Chapter 18 - Assignment
Read the Motivation article and answer the questions.
Instructions:
1. Read the Motivation: What Makes You Tick? article.
o
List five (5) different Extrinsic (external) and Intrinsic (internal) motivation
factors for each of the four (4) categories (Job Content, Work environment,
Leadership, and benefits) Use the table below to help organize your
answers.
o
Extrinsic
(external)
Categories
Job Content
Characteristics
Work Environment
Leadership
Benefits
Intrinsic
(internal)
1
1
2
2
3
3
4
4
5
5
1
1
2
2
3
3
4
4
5
5
1
1
2
2
3
3
4
4
5
5
1
1
2
2
3
3
4
4
5
5
2. Answer the following questions:
a) The research in motivation in nurses suggest that excellent quality patient
outcomes are possible when which condition exists?
b) What types of employee characteristics can demotivators lead to?
c) What is the term “organizational citizenship” related to and why is it so
important in the employee’s role in motivation?
d) Give a description of each of the three leadership styles?
e) Why has the transformational leadership style of such importance when
considering motivation in the workplace? How does empowerment fit into
this aspect of leadership?
f) What is the difference between job satisfaction and motivation?
3. Your paper should be:
o One - Two (1-2) pages
o Typed according to APA style for margins, formatting and spacing standards
o Typed into a Microsoft Word document, save the file, and then upload the
file
Motivation
What makes you tick?
By Debra Dunn, MSN, MBA, RN, CNOR
M
Motivation is a state of mind, an attitude, or a way
of thinking that inspires individuals to go above and
beyond rather than simply performing a job or task
well.1 Being motivated also results in better work
performance.2 Individuals are motivated by both
extrinsic or intrinsic rewards. However, extrinsic
rewards can only go so far. Without the internal
component, a person’s level of motivation is not likely to last.
Motivation is derived from internal urges—needs,
desires, wishes, drives, ideas, and emotions—that
prompt a person to action and result in specific
behaviors.3 Although external stimuli can increase
the level of motivation, it is the inner urge that actually motivates a person.4 Motivation is the driving
force behind a person’s intensity, direction, and
persistence toward attaining a goal.5
From a manager’s perspective, motivation results
in the employee acting in a manner that helps
achieve departmental and organizational aims. It is
to the manager’s advantage to understand employees’ personal desires and needs and help them
meet those needs while working better and more
effectively.
Motivation is very complex and can be difficult
to understand when predicting behavior. First,
38 OR Nurse 2015 March
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39
Motivation: What makes you tick?
motivation is highly situational: what motivates one
person in one situation may not necessarily motivate
that person in a different situation. Second, people
react differently to the same motivational factors.
Third, people may not even be aware of what motivates them, which happens when motivation occurs
at the subconscious level. Finally, motivation can be
positive with a strong level of commitment or negative such as when the person is motivated to do “just
enough” to be adherent but is not very engaged.3,6
Although some individuals may be more motivated
than others, everyone is motivated to some extent.6
Nurses focus on the delivery of effective and efficient patient care with excellent quality outcomes;
however, these outcomes are directly related to a
nurse’s willingness to apply knowledge and skills in
his or her work. Research shows enhanced patient
outcomes when employees are motivated to perform at their highest levels.5,7
Incentives: Extrinsic
and intrinsic factors
Understanding motivational factors is important to
design systems with the correct incentives in place to
encourage motivation.8 It is important to recognize
that motivation is not the same as incentive. With
incentives, the same input is expected to yield greater outputs. With motivation, more inputs are needed
to change the outputs of work performance, an
employee’s attitude, and behavior. Incentives are
external in nature, while motivation is the expression
of an individual’s inner, personal needs.3
Intrinsic motivation is an internal sense of satisfaction due to some sort of achievement, such as
performing a job well. This internal desire or drive is
expressed as behavior designed to accomplish a goal.
