Psychological and organisational experiences influencing perceived job performance among agency nurses in South Africa

Agency nurses are an integral part of South Africa's private-hospital workforce, yet the psychological conditions of their work remain insufficiently understood. High demands, limited control, and inadequate workplace support may undermine their sense of belonging, morale, and perceived capacity to fulfill professional responsibilities. This study explored the organisational, interpersonal, and psychological factors that agency nurses perceived to influence their job performance in private hospitals in Gauteng, South Africa. This exploratory qualitative study was guided by the Job Demand-Control-Support (JDCS) model. Ten purposively selected agency nurses participated in approximately 50-minute face-to-face semi-structured interviews. The sample included three enrolled nurses, four registered nurses without specialist qualifications, and three registered nurses with critical-care qualifications. Interviews were audio-recorded, transcribed verbatim, and analysed thematically in QDA Miner using Braun and Clarke's six-phase approach. Participant feedback, peer debriefing, and an audit trail strengthened trustworthiness. Agency nurses described organisational exclusion, limited recognition, language-based exclusion, and perceived cultural or tribal discrimination. They also reported inequitable workloads and patient allocation, restricted access to assistance and resources, and exclusion from information and decision-making. Participants linked these conditions to diminished belonging, perceived organisational support, autonomy, and morale, and to greater difficulty in fulfilling their professional responsibilities. The findings suggest that agency status shapes nurses' psychological experience of work through the interaction of job demands, control, and social support. They offer a South African account of how organisational exclusion and perceived unfair treatment may intersect with agency employment, language, and workplace belonging. The practical implications concern psychological safety, inclusive communication, equitable workload allocation, and impartial support structures. The small purposive sample was drawn from private healthcare settings in a single province, which limits transferability. The study also relied on self-reported experiences. Findings should therefore be interpreted as participants' perceptions rather than objective measures of job performance and should not be considered causal estimates.