Employment type (Permanent vs Timeshare staff) -0.061 0.015 <0.001 Operating conditions Employment type (Permanent vs Timeshare staff) -0.083 0.015 <0.001 Coworkers Years of work 11-20 vs Up to 10 -0.002 0.010 0.808 Over 20 vs Up to 10 0.023 0.011 0.030 Nature of work Employment type (Permanent vs Timeshare staff) -0.060 0.015 <0.001 Communication Employment type (Permanent vs Timeshare staff) -0.037 0.010 <0.001 Total JSS Employment type (Permanent vs Timeshare staff) -0.055 0.004 <0.001 Professional skill (Specialized graduate nurse vs Graduate nurse) 0.009 0.004 0.029 Note. Logarithmic transformations were used for the analysis +regression coefficient ++Standard Error Figure 1. Percentages of satisfaction in each scale and overall. The clearest evidence of group differences was observed in the total JSS scores, as presented in Figure 1. Temporary nurses reported overall satisfaction levels of 61.7%, whereas only 5.6% of permanent nurses expressed satisfaction (total sample 46.2%). This nearly twelve-fold difference underscores the substantial gap between the two groups. Figure 1 also provides a domain-specific overview of satisfaction levels. Supervision received the highest ratings, with 97.9% of tempo- FACTORS INFLUENCING JOB SATISFACTION AMONG NURSES WITH PERMANENT AND TEMPORARY… 125 rary nurses and 72.2% of permanent nurses reporting satisfaction (total sample 90.8%). High satisfaction was also observed for nature of work (76.6% of temporary vs. 50.0% of permanent nurses; total 69.2%) and communication (78.0% vs. 42.6%; total 68.2%), all of which showed statistically significant differences (p<0.05). By contrast, promotion opportunities were consistently rated lowest, with only 3.7% of permanent nurses and 7.1% of temporary nurses reporting satisfaction (total 6.2%), and no significant group difference (p=0.425). Co-worker relationships also showed no variation, with nearly identical levels of satisfaction in both groups (63.1% vs. 63.0%). Marked disparities were evident in other domains. Satisfaction with pay was reported by 73.0% of temporary nurses compared with 11.1% of permanent staff (total 55.9%), while benefits were endorsed by 51.8% versus 9.3% (total 40.0%). Temporary staff also expressed greater satisfaction with contingent rewards (34.9% vs. 22.2%) and operating conditions (39.7% vs. 11.1%). These findings suggest that, despite the expectation that permanent employment might improve job satisfaction, nurses who transitioned to permanent positions reported generally lower levels of satisfaction across a range of work-related factors. The complexity of factors influencing job satisfaction highlights the importance of considering both the positive and negative aspects of employment status, shift patterns, and experience levels when designing strategies to improve nurse well-being and retention. 4. DISCUSSION This study examined factors influencing job satisfaction among nurses employed under temporary and permanent contracts in North Rhine-Westphalia, Germany. The findings challenge conventional assumptions, showing that temporary agency nurses reported higher satisfaction across multiple domains compared to permanent staff. Similar results have been observed internationally, where temporary and agency nurses valued flexibility, autonomy, variety of tasks, and immediate rewards despite the inherent insecurity of such positions [11,12,13,14]. A particularly counterintuitive finding was that permanent nurses reported lower overall satisfaction. This aligns with Herzberg’s Two-Factor Theory, which distinguishes between hygiene factors and motivators, and suggests that permanent contracts may provide stability but limit autonomy and recognition. Other research has also indicated that permanent nurses tend to express lower satisfaction regarding salary and working conditions than their temporary counterparts [15,16]. Within the framework of the Job Demands-Resources model, permanent employment may involve higher administrative demands without proportional increases in resources, while temporary contracts allow for greater flexibility and more favorable short-term rewards [17,18]. Supervision and support were found to be important determinants of satisfaction, particularly among temporary nurses. Studies have emphasized that effective leadership and supportive management are critical for agency nurses, who often need to integrate rapidly into new teams [12]. Similarly, research in Scandinavian and Central European contexts highlights the dual processes of integration and exclusion that agency nurses experience when working in unfamiliar environments [19]. These dynamics confirm the present finding that supervision and collegial support strongly affect satisfaction for temporary staff. Career advancement opportunities were identified as very limited in both groups, reflecting a structural weakness of the nursing profession. Previous work in psychiatric and surgical settings has also shown that unclear promotion pathways reduce motivation and commitment among both permanent and temporary nurses [20,21]. German studies confirm that limited career progression represents a systemic barrier to job satisfaction, particularly in the nursing sector [17]. Such stagnation contributes to frustration and increased turnover intentions, underscoring the need for structured career ladders and advanced practice roles [13,22]. Education and specialization emerged as key predictors of job satisfaction. This study found that nurses with advanced qualifications reported greater overall satisfaction, consistent with evidence that workplace learning opportunities and advanced training improve motivation and reward perceptions [23,24]. At the same time, the low prevalence