AI.'l APFLICA nON OF HERZBERG'S MOTIVATIONAL THEORY ON A SURGICAL UNIT by Tanna S. Ferrin A thesis subnitted to the faculty of the University of Utah in partial fulfillment of the requirements for the degree of Master of Science College of Nursing University of Utah March 1978
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Application of Herzberg's motivational theory on a surgical unit;
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AI.'l APFLICA nON OF
HERZBERG'S MOTIVATIONAL THEORY
ON A SURGICAL UNIT
by
Tanna S. Ferrin
A thesis subnitted to the faculty of the University of Utah in partial fulfillment of the requirements
1970; Saleh, Les, & Prien, 1965) such as moving out of the city,
pregnancYt getting married, caring for their family, family health
problems, home responsibilities, poor health, retirement, com
pletion of education, conflict with husbandts work t husbond going
on to school, and involuntary termination.
However. it is thought that the other one third of nurses who
left for "volunta.ry reasons" oan provide the most valu3.ble infor
mation on how to increase job satisfaction and decrease turnover
rates. In the Catania (1964), Lyons (1970), and Saleh, Lee, and
Prien (1965) studies the following reasons \,;tere given for voluntary
turnover (this list is not in any particular order):
1- Taking other jobs 2- Dissatisfaction ~~th job or hospital 3- ~ature of ~ork: hours of work, heav~ work load,
not usL~g experience or ability, too much pressure 4_ Lack of promotion 5- Need for new experience 6- Unclear rules, regulations, and lL~its of authority 7- Supervision and human relations: not treated fairly,
did not like supervision, good work not recognized, difficulty in exchanging information with others about the job
8- iI/ages 9- Fellow TNOrkers
10- Inadequate explanations of decisions affecting the job
11- Poor planning
The important realization developing is ~~at wages and the
hours worked are not the major reasons for nurses quitting as it
10
has been assumed in the past. Popular opinion has been that ~uch
could not be done to decrease the turnover rate in hospital nursing
since the hours of work and the wages paid could not be drastically
altered. Hospitals require nurses 24 hours a day seven days a
week and increasing nurse's salaries would necessitate raising
hospital costs. However higher wages and better working hours
consistently are of low importance in studies dete~~ning why
nurses leave their jobs (Benton & ~hite, 1972; Everly & Falcione,
1976; Kr~~er, 1969b; McCloskey, 1975; Saleh et al., 1965; Nright,
1957) •
A study by McCloskey (1974) supported findings that external
rewards draw a person to a job but internal rewards keep that
person there and stimulate him to perform well. In c~~er words,
when a nurse is looking for a new job wages, benefits, and time
off are the most importan t ccnsidera tions; but i-;hen she is
11
deciding whether or not to stay in a nursing position the deciding
factors are the sccial and psychological rewards being received.
Thus the ~ain reason nurses are terminating their jobs is that they
desire more social and psychological rewards than are currently
being provided.
Generally, the social and psychological rewards that nurses
want from work are derived from communications, role definitions,
supervision, relationships wi~~ co-workers, opportunity to use ~~eir
experience and ability, learning opportunities, clinical advance
ment, and recognition. Specifically, ~1aryo and Lasky (1959) found
that nurses wanted a larger nursing staff, improved communications
with other professional staff members, and better definitions of
nursing duties. \o/right (19.57) found good supervision and communi
cation decreased the turn,over rate. In the Saleh, Lee, and Prien
(1965) study the largest percentage of reasons given for voluntary
turnover fell in the nature of work, supervision, human relations,
and lack of promotion categories. The Lyons (1970) study supported
a hypothesis that there was greater role clarity, more job satis
faction, less tension, and a lower turnover rate when adequate
WQrk related communication and better coordination eXisted.
Imparto (1972) found a high turnover rate associated rith low
scores on supervision and satisfaction with co-workers. McCloskey
(1974, 1975) found that psychological rewards were most L~portant
in keeping nurses on the job. Those psychological rewards were
o~~ortunities to attend educational progr~~s, opcortunities to
eonti;,.ue course · .. lork, career adva."1cement other than to the head
12
nurse position, and recognition of work frem peers and supervisors.
An interesting finding of McCloskey·s study was that 69~ of
the staff nurses who left jobs reported that they could have been
influenced to remain. Those who left for a promotion, to try other
areas of nursing, or to obtain increased fringe benefits said they
definitely could have been influenced to remain. The most sur
prising finding was that these who left because of pregnancy,
travel, to return to school, f.or personal and family reasons, or
because of It job dissatisfaction'· reported that they might have been
induced to remain on the job had t~ey been offered more rewards.
These findings cast doubt upon the usual grouping of reasons for
termination into voluntary and unavoidable or nonvol~~tary cate
gories. Perhaps some of ~~e terminations that are occuring for
'-unavoidable reasons I. can be prevented.
McCloskey's study also found that nurses experience a rise in
self-esteem after they quit their jobs. L~is was ascertained by
having nurses who had terminated their jobs complete two tan-item
Semantic Differential indexes headed by the COnC8?t of "Me in ~ly
Last Nursing Job'· and "Me in My Current Posi tion." XcCloskey
speculated that poor interpersonal relationships are often respon
sible for an individual's low level of self-esteem on the job.
The reasons nurses list for ~erminating a job indicate ways to
decrease the nursing turnover and dropout rate because those
reasons reflect areas in r"llich nu~ses &re not being motivated.
Previously cited studies demonstrate that nursas feel their jobs
:nc!'e deficient in provid:'ng social and psychological re·~ards than
in meeting their salary and working hours needs. >!ethods to
satisfy these needs eQuId. significantly reduce the turnover and
~ropOut rate in the nursing profession.
13
Many nursing researchers and t~eorists are attempting to define
more basic reasons behind the dissatisfaction in nursing other than
the simple explanations given for terminating a job. Role con
fusion and role conflict are the primary areas under investigation.
Corwin, Taves, and Haas (1961) feel that nursing students do
not bring realistic impressions of nursing to their jobs and there
fore develop reduced job satisfaction and show reduced job favor
ableness toward nursin~. Schools of nursing define them as pro
fessionals, but hospital bureaucracies define them as employees.
Thus a professional and bureaucratic conflict results which affects
~~e nurse's identity.
Benne and Bennis's study (1959) on role confusion and conflict
in nursing found that a nurse's role is determined by several sets
of expectations. These expectations include those presented by the
institution, her colleagues at work, reference groups outside the
immediate work group, and her own self-expectations. ~hen these
four sets of expectaticns contradict one another, role conflict
results. 'Nben they are consistent and reinforce each other, the
role definition is stable and motivation and job satisfaction are
high. In a nurse~ role there are ~any discre?ancies between the
ideal and the actual expectations of a nurse that promote role
conflict, such as the differing images nurses and doctors hold
re?ardin~ the ~ppropriate functions of nu~ses. Frustration results
14
when the ideal expectations cannot be attained. Tne continuing and
accelerated changes in the health field have probably contributed
tO~5e role conflicts and confusions. Benne and Bennis theorized
that there are three patte~ of adjustment to these conflicts.
Nurses either develop low motivation for work, rationalize away
part of the conflicting demands, or organize to ~esist the demands.
