THE IMPLICATIONS OF NATIONAL CULTURE ON ORGNAIZATIONAL CITIZENSHIP BEHAVIOURS: EVIDENCE FROM NURSES IN THE IRISH HEALTHCARE SECTOR

THE IMPLICATIONS OF NATIONAL CULTURE ON ORGNAIZATIONAL

CITIZENSHIP BEHAVIOURS: EVIDENCE FROM NURSES IN THE IRISH

HEALTHCARE SECTOR

Deirdre O’Donovan,

School of Humanities,

Cork Institute of Technology,

Rossa Avenue,

Bishopstown,

Cork.

0214 335065

[email protected]

Dr Margaret Linehan,

Head

School of Humanities,

Cork Institute of Technology,

Rossa Avenue,

Cork.

0214 335510

[email protected]

POSTGRADUATE PAPER

HUMAN RESOURCE MANAGEMENT TRACK

THE IMPLICATIONS OF NATIONAL CULTURE ON ORGNAIZATIONAL

CITIZENSHIP BEHAVIOURS: EVIDENCE FROM NURSES IN THE IRISH

HEALTHCARE SECTOR

ABSTRACT

It has been previously suggested that social organisation

faces a paradox. While human variability must be reduced to

ensure predictable performance, simultaneously, spontaneous

and innovative activity that goes beyond role requirements

must be encouraged (Katz, 1964). Such behaviour is now often

referred to as Organizational Citizenship Behaviour (OCB)

(Jahangir et al., 2004). Essentially, OCBs are supra-role,

contributory behaviours undertaken by individuals of their own

volition, which are not required as part of their role or task

fulfilment, thus, not practicably enforceable by superiors,

but often help the organisation the individual works for in

some manner (Markóczy et al., 2009; Borman, 2004; Konovsky and

Organ, 1996; Organ 1988).

This paper presents preliminary findings from research

currently being undertaken on OCBs. The focus of this

research is on the implications of inclusion and national

culture on the undertaking of such behaviours, in particular,

among nurses currently employed in the Irish healthcare

sector. One of the main aims of the research is to add to the

dearth of literature in the field by exploring linkages

between employee perceptions of inclusion, national culture,

and the undertaking of OCBs. The results of the research

should not only assist hospital managers in Ireland, but,

managers in various organisations both nationally and

internationally, in developing an understanding of why

employees may or may not undertake OCBs.

The Irish healthcare sector was chosen for a number of

reasons, for example, this sector has, over the past decade,

employed a large number of non-Irish employees, making it

suitably culturally diverse to enable analysis. Further, for

many users of the Irish public service, healthcare is one of

the most important priorities (Byers, 2010). Nurses

participating in primary research are from four countries,

specifically, Ireland, the United Kingdom, India and The

Philippines. These countries were chosen as they are currently

the four most represented countries in the nursing workforce

in Ireland. In-depth interviews have been conducted with

nurses from these countries in a range of Irish hospitals. A

number of findings have begun to emerge from the on-going

research, to date. One such finding concerns individuality.

Although nurses assert that cultures in other countries are

different from that in their own country, the majority of

respondents thus far are of the opinion that individuals

within the same country differ from each other, rather than

being culturally constrained. An implication of this assertion

is that, should employee behaviours result from individual

makeup rather than collective cultural shaping, encouraging

OCBs based on cultural expectations of behaviour and reactions

to stimuli may not be entirely possible. An additional finding

stems from respondents suggestions that organisational and

national culture are equally important, with some respondents

so far suggesting that organisational culture is slightly more

important while at work. Organisations may be able to

capitalise on this finding by striving to develop an

organisational culture that encourages the undertaking of

OCBs.

BACKGROUND

Diversity has always been present in societies (Arredondo,

1996). Arguably, therefore, organizational workforces have

always been diverse. Indeed, van Knippenberg et al. (2004)

consider diversity a fact of organizational life, a notion

supported by Jackson and Joshi (2011) who propose that

diversity exists in all work groups, albeit to varying levels.