Extrinsic motivation is the same as intrinsic motivation except that the motivator is external to the individual. An example of a combined effect is when
someone is recognized for a job well done (extrinsic),
resulting in an increased sense of self-worth, selfesteem, and self-confidence (intrinsic). This symbiotic
reaction increases the likelihood the employee will
be willing to take on new challenges and contribute
new ideas in the future. Extrinsic rewards can only
go so far when they do not match an employee’s
internal needs. For example, compensation is rarely
the number one motivating factor that gets an individual out of bed in the morning to go to work.2
Creating a type of environment where employees
can grow and contribute is more of a motivator than
financial gain because most employees want to feel
they are part of something bigger than themselves.
They want to learn, evolve, and create new and
exciting things in their workplace.1-3,9,10
The desire to excel on the job comes from within
when an employee is internally incentivized to reach
for a goal.2 Although external motivational forces
have their benefits and should not be discounted,
they are subject to each employee’s individual, intrinsic concerns, and the individual needs to “buy into”
them for them to have a positive impact.2
Many employees rate motivating factors such as
good working relationships with colleagues, training
opportunities, and environmental factors (such as,
good physical conditions) as more important than
income.8 A review of 12 empirical studies of motivation found that seven major job characteristics were
important determinants of motivation. These are the
work itself, healthy relationships with others, workplace conditions, opportunities for personal development, pay/rewards, management practices, and
organizational policies.8 Two other important factors
include being given choices and being involved in
decision making.9 Managers need to identify each
employee’s intrinsic motivators and align these needs
with the needs of the department. Managers are
key people who can help their employees behave
in ways that positively meet their personal, internal
needs as well as perform at higher levels and
work more effectively with others.2 (See Extrinsic and
intrinsic motivational factors.)
Demotivators
Demotivators decrease employees’ desires to contribute positively to the organization. Managers
must find demotivators within their departments
and work to eliminate them. If a demotivator is an
employee who thrives on complaining, for example,
the manager should allow that employee 5 minutes
to air a grievance and then ask that person to suggest a solution. This moves the conversation away
from the drama and toward the harmony of moving forward.
Managers also can cause demotivation when
they micromanage, play favorites, pass their work
off to their staff, display coercive types of control,
and are manipulative.2,3,6 Demotivation can lead to
frustration, hostility, laziness, defensiveness, selfdoubt, judgment of others, inflexibility, misplaced
40 OR Nurse 2015 March
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Extrinsic and intrinsic motivational factors
Job content characteristics
External factors
Internal factors
• Challenging nature of the work
• Skill variety–degree to which a job utilizes a
mix of employee knowledge, skills, and abilities
• Task identity–degree to which job involves completing a
complete project versus a piece of work
• Task significance–degree to which job makes a recognizable
impact or contribution
• Ability to provide quality care
• Job enlargement–makes job structurally bigger; improves
job horizontally
• Opportunity to advance
• Career development opportunities that cultivate skills
(professional growth)
• Authority level
• Level of job control–influence in planning work and reviewing
results and setting standards for performance targets
• Clearly defined nursing roles and responsibilities
• Explicit in departmental or organizational goals
• Constructive and objective system of performance appraisal
and merit rating
• Meaningful work (skill variety, task
identity, and task significance)
• Job enrichment (challenging job)
• A sense that one’s expectations can
be filled
• Creativity opportunities
• Decision making
• Sense of control over work
• Setting own goals
• Job pride
• Delegated authority
• Sense of competence
• Perceived increased work
effectiveness
Work environment
• Well-defined and humanistic personnel policy
where the workforce is valued and their needs
and aspirations can be satisfied
• Good working relationships
• Teamwork
• Adequate staffing
• Culture that supports professional growth,
leadership development, and mentorship
• Enthusiastic and warm work environment where
ideas and goals can be shared
• Staff included on councils
• Increased power and authority
• Autonomy
• Empowerment
• Trusting
• Positive reinforcement
• Resources (tools, information, support)
to perform the job
• Pleasant physical conditions of environment
• Safe and respectful work environment
• Distributive justice
• Job security
• Sound and fair promotion and transfer policies
• Well-planned, need-based training, and development
programs
• Strong interpersonal work
relationships
• Social acceptance
• Positive interactions with
physicians
• Minimal perceived environmental
turbulence
• Set own work schedule and breaks
• Feelings of accomplishment and
making a difference; taking pride in
work performed
• Feel like valued member of team
• Professionalism
• Work-life balance with manageable
and suitable workloads
• Hardiness (resilience) — able to deal
with turbulent work environment
because see uncertainty in the
environment as challenging, not
threatening; ability to improvise
and adapt to significant change
(Continued)
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41
Motivation: What makes you tick?