Since the Benne and Bennis study, Marlene r~amer has written
on nursing' s role confusion and what she terms "role deprivation. It
She defines role deprivation as tithe reported discrepancy between
the nurse's role as it should be and as it actually is found to
bett (Kramer, 19698., po 1903). In 1966 a survey of 45 new gra.duates
upon graduation and after three months of employment found that 44%
of the nurses expressed a fear of remaining in hospital nursing~
Specifically. many of those nurses surveyed did not like the rigid
hospital routines and found the work stifling, uncreative, and
confining. They wanted more autonomy to make judgments and deci
sions, to be able to use their knowledge and skills, and to be
evaluated by ~r professional colleagues (Kramer. 1966, po 242C)o
In 1969 Kramer again surveyed the nurses two years afte~ graduation
and found a significant decrease intheir professional role concep
tion or their beliefs and values about their professional role
( Kr amer t 1969a).
Kramer theorizes that the role deprivation in nursing is ca.used
by the conflict between the professional role concept of nurses and
the bureaucratic role concept necessitated by hospital employment.
A person with a high bureaucratic role conce~tion is loyal to a
15
bureaucratic system with its well-defined chain of command, its
system of rules and procedures, its division of labor based on
specialization, its promotion practices based on technical compe
tencies, and its impersonality of human relations. Baccalaureate
educational systems teach nurses a professional role conception
based on autonomy from organizational control, responsibility for
completing their job, self-evaluation, colleague relationships with
others, and freedom of movement from one position to another to
utilize professional behavior (Kramer, 1969b~. 'Nben a nurse taught
the professional role concept enters the bureaucratic setting of
most hospitals and faces the bureaucratic role concept, role depri
vation ensues.
Upon employment, baccalaureate graduates, with strong profes
sional role conceptions, must adopt bureaucratic role conceptions
due to environmental pressure. If they attempt to also retain
their orofessional values much discomfort ensues and there is a 5~
chance that they will leave nursing after trying several jobs
(Kramer & Baker. 1971, p. 26).
r~amer found that collegiate nurses experienced more job satis
faction and less role deprivation when their work situations did
not bind them down with rules and regulations but instead allowed
them to make individualized patient care decisions. A positive
relationship was found between minimal nurse role deprivation and
the presence of innovative ~ccalaureate nurse roles, the presence
of dual prOMotion ladders, the pre~ence of clinical nurse special
ists, and a decentralized decision-making structure (Kramer. 1969b).
16
All the answers about role co~jlict and confusion in nursing
have yet to be fully determined. The complete effect on nursin~ is
not well known. However, the studies that have been done indicate
there is a definite problem in nursing with role conflict and
confusion. The Kramer studies alone demonstrate role deprivation
contributes to turnover and dropout rates. Any serious attempt to
increase motivation and job satisfaction in nursing MUst take this
into account.
Another great conflict in nursing appears to be the amount of
time nurses can spend at the patient's bedside. According to
Hughes (1958). a wish to help others is a co~~~on reason given for
entering nursing. Benne and Bennis (1959) found in their study
that nurses would most miss the relationships with patients if they
did not continue working. Yet, Lysaught (1971) found that only 4~ .
of a staff nurse's time can be used for direct patient care and half
of that time is spent passing medications. An RN actually spends
less tL~e in direct patient care than the LPN, aide, or nursing
student. The system of giving care in ~ost hospitals today does not
allow a nurse to really function in a manner that can satisfy one of
her most L~portant reasons for being a nurse.
Another topic that has received much attention in the litera
ture is the relationship between job satisfaction and productivity~
The popular opinion is that the satisfied worker is mere productive.
Haw~vert very few well controlled studies clearly support this.
Brayfield and Crockett (1955) conducted a detailed review of
the research done on employeets attitudes and e~plcyee performance
17
up to 1955. They found little evidence that ~n employee's attitude
has an appreci~ble rel~tionship to his work performance. They did,
however, find data suggestive that ~ttitudes may be related to
withdrawal from ~ job. In explaining the findings that were so
contrary to popular opinion, Brayfield and Crockett proposed that
researchers have tried to define the motivaticnal structure of
workers too simplistically overlooking individual differences in
motivations and perceptions. They suggested that researchers study
separately the causes, correlations, and consequences of satisfac
tion and the effects of different management philosophies upon the
attitudes and performances of employees with different Motives,
aspirations, and ex~ectations.
In 1970 Schwab and Cummings also reviewed ~ literature on
theories of performance and satisfaction. They concluded that
research to date had not accounted for enough variables which could
influence the strength and perhaps even the direction of the rela
tionship between satisfaction and performance. The relationship
between job satisfaction and productivity is therefore still unclear
due to its complex nature.
Today nursing is facing a very complicated problem. As stated
earlier t employees are be~inning to demand that work help satisfy
many of their needs. Health care costs are spiraling at a dramatic
rate. Consumers are demanding high quality but economical health
care. Hospitals are having to find methods to L~prove the effi
ciency of utilization of their health care provicers. The nursing
profession; at a time when it needs to be giving care that is even
18
more efficient and of higher quality. is faced with a high turnover
rate. a high ~ropout rate, malcontent, work alienation, role Con
flict, deprivation, and confusion. Therefore. the need for re
searching and improving motivation and job satisfaction in nursing
is essential.
As stated earlier, the purpose of this particular study was to
improve the motivation level of a group of nursing personnel in a
work situation. It is difficult to objectively measure a person's
level of motivation. However instead, specific outcomes resulting
from a changed level of motivation can be measured. As indicated
in the literature review, a low level of job satisfaction and the
resultant high dropout and turnover rates are s~ecific outcomes of
the motivational problem in nursing. Consequently increaling the
measured level of job satisfaction and decreasing the turnover rate
were the specific objectives of this research problem.
A method of measuring employee turnover rate is subject to
debate in the literature. It is generally agreed that the turnover
rate equals the totel number of terminations divided by the total
number of employees (Dane, 1972; Dodge, 1960i & Tuchi & Carr, 19?1~
The debate revolves around what to include in the total number of
terminations. Some authors do not include nonvoluntary or unav·oid
able turnover in that number as they feel management can do nothing
to reduce that part of the turnover rate; in fact, it may ~e
beneficial to a co~pany as it prevents stagnati0n and because
startin~ salaries are lower it saves the company money_ ether
aut~ors include every termination in t~e total number no matter
19
what the reason.
For the purpose of this .~tudy turnover rate included all a.ctual
terminations and transfers from the unit regardless of the reasono
This was decided because of the doubt cast upon the usual grouping
of reasons into voluntary or nonvoluntary categories (McCloskey,
1974, 1975).
Although job satisfa.ction is a very complex attitude to
measure, several means of measuring job satisfaction have been
tried. There are tests that claim to give an indication of overall
job satisfaction and others that indicate specific problem areas.
Part of the difficulty in measuring job satisfaction lies in our
actual understanding of just what it includes. There is no widely
accepted definition nor even a common understanding of the basis of
job satisfaction. Therefore, researchers must select an already
devised measure or create their own based upon what they wish to
measure"
The measure used in this study was a tool devised by
Dr. Frederick Herzberg to measure the success of some of his job
e~xichment programs (see AppendLx a). lne use of this auestion
naire was necessary as the motivational methods 'lsed in this study
were based upon Herzberg's Theory of Hotivationo This theory does
not support a measure of overall job satisfaction since it is based
upon the existence of two separate factors--job satisfaction and
job dissatisfaction. To be in line with Herzber~fs Theory~ ~n
overall look at .iob attitudes must measure job satisfaction and
job dissatisfaction separately as ·~1.11 be ex~lained in greater
20
detail in the next chapter.
