A Result of Human Motivation - Dissertation Example

Performance A Result of Human Motivation Human being’s behaviour is driven by his needs, desires, goals and ambitions. His behaviour has a certain motive behind it (McKenna, 2001, p.89). Motive can be defined as the inner state of mind that directs a person to take certain action with the intention of attaining certain goal (McKenna, 2001, p.89). It can be said that if a person is not motivated to achieve something then he doesn’t perform to the best of his abilities even if he has the skills and the expertise to achieve that certain thing. At the same time, it is important to know that motivation is affected not only by internal feelings but also by the external factors. The ‘morale’ of a person plays a major role in maintenance of motivation. The feeling of zeal and the enthusiasm with which a person works is called ‘morale’ (Swansburg, 1995, p.10). Hence, if a person is dissatisfied with his job and is unhappy with the way he is treated at work, then his enthusiasm and energy to do his work wanes to a great degree (Swansburg, 1995, p.10). People who lose the enthusiasm and energy to perform at work are said to have ‘poor morale’. Poor morale is a result of poor working conditions and inability of the management to generate a relation of trust in their employees. Hence, the statement that the staff morale and motivation can affect the quality of patient care is true in every sense because if the morale of the nursing staff is not high, then their motivation to perform to the best of their ability is lost. The lack of motivation affects their performance at work and hence, also affects the quality of patient care. Factors Affecting Performance People working in health services come in contact with people suffering from physical and mental problems every day. Their job is to take care of these people and see to it that they recover soon. Caring for patients gives great satisfaction to the nurses. The nurses have described immense satisfaction in giving a quality care to the patients (Wray et al, 2007, p.39). In fact, it can be said that the only thing that the nurses enjoy in their job is the communication and interactions with the patients they come in contact with (Wray et al, 2007, p.39). The opportunity to see people get well, come out of their depression and getting healed from their sickness gives the staff a feeling of complete satisfaction (Wray et al, 2007, p.39). However, it has been found that even those nurses who love their profession and have no problem with their schedules are forced to think of leaving their jobs (Joshua-Amadi, 2003, p.14). The reason is the lack of supportive external factors. It is important to understand that no matter how much a person loves his job, if he thinks that the job is not paying him fairly and is not recognizing his contribution then he is most likely to leave the job. This is what is happening with the people working in health services. The lack of support from the employers and uncaring attitude by seniors is making the health service staff to lose their drive and energy. Research by Wray et al has revealed that it is not the internal motivation but the external conditions that are affecting the quality service of the patient care (2007, p.35). Low Salaries People working in health services are going through a tough time these days. In today’s world, financial condition of a person plays a major part in deciding the social status of a person. People working in health services are finding it difficult to accept the fact that despite of working harder and for longer hours than people working in other fields, their salaries are lower compared to them. The dissatisfaction with the salary slowly starts affecting their work and they begin to think of alternatives. In short, they lose motivation for the work. People have a tendency to weigh their social position on the basis of their payment. Payment is one of the most important factors in motivating people to perform to the best of their abilities. Hence, payment according to their competence and performance will encourage the nurses to give their best in their job (Joshua-Amadi, 2003, p.17). The feeling that they get less payment compared to the ambulance staff and the police officers in spite of putting in equal amount of work makes them feel that they are being treated unequally (Joshua-Amadi, 2003, p.17). This lowers their morale and affects their performance. To avoid the dissatisfaction related to payment, the bonus schemes and the incentive schemes should be introduced on a large scale (Joshua-Amadi, 2003, p.18). Appreciation through incentives or rewards not only gives the staff recognition at work but also makes them feel proud in front of their family and friends. In this way it helps to increase their self-esteem and confidence level, which in turn makes them hungry for more. Overload Of Work The stress at work affects the way the nurses carry out their duties. Nurses are expected to do the paperwork along with doing their usual duty of caring for the patients. This adds a lot of pressure to their already heavy work load. According to some nurses, the paper work takes so much of their time that their original job, which is to take care of the patients, remains aside as they have to focus on doing the administrative work (Joshua-Amadi, 2003, p.16). This means that they are expected to do the work of two people and still give their 100 percent. These kinds of expectations add to their frustration. It has been observed that along with the low salary, the uncaring attitude of seniors is also increasing their dissatisfaction. The lack of motivation is affecting the interpersonal relationships amongst the nurses (Joshua-Amadi, 2003, p.16). This increases the friction and stress of work. Also, the pressure to please everyone and fulfill everyone’s expectation is making life very difficult for the nurses. Unrealistic Expectations Being a nurse is not an easy thing. The nature of