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A study of motivating factors among nurses in Nigeria
ht. .I. Nurs. Stud.. Vol. 20.No. 4. pp. Printed in Great Britain
im2&7489/83 s3.00+0.00 0 1983 Pn~emon Press Ltd
215-221, 1983
A study of motivatingfactors among nurses in Nigeria MUSA KOLAWOLE JINADU, M.Comm.H., M.P.A. ,R.N., R.P.H.N.T., F.W.A.C.N. andD. A. JAIYEOBA, B.Sc., M.Sc., R.N., F.W.A.C.N. Faculty of Health Sciences, Universityof Ife, Iie-Ife, Nigeria.
Effective performance of nurses is crucial to the success of health care organization. Such performance depends not only on acquired skill and knowledge but also on individual motivation. Therefore, an understanding of what motivates nurses in different cultures and environments is needed to explain their job attitudes and job performance. In Nigeria, the problem of how to motivate nurses, and other health workers, is considerable. It is a common observation that many young nurses are leaving the profession for other jobs and the majority of those that are left behind are performing below expectation. Whatever might be responsible for this sad state of affairs, it is probable that the majority of these nurses entered into the profession with a strong desire to care for the sick. However, somewhere along the line they felt frustrated and lost their initial motivation. With this problem in mind, this study is designed to provide some explanations of the factors influencing job attitudes and job performance among nurses in a developing country. The study will also help to verify some theories of motivation developed in industrialized countries as applied to a non-industrialized and developing country. Brief literature review
Over the past three decades, methods of organizing workers to achieve specific organizational goals have undergone considerable changes, largely as a result of studies and scholarly articles devoted to motivation in organizations (McGregor, 1960; Cofer and Appley, 1964; Miner and Dachler, 1973; Cooper, 1974). Research has focused on three main questions: why people choose a particular work role, the extent of their satisfaction with a chosen work role and why people of apparently similar abilities perform differently in their chosen work roles (Torrington and Chapman, 1979). The work of Vroom (1964) and Candy and Trumbo (1976) provided some preferences to primary sources of the theories of motivation. Campbell et al. (1970) divided the theories into two broad classes: content theories and process theories, as shown diagramatically in Table 1. 215
216
MUSA KOLA WOLE JINADUAND
D. A. JAIYEOBA
Table 1. Summary of two groups of motivation theories
Type
Characteristics
Examples of theories
Management examples
Content theories
Describe human motives in terms of needs, drives and goals which arouse behaviour
1. Needs hierarchy of Maslow (1943)
Motivation by satisfying individual needs, e.g. money and status
Process theories
Concerned with factors that arouse behaviour but also the process or choice of the the behavioural patterns
2. Two-factor Theory of Herzberg (1966) 1. Expectancy Theory of Lewin and Vroom (1964) 2. Equity Theory of of Adams (1965)
Through individual perception of work input/ performance requirements and rewards
The most popular of the content theories is that of Maslow (1943) who provided a framework for integrating many of the preceding content theories of motivation. He classified needs into five categories, popularly known as Maslow’s hierarchy of needs, as follows: physiological needs, safety needs, social needs, esteem needs and actualization needs. Physiological, safety and social needs were considered as lower-order needs which could be satisfied by economic rewards, whilst esteem and actualization needs were higher-order needs which could be satisfied by the nature of the work itself (Torrington and Chapman, 1979). Another popular content theory was the two-factor theory developed by Herzberg (1966) in relation to the criticisms of Maslow’s work. Herzberg argued that some of the organizational factors relating to Maslow’s hierarchy of needs were simply “hygiene factors” which motivate negatively and only reduce levels of dissatisfaction. Some process theories, represented by the Equity Theory of Adams (1965), focus on outcome of work in relation to personal input. Other important process theories are Goal Setting Theory of Locke (1968) and VIE (Valence Instrumental Expectant) Theory of Vroom (1964), and Porter and Lawler (1968). In summary, there is no theory of motivation that has universal applicability and acceptability. Many of the content and process theories offer some useful but partial explanations of work behaviour and action based on them cannot always guarantee desired results. Therefore, scientific verification of the theories will lead to their judicious applications in various organizational settings. Materials and methods