Herzber~'s tool measures ~hether or ~ot an e~ployee feels that
his job has provided him -,..ri th th058 factors defined by Herzberg as
necessary to promote job satisfaction. No other m.easure of job
satisfaction ~o(not.m to the author tests job satisfa.ction and job
dissatisfaction as two separate attitudes. All other tests are
based upon the theory that job jissatisfaction is the opnosite of
job satisfaction and thus give an overall job satisfaction score
that reflects an employee's position on that continuum. DeviSing a
test to measure the success of attempts to install Herzberg's
motivational methods was beyond the scope of this study.
Another area of concern was the possibility of measuring per
formance results. Many researchers attempt to measure the effect
of changes in a ~er50n's level of motivation upon his performance
or productivity levels. This study did not attempt to measure the
nursing performance ch3ngss o This was decided for two reasons.
The most important reason was because of the nebulous relationship
between motivation and performance. As explained earlier, to date,
few well controlled studies support the popular opinion that the
satisfied worker is more productive. The second reason why an
attempt to measure changes in the subject's nursing performance was
not made was due to the great difficulty involved in measuring that
performance. Nursing is not an exact science. It involves many
skills. such as therapeutic behavioral techniQues, for which a
satisfactory method of measurement has not been developed.
Instead of measuring total nursing performance, other indica-
21
tors of the level of motivation were measured. As explai~ed
earlier, the liter~ture review revealed that the turnover rate and
the level of job satisfaction are strong indicators of motivational
problems in nursing. If those indicators change then it can be
assumed that the level of motivation changed.
The turnover rate is a simple measure to calculate; howeyer.
job satisfaction is more complex. Determining the level of job
satisfaction necessitated assessing many components of that attitud~
This was accomplished by the use of Herzberg's questionnaire. It
asked if any changes in work had been noticed; specifically, if
there was an increase or decrease in recognition, achievement,
work itself, responsibility, advancement, and srowth. Each person
was asked how they felt about the changes and if, because of the
changes, there was an increase or decrease in the amount of satis
faction attained from work. Finally, a rating was made of how
strongly nositive and negative feelings were affected by the
changes. A second tool used to assess components of job satis
faction asked each person to rate 12 factors Herzberg identified as
contributing to job satisfaction and job dissatisfaction in order
of priority for an ideal job (see AppendiX C). Collectively then
these two tools gave indications of chan~es in the level of job
satisfaction. Combined with the turnover rate measures, changes
in the level of motivation was determined.
CHAPT.sR J
CONG EPTUAL F:1.ANEtiORK AND HETHOr.:oLOGY
Motivation Theory
Motiv~tion is a po9ular term. Volumes have been written on
~otivation and it is a word that can be heard aL~ost daily. So
called "axperts" are easy to find. There are many personnel prac
tices in use, such as the shorter work week, higher wages, better
fringe benefits, strivings for better commu~ication, and sensitiv
ity training, which attempt to ~otivate~ the ~o~ker. Caution must
be exercised when seeking ~n ll..""lderstandlng of motivation to differ
entiate between that which is based on tested, accepted theories
of ~otivation and that which is based on popular opinion atout mo
ti vation 'i-Ii thout any supporting research. erver the years, a. docu.
mented 1.L"r'lderstanding of the basis of motivation has increased.
One of the earliest theories on how to motivate workers came
from Frederick Taylor (1911). He felt that men i,zere motivated by
money. He supported an incentive system ',.;hereby the m.or9 an ambi
tious worker produced the ~ore he earned. Taylor argued that if a
highly productive worker ea~ed the same as a lazy ~orker the
highly productive worker r..;ould loose incenti va to produce at his
maximu.'1l.
It ~ust be remembered that when this theory ~as popular ~oney
23
had a different connotation than it does today. Pay to many
peo91e~eant a mea..'1S for obtaining the basic neces3i ties in life.
With extra hard wor~ and saving they ho?ed to be able to earn some
of the luxuries in life. Money, or the lack of it, was a strong
motiv~tor. Today it is not the same motivator as it once Nas.
Many people now take the basic necessities and even many of the
luxuries in life for granted feeling that it is only a matter of
justice and equality that they have them. ~~st peo~le expect to
obtain luxuries early in their working careers. Therefore, money
does not Motivate in the same manner as it once did since it no
longer means basic survival to many people (Gelle!'!Tlan, 1971).
The Hawthorne Studies were the next major step in motivational
theory. These studies lasted over 15 years at the Hawthorne Works
of ta.'1e t,";estern Electric Company in Chicago. The first studies de
monstrated that employee attitudes can counteract the effects of
poor environmental working concitions. Later, the role of super
visory ?ractices in influencing employee attitudes was recognized.
This research precipitdted the ''human-rela.tions·· movemar:t in man
agement (Anastasi, 1964).
A. H. Maslow (1943) developed a theory of motivation that
sho~'1ed man to be motivated by different needs at different times.
He proposed a hierarchy of five levels of needs. The most basic
he called the physiological needs. These are h~~ger, thirst, sleep,
activity, and sex. He felt it impossible to list all of the f~~~da
mental physiological r~Guiremer.ts ~an can have. L~e second level
are the safety needs. These are characterized by man seeki~g
safety, security, and organ~zation in his world. In fact, :~slow
felt that man's i!1terest in science, philosophy, and religion is
stimulated by t~is need. The third level is the need for lava.
This includes :nan's need for love, affection, and belonging. Tne
fourth level are the esteem needs. This means that man desires a
stable, high evaluation of himself, self-respect, self-esteem, and
the esteem of others. The last level is self-actualization. This
is man's desire for self-fulfillment or to become actualized in
what he has the potential to become.
Maslow characterized the levels of needs as prepotent. This
means that man will be motivated by the most basic need that is not
satisfied. This xiII monopolize his consciousness and will tend to
organize and move his various capacities into action to meet that
need. For example, if a man was lacking food, safety, love,
esteem, and actualization he would desire food more strongly than
any of the other things. Once he had enough food he would desire
safety since his need for food is now nonexistent. Thus, ~an is
motivated only by unsatisfied neecs and his behavior becomes organ
ized towards thair satisfaction. Gratification of a need is im
portant, though, in that it releases man from its domination and
allows him to move tOl-1ards attaining higher level goals.
~~slow's hierarchy of needs is not to be taken in a step-wise,
all-or-none relationship to each other. ~~st people are partially
satisfied and partially ~~satisfied in all their basic needs at the
same time. ~~e percent of satisfacti~n :or a normal person prob
ably has a decreasing percent as one ascends the hierarchy. After
the satisfaction of a prepote~t need, the emergence of a new need
is gradual, not sudden. Also ~ost behavior is multi-motivated; it
is determined by several or all of the basic needs simultaneously.
Maslow also recognized that there are many determinants of behavior
other than the gratification of basic needs. He characterized man
as a perpetually wanting animal. If a person is blocked from sat-
isfying a basic need he sees it a psychological threat which can
lead to frustration.
