Work Motivating Factors as Identifed by Nurses in Children Hospital at Elmonira and Specialized Pediatric Hospital Cairo University

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1 Med. J. Cairo Univ., Vol. 81, No. 2, June: 27-31, Work Motivating Factors as Identifed by Nurses in Children Hospital at Elmonira and Specialized Pediatric Hospital Cairo University RADWA M. SAID, D.N.Sc.; FATMA A. ABED, D.N.Sc. and LAILA M. ABDO, D.N.Sc. The Department of Nursing Administration, Faculty of Nursing, Cairo University Abstract Nurses comprise the major component of all health care employees, being in the front line and having the most frequent direct contact with clients. Thus their performance is influenced by motivation which directly has a great impact on organizational success. Identifying the factors that influence the nurses' motivation is useful for creating motivating work environment. Aim of the Study: The aim of this study was to identify work motivating factors by Nurses in Cairo University Children Hospital at Elmonira and The Specialized Pediatric Hospitals. Methods: Descriptive research design was utilized to attain the aim of the current study. the study samples that include 60% of the staff nurses working at each hospital were selected using simple random approach. Data was collected using a questionnaire developed by the investigator and consists of two part. The first part is the socio demographic data and the second part was the work motivating factors scale, which was grouped into eight factors. Results: The finding of the study based on eight motivation factors: nature of work, achievement, pay and fringe benefits, supervision and guidance, social work environment, recognition and promotion, participation and hospital policy. the finding indicated that the nurses perceived the social work environment, supervision and guidance as the highest motivating factors, the finding of the study indicated that there is significant difference between aboelreesh hospital and elmonira nurses hospital on the perception of the supervision and guidance and social work environments motivating factors. Recommendation: The main study recommendation included further study should be done to investigate nurses' satisfaction with the item which perceived as a highly motivated. Key Words: Motivation Staff Nurse Motivating Factors. Introduction NURSE'S motivation is the key factor for organizational success. managerial planning in a health care facility involves a deep understanding of the motivational drives of the nurses and that in turn Correspondence to: Dr. Radw a M. Said, The Department of Nursing Administration, Faculty of Nursing, Cairo University involves a deep study of the factors influencing these drives. It is important for the management to understand the "definite causes" based on operational needs in an analytical fashion ill. The motivational factors can be grouped into three dimensions: Social, mental and physical. Thus in the social dimension, factors arise from work place, social contacts, the characteristics of the task and the physical and material circumstances related to work. On the other hand in the mental dimension, the motivational factors derive from work itself. In the physical dimension, physical working condition and rewards are the motivational factors [2]. Nurse's professional performance can be thus defined as a product of motivation and abilities of the nurse, whereas any reduction in motivation results in diminished end product, i.e. performance hence, every health care organization should strive to encourage nurses to continuously develop new skills, retain them by offering challenging assignments and rewards [3]. A motivated nurse has probably greater readiness to take care of patients and collaborate with her colleagues, and thereby provide a better healthcare service. Motivated nurses have reported stronger behavioral, verbal and outcome empowerment than unmotivated nurses, whereas low work motivation and job satisfaction. On the contrary, have led to a decrease in both service quality and patients' intention to return for future care and in addition to of patient care, an increase in the cost [4]. Motivation is one of the most important factors determining organizational efficiency. All organizational facilities will go to waste in absence of 27

2 28 Work Motivating Factors as Identifed by Nurses motivated people to utilize these facilities effectively. Motivation is an effective instrument in the hand of management in inspiring the work force, motivation increase the willingness of the worker to work thus increasing efficiency and effectiveness of the organization [5]. Subjects and Methods Study design: A descriptive design was utilized in this study. Setting: This study was conducted at two hospitals affiliated with Cairo University. 1- Specialized Pediatric Hospital (Aboelreesh). 2- Cairo University Children Hospital (Elmonira). Sampling: The sample was 60% of the total nurses working at each hospital (150 staff nurses from aboalreesh hospital and 120 staff nurses from elmonira hospital). The sample was randomly selected using simple random approach. Tools for data collection: Guided by literature the study questionnaire was developed by the investigator. The developed questionnaire consisted of two parts: First part was the socio-demographic data sheet, the second part motivating factors scale sheet. The first part: Sociodemographic data: This part was related to the demographic characteristics of the respondents such as age, sex, and marital status...etc. The second part: Work motivating factors scale. The items were rated on a five-point scale scored at follows "strongly agree (2), agree (1), indifferent (0), disagree (-1), strongly disagree (-2). Indifferent response was scored zero to neutralize response. The level of motivation was as follow: - From 0.<1---unmotivated. - From 1<1.3---moderate motivated. - From 1.3 to 2---highly motivated. Statistical design: The data were analyzed using descriptive statistics such as, mean and standard deviation. t-test was used to find out any significant difference between the respondents by the independent variables. All statistical analyses was at 0.05 (p-value) the p-value indicate insignificant result. The p indicate significant result. Results Results of the present study showed that: Table (1) shows that 97.5% at elmonira hospital nurses were females compared to 92.7% at aboelresh. Regarding that sample age the largest percentage 52.6% was between years old. The mean age of the respondents is 29.73±6.65. regarding the level of education the majority (85.9) of the sample from both hospitals has nursing diploma, only (5.2%) of them having baccalaureate degree. only (54.8%) of them are married. Table (2) shows that the highest mean score was related to social work environment, supervision and guidance while the lowest mean score was related to nature of work as a motivating factors. Table (3) show the highly motivating items as identified by the respondents within each factors. Table (4) show significant difference between the aboelresh hospital and elmonira hospital on the supervision and guidance (t 6.41 p<000). As well as on the social work environment (t 0.06 p<000). Table (1): Demographic characteristics of the respondents. Items Elmonira (N=120) Aboelreesh (N=150) Total (N=270) (No.) % (No.) % (No.) % Sex: Male Female Age/years: 19< < > Mean±SD 29.66± ± ±6.65 Marital status: Single Married Divorced Widow Educational level Degree: Diploma Associate degree Baccalaureate degree Total