The population of the study consisted of registered nurses with at least 1 year postregistration experience, working in a University of Ife Teaching Hospital in Oyo State of Nigeria. The study thus covered nurses with a wide variety of qualifications and experience. A five-page self-administered questionnaire, which contained sixteen closed and two
MOTIVATING
FACTORS
AMONG NURSES IN NIGERIA
211
open-ended questions, and which took about 25 minutes to complete, was used to collect the necessary data for the study. The questionnaire was distributed by a research assistant but was accompanied by a letter from the authors, soliciting the cooperation of the nurses with the study. It was stated in the letter that the study was part of the on-going research into the problems of how to improve nursing services and image of nursing in the country. (The two authors are well-known to the respondents as teachers and researchers in nursing.) The respondents were asked in the letter not to give their names in order to ensure free and better responses. The questionnaire was designed to elicit information on some demographic and professional characteristics of the nurses, factors perceived as influencing promotion of nurses, desire to leave nursing for another job in the near future and other related factors. Herzberg’s method of story telling, or critical incident methodology (Herzberg, 1966) was used to obtain specific information on factors affecting performance at work among the nurses. To identify factors leading to increased motivation, the nurses were asked: “Think of a time when you felt exceptionally satisfied with your nursing duty. Tell us what happened.” To identify factors leading to decrease in motivation at work they were asked: “Think of a time when you felt exceptionally dissatisfied with your present nursing duty. Tell us what happened.” Analysis of the stories was carried out, using Herzberg’s framework. The stories were scored independently by the two authors, with 95% agreement between the scorers. The 5% of the scores in which there were disagreements were then re-scored by a third person who had no knowledge of the previous scores. Most of the stories told by the nurses were simple and straightforward and therefore presented no severe problem of interpretation. 118 Questionnaires were distributed and 96 (81.4%) were returned fairly completed. The data were coded and analysed by hand.
Results
Table 2 shows some demographic and professional characteristics of the 96 nurses. About half (47.9%) were within the age-group of 26-35 years, 24.0% were below 26 years and the rest were above 35 years. Seventy-five per cent were females and 65.6% were married. 10.4% were staff midwives, 33.3% were staff nurses, 39.6% were staff nurses and midwives, 14.6% were nursing sisters and charge nurses, and the rest (2.1%) were nurses with a degree in nursing. Table 3 shows the distribution of the nurses according to their professional status and years of experience. 68.7% of the nurses had less than 6 years experience and these were staff nurses, staff midwives, staff nurses and midwives and graduate nurses. The rest (3 1.3 Vo)had over 6 years experience, half of whom were nursing sisters. In Table 4, responses of the nurses to the question on whether or not they wish to leave nursing in the near future were cross-analysed with what they perceived as influencing promotion of nurses (perceived fairness) and also the length of service of the nurses. Table 4 shows that the majority of the nurses did not wish to leave nursing in the near future. However, among those who wish to leave nursing, the majority of them (62.5%) perceived personal influences, such as blood or social relationship to a nurse administrator, as a major factor influencing promotion of a nurse rather than hard work, management and technical abilities. There was no significant difference (P > 0.01) in the
218
MUSA KOLA WOLE JINADUAND
D. A. JAIYEOBA
Table 2. Age, sex, marital and professional status of the 96 nurses Variable
W)
Age group < 25 26-35 36-45 > 45 Total
24.0 47.0 14.6 13.5
100.0
Sex Male Female Total
25.0 75.0
100.0
Marital status Single Married Total
100.0
Professional status Staff midwife Staff nurse Staff nurse and midwife Nursing sister and charge nurse Graduate nurse Total
10.4 33.3 39.6 14.6 2.1 100.0
54.4 55.6
Table 3. Distribution of the nurses according fessional status and years of experience Years of experience
Staff Nurse, staff Midwife and graduate Nurse
<3 3-5 6-10 > 10
Nursing sister/ charge nurse
30 36 15
to pro-
(Qo)
31.2 37.5 19.8 11.5
4 11
Total
100.0
Table 4. Desire to change or not to change job in the near future vs fairness in consideration for promotion and duration of service among the nurses Factors perceived as influencing promotion
Desired to change job
No desire to change job
n
n
(Q)
Hard work, management and technical abilities 12 37.5 41 Personal influences 20 62.5 16 Total 32 100.0 57 ~Z=8.70.D.F.=1,N.S.at0.01 Duration of service l-5 years 6-10 years Over 10 years Total
20 55.6 46 11 30.5 8 5 13.9 6 36 100.0 60 ~~=5.12,D.F.=2,N.S.at0.01
(Q) 71.9 28.1 100.0
76.7 13.3 10.0 100.0
MOTIVA TING FACTORS
AMONG NURSES IN NIGERIA
219