of specialist roles across both groups corresponds with reduced quality of care and greater risk of adverse patient outcomes, as has also been emphasized in international literature [25]. The influence of professional experience was complex. More experienced nurses reported stronger teamwork and social cohesion, confirming the positive role of long-term engagement. However, other studies have shown that midcareer nurses may encounter stagnation or disillusionment, and the presence of temporary staff can also affect permanent nurses’ commitment when tasks are distributed unequally or perceived as illegitimate [15,19,26]. This suggests that collegial relationships are shaped not only by individual ex- 126 REVIEW OF CLINICAL PHARMACOLOGY AND PHARMACOKINETICS, INTERNATIONAL EDITION 2025 perience but also by organizational culture and workforce composition. Although temporary nurses reported higher satisfaction in several areas, previous studies have indicated that they may also experience greater levels of work-related stress due to employment precariousness. Such precariousness has repeatedly been linked to increased burnout and psychological strain [17,18,27]. In the present study, no significant differences were observed in overall physical and mental health scores between permanent and temporary nurses, suggesting that the higher satisfaction of temporary staff cannot be explained by better health status. Instead, organizational and psychosocial factors are more likely to account for the variations observed. Similar evidence from pandemic-related studies also highlighted how job insecurity and increased workload heightened stress among nurses [27]. Remuneration and benefits revealed substantial disparities. Temporary nurses expressed higher satisfaction with pay and additional rewards, which reflects the premium rates often offered to cover urgent staffing shortages [16,28]. Permanent staff, by contrast, reported dissatisfaction with static salary structures and limited incentives, a result consistent with previous findings across Europe [29]. Temporary nurses also evaluated benefits more positively, though both groups were dissatisfied with promotion prospects, confirming that financial incentives alone cannot compensate for a lack of professional advancement opportunities [16,20,21]. Motivation and turnover intentions further illustrated the dual nature of temporary work. While temporary employment can sustain intrinsic motivation by offering diversity of experiences [14,30], it is also associated with elevated turnover intentions. Studies on temporary agency nurses have found similar patterns, with high satisfaction in certain domains but a greater likelihood of leaving the profession or seeking new assignments [31,32]. During the COVID-19 pandemic, temporary and travel nurses reported both heightened stress and increased motivation, reflecting the complexity of their experiences [25]. Overall, the findings of this study confirm that job satisfaction in nursing is shaped by a combination of structural and individual factors. Employment type emerged as the most powerful predictor, but education, shift work, and experience also played meaningful roles. The results align with previous international evidence, demonstrating that permanent contracts do not guarantee higher satisfaction, while temporary employment, despite its insecurity, can enhance autonomy, flexibility, and perceptions of reward [14,16,17,23,30,32]. This study is not without limitations. Its crosssectional design precludes causal inference, and the reliance on self-reported data may introduce bias. The distribution of questionnaires through staffing agencies may also have influenced the sample composition. Nonetheless, the anonymous procedure and 100% response rate substantially reduced the risk of non-response bias, as reported in similar surveys [33,34]. Future research should adopt longitudinal designs to investigate causal mechanisms and the impact of transitions between employment types. Qualitative studies could provide deeper insights into the lived experiences of nurses working under temporary and permanent contracts and explain the paradoxical results observed in this and other studies. 5. CONCLUSION This study demonstrated that employment type is a key determinant of job satisfaction among nurses. Contrary to common assumptions, temporary agency nurses reported higher satisfaction than permanent staff across most domains, including pay, supervision, benefits, and overall job satisfaction. Only promotion opportunities and coworker relationships showed no differences, both remaining universally low. These findings suggest that while permanent employment provides security, it may also be associated with rigidity and reduced autonomy, limiting satisfaction. Temporary nurses, though more satisfied, continue to face insecurity and restricted career development. Addressing stagnation among permanent staff and improving inclusion and advancement opportunities for temporary nurses are essential steps toward enhancing retention, motivation, and the quality of patient care. ACKNOWLEDGMENTS The author gratefully acknowledges the support and guidance of colleagues and mentors, as well as the access to scientific resources that made this review possible. CONFLICT OF INTEREST STATEMENT The authors declare no conflicts of interest. REFERENCES 1. Griffiths P., Saville C., Ball J. E., Jones J., Monks T., Safer Nursing Care Tool study team: Beyond ratiosflexible and resilient nurse staffing options to deliver costeffective hospital care and address staff shortages: a simulation and economic modelling study. Int J of Nurs Stud. 117: 103901 (2021). 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