3 Radwa M. Said, et al. 29 Table (2): Mean, standard deviation of the respondents related to nature of work as a motivating Factor. Factors Mean SD Nature of work Achievement Social work environment Pay and fringe benefit Supervision & guidance Recognition & promotion Participation Hospital policy Table (4): Difference between the respondents by the hospitals on the perceived motivating factor. Factors Elmonira Aboelreesh t p Nature of work 0.9± ± Achievement 1.1± ± Social work environment 1.3± ± Pay and fringe 1.2± ± benefit Supervision 1.2± ± & guidance Recognition 1.1± ± and promotion Participation 1.1± ± Hospital policy 1.1± ± Table (3): Highly motivating items as identified by the respondents within each factors at both hospital. Items Mean Factors Clear job description Nurse patient ratio 1.4 Availability of nurse aid 1.5 Availability of training program 1.3 Nature of work 1.3 Achievement Respectable relationship 1.6 Social work environment within the hospital Respect from worker 1.5 to nurse Respect from doctor 1.5 to nurse Cooperation among 1.3 nurses Work environment free 1.4 from tension Periodical medical checkup Meal for nurses 1.3 Nursery for nurses' 1.3 children Safety & security in the hospital Fair selection for the best nurse Recognition for outstanding work Career ladder for nurses polices against carless nurses Criticism is given privately 1.4 Pay & fringe benefits Recognition & promotion Hospital policy 1. 5 Supervision & guidance Discussion It's the major task of every manager to motivate his subordinates to create the willing to work among the subordinates. It should also be remembered that a worker may be immensely capable of doing some work; nothing can be achieved if he is not willing to work. A manager has to make appropriate use of motivation to enthuse the employees to follow them [6]. Hence the aim of the study was to identify work motivating factors as identified by Nurses in Cairo University Children Hospital at Elmonira and the Specialized Pediatric Hospital. The study finding indicated that the highest percentage of the staff nurses age is less than 30 years. this finding indicated that nurses are mostly young, accordingly they will have long year to work. So motivation is very important to retain and promote their enthusiasm in the job and get out the best of them. Regarding nurses motivation, eight motivation factors were studied. The respondents' perceived nurse patient ratio and availability of nurse aid as highly motivating items. It may be that appropriate nurse patient ratio is important to maintain quality and safe patient care and to prevent nurses' exhaustion that leads to high turnover [7] pointed that nurses were spending significant amounts of time in non-nursing activities, so nurse aids will relieve nurse from non-nursing activities which consumed nurse effort that will be reflected negatively on performance The finding of the study showed that availability of job description is highly motivating item for the respondents it may be that the clear job description reduces conflict among nurses and between nurses and other health team member.