the job demands constant alertness, physical activeness and maintenance of calmness under emergency situation (Joshua-Amadi, 2003, p.17). People expect nurses to be warm, caring and understanding at every moment of their job. If they get irritated or show little intolerance then they are considered rude and are blamed for not doing their duties properly. This pressure of showing caring attitude and maintaining a smiling face even if they are feeling angry, frustrated and dissatisfied inside, takes a toll on the mental and emotional health of the nurses (Joshua-Amadi, 2003, p.17). They feel that they are being neglected, unappreciated and isolated (Joshua-Amadi, 2003, p.17). They get a feeling that no one cares for what they are going through. This feeling of constantly giving and getting nothing in return lowers their morale and enthusiasm towards the job. People in nursing profession feel that no one in the higher position cares about them. Professional life has become a struggle for them (Joshua-Amadi, 2003, p.14). One cannot expect the nurses to show care and warmth towards the patients when the nurses are not getting treated with affection, respect, warmth and care by their seniors. They lose the motivation to put their heart and soul in their duties. Moreover, as nursing is a profession which demands not only physical and mental precision but also emotional involvement and care, it becomes very difficult for nurses to give their 100 percent if what they get in return is cold and disrespectful treatment from their seniors, relatives of patients and colleagues (Joshua-Amadi, 2003, p.14). Only a powerful and a positive leadership style can help to keep the employees happy under stressful working conditions. Unfortunately, the management in health services is not able to understand the needs of the nurses. Lack Of Supportive Leadership One of the main reasons for employee satisfaction is having supportive and understanding people in the managerial and leadership positions (Joshua-Amadi, 2003, p.17). Lack of appreciation, support and empathy from the managers often lead to an emotional and psychological distance between the nurses and their managers. The authoritative style of leadership causes more harm than good to the nurse-manager relationship (Joshua-Amadi, 2003, p.17). People working as nurses expect their leaders to appreciate their good work, guide them into doing things correctly and mentor the new comers (Joshua-Amadi, 2003, p.17). In short, what they need is a leader who can be a friend and a philosopher and not a leader who likes to get things done by controlling and dominating his staff. NHS and other government organisations are doing their best to take the initiatives to improve the leadership quality so that the staff in the hospital feel cared for and supported, and remain motivated to give their best when taking care of people who are sick (Joshua-Amadi, 2003, p.17). Interviews with nurses who wanted to leave their jobs revealed that the current style of leadership often demotivate and demoralise them (Joshua-Amadi, 2003, p.17). They feel that they are not only expected to give their best every moment but are also expected to remain silent about the pain and frustration they experience in their job. This means that they have to suppress their emotions and at the same time show care and patience while interacting with patients. It has been observed that people who are promoted to the leadership position are not trained in handling a team (Joshua-Amadi, 2003, p.17). According to Alimo-Metcalf (2000), a good leader not only facilitate, appreciate and delegate work but also becomes an inspiration to his team by providing guidance and direction to his team members (Joshua-Amadi, 2003, p.17). This keeps the team motivated and loyal to their job. However, to generate good leaders, it is very important to nurture and develop the leadership skills of nurses who show a potential of being a good leader (Joshua-Amadi, 2003, p.17). This will assure that only capable people are promoted to the leadership position. However, bias and discrimination at workplace is resulting in wrong people being promoted to the leadership positions. Hence, people who are capable of becoming good leaders are getting neglected and this leads to frustration and loss of hope in the future prospects. Discrimination At Work It has been found that women experience discrimination not only during the hiring process but also at the time of promotions. Whittock (2003) found that even though only 10 percent of the nurse workforce are male, their number in the senior grade is very high (Nazarko , 2004a, p.26). “31 percent of men reach grade G compared with only 24 percent of women, and men are more likely to have grade H or I position than women” (Nazarko , 2004a, p.26). Lane (1999) found that men are found to be promoted early in their career while women have to spend twice the time in the same position before they get the promotion (Nazarko , 2004a, p.26). According to McDougall (1997), men enjoy the luxury of being promoted quickly to the position of power in spite of occupying only a minor population of the nursing workforce (Nazarko , 2004a, p.26). Wison’s (1998) research of the NHS career path showed that not all the organisations are able to follow the practices that are free of gender bias (Nazarko , 2004a, p.26). Occupations like nursing which are dominated by female workers have less value and are less paid compared to the occupations dominated by male population (Nazarko , 2004a, p.27). The discrimination has led to nurse staff feeling unhappy with their jobs. They are made to believe that lack of masculine qualities were responsible for them not getting the promotion. How can a person be happy when she is forced to adopt an artificial personality in order to get a promotion at work? Female nurses are forced to let go of their feminine qualities like caring nature, flexible attitude and understanding nature in order to be considered as strong