Extrinsic and intrinsic motivational factors (continued)
Leadership
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Two-way communication that is respectful and open
Be a good listener–appreciate what others have to say
Maintain visibility
Demonstrate trust and respect
Show others that you value their perspectives–
seek their opinions and ideas and implement them
Show confidence in employee’s ability to perform
at a high level
Encourage participation in decision making
Delegation of responsibility
Help staff set ambitious goals and help them work toward
these goals–extend people beyond their comfort zone
Coaching, role modeling, mentorship
Eliminate obstacles for employees to succeed
Accurate, honest, and constructive feedback on work effectiveness; should be corrective but not punitive; also point out
the positive and provide encouragement
Honest praise; sincere compliments
Good performance rewarded adequately
Treat people consistently and fairly
Shows concern for employee as an individual
Provides rewards (bonuses, gift certificates, certificates of
appreciation, thank-you notes, day off with pay, parking
spot closest to facility for a month, articles in local paper or
internal newsletter)
• Sense of self-efficacy
• Recognition of efforts when successful, or when attempted to
improve effectiveness or productivity, or overcame an obstacle
• Earned respect
• Input is sought for decision making
• Feel empowered
• Autonomy–independence and
freedom
• Knowing what is expected to do
the job (preparedness)
• Knowledge of results (feedback)
Benefits
•
•
•
•
•
•
Fair wages and salary administration
Financial incentives
Paid time off
Medical and life insurance benefits
Retirement pension
Location of facility
• Feel appreciated and rewarded
financially
Sources: http://www.egyankosh.ac.in/jspui/bitstream/123456789/38773/1/unit-15.pdf;
Bruce A. Manager’s Guide to Motivating Employees. 2nd ed. Madison, WI: McGraw-Hill; 2011;
Callicutt D, Norman K, Smith L, Nichols A, Kring D. Building an engaged and certified nursing workforce. Nurs Clin North Am. 2011;46(1):81-87;
Gambino KM. Motivation for entry, occupational commitment and intent to remain: a survey regarding registered nurse retention. J Adv Nurs.
2010;66(11):2532-2541;
Brady Germain P, Cummings GG. The influence of nursing leadership on nurse performance: a systematic literature review. J Nurs Manag.
2010;18(4):425-439;
Hahn JJ, Butz KP, Gavin JG, Mills RS, Welter CJ. Recognizing professional and volunteer activities. AORN J. 2004;79(5):1006-1010;
Lambrou P, Kontodimopoulos N, Niakas D. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital. Hum
Resour Health. 2010;8:26.
http://www.human-resources-health.com/content/8/1/26;
Llanos EB. Motivating co-workers. Advance for Nurses, Northeast. 2013;28-30;
Mone E, Eisinger C, Guggenheim K, et al. Performance management at the wheel: driving employee engagement in organizations. J Bus Psychol.
2011;26:205-212;
Newcomb P, Smith A, Webb P. Relationship of nurse job satisfaction to implementation of a nursing professional practice model. Southern Online
Journal of Nursing Research. http://www.resourcenter.net/images/SNRS/Files/SOJNR_articles2/Vol09Num03Art11.pdf;
Peters DH, Chakraborty S, Mahapatra P, Steinhardt L. Job satisfaction and motivation of health workers in public and private sectors: cross-sectional
analysis from two Indian states. Hum Resour Health. 2010;8(27):1-11;
Shermont H, Krepcio D, Murphy JM. Career mapping: developing nurse leaders, reinvigorating careers. J Nurs Adm. 2009;39(10):432-437;
Sledge S, Miles AK, van Sambeek MF. A comparison of employee job satisfaction in the service industry: do cultural and spirituality influences matter? Journal of Management Policy and Practice. 2011;12(4):126-145;
Utriainen K, Kyngäs H. Hospital nurses’ job satisfaction: a literature review. J Nurs Manag. 2009;17(8):1002-1010.