Despite the ever presence of diversity, however, workforces

today are rapidly becoming increasingly even more diverse

(Bell and Kravitz, 2008). The rapid increase may be

attributable to a number of factors, including, for example,

changing demographics among populations, globalisation of

organizations services, employees, customers and suppliers, or

anti-discrimination legislation (Jackson and Joshi, 2011;

Monks 2007).

From an Irish organizational perspective, recent years have

seen a sharp rise in immigration, which has brought with it

the diversity of many cultures (Connolly and McGing; 2006,

SIPTU, 2006). As a result, one of the most prevalent forms of

diversity in Irish workforces at present is cultural

diversity. Furthermore, in the context of the Irish Healthcare

sector, a shortage of nurses since the 1990s resulted in

active, rapid, overseas recruitment (Humphries et al., 2008).

The extent of overseas recruitment initiatives meant that

while in 1990, three of every four new registrations with An

Bord Altranais (/The Irish Nursing Board) were Irish, by 2006,

three of every four new registrations were from another

country (Buchan, 2009). Evidently, the Irish Healthcare Sector

has become heavily reliant on migrant nurses (Humphries et al.,

2009). Such reliance has increased the levels of cultural

diversity among nurses in Irish hospital wards.

Cultural Diversity and Inclusion

According to Kokt (2003), there is no single definition of the

term culture. Seminal research conducted by Hofstede

(1991:5), however, defines the concept as:

The collective programming of the mind which distinguishes the members of

one group or category from another.

Cultural diversity holds particular significance for

organizations, as culture influences the behaviour of

employees (Gardenswartz and Rowe, 2001). Additionally, it has

been suggested that culture also has implications for other

concepts and practices, for example, motivation and

motivational theories, leadership, employee participation and

organizational structure (Bing, 2004; House et al., 2001).

Consequently, it has been proposed that attempting to ignore

cultural differences can result in negative outcomes for both

individuals and the organization as a whole (Gardenswartz and

Rowe, 2001). In practical terms, the dimensions of culture as

proposed by researchers should assist in making organizations

aware that employees from different countries may think, feel

and act differently than others in various situations

(Hofstede, 1993).

When considering the differences among people, however, there

is a tendency to become rigid or simplistic (Ferdman and

Brody, 1996). Rather than cultural differences becoming the

source of division between individuals, they should be a

source of pride, used for the benefit of all (Ferdman and

Brody, 1996). Consequently, diversity management needs to

move beyond reacting to a shift in workforce dynamics (Pless

and Maak, 2004). Indeed, while addressing how diversity

should be dealt with in an organisation, Davidson and Ferdman

(2001) propose that the answer lies in an inclusive version of

diversity. Such an inclusionary approach is one in which:

Differences are recognized, valued and engaged. Different voices are

understood as being legitimate and as opening up new vistas; they are heard

and integrated in decision making and problem solving processes; they have

an active role in shaping and fostering creativity and innovation; and

eventually in adding value to the company’s performance (Pless and

Maak, 2004:130).

This approach is concerned with not just identifying the

differences of all individuals in the workplace, rather,

integrating them into the culture of the organization. Such

an approach has been supported by a report examining global

diversity and inclusion published by Forbes in (2011),

which proposes that both a diverse workforce and an

inclusive culture are necessary for global success. The

report further suggests that when diversity exists in an

inclusive environment, it is a key driver of innovation and

creativity and can also guide business strategies.

Inclusion is considered by Gasorek (2000) to be a multi-

dimensional concept concerning, for example, the degree to

which employees believe they are valued and whether their

ideas are taken into account, and used, employees feel they

belong in the organization, and employees feel committed to

each other, the organization and the organizations goals.

An underlying assertion of this current research is that

as, according to cultural theory, culture affects how

individuals, thus employees, behave and possibly therefore

perform in the workplace, it may also impact whether they

undertake Organizational Citizenship Behaviours (OCBs). The

following section, therefore, briefly addresses the concept

of OCBs.