perception of fairness of promotion exercise between this group of nurses and those who did not wish to change their occupation in the near future. Furthermore, Table 4 shows that there was no significant relationship (P > 0.01) between the length of service of the nurses and their desires to leave, or not to leave, nursing in the near future. Table 5 shows percentage distribution of the motivator and hygiene factors extracted from 73 motivator stories and 85 hygiene stories told by the nurses, using critical incidence methodology and Herzberg’s framework of analysis. It is important to mention that each nurse told one motivator and one hygiene story, from which one motivator and one hygiene factor were extracted. Among the motivator factors, “achievements” (63%) dominated the periods when the nurses felt exceptionally happy with their job. “Recognition” (16.4%) followed achievement as a motivator. The “work itself” (6.8%) and “responsibility for work” (4.1 (r/o)ranked third and fourth respectively. Table 5. Factors affecting job attitudes that led to extreme satisfaction (motivation) and extreme dissatisfaction (hygiene factor) at work among the nurses Motivators Achievement Recognition Advancement The work itself Responsibility for work Total Hygiene factors Hospital’s policy and administration Working conditions Relationship with supervisor Interpersonal relationship Total
n
%
46 12 7 5 3 731
63.0 16.4 9.6 6.8 4.1 99.9
47 31 5 2 85*
55.3 36.5 5.9 2.3 100.0
*Seventy-three motivator stories and 85 demotivator stories were told.
Among the factors leading to job dissatisfaction among the nurses, that is, hygiene factors, “hospital’s policy and administration” accounted for 55.3%. This was followed by “working conditions” (36.5%), “supervision” (5.9%) and “interpersonal relationships” (2.3%). Discussion
In this study, some factors affecting job attitudes and job performance among nurses in a Nigerian socio-cultural environment were investigated. Of significance was the use of critical incident methodology in the investigation of the two-factor theory of Herzberg (1966). Before discussing the main findings of this study it is important to mention some of its limitations. The two-factor theory had been criticized as “method bond” and that ego defences were at work when people said they were satisfied or dissatisfied (Sarveswara Rao, 1972). Also, our study is limited to the nurses’ view about their jobs and no attempt was made to collect objective indices of their performance. However, since many factors derived from the theories of motivation were investigated together, the study thus offers us some useful information about job attitudes and job performance among the nurses in Nigeria.
220
MUSA KOLA WOLE JINADUAND
D. A. JAIYEOBA
This study shows that the majority of nurses who wanted to leave the nursing profession in the near future were those who perceived the system of rewarding performances, in the form of promotion, as being unjust. The majority of the nurses had not been promoted after many years of service, and when asked why they wanted to leave the profession, desire to earn better income was their main motivation for contemplating a change of job. Although duration of service of the nurses was a major determinant of promotion prospect, a shown by the fact that all those who had served for 10 years or more had been promoted and none with less than 6 years experience had been promoted, the duration of service did not appear to affect the desire of the nurses to change or not to change their occupation. Therefore one can reasonably conclude that the more experienced nurses did not appear to derive better job satisfaction than the less experienced ones. From the analysis of the stories of job satisfaction, achievement dominated the periods when the nurses felt exceptionally satisfied with their work. Recognition follows achievement-a finding which agrees with Herzberg’s (1966). Most of the achievement stories concerned successful nursing care of critically-ill patients. However, advancement in the form of more responsibilities and opportunities for growth must accompany recognitions and achievements if they are to serve as motivators. Unfortunately, this has not happened among the nurses studied, as shown by the lack of promotion prospects among the nurses. The number of stories concerning advancement, the work itself and responsibility for work were very small and their order of occurrence was, probably as a result of this, different from Herzberg’s. Four hygiene factors were identified from the stories of job dissatisfaction told by the nurses. While the order of their distribution agrees with the findings of Herzberg’s, there was the absence of a salary administrative factor in our study. This was due to the fact that there was a unified system of salary administration in governmental and parastatal organizations in the country, which most of the hospitals in the country were part of, and any dissatisfaction with salary administration was bound to be universal. Examples of