~~slow's theory of motivation initiated in-depth analysis of
individual's need hierarchies. Chris Argyris (1957) developed a
theory of motivation based on the needs of Doth the formal struc-
ture of the organization and of the individual. He was concerned
about the relationship between the two and their mutual impact upon
each other. He discovered some basic incongruencies between the
requirements of a formal organization and the growth trend of a
healthy personality in our culture. The result of this conflict
will be f~~strationt failure, short-time perspective, and conflict.
The subordinates of an organization will experience competition,
rivalry, insubordinate hostility, and concern about the par~s
rather than the whole. The result of all of this will be that the
in~ividual will undertake some defensive acts that will be destruc-
tive to the organization. Argyris felt the solution would be to
reduce the degree of dependency, subordination, and submissiveness
experienced ty e~9Ioyees. He felt job enlargement a~d e~plcyee-
centered, democratic, or participative leadership were specific
ways of acco~plishing this.
26
The two terms ;ob enrichment and job enlargement are fre-
quently used interchangeably ~n the literature. For the purpose
of this study, job enrichment will me~~ rehabilitating jobs or
giving peo~le better or more meaningful work to do. Job enlarge
ment will mean practices aimed at giving employees more work to do
rNithout changing the meaning of that work (Herzberg, 1976, p.95).
Douglas McGregor (1960) developed a theory of motivation
called Theory X and Theory Y. Theory X management practices are
based on the belief that people dislike work and will avoid it.
Management, accordi~g to this theory, must direct, control, coerce,
and threaten its employees to gain results. McGregor maintains
that people who dislike work do so because of the above mentioned
management practices. Theory Y assumes that people like and enjoy
work ~~d that they are self-directed and seek responsibility. Thus
a Theory Y ma~ager 'Nill use job enlargement, decentralization,
positive incentives, and provide opportunities for personal growth.
McGregor believes that if TCeory Y management is used an indi\~d
ual's perforr.Ance can be stimulated to exceed the requirereents of
his job description.
Rensis Likert developed the participative ~anageMent theory
(1961). This theory supports the use of the human relations tools
to foster supportive relationships among all group ~embers, to
keep groups working as a unit. to keep the ~anager orien~ed toward
his employees, to facilitate group decisicn making, and :0 promote
t~~st and favor~cle attitudes between superiors and subordinates.
Y~nazement by objectives ~~d enrichment approaches a~e used
27
in partici?ative ~ana~ement.
The t}:eory used fer this stt:.dy, the '1::1ual factor theory" \o[as
develooed by Frederick ne!'zberg (1973, 1976). This th eory ~a.s
been widely ve~fied. By 1976 fifty repetitions of the original
study had been reported (Herzberg, 1976, p. 311). Nore than 17
different occupations had been studied involving a wide range of
skills, job levels, and types of organizations, inclucing workers
in Finnish and Hungarian industries (Herzberg, 1973).
Basic to his theory is Herzberg's belief that man has two
sets of needs: his need as a human being to grow psychologically
and his need as an animal to avoid pain. He developed his theory
from a study he conducted of two hundred engineers and accoQ~tants.
In interviews ~~ey were asked about events at work they had exper
ienced that resulted in either marked improvement or marked re
duction in job satisfaction for them, and they were asked to give
a sequence of events that resulted in negative and positive feel-
in~s about their jobs.
From this study and subsequent others, Herzberg discovered
that workers identified totally different events as being associ
ated with positive feelings about thei~ job or job satisfaction
than they identified as being associated \lith negati""e feelings or
job dissatisfaction. The factors associated w~th job dissatis
faction rarely appeared in the events :~e subjects described for
job sa.tisfaction. Conversly, the factors associated with job
satisfaction rarely appeared in the events the subjects described
for job dissatisfa.ction. Therefore, Herzbsrg deter:nined that job
23
satisfaction and job dissatis:acti~n are two saoarate, u~ique atti
tudes. Job satisfacti~n and job dissatisfacticn are net on the
same continuum; instead, they are separate unipolar concep~s. A
person can experience high or low job satisfac~ion and high or lew
job dissatisfaction at the same time.
The factors that Herzberg has found to be strong detarmin~~ts
of job satis:8cticn he term.ed motivator factors. Those factors are
achievement, recognition, work itself, responsibility, advancement,
and possibility of grcwth. These factors describe man's relation
ship to ~hat he does in his job. Herzberg asked subjects of the
studies to interpret the events they described and tall why they
led ,to a change in their feelings. The results showed that ~otiva
tor events led to job satisfaction because of mants need for
growth; or as Herzberg believes, one of man's set of needs is to
grow psychologically.
The factors found to be stror.~ determinants of job dissatis
faction, Serzberg termed hygiene factors. Those factors are com
pany policy and administration, supervision, salary, interpersonal
relations, working ccncitions, status, job security, and effect on
personal life. The hygiene factors describe mants relationship to
the context or environment L~ which he does his job. wben subjects
were asked to interpret hygiene factors it was found that they led
to job dissatisfaction because of a need to avoid wipleasantness;
or as Herzberg believes, man's second set of needs is as an animal
tc avoid pain.
The i~portant tting :or ~~na~e~ent to understand from this
29
theory is tt_st "the two sets of factors (hygiene and !!1ctivator)
are unipolar, i.e. separate and distinct from each other. The op-
posite of job satisfaction is no job satisfaction, not job dissat-
isfaction. Likewise, the opposite of job dissatisfaction is no job
dissatisfaction, not job satisfaction. However, Herzberg does be
lieve that there are some individuals who do receive job satisfac
tion soley from hy~iene factors. This is because they have not
reached the stage of personality develo~~ent at which self-actual
izing needs are active or because of their past experiences they
have learned to react positively to hygiene factors as satisfiers.
Herzberg believes that the lack of motivators in a job in
creases the employee's sensitivity to real or i~agined poor job
hygiene nractices. The amount and ~uality of job hygiene !Ylust be
constantly improved as the relief from job dissatisfaction is only
temporary. Hygiene factors are short range whereas motivator fac-
tors are long range.
Herzberg believes that motivated oerform.ance ~..rill result when
motivators are combined with good hygiene practices. He has insti
tuted practical apolications of his ~~eory in industry through the
utilization of "Orthodox Job Enrich~ent.1t This ba~ically calls for
installing motivator factors into a person's job. Exactly how this
is done varies ~~th each unique situation. Herzberg believes that
the following factors are essential to orthodox job enrichment:
direct feedback, a cli~nt to employee relationship, a learning func-
tio~, the opportu~ity ~or each person to schedule ~~s o~~ wor~,
unique expertise, cont~ol over resources, direct ~ommu~ication, and
30
personal aoco~tability (Herzb~rg, 1974 ).
The result of orthodox job enrichment, as demonstr~ted five
studies carried out at L~perial Che~~cal Industries Limited, was an
increase in performance. In all of the studies there were in-
creases in parfor'manca and some of those increases were spectacular.
However, this is expected in orthodox job enrichment as satisfac-
tion is believed to be the result of performance, not the cause.
Attitudes do not change quickly and w~th many jobs there is much
frustration to overcome and forget. In those studies, the largest
gains in job satisfaction came after the longest job enricr~ent
trial periods (Paul, Robertson, and Herzberg, 1969).