42 OR Nurse 2015 March
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www.ORNurseJournal.com
priorities, absenteeism, poor staff retention, low
productivity, and apathy.3 Managers can combat
demotivation by holding regular staff meetings,
soliciting feedback from employees, offering incentives, praising successful employees, celebrating victories, and showing concern about employees
beyond the workplace.
Multigenerational influences
Multigenerational differences among employees
need to be considered when discerning which
extrinsic and intrinsic factors might be more
likely to motivate certain people. Nurses raised
in different generations may respond differently
to extrinsic forces cultivated in the work area.
Understanding these additional differences will
help managers choose more appropriate actions to
motivate employees. It is important to always take
a closer look at where the individual “is coming
from” based on their age-group, which can offer
new ways to change attitudes and increase motivational levels.7
The employee’s role
Thoughts and behaviors, which are derived from
internal urges, result in actions to fulfill current or
future personal goals or desires. A sense of purpose
results when an employee’s activities align with his or
her values and beliefs. Employees should understand
and attend to their internal forces in order to build
on their motivation levels. The higher the need satisfied by an activity in the workplace, the greater the
motivation will be to perform that activity.2,11
Nurses have their own internal working styles
that drive them to achieve and satisfy personal
desires. These motivational forces can be positive,
neutral, or negative, which directly impact the level
of success nurses will have within the healthcare
facility. Positive internal motivational forces result
in “organizational citizenship” where the nurse is
results-oriented, believes the organization and the
nurse are part of an integrated unit, and views his
or her assigned tasks as a fundamental duty. Nurses
who feel neutral may function at a subsistence
level where they perform their required duties but
only at a minimal level. These nurses survive in the
organization but do not have any concern for longterm results. Finally, nurses who harbor negative
beliefs about themselves, their capabilities, the people around them, or how things are viewed in the
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world will find their abilities to be successful to be
stunted and limited.4,11
Nurses should participate in the creation of their
workplace cultures by engaging in activities that
enhance the work experience. Nurses are responsible
to communicate professionally with their nurse leaders about what they need to complete their tasks efficiently and expertly.12 In other words, everyone has
an inherent responsibility to make their work experiences better for themselves and for their patients.
The manager’s role
Managers should seek to understand what motivates
each of their employees and then help them make
the connection between those inner drives and the
needs of the department.2 Nurses with greater internal needs for professional growth, for example,
might demonstrate a more positive response to job
enrichment than other nurses might.13 Nurses who
view their work as a 9-to-5 job might be more
enticed by financial rewards.
One of the characteristics of a leader is the ability
to influence the actions of others toward accomplishing specific goals. Before a manager can do this, however, he or she needs to be motivated. This internal
desire within the manager ultimately will ignite the
passion in the employees. A manager’s attitudes,
behaviors, and practices directly influence those of
the employees. If a leader is not motivated, how can
the staff be?2,3,14 Only when a leader understands his
or her own internal motivation can he or she more
readily understand the employees’ motivational forces and the best way to guide and motivate them.11
Employee motivation is of great concern to
leaders, as it directly impacts human behavior and
attitudes toward work. Just as employees have
certain desires the organization is expected to
satisfy, the organization also expects certain types
of behaviors from employees. The task for the
leader is to make the work more interesting, purposeful, and acceptable to employees so they perform it more enthusiastically and with a greater
sense of responsibility. Leaders need to search for
opportunities to create, develop, and improve processes and to enable others to act to feel competent and dedicated.