hospital’s policies and administration given by the nurses were: lack of adequate authority to discharge their responsibilities to patients; policies on promotion; and lack of inservice education. Examples of working conditions were: too many non-nursing duties; inadequate facilities for patient care; and constant shortage of nurses. Lack of, and inadequate, clinical supervision of inexperienced staff nurses and students, lack of cooperation and absence of team-work spirit among the health care workers were the least mentioned of the factors leading to extreme dissatisfaction at work. Herzberg (1966) argued that the physiological, safety and social needs of Maslow’s were simply lower order needs which only reduce levels of dissatisfaction at work and therefore do not positively motivate workers. Herzberg formulated his theory from his observations and studies of workers in a developed country. However, our study shows the need for some modification of the theory when applied to underdeveloped countries like Nigeria. Economic incentives cannot be easily discounted as motivators in a society with no other form of organized social security system in the face of disintegrating traditional society. In the absence of an adequate governmental social security system that can guarantee adequate income and support in old age, individual health workers will perceive adequate income as incentives to hard work. There are other innumerable financial burdens imposed on the nurses and other workers by the extended family system which make adequate economic reward a basic requirement for job satisfaction in the country.
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Conclusion
This study identified some factors affecting job attitudes and satisfaction at work among hospital-based nurses in Nigeria. Although the main factors found that make nurses fully satisfied with their work were such factors which, when built into a job, make for a job-enrichment programme and therefore satisfied higher goals (such as the needs for self-esteem and actualization), lower-order needs, that is physiological and safety needs in the form of adequate financial rewards, figured so largely in the study that one cannot but conclude that they are powerful motivators and not simply satisfiers among the nurses in Nigerian socio-cultural environment. In relation to the above, achievements at work, a higher-order need, without tangible rewards in the form of promotion and other forms of advancement and recognition will lead to frustration and poor performance at work among the nurses. The study shows that some of the theories of motivation, especially Herzberg’s, with some modifications, have important implications for personnel management in health care organization of developing countries. However, further studies need to be conducted on the precise effects of job attitudes, job satisfaction and job dissatisfaction on work performance, thus operationalizing some of the theories among the health care and other workers, as a further verification of them. References Adams, J. S. (1965). Inequality in social exchange. In Advunces in Experimental Social Psychology. Berkowitz (Ed.), Vol. 2, pp. 267-279. Academy Press, Campbell. Campbell, J. W., Dunnettee, M. D., Lawler, E. E. and Weich, K. W. Jr. (1970). Managerial Behaviour, Performonce and Effectiveness. McGraw-Hill, New York. Candy, F. T. and Trumbo, D. A. (1976). Psychology of Work Behaviour. Dorsey, Homewood. Wiley, New York. Cofer, N. C. and Appley, M. H. (1964). Motivation TheoryandResearch. Cooper, R. (1974). Job Motivation and Job Design. Institute of Personnel Management, U.K. Herzberg, F. (1966). Work and the Nuture of Mon. World Publishing, Cleveland. Locke, E. A. (1968). Towards a theory of task motivation and incentives. Org. Behav. hum. Perform. 3, 157-187.
Maslow, A. H. (1943). A theory of human motivation. Psychoi. Rev. M,370-3%. McGregor, D. (1960). The Humun Side of Enterprise,. McGraw-Hill, New York. Miner, J. B. and Dachler, H. P. (1973). Personnel attitudes and motivation. A. Rev. Psychol. 24,379-402. Porter, L. W. and Lawler, E. E. (1968) ManagerialAttitude and Performance. Irwin-Dorsey, Arundel. Sarveswara Rao, G. V. (1972). Theoretical and empirical consideration of the two-factor theory of job satisfaction. Ind. J. Indust. Relat. 7,3 1l-330. Torrington, D. and Chapman, J. (1979). Personnel Munagement, pp. 98-115. Prentice-Hall, Englewood Cliffs. Vroom, V. H. (1964). WorkondMotivotion. Wiley, New York. (Received 5 January 1983; acceptedforpublication
28 June 1983)
M. K. Jinadu is a lecturer in occupational health, health administration and primary health care in the Faculty of Health Sciences of the University of Ife. He is a foundation fellow of the West African College of Nursing and an author of a number of articles in international journals. D. A. Jaiyeoba is also a lecturer in psychiatric nursing in the Faculty of Health Sciences, University of Ife. He studied nursing in Nigeria and the U.S.A. and is also a foundation fellow of the W.A.C.N.