Although considerable research has been done on motivation and
job satisfaction, very little has been done in the nursing profes-
sion. There are many articles in the nursing literature expressing
opinions about motivation or saying that motivation is needed, but ...
there is verJ little actual research. Most of what there is has
been done only in recent years. There are four studies in which
the researchers surveyed nurses to discover what they perceived as
important determinants of job satisfaction. In reading the results
of these it is interesting to note the most imuortant ~actors in
each study, but the value of this information is questionable as
there is no general agreement between studies.
Marlow (1966) surveyed 200 nurses in Pennsylvania and deter-
mined that the following factors determined e~ployee needs in order
1- good working conditions 2- ~ork that keeps you interested J- jeD :S8c:.lrity 4_ good wa~es 5- full aporeciation of work done 6- tactfui'discipline 7- personal loyalty to workers 8- promotion and grow~h in the hospital 9- feeling "inft on things
10- sympathetic help on personal problems
31
Slocum, Susman, and Sheridan (1972) in a study of need satis-
faction and job performance among professional and paraprofessional
scores for each group. They found ~~at differences did exist in
satisfaction of basic needs between the two groups. It was inter-
~sting that for the profeSSional personnel satisfaction of self-
actualization needs was related to job per.fo~Ance.
Everly and Falcione surveyed 144 staff RNs in four east coast
metropolitan hospitals to discover the determL~~~ts of their job
satisfaction. The ~ost i~oortant factor was interpersonal rela-
tionshi?s T~th co-workers, their immediate super/isor, and zaneral
supervisory personnel. The second factor was intrinsic satisfac-
tion gained from the work itself through ~~e development and use of
new skills and abilities. The third factor was opportunities for
advancement, pay, and employee benefits. Finally, the last deter-
minant of job satisfaction was administrative policies (Everly and
Falcione, 1976).
Benton ~~d wbite (1972) surveyed 565 ~~s to obtain their reac-
tions to 16 job satisfacticn factors. The nurses ~anked the factors
in :he ~ollowing order of importance:
1- patient care 2- adequate personnel per shift J- congenial work associates 4- job security 5- authority and responsibility to do job 6- physical working conditions 7- basic salary 8- written personnel policies 9- appropriateness of hours worked
10- inservice training programs 11- pay differential for experience 12- management recognition of nurses' personnel unit 13- appreciation by patients 14- written job descriptions 15- pay differential for education 16- promotion opportunities
When these factors were divided into Maslow's need hierarchy,
32
Benton and wbite dete~ned that safety and security were the most
important followed by social, esteem, and self-actualization
factors.
A few researchers have looked at job satisfaction in nursing
in light of the Herzberg Theory. Longest (1974) investigated job
satisfaction among nursing supervisors in ten Atlanta hospitals by
determining the effect of Herzberg's ten factors of achievement,
recognition, work itself, responsibility, advancement, policy and
administration, technical supervision, working conditions, inter-
personal relations, and salary en job satisfaction. 'TI~e nurses
were asked to rate, in te~s of perceived importance, the effect of
the factors on their job satisfaction level. The following ranking
was obtained:
1- achiev":'!T!.ent 2- interpersonal relations 3- ',..-ork i tsel! 4- policy and adMinistration 5- responsibility 6- supe~ision-tecr~~ical
7- salary 8- working conditions 9- recognition
10- advancement
33
TNhite and Ma~uire (1973) surveyed nursing supervisors in six
Philadelphia hospitals to determine if the Herzberg theory was
applicable to them. The nurses were asked to describe times during
their employment when they felt job satisfaction and ti~es when
they felt job dissatisfaction. The method of t~e study and the
method of analyzing the data essentially duplicated ~he methods
used by Herzberg. Tne list of job satisiiers and job dissatisfiers,
as described by the nursing superrisors ~as similar to those lists
discovered in the Herzberg studies. Work itself, achievement.
recognition, responsibility, growth and advancement were found to
contribute to job satisfaction. Supervision, hospital policy,
working conditions, interpersonal relations, salary, and personal
life contributed to job dissatisfaction. TI~e main difference be-
tween the Herzberg studies ~~d this one was that, inste~d of job
security and status, the nursing supervisors described a factor
called competenca-com~ittmant-contentment of allied personnel.
was classified as a ~ogienet. as it did not distinctly fall into
either the satisfier or the dissatisfier column. The nurses listed
as motivators in order of importance: work itself, achievement,
recognition, responsibility, growth, and advancement. The hygienes,
in order of i~po~t~~ce, ~ere supervision-technical, hospital policy,
work~~g conditions, interpersonal relations, s~larJ and perscnal
life.
J4
Dr. Frederick Anderson (Herzberg, 1973) studied 29 ?rofessional
nurses in a Veterans ~~inist~ation Hospital in Utah. ~e also ~sed
L~e Herzberg methods. He found the motivators to be recognition
and achievement and the hygienes to be company policy and adminis
tration, interpersonal relations with supervisors, and working
conditions. L~ the study the factors of recognition, achievement,
and .vorking conditions only approached statistical significance due
to the small n~~ber investigated and to problems in the interviewing
situation.
Furnese of 1h! Study
The purpose of this study was to improve the level of motiva
tion of a group of nursing personnel. As can be seen from the re
view of the literature on motivation, there are many similarities
between the theories and how they propose to increase the worker's
level of motivation.
The theory selected for this study was Herzberg's Dual Factor
Theory. The fact that it has been ,,.ridely tested was an important
consideration deteMlining it-s choice. Also, 3:erzberg goes one step
further than oL~er ~~eorists and gives specific ways to implement
his theory on a practical level with his orthodox job enric~~ent
plan. Studies of companies who have i;Tr~lemented Herzberg's ortho-
dox job enrichment prog:r-aIn have demo!1~tra.ted positive results
(Herzberg, 1968; Herzberg and Rafalko, 1975; Paul et al., 1969).
However, the decidin~ factor for choosing Herzberg's t~eory Nas
how ~ell it indicated solutions to many of ~he o~oblems demcnstated
35
in the review of the !1ursir..2: literature. TI'le stuciies or. :.rhy nurses
ter~inat9 a job indicate t~at t~ey ¥ant mo~e social and ~sycholog
ieal rel~Tards; snecifically, they ·..ra:!1.t ir'lproved communications, role
The percentage of return was determined by dividing the n~~ber
of questionnaires returned by the number of staif members (FUIs, LPNs
and Aides) on the unit. However this is misleading and not an accu-
rate representation of the return as not every person on ~he staff
was contacted and asked to participate. The method of conta.cting
staff members for the pre and posttest on the control ~~its and for
the pretest on the experimental unit was to ~eet with staff members
during between shift report. This was repeated several times on
each unit. However due to differences in schedules not every staff
member was contacted by this method. For the pretest on the exper-
imental unit more attempts were made to contact every staff member
and they w,.;erl9 encouraged and reminded to return t.he questionna.ires.
The posttest on the experi~ental unit was given iu~ing a general
staff meeting and time ',.;as allowed fo r t!:em to complete it then.