Employees are motivated to do a job well when
it helps them meet one or more of their personal
needs, aims, objectives, and values. The challenge
for managers is that different people have different
March OR Nurse 2015
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43
Motivation: What makes you tick?
needs, and these needs change over time and
according to the context of the situation.2,12 “There is
no single magic wand to motivate employees, as
their needs and priorities of satisfaction differ. What
may motivate one may not motivate the other.”3
Managers can assist their nurses uncover their
motivational forces to reach their highest level of performance and productivity. A first step is to ask the
nurse what motivates him or her. If the answer lies
buried, then the manager needs to get to know the
nurse on a more personal level to learn these inner
desires. This also can be accomplished by observing
individual actions and behaviors and interpreting
them in terms of some underlying motivation.3
Motivated managers see their role as facilitators,
trainers, and coaches; they provide inspirational motivation through enthusiasm and challenge. These
managers clearly articulate a vision, encourage the
evolution of the individual and team spirit, and support goal achievement. Effective leaders develop and
maintain a trusting and positive motivational climate
so that nurses feel satisfied and motivated to consistently perform at their highest level of productivity.
This is accomplished by understanding nurses’ desires,
appealing to their sense of self-improvement and selfworth as human beings, and working to elevate their
level of effectiveness to accomplish departmental
goals. It is up to the manager to assist their nursing
staff to connect their intrinsic motives to the organization’s goals.2 Employees will surprise their managers
with their levels of motivation to perform high-quality
patient care when their assignments meet their inner
drives (see Stimulating motivation in employees).2,6,12,14,15
Leadership styles
Leadership styles directly impact the manner in
which managers brings out the best in their
employees. There are three types of leadership
styles: transactional, passive avoidant, and transformational. The transactional leadership style is based
on a reciprocal exchange between the leader and
employees. In this relationship, leaders specify the
standards of performance with a strong focus on
deviations from this standard, and employees are
given something in return for their adherence and
acceptance of authority (incentives, pay raises, status increases). The leader is an authority figure, and
staff members are motivated by the reward for
their adherence. In the passive avoidant leadership
style, the leader avoids involvement in important
issues or making decisions. Staff generally experience lack of empowerment and are not committed
to established goals.15
A strong relationship has been demonstrated
between the transformational leadership style and
clinical nurse job satisfaction.15 Transformational
leadership, which is an inclusive and participative
management style, is a process where leaders raise
the aspirations and motivations of staff members to
higher levels by appealing to ideals and values. A
transformational leader engages others by finding a
common purpose and meaning to achieve a common set of goals. When a leader models a higher
level of ideas, values, and behaviors, staff members
begin to do so as well.
Employees are motivated because the leader helps
them meet their individual needs. Transformational
leaders challenge employees to excel, establish
accountability, and create a collective team spirit with
shared ownership to attain goals. They ensure a trusting environment with an open door policy, display
confidence, actively listen and address concerns, provide a clear mission and set of values, seek creative
approaches to problem solving, provide a supportive
climate for professional growth, and act as mentors
and teachers.2,7,15 In this environment, staff members
feel empowered to share and openly discuss their
concerns and to participate in decision making.
An important concept within transformational
leadership is “empowerment,” which is a heightened
state of motivation that is caused by optimistic
effort-reward expectations.16 Empowered nurses
expect their efforts to succeed and are therefore
motivated to exert high levels of effort. They also
have a sense of accountability for their work and
the results they achieve. Motivated employees work
hard when they feel empowered to make decisions
about their work and when they feel supported and
have the resources.2,16 Empowerment makes the
employee feel trusted and valued, which then fosters a sense of confidence.2 Empowerment challenges managers to share their formal and informal
power with their nursing staff.12
Transformational leaders delegate and give their
employees more discretion and choices. This helps
them expand their minds, develop their talents and
skills, discover untapped abilities, and ultimately leads
to feelings of a greater sense of self-efficacy, selfdetermination (control), and self-responsibility for
improving the way they do their jobs and contribute
44 OR Nurse 2015 March
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Stimulating motivation in employees
• Share the overall organizational strategy and
discuss with the staff.
• Employees should understand how their work
supports organization strategy and direction.
• Visibility, interaction, and communication with
the staff should be advocated.
• Raising the bar regarding the expectations from
the staff. Employees will perform better if the
manager expects high-level performance.
• Collaboratively set performance and development goals with the employee.