Organizational Citizenship Behaviour

Similar to the concept of diversity, the concept of

Organizational Citizenship Behaviour (OCB) is not new.

Indeed, Barnard (1938) first alluded to the idea in relation

to willingness to cooperate, following which in 1964, Katz

suggested that social organisation faces a paradox, proposing

that human variability must be reduced to ensure predictable

performance, while simultaneously, spontaneous and innovative

activity and behaviour that goes beyond role requirements must

be encouraged. Bateman and Organ termed these behaviours

“citizenship behaviours”, resulting in the construct of

Organizational Citizenship Behaviour being explicitly

developed in the 1980s (Markóczy et al., 2009; Becton et al.,

2008; Borman, 2004; Bateman and Organ, 1983). Essentially,

OCBs are supra-role, contributory behaviours undertaken by

individuals of their own volition, which are not required as

part of their role or task fulfilment, thus, not practicably

enforceable by superiors, but often help the organisation the

individual works for in some manner (Markóczy et al., 2009;

Borman, 2004; Konovsky and Organ, 1996; Organ 1988). The

importance of OCBs has been stressed by Jahinger et al. (2004),

who contend that organizations could not survive without the

undertaking of OCBs by employees. Indeed, a wide-ranging,

multi-dimensional concept, OCBs can be categorised into seven

dimensions, specifically, Helping Behaviour, Sportsmanship,

Organisational Loyalty, Organisational Compliance, Individual

Initiative, Civic Virtue and Self-Development (Podsakoff et al.,

2000).

Previous research has focussed on the relationship between

various contextual factors, and the undertaking of OCBs.

Areas previously addressed include the relationship between

OCBs and job satisfaction (Bateman and Organ, 1983), an

individual’s disposition (Borman, 2004), equity sensitivity

(Konovsky and Organ, 1996), perceptions of organizational

justice (Blakely et al., 2005), a supportive work environment

(Boorman, 2004), and gender roles (Kidder and McLean Parks,

2001), viewing the aforementioned as antecedents or

predictors. This research aims to add to the existing

literature on OCBs and antecedents by exploring whether a link

exists between national culture, the perception of inclusion,

and the undertaking of OCBs. This research is work-in-

progress, but the methodological approach is outlined in the

following section.

METHODOLOGY

A number of hospitals in Cork and Dublin have been chosen for

this research. The Irish healthcare sector was chosen for a

number of reasons, for example, this sector has, over the past

decade, employed a large number of non-Irish employees, making

it suitably culturally diverse to enable analysis. Further,

for many users of the Irish public service, healthcare is one

of the most important priorities (Byers, 2010). Nurses

participating in primary research are from four countries,

specifically, Ireland, the United Kingdom, India and The

Philippines. These countries were chosen as they are currently

the four most represented countries in the nursing workforce

in Ireland, as per the Active Register. The sampling frame

included nurses (both male and female) of different staff

grades (from Registered General Nurse/RGN to Clinical Nurse

Manager/CNM 2), from Ireland, the United Kingdom, India, and

the Philippines.

Exploratory and descriptive research has been deemed most

appropriate to gather information to answer the research

question. Generally, exploratory research is undertaken to

enable the researcher to gain background information about the

research problem (Burns and Bush, 2006). Descriptive research

provides an insight into the thoughts, feelings, or behaviours

of respondents, allowing for the development of a greater

understanding of what is happening (Stangor, 1998). In

specific, in-depth interviews are being used, and are

considered suitable for a number of reasons. In-depth

interviews afford an opportunity to gain a depth of

information on the interviewees’ thoughts, interpretations,

and feelings. Additionally, in-depth interviews enable

participants to elaborate on their responses, and also afford

the researcher an opportunity to ask additional questions

leading on from respondents’ answers to questions. A main aim

of the research was to gain insights into the perceptions of

nurses from different cultures on inclusion and diversity

practices in the Irish healthcare sector, and to discover

whether there were links between the nurses’ national cultures

and their undertaking of OCBs.