and dominant personality like males. Rosner (1995) observed that women have the ability to encourage their colleagues to leave aside their selfish interests and work towards a broader goal (Nazarko , 2004b, p.25). With their interpersonal skills and transformational communication styles, they can motivate others to give their best performance every moment of their job. Not only that but the qualities of hard work, personal power, emotional involvement, interpersonal skills and genuine concern for the patients make the female nurses a role model for new comers (Nazarko , 2004b, p.25). Being a role model makes it easy for female nurses to lead a team because the team members realise that their leader is not just a ‘talker’ but also follows the practices she talks about. However, sadly, as the women are experiencing a bias treatment at the hands of male dominated management, their motivation to perform has lowered. Female nurses are forced to adopt a male style of working in order to please the seniors who are influenced by prejudiced thinking and who believe that only those people who are authoritative, strict and dominant by nature can become good leaders. The discrimination makes the female nurses to leave their natural behavior patterns and adopt an artificial personality to be considered a choice for managerial position. In this way, the organisation loses the loyalty of the people who put their heart and soul in taking care of the patients. Being ‘loving’ and ‘caring’ towards everyone is considered to be a feminine quality. If the quality of being loving and caring is not valued and becomes an obstacle in the path of growth, then the nurses will stop showing love and care. Nurses are not motivated to give their best if their performance and their qualities are not valued. This affects the quality of the patient care. The unrealistic expectations and uncaring attitude by the managers make it difficult for the nurses to maintain their mental and physical health. This leads to further problems. Staff Shortage It is important to understand that the performance of a person is not independent of his emotional and mental state. If a person is unhappy with the working environment and the behaviour of the supervisors, then he does not feel like going to work. His dissatisfaction drains his energy. The constant tension and hostile environment at work has led to a problem of absenteeism in health services (Joshua-Amadi, 2003, p.18). This leads to shortage of nurse staff which affects the quality of patient care (Joshua-Amadi, 2003, p.18). At the same time, the hostile environment also increases the risk of nurses leaving the job and going somewhere else. According to a study by Aitken et al, the factors like low payment, poor infrastructure, unrealistic work load and work related health risks are making nurses to move to different careers (Campbell, 2006, p.47). The lack of job satisfaction and the problems experienced by the nurses has led to a perception that nursing is not a good choice of career (Campbell, 2006, p.47). People have a wide variety of choices where they can get better pay, better working environment and better leadership. This has led to decrease in new people joining the work force. This again creates a shortage of nurses. Shortage of nurse staff is extremely dangerous to the quality of the patient care. Several studies have concluded that shortage of nurse staff not only increases the cost to the hospital but also proves threatening to the lives of the patients (Garretson, 2004,p.34). Aiken et al (2002) has found that “when the nurse to patient ratio was 1:6 rather than 1:4, an additional 2.3 deaths per 1,000 patients could be expected” (Garretson, 2004,p.34). They have also found that the mortality rates decreases when there are fewer patients per nurse (Garretson, 2004,p.34). This shows that the role of a nurse in the patient care is extremely valuable. Hence, her motivation and satisfaction plays an important role in the quality of patient care. The shortage of nurses also leads to lack of time to take re-training to improve and develop professional skill (Bennett & Thomas, 2003, p.12). Cross training to increase the skill set of the staff is necessary to ensure good quality of service in absence of other nurses. However, the nurses are so overloaded with work that they hardly get time for training and also lack the drive to learn new skills (Bennett & Thomas, 2003, p.12). If a nurse having a particular expertise is absent, then others are not able to handle her responsibilities properly and this affects the quality of the patient care. The idea of learning new skill creates a fear of inviting more workload. This fear lowers their morale and keeps them away from acquiring new roles. Lack of drive to undergo retraining and learning new skills brings down the quality of the patient care. Also, the prejudiced mentality of managers creates an obstacle in hiring those people who can prove to be excellent assets to the organisation. According to study by Woodall and Winstanley (1998), the selection procedure “discriminate against women” and workers who are old (Nazarko , 2004b, p.27). Arrowsmith and Goldrick (1996) found that the management thinks that people who are old are incapable of being productive, flexible and learning new skills efficiently (Nazarkob , 2004b, p.27). Moreover, Atkin et al (2004) has observed that instead of hiring new people for the non-nursing work, the organisations are making the current nurses to do the non-nursing work. This not only increases their work load but also keeps them away from doing their real job which is to take care of the patient. In an effort to juggle between different responsibilities, their energies are dissipated and their attention is diverted. Doing the work which is not a part of their job frustrates them. Too many responsibilities make them tired and this affects the quality of their work. Keeping the staff motivated and happy not only result in high quality patient