CHAPTER 4
FINDINGS
Biographical ~
The biographical questionnaire yielded the following infor
mation which must be taken into consideration when interpreting
the acquired data. The experimental group consisted of ~5% RNa,
30% LPNs, and 25~ Aides. The control groups T~re composed of
57% RNS, 14% LPNs, and 29% Aides. In the experimental group the
typical RN had 5 to 10 years of experience, had been in the present
position less than one year, was bet~een 20 to 30 years of age, and
had obtained basic nursing education in either a hospital or was an
associate degree graduate. The typical RN in the control groups
had one to ten years of experience, had been in the present posi
tion less than one year, was over 30, and had a bachelor's degree
for basic nursing aducation. The LPNs and Aides in the experi
mental group had less than one year of experience, less than one
year in their present position, and were 20 to 30 years old. The
LPNs and Aides in the control group had one to two years of expe
rience, less than one year in their present ~ositiont and w~~e 20
to 30 years old.
Turnover ~
The turnover rate was ~Aasured during the nine month periods
53
of February to October of 1975. 19?~. and 1977. as well as the 12
month periods of January to Dece~ber of 1975 to 1976. The experi
~ental period bein~ February to October 1977. The turnover rate
,,,as determined by dividing the total number of employees on the unit
into t~e total number of terminations and transfers from the unit
during a specified period of time. One research hypothesis tested
by this study was that the turnover rate in a group of nurses would
decrease if motivators were provided. Table 1 gives the yearly and
the nine month turnover rate data. As can be seen, the turnover
rate Nas lower during the experimental period than it was during
the same nine month periods of the preceding two years.
To determine it the decrease in the turnover rate was signif
icant. the t test c~parision of means and the F test analysis of
variance (Young & Veldman, 1977. p. 315) T~re run on the average
monthly turnover rate for each period. The average monthly turn
over rate was determined by dividing the number of terminations
each month by the number of emnloyees to obtain the monthly turn
over rate. Then for a specified period of time, the monthly turn
over rates '\-{ere added together and divided by the number of months
in that period to yield the average monthly rate. Table 2 gives
the average monthly turnover rates and their standard deviations to
indicate degrees of variability. Again note that the rate was
lowest durin~ the experimental period.
Table 3 details the rasults of the t tests and the F tests
used to rletermine significance bet\~~en the turnover rates. The
statistical null hypot~esis tested was ~at there would be no
TABLE 1
Turnover Rate
Rate for Eeriod of Time 12 Month Period Jan 75- Dec 75 -88,( Jan 76- Dec 76 76% Feb 75- Oct 75 Feb 76- Oct 76 Feb 77- Oct 77 ** 5n •
* adjusted yearly = period turnover rate X 12 9
** experimental period
Rate for 9 Month Period
61% 5~ 43%
\.n f::"
TABlE 2
Average Monthly Turnover Rate
e . d Ti e Rate Standard Deviation Jan 75- Dec 75 7.2 4.79 Jan 76- Dec 76 6.4f; 3.162 Feb 75- Oct 75 6.7f:. 5.196 Feb 76- Oct 76 6.2~ 3.66 Feb 77- Oct 77 * 5.~ 3.606
• experimental period
\ft \ft
Average Monthly Turnover Rate
Pericx:! of Time or Mean Feb 77- Cct 77 5.~ Fe b __ zQ- Oct 26 6.2 Feb 77- Oct 77 5.~ Feb 25- Oct 2L ~~-Feb 7'1- Oct 77 5. Feb 76- Oct 76 6.~ ~~ 25=-..J)c.L2.5... 6.7% Feb 77- Oct 77 5.~ Jan 76- Dec 76 6.4% Jan 75- Dec 75 7.2%
* not significant
TABlE 3
Turnover Rate Test of Significanoe
Values of t t equals beyond .05 Significant F equals
.7141 2.12 NS .. .51
.7937 2.12 NS .625
.6083 2.06 NS .37
.866 2.04 NS .75
Values of F beyond .05
4.49
4.49
3.40
3.32
Signif-icant .
NS
NS
NS
NS
,--
\..n ()',.
57
difference in the turnover rate among the groups. The rBsults of
the tests ofsi~nificance demonstrate that, while the turnover
rate was lowest during the experimental period, the difference was
not enough to be significant. In all the comparisions the F test.
which is a comparision of variances, accepted the null hypothesis.
Therefore, it could not be concluded that there ~as a difference
in the turnover rate among the groups as there was no statistical
support that the means were different from one another. Likewise,
the t t~st also accepted the null hypothesis as there ~as no
evidence that the turnover rate was less than expected by chance.
The research hypothesis that the turnover rate in a group of
nurses would decrease if Motivators were provided was not supported.
Data ~ Job Satisfaction Audit I22l
When analyzing the information obtained from the job satis
faction audit tool it was discovered that most of the questions
were answered in a manner that allowed categorizing. The first
question consisted of two parts. The first part which asked if the
person had noticed any changes in their work over the last eight
months, obtained yes or no answers. In the second part, they
described changes that had taken place, specifically what their job
assignments '~re before and after the chan~es in terms of func
tional duties such as passing medications or team leading.
~uestion 2 asked if there had been an increase or decrease in re
cognition for achievements, op~ortunities to achieTe, work itself,
amount of responsibility, advancement, and growth. The answers to
this question allowed categorizing into either yes. there ~as an
increase, or no there was no increase. Question 3 asked how they
felt about the changes and ~hy they felt the ~ay they did. The
answers could be classified as either positive or negative feelings.
Cuestion 4 asked if because of the changes there had been an in-
crease or a decrease in the amount of satisfaction obtained frOM
work and the answers fell into either an increase or & decrease
category. Question 5 asked if the changes affected the individual
personally, specifically did it change their relations with people
in general or with family and did it affect their sleep, appetite,
digestion, or general health. The answer to this question could
be categorized as either yes or no. Finally, question 6 asked the
individual to ~ate on a scale of one to seven how strongly their
negatiTe feelings about their job were affected by the changes.
This allowed the calculation of a mean number for each.
Table 4 gives the mode responses for question one through five
and allows comparison of various groups. or prime interest was the
resnonses of the experimental unit. The)C staff did see that
changes in their job had occurred during the exnerimental period.
However, the control units' staff also saw job changes during that
same period of time. Likewise 3e, in the pretest covering the nine
Month period before the experiment began, reported job changes.
During the experimental period, JC did not see an increase in re-
cognition, achievement t or work itself and the control units did.
The 3C staff felt there was an increase in ac~ieveMent before the
Motiva.tors were introduced but not after. An incraase in respon-
sibili ty was seen by the 3C staff after the in":.rodllction of the
TABLE 4
Comparision of Job Satisfaction Audit Data Among Units •
I control control control units control units 3C 3C units units without inter. without inter.
Group ipretest iposttest pretest posttest unit pretest unit posttest .Number il!. Group 16 20 17 14 12 5
Changes in Job yes yes no yes no -Recogni tion no no yes yes yes yes Achievement yes no no yes no yes Work Itself no no no yes no yes Responsibility no yes no no no no Advancement no no no no no no Growth yes yes yes yes yes yes Fe"a About Changes pos. pos. pos. pos. pos. pas. J\mt. of Satisfaction inc. inc. inc. inc. inc. inc. Personal Affects yes yes yes yes yes yes Relations to
People/Family yes yes yes no yes no Affect on Health yes no yes no yes yes
*Answers noted are the mode response (see AppendiX E for complete derivation)
inter .. inter. unit unit Ea. J2~~!_~ _ 5-- 9 _
--,-~---
no yes yes yes yes yes no yes no no no no yes yes pos. pas. inc. inc. no yes
no no no no
V'\ '-D
motivators; whereas, the control units did not see an increase in
responsibility. None of the units saw an increase in acvancement
opportuni ty. A chance for growth T,yB.S consistently seen in all of
the groups tested. 30th 3C and the control units reported that
they felt positive about the changes they had identified and all
groups said their amount of satisfaction had increased. The 3C
staff said that the changes they identified personally affected
them and their relations to other neonle and family but did not
affect their health.