im2&7489/83 s3.00+0.00 0 1983 Pn~emon Press Ltd
215-221, 1983
A study of motivatingfactors among nurses in Nigeria MUSA KOLAWOLE JINADU, M.Comm.H., M.P.A. ,R.N., R.P.H.N.T., F.W.A.C.N. andD. A. JAIYEOBA, B.Sc., M.Sc., R.N., F.W.A.C.N. Faculty of Health Sciences, Universityof Ife, Iie-Ife, Nigeria.
Effective performance of nurses is crucial to the success of health care organization. Such performance depends not only on acquired skill and knowledge but also on individual motivation. Therefore, an understanding of what motivates nurses in different cultures and environments is needed to explain their job attitudes and job performance. In Nigeria, the problem of how to motivate nurses, and other health workers, is considerable. It is a common observation that many young nurses are leaving the profession for other jobs and the majority of those that are left behind are performing below expectation. Whatever might be responsible for this sad state of affairs, it is probable that the majority of these nurses entered into the profession with a strong desire to care for the sick. However, somewhere along the line they felt frustrated and lost their initial motivation. With this problem in mind, this study is designed to provide some explanations of the factors influencing job attitudes and job performance among nurses in a developing country. The study will also help to verify some theories of motivation developed in industrialized countries as applied to a non-industrialized and developing country. Brief literature review
Over the past three decades, methods of organizing workers to achieve specific organizational goals have undergone considerable changes, largely as a result of studies and scholarly articles devoted to motivation in organizations (McGregor, 1960; Cofer and Appley, 1964; Miner and Dachler, 1973; Cooper, 1974). Research has focused on three main questions: why people choose a particular work role, the extent of their satisfaction with a chosen work role and why people of apparently similar abilities perform differently in their chosen work roles (Torrington and Chapman, 1979). The work of Vroom (1964) and Candy and Trumbo (1976) provided some preferences to primary sources of the theories of motivation. Campbell et al. (1970) divided the theories into two broad classes: content theories and process theories, as shown diagramatically in Table 1. 215
216
MUSA KOLA WOLE JINADUAND
D. A. JAIYEOBA
Table 1. Summary of two groups of motivation theories
Type
Characteristics
Examples of theories
Management examples
Content theories
Describe human motives in terms of needs, drives and goals which arouse behaviour
1. Needs hierarchy of Maslow (1943)
Motivation by satisfying individual needs, e.g. money and status
Process theories
Concerned with factors that arouse behaviour but also the process or choice of the the behavioural patterns
2. Two-factor Theory of Herzberg (1966) 1. Expectancy Theory of Lewin and Vroom (1964) 2. Equity Theory of of Adams (1965)
Through individual perception of work input/ performance requirements and rewards
The most popular of the content theories is that of Maslow (1943) who provided a framework for integrating many of the preceding content theories of motivation. He classified needs into five categories, popularly known as Maslow’s hierarchy of needs, as follows: physiological needs, safety needs, social needs, esteem needs and actualization needs. Physiological, safety and social needs were considered as lower-order needs which could be satisfied by economic rewards, whilst esteem and actualization needs were higher-order needs which could be satisfied by the nature of the work itself (Torrington and Chapman, 1979). Another popular content theory was the two-factor theory developed by Herzberg (1966) in relation to the criticisms of Maslow’s work. Herzberg argued that some of the organizational factors relating to Maslow’s hierarchy of needs were simply “hygiene factors” which motivate negatively and only reduce levels of dissatisfaction. Some process theories, represented by the Equity Theory of Adams (1965), focus on outcome of work in relation to personal input. Other important process theories are Goal Setting Theory of Locke (1968) and VIE (Valence Instrumental Expectant) Theory of Vroom (1964), and Porter and Lawler (1968). In summary, there is no theory of motivation that has universal applicability and acceptability. Many of the content and process theories offer some useful but partial explanations of work behaviour and action based on them cannot always guarantee desired results. Therefore, scientific verification of the theories will lead to their judicious applications in various organizational settings. Materials and methods