4 30 Work Motivating Factors as Identifed by Nurses Social work environment is perceived by the respondents as highly motivating factor. Herzberg mentioned that the respectable relationship and cooperation among coworkers increase motivation [8] found that nursing staff and management are experienced low morale when their peers cause troubles. Nurses in the present study like to be respected by the medical staff. Being respected is a basic need for the individual. nurses are motivated when there is respectable relationship within hospital and be respected by others especially medical staff as well by cooperation among nurses in the hospital. Fringe benefits such as meals or payment for meals, lockers for change clothes, and nursery are seen as highly motivating item for nurses. Fringe benefits increase nurses' satisfaction and reduce turnover. Private Hospital is competing with each other using fringe benefits to attract more competent nurses. Nurses perceived the safety and security as the highly motivating item at the same time periodical medical checkup is highly motivating items for nurses. Nurses are exposed to infection so periodical medical checkup is important for early detection of any health problem, also make them feel cared for by the administration. The finding of the study indicated that the availability of change area and place for break time is highly motivating item [9]. Pointed out that equipped change room increase job satisfaction and performance Meals as fringe benefits were perceived as a high motivating item by the nurses it may be the nurse's works require mental and physical effort, also sometimes they work extra hours, so availability of meals supplied by the hospital is important. The result of the study indicated that the majority of the respondents are young age and at the bearing age. This may explain the finding that the availability of nursery is a highly motivating items for them [101 found that unavailability of nursery was the reason for the nurses dissatisfaction. The respondents perceived supervision & guidance as high motivating area. Good supervision creates positive social environment and solve problem before they interfere with performance it's important that the leader should be aware that employees' needs to be motivated, acknowledgment, praise, encourage feedback, opportunities to take responsibility, consistency and sincerity from their leader and coworker and job security The respondent perceived polices against careless nurse as a high motivating item this may be taking action against careless nurse make other feel their performance is indirectly appreciated, as well it may force poor performance to improve their performance The study indicated that the difference between Elmonira Hospital and Aboelreesh Hospital is significant on the supervision, guidance and social work environment factors. Aboelreesh Hospital Nurses' perceived supervision and guidance as well social work environment factor as more motivating compared to elmonira hospital nurses. The difference between the nurses of the two hospitals in perception of the social relationship as motivating one could be attributed to the difference between the culture of the two hospital. Conclusion: The present study concluded that the social work environment, supervision and guidance were perceived by the nurses as the highly motivating factors compared to hospital policy, participation, achievement pay and fringe benefits recognition and promotion perceived as moderate motivating factors the nature of work factor perceived by the respondent as un motivating factors. However there are several highly motivating item within each factor such as: Clear job description, nurse patient ratio, availability of nurse aid, nurse patient ratio, availability of training program, respectable relationship within the hospital, respect from worker to nurse, respect from doctor to nurse, cooperation among nurse, meal for nurses, periodical medical checkup, work environment free from tension and stress, nursery for nurses children, safety & security in the hospital, fair selection for the best nurse, recognition for outstanding work, polices against carless nurse and career ladder for nurses, criticism is given privately. Recommendation: Nurses are given the opportunity for involvement in decision making especially decision related to nurse. There should be job description for each position in the nursing service department and be communicated to the nurses. Periodical medical checkup for all nurses has to be done at specified interval because the nature of their work exposes them to many hazards.

5 Radwa M. Said, et al. 31 To reduce staff nurse workload nurse aid has to be employed by the hospital and be trained to activities that relieve nurses for professional activities. Meal needs to be available for nurses during long and night shift or providing meals with low price. Availability of appropriate change rooms with locker for nurses. Further study should be done to investigate nurses' satisfaction with the item which perceived as a highly motivated. References 1- YILDIZ Z., AYHAN S. and ERDOGMUS S.: The Impact of nurses' motivation to work, job satisfaction, and social demographic characteristics on intention to quit their current job: An empirical study in turkey, Applied Nursing Research, 22 (3): , OSTRAKER M.: Measuring motivation in dynamic organization a contingency approach, strategic change, 3rd Ed. Mosby Comp., USA, Pp , TROSSMAN J.A., LANDEWEERD G.E. and TUMMERS G.G.: A comparative study of organizational characteristics, work characteristics and nurses psychological work reactions in a hospital and nursing home settings, International Journal of Nursing Studies, 43 (4): , SUOMINEN T., LEINO-KILPI H., MERJA M., DORAN D.I. and PUUKKA P.: Staff empowerment in finnish intensive care units, Intensive and Critical Care Nursing, 17 (8): , SAMITH G.P.: Motivation in human resources management and development handbook. (7Th Ed., u, Pp.70-90), New York: Amaco, PHILIPS J.S.: Evolution of affective career outcomes: A field study of academic librarians. College and Research Libraries, 55 (6): , RYAN J.W. and THOMPSON K.O.: Changing how nurses spend their time. Image: The Journal of Nursing Scholarship, 23 (1): 23-28, TUMULTY G., JENIGAN I.G. and KOHUT G.F.: The impact of perceived work environment on job satisfaction of hospital staff nurses. Applied Nursing Research, 7 (6): 84-90, ALI R. and AHMED M.S.: The impact of reward and recognition programs on employee's motivation and satisfaction: An empirical study. International Review of Business Research Pepers, 5 (4): , SEMBLI S.: Job satisfaction of nurses working at Turkish Military Medicine Journal of Nursing Administration, 162 (2): , JOSEPH E.E. and WINSTON B.E.: A correlation of motivational leadership, leader trust and organizational trust. Leadership & Organization Development Journal, 26 (1): 6-22, 2005.