Table 5 compares the responses of the RNs, LPNs. and Aides on
the experimental unit. The LPNs saw an increase in recognition and
achievement, but the RNa and Aides did not. The RNs and LPNs felt
an increase in responsibility but the Aides did not. On the rest
of tl::e questionnaire, the three groups agreed. They saw no change
in work itself or advancement, did see an increase in growth oppor-
tunity, felt positive about the changes, and experienced an in-
creased amount of satisfaction.
During the experimental peried one of the control units, the
intermediate care unit, initiated a modified t~e of primary care
nursing. 3ecause of the nature of this type of nursing, primary
nursing is frequently mentioned in the literature as a strong way
to motivate nurses and increase their job satisfaction. To deter-
mine how the intermediate care unit's staff saw the chan~e to
primary nursing, their responses to the Job Satisfaction ~udit
Tool were se~arB.ted out and compared in Table~. C~~paring the
intermediate care unit's responses to 3e t s reSDcnses it can be seen
TABLE 5
3C Posttest If!
RNa (N=9) tPNs (N=6) Changes in Job yes yes Recognition no yes Achievement no yes Work Itself/Assign. no no Responsibility yes yes Advancement no no Growth yes yes Feeling About Change pOSe pOSe Amt. of Satisfaction ino. ino. Personal Affects yes yes Relations to
People/Family yes yes Affect on Health no no
-~---
*Answers noted are the mode response (see Appendix E for complete derivation
Aides (N=5) yes no no no no -yes pOSe
inc. yes
yes yes ------
U' I·..J
62
that they saw an increase in recognition, achievement, and work
itself where 3C did not. The 3C staff felt an increase in respon
sibility where the intermediate care unit's staff did not. Both
units saw no increase in advancement but did see an increase in
growth. Both units felt positive about the changes and identified
an increased amount of job satisfaction. It should be noted that
the responses of the inte~ediate care unit are identical to the
rest of the control units.
The last question ta be considered in the Jab .. Satisfaction
Audit Tool is question 6 which obtained a rating from one to seven
of how strongly an individual's positive and negative job feelings
were affected by the changes with one being no chan~e and seven
meaning a great deal of change. The response to this question
tested the research hypothesis that the measured level of job
satisfaction in a group of nurses w~uld increase if motivators were
provided. Table 6 gives the mean score for each feeling for the
various groups. The scores indicate that both the positive and the
negative mean score increased in the experL~ental gro~o's ?osttest
compared to the pretest. The experimental unit's positive and
negative feeling pretest scores were lower than the control units'
pretest; however, in the posttest the experimental unit's scores
were hir;her.
Because of the initiation of prL~ary nursing on the inter
mediate care unit, a comparison was m~de of the ex~erimental unit's
pcsttest scores to the posttest sco~es of the cont~ol units ex
cluding the intermediate ca~e unit. The experimental unit's
TABLE 6
Mean Score for Change in Positive and Negative Feelings
control control control units inter. 3C 3C units units without inter. unit
Changes in Posltive Feelings 2.9 4.8 3.2 3.5 4.0 2.8
Changes in Negative Feelings 2.9 3.6 3.6 2.6 4.0 2.3
(see Appendix F for complete derivation)
inter. unit posttest
3.4
2.1
0'\....J
64
positive feeling score was hi~her and the negative feeling score
was lower. The experi~ental posttest scores ~~re higher than the
intermediate care unit's scores. The intermediate care unit's
scores 'Nere lower than the rest of the control units. Finally, a
comparison of the intermediate care unit's scores showed a higher
score in positive feelings and a lower score in negative feelings
in the posttest than in the pretest.
To determine if the differences in mean scores were signifi
cant the t test comparison of means and the F test analysis of
variance test were used. The statistical null hypothesis was that
the changes in the positive and negative feeling scores would be
the same in all the groups tested. Table 7 gives the results. The
only comparison that reached significance was when JCts pretest
pOSitive feeling mean score of 2.9 was compared to JC's posttest
positive feeling Mean score of 4.8. The statistical null hypothe
sis was rejected in this comparison both by the F test and by the
t test. Sat it could be concluded that the mean scores were
different from one another and that difference was greater than
that exuected by chance. Therefore, the research hypothesis that
the measured level of job satisfaction wculd increase if motivators
were provided was supported by the comparison of Je's pretest
positive feeling mean score to its posttest score. However in all
other comparisons. among the various groups, of the positive and
the negative feeling scores, the differences were not statistically
si~ni!icant. ~ereforet the statistical null hypct~esis that the
changes in the p~sitive and negative feeling scores would be the
Positi.ve Feeling
Grouo Test lMean Score 3C Fre 209 13G Post 4.8 )C Pre )C Post 3C Pre 2.9 Control Pre 3.2 3C Pre Control Pre 3C Post 4.8 Control Post 3.5 3C --Post Control Post )C Post 4.8 Inter 0 Post 3.4 3C Post ±!It er~. Po s t 3C Fost 4.8 Control without _lnt~!':. _ F'ost -- 4.,0 )C Post C ontr 01 wi thaut
Inter. Post Inter. Post 3.4 Control without
Inter. Post 4.0
TABLE 7
Positive and Negative Feeling Tests of Significance Negative Feeling Values of t Mean Score t egua1s beyond .05 Significant F equals
2.28 2.08 S 5.18
2.9 .8602 2.11 NS .71 .. 3.6
.4899 2 .. 0'li NS .24
2.9 .7071 2.11 NS .50 1.6
1.68 2.08 NS 2.84
3.6 1.23 2.11 NS 1.53 2.6
.4899 2.09 NS 2.40
3.6 .6083 2.13 NS 307 2.1 -
.4899 2.18 NS .24
3.6 .244 2.2) NS .06
4.0
.43.59 2.26 NS .19
Values of F beyond .05
4.32
4.45
4.30
4.45
4.32
4.45
4.38
4.54
4.75
4096
5.12
Signif-icant s
NS
NS
NS
NS
NS
NS
NS
NS
NS
NS 0-
\J'I
Positive Negative rt'eeling Feeling
Group Test t-Iean Score Mean Score t equals Inter. Post 2.1 Controls without 1.22
Inter. Post 4.0 Inter. Pre 2.8 .7483 Inter. Post 3 .. 4 I It .. Pre 2.3 1.76 Inter .. Post 2.1 Con'trol Pre 3 .. 2 0 .c.Qntr.oLP~d_~ 3....5... ___ Control Pre 3.6 1.05 Control Post 2.6
TABlE 7 (Cont.)
Va.lues of t beyond .05 Significant F equals
2031 NS 1.49
2.16 NS .56
2.31 NS -3.1
2.07 NS 0
2.11 NS 1.11
Values of F beyond .05
5.59
4.67
5.32
4.30
4045
,-
Signif-icant
--
NS
NS
NS
NS
NS
'-'" ("
t7
same was accepted in those comparisons. The research hypothesis
was not aC06Dted.