The population of the study consisted of registered nurses with at least 1 year postregistration experience, working in a University of Ife Teaching Hospital in Oyo State of Nigeria. The study thus covered nurses with a wide variety of qualifications and experience. A five-page self-administered questionnaire, which contained sixteen closed and two
MOTIVATING
FACTORS
AMONG NURSES IN NIGERIA
211
open-ended questions, and which took about 25 minutes to complete, was used to collect the necessary data for the study. The questionnaire was distributed by a research assistant but was accompanied by a letter from the authors, soliciting the cooperation of the nurses with the study. It was stated in the letter that the study was part of the on-going research into the problems of how to improve nursing services and image of nursing in the country. (The two authors are well-known to the respondents as teachers and researchers in nursing.) The respondents were asked in the letter not to give their names in order to ensure free and better responses. The questionnaire was designed to elicit information on some demographic and professional characteristics of the nurses, factors perceived as influencing promotion of nurses, desire to leave nursing for another job in the near future and other related factors. Herzberg’s method of story telling, or critical incident methodology (Herzberg, 1966) was used to obtain specific information on factors affecting performance at work among the nurses. To identify factors leading to increased motivation, the nurses were asked: “Think of a time when you felt exceptionally satisfied with your nursing duty. Tell us what happened.” To identify factors leading to decrease in motivation at work they were asked: “Think of a time when you felt exceptionally dissatisfied with your present nursing duty. Tell us what happened.” Analysis of the stories was carried out, using Herzberg’s framework. The stories were scored independently by the two authors, with 95% agreement between the scorers. The 5% of the scores in which there were disagreements were then re-scored by a third person who had no knowledge of the previous scores. Most of the stories told by the nurses were simple and straightforward and therefore presented no severe problem of interpretation. 118 Questionnaires were distributed and 96 (81.4%) were returned fairly completed. The data were coded and analysed by hand.
Results
Table 2 shows some demographic and professional characteristics of the 96 nurses. About half (47.9%) were within the age-group of 26-35 years, 24.0% were below 26 years and the rest were above 35 years. Seventy-five per cent were females and 65.6% were married. 10.4% were staff midwives, 33.3% were staff nurses, 39.6% were staff nurses and midwives, 14.6% were nursing sisters and charge nurses, and the rest (2.1%) were nurses with a degree in nursing. Table 3 shows the distribution of the nurses according to their professional status and years of experience. 68.7% of the nurses had less than 6 years experience and these were staff nurses, staff midwives, staff nurses and midwives and graduate nurses. The rest (3 1.3 Vo)had over 6 years experience, half of whom were nursing sisters. In Table 4, responses of the nurses to the question on whether or not they wish to leave nursing in the near future were cross-analysed with what they perceived as influencing promotion of nurses (perceived fairness) and also the length of service of the nurses. Table 4 shows that the majority of the nurses did not wish to leave nursing in the near future. However, among those who wish to leave nursing, the majority of them (62.5%) perceived personal influences, such as blood or social relationship to a nurse administrator, as a major factor influencing promotion of a nurse rather than hard work, management and technical abilities. There was no significant difference (P > 0.01) in the