care but also ensure loyalty of the nurses. Caring For Nurses Study by Borril et al. (1996) has found that professionals working in health services have more chances of getting sick, experience poor mental health and suffer higher level of stress than professionals working in other fields (Beeston & Jesson, 1999, p.43). Nurses even experience threat to their lives as patients who are mentally disturbed and depressed have a tendency to become violent towards them (Ferns & Chojnacka, 2005, p.52). Booth (1995) has found that the mental, emotional and physical health of the nurses directly affects the recovery and the turnover rates of the patients (Beeston & Jesson, 1999, p.43). If the nurses feel happy and cared for, they take care of patients with a lot of positive energy, enthusiasm and friendliness. The atmosphere at the work place becomes lively and facilitates recovery. Moore (1996) found that the mental and physical health of the nurses, who get to participate in decision making, get complete support from their seniors and have liberty to communicate freely at their workplace, is two times better than the nurses who do not get all these facilities at their workplace (Beeston & Jesson, 1999, p.43). Open communication not only facilitates trust in relationships but also willingness to share and learn best practices from the supervisors (Clough, 2003, p.16). Supporting environment for the nurses means creating a caring atmosphere at workplace and listening to their grievances with the intention of finding a solution for them (Beeston & Jesson, 1999, p.43). People who experience love and care from others are able to display love and care in their behavior. If the nurses are not shown care and support, then it can affect the way they take care of the patients. The question is what affects the nurse’s performance, lack the internal motivation or lack of support from the external factors? Morale And Motivation Even if a person is highly skilled in a job, lack of motivation can lead him to perform below his ability (Al-Assaf, 1998, p.83). If people are not motivated to do a particular job then no matter how much training you give them, they will not improve (Al-Assaf, 1998, p.84). It is the responsibility of a leader to introduce innovative ideas to keep the staff morale high. It was found that when the nurses are allowed to take time away from work together, their performance and productivity increases to a great extent (Binnie & Titchen, 2003, p.xiv). It has also been observed that the area where the communication between the individuals is encouraged and is strong shows great improvement and openness to change (Best & Thomas, 2001, p.44). Small things like keeping a note of appreciation, introducing a weekly and monthly reward for best work, gifting vouchers for the family etc., can bring about tremendous change and enthusiasm at the workplace. Making a workplace colourful, fun and friendly place can motivate the staff to look forward to go to work and give their best. However, the management and the leadership in the health services have failed to realise that small things can make a big difference in the attitude of the staff. Manthey (1980) has observed that “patients cannot receive humane and thoughtful care from staff members who have been treated in a dehumanised fashion by their managers” (Binnie & Titchen, 2003, p.20). High stress of the job, requirement of constant alertness and dealing with negative people at workplace takes its toll on the health of the staff. This makes them to take out their frustration on people working under them. What the nurses need is a management structure where they get “real authority to manage their own clinical areas” and implement their ideas to improve the efficiency of the work without getting interfered by people belonging to other level of management (Binnie & Titchen, 2003, p.28). This not only gives authority to nurses to do what they feel is best but also creates an atmosphere which is open and conducive to new ideas, fresh outlook, growth and improvement. When people realise that their suggestions and ideas are being taken seriously, they participate actively in the growth and improvement of the organisation. They are motivated to work hard and give excellent care to the patients. Manley (1997) has found a correlation between the “quality of patient care, staff morale and effective nursing leadership” (Clegg, 2000, p.43). Hence, motivation and morale of the staff is very important to maintain a good quality of patient care. Conclusion The amount of work related pressure, stress, tensions and problems experienced by people working in the health services is twice compared to the people working in other fields. Working in high pressure environment with no time to relax and enjoy takes a toll on their body and mind. The lack of positive environmental factors leads to poor morale and motivation which in turn affects their performance negatively and leads to poor quality of patient care. Positive feedback from the patients and care shown by the seniors makes them feel important. This increases their self-esteem and encourages them to continue with the good work. These factors not only create a positive environment at work but also motivate the nurses to work hard and provide quality patient care. In this way, the staff morale and motivation affects the quality of the patient care. References: Al-Assaf, A.F. (MMMM). Managed Care Quality: A Practical Guide. Boca Raton, FL: CRC Press LLC. Beeston H. &s Jesson A (1999) Caring for staff: setting quality standards. Nursing Standard. 13, 36, 43-45 Bennett, M. & Thomas, S (2003). Developing Community Nurses. Primary Health Care, 13(4), 12. Best, C. & Thomas, S. (2001) Improving practice with a nurse nutrition team. Nursing Standard, 15(19), 41-44. Binnie, A. & Titchen, A. (2003). Freedom to Practise: The Development of Patient- centred nursing. Edinburgh: Butterworth-Heinemann. Campbell, S. 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