• Employees who have been successful in their
work or accomplishing specific goals should be
recognized.
• Stretch goals should be determined with the
employee to enhance personal growth, professional development, and to improve organizational effectiveness.
• Employees should be allowed to tackle surmountable assignments before engaging in
more difficult tasks.
• Employees should be treated as partners
to increase buy-in and to achieve better
performance.
• Cross-training–employees appreciate each other
more when they have walked in each other’s
shoes.
• Opportunities for training and development
(such as in-house education) should be provided
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
along with career development and advancement efforts.
Guidance and coaching should be provided.
Staff should be mentored for long-term professional development.
Performance appraisals are to be objective,
measurable, and transparent.
Tie raises to performance, not seniority.
A climate of trust, ownership, empowerment,
and autonomy should be fostered.
Creativity and innovation should be
encouraged.
Employees should be included in the decisionmaking process.
Improvement in work processes and productivity should also be encouraged.
Fairness and respectfulness of the staff should
be paramount.
The resources and authority needed for the staff
to perform effectively should be provided.
The staff should be advocated for.
An interest in the staff should be displayed.
Reinforcement, recognition, and rewards should
be provided.
An atmosphere where working relationships and
interactions are valued and emphasized should
be promoted.
Employees should share responsibility for
improving work processes.
Sources: Bruce A. Manager’s Guide to Motivating Employees. 2nd ed. Madison, WI: McGraw-Hill; 2011;
Harvey P, Martinko MJ. Chapter 7: Attribution theory and motivation. In. N. Borkokwski (ed) Organizational Behavior, theory and Design in Health
Care. Sudbury, MA:Jones and Bartlett Publishers, LLC. pp. 147-164. http://samples.jbpub.com/9780763763831/63831_08_CH07_final.pdf;
Kuokkanen L, Suominen T, Härkönen E, Kukkurainen ML, Doran D. Effects of organizational change on work-related empowerment, employee satisfaction, and motivation. Nurs Adm Q. 2009;33(2):116-124;
Mone E, Eisinger C, Guggenheim K, et al. Performance management at the wheel: driving employee engagement in organizations. J Bus Psychol.
2011;26:205-212;
Sikroria R, Srivastava V. Shaping employee oriented human resource policies through analyzing motivational needs. European Journal of Business
and Management. 2012;4(14):177-181;
Utriainen K, Kyngäs H. Hospital nurses’ job satisfaction: A literature review. J Nurs Manag. 2009;17(8):1002-1010.
to the organization’s goals. As a result, nurses have
greater job satisfaction, are more motivated and committed to their work, and involve more of themselves. These attributes are associated with patient
satisfaction, patient care, and patient safety.2,7,17
Nursing leadership behaviors directly influence
nurses’ abilities to exceed their employer’s expectations in meeting organizational goals.12 Leadership
practices affecting motivation and work performance
include:
• encouraging the heart: providing encouragement
and celebrating accomplishments
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• inspiring a shared vision through commitment
• enabling others to act
• challenging the process
• modeling the way
• leadership with building, coaching, and mentoring.12
Employee engagement is an important outcome
of working for a transformational leader. An
engaged employee is not only fully involved in and
enthusiastic about work but is also “inspired by it,
committed to it, and fascinated by it.”9 Engaged
employees align their own purpose with the organization’s values and goals so that they are personally
March OR Nurse 2015
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45
Motivation: What makes you tick?
invested in their tasks and outnurses take exceptional pride in
comes.2 Engagement is distheir work. When they experiplayed with personal initiative,
ence this, they work at a consisbeing adaptable, effort, and
tently higher capacity and are
persistence toward achieving
more motivated and satisfied at
the organizational goals.18 High
their job. Employees work hardlevels of trust and fairness in
er and smarter, not for their
the organizational culture are
manager or the organization,
necessary to create and sustain
but for themselves. Managers,
an engaged workforce.
however, are the link between
Interventions for driving
nurses meeting their own needs
engagement include:
and doing exceptional work for
Nurses should
• building confidence, resiliency,
the healthcare facility. Nurses
participate in the
and social support networks
need to understand how their
creation of their
• renewing or restoring employown and the healthcare facility’s
workplace cultures by
ee energy
values connect to bring meaning
engaging in activities
• empowerment
to their life through work. Those
that enhance the work
• providing control over work
managers who work to build
experience.