218
MUSA KOLA WOLE JINADUAND
D. A. JAIYEOBA
Table 2. Age, sex, marital and professional status of the 96 nurses Variable
W)
Age group < 25 26-35 36-45 > 45 Total
24.0 47.0 14.6 13.5
100.0
Sex Male Female Total
25.0 75.0
100.0
Marital status Single Married Total
100.0
Professional status Staff midwife Staff nurse Staff nurse and midwife Nursing sister and charge nurse Graduate nurse Total
10.4 33.3 39.6 14.6 2.1 100.0
54.4 55.6
Table 3. Distribution of the nurses according fessional status and years of experience Years of experience
Staff Nurse, staff Midwife and graduate Nurse
<3 3-5 6-10 > 10
Nursing sister/ charge nurse
30 36 15
to pro-
(Qo)
31.2 37.5 19.8 11.5
4 11
Total
100.0
Table 4. Desire to change or not to change job in the near future vs fairness in consideration for promotion and duration of service among the nurses Factors perceived as influencing promotion
Desired to change job
No desire to change job
n
n
(Q)
Hard work, management and technical abilities 12 37.5 41 Personal influences 20 62.5 16 Total 32 100.0 57 ~Z=8.70.D.F.=1,N.S.at0.01 Duration of service l-5 years 6-10 years Over 10 years Total
20 55.6 46 11 30.5 8 5 13.9 6 36 100.0 60 ~~=5.12,D.F.=2,N.S.at0.01
(Q) 71.9 28.1 100.0
76.7 13.3 10.0 100.0
MOTIVA TING FACTORS
AMONG NURSES IN NIGERIA
219
perception of fairness of promotion exercise between this group of nurses and those who did not wish to change their occupation in the near future. Furthermore, Table 4 shows that there was no significant relationship (P > 0.01) between the length of service of the nurses and their desires to leave, or not to leave, nursing in the near future. Table 5 shows percentage distribution of the motivator and hygiene factors extracted from 73 motivator stories and 85 hygiene stories told by the nurses, using critical incidence methodology and Herzberg’s framework of analysis. It is important to mention that each nurse told one motivator and one hygiene story, from which one motivator and one hygiene factor were extracted. Among the motivator factors, “achievements” (63%) dominated the periods when the nurses felt exceptionally happy with their job. “Recognition” (16.4%) followed achievement as a motivator. The “work itself” (6.8%) and “responsibility for work” (4.1 (r/o)ranked third and fourth respectively. Table 5. Factors affecting job attitudes that led to extreme satisfaction (motivation) and extreme dissatisfaction (hygiene factor) at work among the nurses Motivators Achievement Recognition Advancement The work itself Responsibility for work Total Hygiene factors Hospital’s policy and administration Working conditions Relationship with supervisor Interpersonal relationship Total
n
%
46 12 7 5 3 731
63.0 16.4 9.6 6.8 4.1 99.9
47 31 5 2 85*
55.3 36.5 5.9 2.3 100.0
*Seventy-three motivator stories and 85 demotivator stories were told.
Among the factors leading to job dissatisfaction among the nurses, that is, hygiene factors, “hospital’s policy and administration” accounted for 55.3%. This was followed by “working conditions” (36.5%), “supervision” (5.9%) and “interpersonal relationships” (2.3%). Discussion
In this study, some factors affecting job attitudes and job performance among nurses in a Nigerian socio-cultural environment were investigated. Of significance was the use of critical incident methodology in the investigation of the two-factor theory of Herzberg (1966). Before discussing the main findings of this study it is important to mention some of its limitations. The two-factor theory had been criticized as “method bond” and that ego defences were at work when people said they were satisfied or dissatisfied (Sarveswara Rao, 1972). Also, our study is limited to the nurses’ view about their jobs and no attempt was made to collect objective indices of their performance. However, since many factors derived from the theories of motivation were investigated together, the study thus offers us some useful information about job attitudes and job performance among the nurses in Nigeria.