A final objective of the data analysis of the information ob
tained from the Job Satisfaction Audit Tool ~as to determine if the
3C nursing staff had recognized the planned changes that had
occurred during the experimental period and if they saw those
changes as motivators. To identify this their individual replies
to the question asking 1mat changes had taken place a.nd if there
had been an increase or decrease in recognition, aChievement, work
itself, responsibility, advancement, and growth was noted from the
posttest questior~aires.
From the question that asked for a. description of chan~e5 that
had taken place the following changes were noted: three people saw
improved staffing. four people felt an increase in responsibility
or an increase in what was expected of them, two Aides noted a
change intNdr position to that of Unit Clerk, one person recog
nized a change in the manner in which report was taken and assign
ments made, one person experienced a leadership opportunity, and
one person felt an increase in paper 'T.rork. ~"Inen asked about re
cognition for achievement only three people identified a specific
example. They cited the three month post-hire evaluation as a
source of recognition for achievement. Teaching inservices to the
3C staff was recognized as an opportunity to achieve by one person.
Another individual stated that knowledge of nursing increases your
opportunity to achieve. In response to the question regardin~ a
change in ·...Tork itself or job assigments, two peo~le identified an
increase in responsibility, one saw heavier Fatient assigr~entst
another recognized additional duties for staff nurses. An Aide
saw promotion to the Unit Clerk Fosition as a chan~e in work itself.
A change in amount of responsibility for work was seen by one per-
son as more paper work and an LPN felt that the team leaders relied
on her more to make accurate observations. The only advancement
noted was by an Aide promoted to the Unit Clerk position. The
final motivator question asked if a change in opportunity to learn
or advance in skills was noted. One person felt she achieved this
from inservices and two Aides felt the RNs aided their learning.
~ ~ ~ ~ ~ Questionnaire
In this questionnaire the staff was asked to rank 12 factors,
in order of priority, as they considered an ideal job. Number one
was the factor most preferred in an ideal job and number twelve was
the factor least preferred. Then after ranking the factors the
staff was asked to distribute 100 points among the factors giving
the highest number of points to the factor most preferred and the
lowest number of points to the factor least preferr9d. The 12
factors ~oTere:
High (salary) A chance to make full use of your (abilities) Helpful and cooperative (associates) Comprehensive fringe (benefits) A boss who provides autonomy, help when needed, and
recognition Y..lhen deserved (supervision) Friendly, cordial relations with patients and thei~
families (relationshios) Relati'Te freedom from (tension) and pressure (Cnportuni~ies to learn) new things (J~b security) -A chance to make (indeFendent decisions)
A sense of really (helping others) A stable ~Norking (schedule)
Reference to these factors throughout the rest of the text
69
will be through use of the words in parenthesis. In the posttest
the experimental and the control units combined ranked the 12
factors in the following order (see Appendix G for complete
1. Rank each of t~e follm~ng factors in the order of priority to you as you consider an ideal iob. Give a rank of "III to the item that you !!!,2ll prefer in an ideal ,job and. a rank of "1211 to the item you ~ prefer, and so on for the !actors in between.
2. After completing the ranking, then distribute 100 points among the eight factors. Give the highest n~~ber of points to the item you prefer !!!,2ll, the lowest number of points to the factor you prefer 1!!!1 and so on for the items in between. Ple&se check to be sure that the numbers add to 100.
RANKING POINTS FACTCiiS
High salary
A chance to make full use of your abilities
Helpful and cooperative associates
Comprehensive fringe benefits
A boss who provides autonomy, help when needed, and recognition when deserved
Friendly, cordial relations with patients and their families
Relative freedom from tension ~nd pressure
Opportunities to learn new things
Job security
A chance to make independent decisions
A sense of really helping others
A stable working schedule
___ Total= 100
APPENDn D
BIOGRAPHICAL DATA
93
INSTRUCTIONS
This questionnaire is ccncerned with job attitudes in nursing. Please ans~~r each question carefully and honestly. All information given will be kept in strict confidence. Your assistance will be greatly appreciated.
'ward Clerk ---other: (Please Specify) ---How Long at Present Position __________________ __
Number of Years of Experience in Nursing -----------------If RN the type of school in which you received your (basic) nursing education:
Junior College, or Associate Degree -nospita1
University or Bachelors Degree
List all further degrees you have obtained ______________________ _
List how many college credits you have earned since graduation from your basic program ________________________________ _
If LPN, NAt or Clerk please list highest level of educational achievement including number of college credits earned
APPENDIX E
DATA FROM JOE SATISFACTION AUDIT
EXPERIMENTAL PRETEST KEY: RNs, LPNs, & Aides N=16
MODE
Changes in Job 1 Recognition 2 Achievement 1 Work Itself/Assignments 2 Responsibility 2 Advancement 2 Growth 1 Feelings About Chang~s 1 Amount of Satisfaction 1 Personal Affects 1 Relations to People/Family 2 Affect on Health 2
1- Yes an increase 2- No a decrease 4- Yes an increase but feel negative about it 5- Both an increase and a decrease
FREQUENCY P~RCENTAGE OF GROUP 1 2 4 2 COMPLETING QUESTION 5 3 50.~ 5 9 87.5% 9 4 81.3% 3 7 4 87.5% 5 6 2 81.3% 3 10 81.3~
Changes in Job 1 Recognition 2 Ac hi eveme nt 2 Work Itself/Assignments 2 Responsibility 1 Advancement 2 Growth 1 Feelings About Changes 1 Amount of Satisfaction 1 Personal Affects 1 Relations to People/Family 1 Affect on Health 2
1- Yes an increase 2- No a decrease 4- Yes an increase but feel negative about it 5- Both an increase and a decrease
Changes in Job 1 Recognition 2 Achievement 2 Work Itself/Assignments 2 Responsibility 1 Advancement 2 Growth 1 Feelings About Changes 1 Amount of Satisfaction 1 Personal Affects 1 Relations to People/Family 1 Affect on Health 2
1- Yes an increase 2- No a decrease 4- Y~s an increase but feel negative about it 5- Both an increase and a decrease
Changes in Job 1 Recognition 2 Achievement 2 w:ork Itself/Assignments 2 Responsibility 2 Advancement Growth 1 Feelings About Changes 1 Amount of Satisfaction 1 Personal Affects 1 Relations to People/Family 1 Affect on Health 1
1- Yes an increase 2- No a decrease 4- Yes an increase but feel negative about it 5- Both an increase and a decrease
CONTROL UNITS KEY: POSTTb.ST RNs, LPNs, & Aides N=]4
MODE
Chan~s in Job Recognition 1 Achievement 1 Work Itself/Assignments 1 Responsibility 2 Advancement 2 Growth 1 Feelings About Changes 1 Amount of Satisfaction 1 Personal Affects 1 Relations to People/Family 2 Affect on Health 2
1- Yes an increase 2- No a decrease 4- Yes an increase but feel negative about it 5- Both an increase and a decrease
FREQUENCY PERCENTAGE OF GROUP 1 2 4 2 COMPLETING QrriSTION 3 0 21.1~ 8 4 85.7 8 3 78.6 6 4 1 78.6 J 8 78.6 3 8 78.6
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