• enhancing the motivation and
hope and trust will find a motifreedom to engage
vated workforce.2,11
• involving staff in decision making
• providing effective recognition and rewards and
Job satisfaction
fair and equitable treatment.18
Employee motivation and job satisfaction are related
Building engagement is based on “knowing,
but distinct phenomena. Job satisfaction is an individgrowing, inspiring, involving, and rewarding employual’s emotional response to his or her job condition;
ees,” which can produce organizational commitmotivation is the driving force to pursue and satisfy
ment and increased employee satisfaction levels.15,18
needs.5 Employees are more likely to feel satisfied
Engagement is a prerequisite before an employee
when they perceive that their efforts are rewarded
can increase motivation levels.18
based on their standards and internal motivators.19
Organizations with engaged employees have
Motivational levels and job satisfaction are positively
employees who are 20% more likely to perform
correlated and both work together to increase job
better and 87% less likely to leave the organization.9
performance.5,10,13,19 The following themes are relatThe 10 Cs of employee engagement require leaders
ed to nurses’ job satisfaction:
to do as follows:
• positive interpersonal relationships and communica• connect with employees
tion between nurses and other healthcare providers
• provide opportunities for career advancement
• nurses who believe they provide high-quality care
• provide a clear vision
and have a strong connection to patients
• convey meaningful feedback
• a culture where management and employees con• congratulate strong performance
sult together on decision making
• allow for employee contributions and control over
• teamwork and peer support
their work
• control over nursing practice
• encourage collaboration among team members
• empowerment and autonomy
• establish credible standards
• participation and open discussion
• create confidence.9
• sensitivity for employees’ ideas
Managers need to create a trusting environment
• loyalty and trust.10,19
where nurses can flourish, get swift feedback and
Meeting the needs and achieving the goals of
recognition, and earn rewards for their good ideas.2
both the nurse and the healthcare facility provide the
They also need to build confidence, cultivate feelings
“cornerstone” for job satisfaction.5 “Job satisfaction is
of ownership, and allow their nurses to question,
inextricably linked to motivation, and both involve
challenge, influence, and make decisions. Motivated
cognitive, affective, and behavioral processes, with
46 OR Nurse 2015 March
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employee motivation commonly understood as the
reason why employees behave as they do towards
achieving personal and organizational goals.”8 OR
BONE FOAM INC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C2
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EPS, INC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9, 11, 13
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WI: McGraw-Hill; 2011.
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unit-15.pdf.
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CLOROX SERVICES CO. . . . . . . . . . . . . . . . . . . . . . . . . . . C4
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satisfaction in the service industry: do cultural and spirituality influences
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14. Feltner A, Mitchell B, Norris E, Wolfle C. Nurses’ views on the
characteristics of an effective leader. AORN J. 2008;87(2):363-372.
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D. Effects of organizational change on work-related empowerment, employee satisfaction, and motivation. Nurs Adm Q. 2009;33(2):116-124.
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Debra Dunn is the Perioperative Nurse Director at East Orange General
Hospital, East Orange, N.J.
The author has disclosed that she has no financial relationships related to
this article.
DOI-10.1097/01.ORN.0000460902.65598.e0
www.ORNurseJournal.com
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March OR Nurse 2015
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47
Chapter 18
Creating a Motivating Climate
Fourth Phase of Management Process:
Directing/Coordinating/Activating
• The “doing” phase of management
• Components include:
– Creating a motivating climate
– Establishing organizational communication
– Managing conflict
– Facilitating collaboration
– Negotiating, working with unions
– Complying with employment laws
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Motivation
• Motivation may be defined as the force within the
individual that influences or directs behavior.
• Because motivation comes from within a person,
managers cannot directly motivate subordinates.
• The humanistic manager can, however, create an
environment that maximizes the development of
human potential.