220
MUSA KOLA WOLE JINADUAND
D. A. JAIYEOBA
This study shows that the majority of nurses who wanted to leave the nursing profession in the near future were those who perceived the system of rewarding performances, in the form of promotion, as being unjust. The majority of the nurses had not been promoted after many years of service, and when asked why they wanted to leave the profession, desire to earn better income was their main motivation for contemplating a change of job. Although duration of service of the nurses was a major determinant of promotion prospect, a shown by the fact that all those who had served for 10 years or more had been promoted and none with less than 6 years experience had been promoted, the duration of service did not appear to affect the desire of the nurses to change or not to change their occupation. Therefore one can reasonably conclude that the more experienced nurses did not appear to derive better job satisfaction than the less experienced ones. From the analysis of the stories of job satisfaction, achievement dominated the periods when the nurses felt exceptionally satisfied with their work. Recognition follows achievement-a finding which agrees with Herzberg’s (1966). Most of the achievement stories concerned successful nursing care of critically-ill patients. However, advancement in the form of more responsibilities and opportunities for growth must accompany recognitions and achievements if they are to serve as motivators. Unfortunately, this has not happened among the nurses studied, as shown by the lack of promotion prospects among the nurses. The number of stories concerning advancement, the work itself and responsibility for work were very small and their order of occurrence was, probably as a result of this, different from Herzberg’s. Four hygiene factors were identified from the stories of job dissatisfaction told by the nurses. While the order of their distribution agrees with the findings of Herzberg’s, there was the absence of a salary administrative factor in our study. This was due to the fact that there was a unified system of salary administration in governmental and parastatal organizations in the country, which most of the hospitals in the country were part of, and any dissatisfaction with salary administration was bound to be universal. Examples of hospital’s policies and administration given by the nurses were: lack of adequate authority to discharge their responsibilities to patients; policies on promotion; and lack of inservice education. Examples of working conditions were: too many non-nursing duties; inadequate facilities for patient care; and constant shortage of nurses. Lack of, and inadequate, clinical supervision of inexperienced staff nurses and students, lack of cooperation and absence of team-work spirit among the health care workers were the least mentioned of the factors leading to extreme dissatisfaction at work. Herzberg (1966) argued that the physiological, safety and social needs of Maslow’s were simply lower order needs which only reduce levels of dissatisfaction at work and therefore do not positively motivate workers. Herzberg formulated his theory from his observations and studies of workers in a developed country. However, our study shows the need for some modification of the theory when applied to underdeveloped countries like Nigeria. Economic incentives cannot be easily discounted as motivators in a society with no other form of organized social security system in the face of disintegrating traditional society. In the absence of an adequate governmental social security system that can guarantee adequate income and support in old age, individual health workers will perceive adequate income as incentives to hard work. There are other innumerable financial burdens imposed on the nurses and other workers by the extended family system which make adequate economic reward a basic requirement for job satisfaction in the country.
MOTIVATING
FACTORS
AMONG NURSES IN NIGERIA
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Conclusion
This study identified some factors affecting job attitudes and satisfaction at work among hospital-based nurses in Nigeria. Although the main factors found that make nurses fully satisfied with their work were such factors which, when built into a job, make for a job-enrichment programme and therefore satisfied higher goals (such as the needs for self-esteem and actualization), lower-order needs, that is physiological and safety needs in the form of adequate financial rewards, figured so largely in the study that one cannot but conclude that they are powerful motivators and not simply satisfiers among the nurses in Nigerian socio-cultural environment. In relation to the above, achievements at work, a higher-order need, without tangible rewards in the form of promotion and other forms of advancement and recognition will lead to frustration and poor performance at work among the nurses. The study shows that some of the theories of motivation, especially Herzberg’s, with some modifications, have important implications for personnel management in health care organization of developing countries. However, further studies need to be conducted on the precise effects of job attitudes, job satisfaction and job dissatisfaction on work performance, thus operationalizing some of the theories among the health care and other workers, as a further verification of them. References Adams, J. S. (1965). Inequality in social exchange. In Advunces in Experimental Social Psychology. Berkowitz (Ed.), Vol. 2, pp. 267-279. Academy Press, Campbell. Campbell, J. W., Dunnettee, M. D., Lawler, E. E. and Weich, K. W. Jr. (1970). Managerial Behaviour, Performonce and Effectiveness. McGraw-Hill, New York. Candy, F. T. and Trumbo, D. A. (1976). Psychology of Work Behaviour. Dorsey, Homewood. Wiley, New York. Cofer, N. C. and Appley, M. H. (1964). Motivation TheoryandResearch. Cooper, R. (1974). Job Motivation and Job Design. Institute of Personnel Management, U.K. Herzberg, F. (1966). Work and the Nuture of Mon. World Publishing, Cleveland. Locke, E. A. (1968). Towards a theory of task motivation and incentives. Org. Behav. hum. Perform. 3, 157-187.
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28 June 1983)
M. K. Jinadu is a lecturer in occupational health, health administration and primary health care in the Faculty of Health Sciences of the University of Ife. He is a foundation fellow of the West African College of Nursing and an author of a number of articles in international journals. D. A. Jaiyeoba is also a lecturer in psychiatric nursing in the Faculty of Health Sciences, University of Ife. He studied nursing in Nigeria and the U.S.A. and is also a foundation fellow of the W.A.C.N.