Gauteng public hospitals are spending millions on part-time nurses, because they can't attract permanent staff.
About a third of all nurses working in Gauteng's hospitals are agency nurses doing shift work and the city's main hospitals - Chris Hani-Baragwanath, Helen Joseph and Johannesburg - spend more than R10-million a year between them on moonlighting nurses.
Currently, 32 percent of health professional posts, which includes doctors and nurses, in the province are vacant. As a result, hospital managers are forced to employ agency staff to boost their staff complements to deal with the increasing patient loads. But these agency nurses cost more than permanent staff.
A nurse permanently employed in the public sector earns about R8 500 before tax a month. A moonlighting professional nurse working one 12-hour shift at the maximum rate of R117 an hour earns R1 404. If she worked eight shifts a month, she would earn more than R11 000.
A nurse, who did not want to be named, said she had a permanent job at Chris Hani-Baragwanath Hospital and did agency work at the same hospital.
"I know the procedure and policies of the unit and therefore can do my job to the best of my ability," she said.
Another nurse who also wanted to remain anonymous said she did moonlighting work in the public sector when she was on leave.
"I have a permanent job at Dobsonville Clinic but when I take my annual leave of four weeks, I use two of the weeks to moonlight at Yusuf Dadoo Hospital. I do the same work that I do at the clinic, so it is not that challenging, but it is tiring.
But it is not only Gauteng nurses who are moonlighting in the province's hospitals.
According to a manager of a nursing agency, who did not want to be named, moonlighting in Gauteng was so lucrative it attracted nurses from KwaZulu-Natal, Limpopo and the Eastern Cape.
Dr Khairul Mustafa, senior clinical executive of Chris Hani-Baragwanath Hospital, which spends about R7-million on moonlighting staff, said agency staff were called in for all areas.
Spokesperson for Helen Joseph Hospital, Zukisa Pumane, said using agency staff was a "quick, short-term solution which did not address the problem but alleviated it".
Leslie Magee, manager and owner of Nursing Emergencies said that with the current shortage of staff there was a definite need for agency workers.
But it is not only the public health sector which is relying on agency nurses to provide care.
According to Francois Jordaan, chairperson of the Association of Nursing Agencies of South Africa, private hospitals were also having to use agency staff to bolster their staff complements.
In Gauteng, about 1 000 nurses leave hospitals annually in pursuit of huge financial rewards elsewhere.
Mary-Grace Msimango, director of human resources for the Gauteng Department of Health said while agency workers were performing a critical function, in speciality areas, the shortage of health professionals needed to be addressed.