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Intrinsic Versus Extrinsic Motivation
• Intrinsic motivation—internal drive to do or be
something
• Extrinsic motivation—motivation enhanced by the job
environment or external rewards
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Motivational Theorists
• Maslow—hierarchy of needs
• Skinner—operant conditioning/behavior modification
• Herzberg—motivator/hygiene theory
• Vroom—expectancy model
• McClelland—basic needs
• Gellerman—“stretching”
• McGregor—Theory X and Y
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Herzberg’s Motivators and Hygiene
Factors
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Abraham Maslow’s (1970) Hierarchy of
Needs
Maslow suggested that people are motivated
to satisfy certain needs, ranging from basic
survival to complex psychological needs, and
that people seek a higher need only when the
lower needs have been predominantly met.
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Maslow’s Hierarchy of Needs
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Question
Where does safety fall in Maslow’s hierarchy
of needs?
A. Most basic
B. Second most basic
C. Middle of the hierarchy
D. Top of the hierarchy
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Answer
B. Second most basic
Rationale: According to Maslow, physiologic
needs are the most basic, followed by safety.
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Douglas McGregor’s (1960) Theory X and Y
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Victor Vroom’s (1964) Expectancy Theory
Vroom argued that a person’s expectations about his
or her environment or a certain event will influence
behavior. Therefore, if there is an expectation of a
reward and it does not occur, the individual is less
likely to repeat that behavior in the future.
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Vroom’s Expectancy Model
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Saul Gellerman’s (1968) Theory of
“Stretching”
• Gellerman suggested that individuals should be
periodically “stretched” to do tasks more difficult than
they are used to doing.
• The challenge of “stretching” is to energize people to
enjoy the beauty of pushing themselves beyond what
they think they can do.
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David McClelland’s (1971) Basic Needs
Theory
McClelland argued that people are motivated by
three basic needs:
•
Achievement
•
Affiliation
•
Power
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Question
Which theory explores the importance of a
manager’s assumptions on workers’ motivation?
A. Basic needs theory
B. Expectancy
C. Theory of X and Y
D. Theory of “stretching”
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Answer
C. Theory of X and Y
Rationale: Douglas McGregor’s 1960 theory examined
the relationship between assumptions and motivation.
These assumptions, which McGregor labeled Theory X
and Theory Y, led to the realization in management
science that how the manager views, and thus treats,
the worker will have an impact on how well the
organization functions.
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Question
According to McClelland, which of the following is
one of the basic needs that motivate people?
A. Power
B. Money
C. Expectations
D. Sense of duty
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Answer
A. Power
Rationale: According to McClelland, the three basic
needs are power, affiliation, and achievement.
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Strategies to Create a Motivating Climate
• Have clear expectations for workers.
• Be fair and consistent with employees.
• Encourage teamwork.
• Know the uniqueness of each employee.
• Stretch employees intermittently.
• Reward desired behavior.
• Allow employees as much control as possible.
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Incentives
Organizations must be cognizant of the need to
offer incentives at a level where employees
value them. This requires that the organization
and its managers understand employees’
collective values and devise a reward system
that is consistent with that value system.
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Recognition—A Powerful Motivational Tool
• Positive reinforcement must be specific or relevant to
a particular performance.
• Positive reinforcement must occur as close to the
event as possible.
• Reinforcement of new behaviors should be
continuous.
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Promotion: Elements to Prevent Negative
Outcomes
• Whether recruitment will be internal or external
• What the promotion and selection criteria will be
• The pool of candidates that exists
• Handling rejected candidates
• How employee releases are to be handled
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Attitude and Energy of Managers
The attitude and energy level of managers directly
affects the attitude and productivity of their
employees.
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Self-Care—Preventing Burnout
A burned-out, tired manager will develop a lethargic
and demotivated staff.
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Question
Taking pride in a particularly well-handled case is an
example of which pathway?
A. Recognition
B. Connection
C. Achievement
D. Love of work
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Answer
C. Achievement
Rationale: In the achievement pathway, one experiences
joy through accomplishment and positive work.
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