AIM: To identify and describe evidence from original studies on the contextual factors, dimensions, and outcomes of decent and precarious work among nursing and care workers.

DESIGN: This is a mixed-methods systematic review.

DATA SOURCES: The Scopus, Web of Science, PubMed, CINAHL, PsycINFO and SocINDEX databases were searched on January 11, 2024.

METHODS: Two reviewers independently applied eligibility criteria, selected studies, and conducted quality appraisals. We employed data-based convergent synthesis as the data synthesis method. The dimensions of decent and precarious work were analysed deductively using the Employment Quality Framework.

RESULTS: Five studies on decent work and 13 studies on precarious work were included. Five contextual factors were common, though opposite, in both decent and precarious work studies: employment contract, position, financial situation, age, and work experience. Three outcomes were also common. Decent work increased, and precarious work decreased, physical and mental health and empowerment, whereas turnover was decreased by decent work and increased by precarious work.

CONCLUSIONS: Challenges can be converted into positive outcomes for the future, moving towards meaningful work, fair jobs, sustainable employment policies, and attractive career prospects. To achieve this, more knowledge is needed about employment quality in nursing and care work.

IMPLICATIONS FOR THE PROFESSION: Young nurses and care workers should be provided opportunities to fully engage in their work and organisations. Training is also crucial for managers, as it decreases authoritarian and controlling management practices.

IMPACT: This review is the first to synthesise research evidence on decent and precarious work in nursing and care work, confirming that they are opposite concepts of employment quality. The results benefit nurses and care workers, organisations, and decision-makers.

REPORTING METHOD: The study was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist.

PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.