To date, 23 interviews have been conducted with nurses from

different staff grades in four hospitals in Cork, with 8

Irish, 5 Indian, 9 Filipina/o and 1 UK nurses taking part (18

female, 5 male, and 6 CNMs, 17 RGNs). Another 13 interviews

have been arranged and will be undertaken in Cork over the

coming months. Ethical clearance processes have begun in

order to gain access to a further five hospitals in Dublin.

The first step in gaining entry to the hospitals was to

contact each hospital to obtain the directors of nursing’s

email contact information. Once this contact information had

been obtained, each director was contacted individually by

email with a detailed explanation of the study. All directors

responded positively, and the process of gaining access to

nurses was initiated. The process varied for each hospital.

In some hospitals the lead researcher was set up with a

liaison, in others prior meetings were held with senior staff,

in others contact details of suitable wards were given to the

lead researcher and access was established without a middle

party.

All interviews have been, and will continue to be, with the

permission of the nurses, recorded on a dictaphone, and

transcribed as soon as possible after the interview. These

transcripts are necessary for content analysis. Content

analysis, which involves coding groups of words or phrases

from the research transcripts into categories, is being used

to analyse the data. Coding refers to putting data into

theoretically defined categories to analyse it (Carson et al.,

2001). Although it is expected that there will be a large

volume of data, manual coding and analysis will be utilised.

DISCUSSION OF FINDINGS

Although relatively early in the process, a number of findings

have begun to emerge from the on-going research. One such

finding concerns individuality. The nurses interviewed assert

that cultures in other countries are different from that in

their own country; the majority (16) of the 23 respondents

thus far are of the opinion that individuals within the same

country differ from each other, rather than being culturally

constrained. When questioned regarding whether everyone from

the same country was the same or similar, the following

quotations represent responses to the negative:

No, it’s like anything – you could get four people in a room and everyone

could be totally different. Some people would be harder workers than others.

Other people would be more of a thinker. Other people would be more of a

doer, a practical person. And it’s the same worldwide, but that’s the mix that

makes the place good…If you had everyone the same, totally, rigidly the

same, it would be very boring and you wouldn’t work things out. And

everybody is different (Nurse 5, Hospital A, Irish Female).

No, they are all different. From different religion, different caste, you can

have different communities and beliefs, even from a different part in the

country. The Indians, we are not all the same (Nurse 9, Hospital A,

Indian Female).

Their culture, their tradition or their practice at home, and the way they deal

with other people [makes them different]. We’re different from each other

personality wise, in every aspect of what you practice or way of dealing with

situations. I think we are different because you have your way to do things,

and I have my way (Nurse 14, Hospital B, Filipina).

I wouldn’t say so. Everyone has different opinions really. Someone might

believe in a certain practice that another person might not believe in, for

example, the whole abortion thing recently; some people feel it should have

been handled another way, whereas another person might feel it should

have been handled another way, and they are both from a Catholic point of

view, but have a different way of dealing with it. So everyone has different

opinions, but they might be from the same culture. You can’t paint all with

the same brush. We have Indian nurses on the ward, we have Filipino nurses

on the ward, and they might all have different opinions, so you can’t paint

them all with the same brush really (Nurse 15, Hospital B, Irish

Female).

The above opinions of employees regarding individuality are

reflective of previous research conducted by O’Donovan and

Linehan (2012a; 2012b; 2011) which also suggested that

individuals may not be culturally constrained, in particular

to the degree suggested by previous cultural studies. An

implication of this finding is that individuals are not

culturally constrained, but, rather are shaped by their

individuality. Trying to better understand the behaviour of

employees by viewing them through a lens which applies

particular cultural dimensions to an individual based on their

country of origin, therefore, may be fruitless. Weight is

added to this finding when the makeup of the respondents is

considered, as employees from each of the four different

countries stated that individuals are not culturally

constrained. A further implication of this assertion is that,

should employee behaviours result from individual makeup

rather than collective cultural shaping, encouraging OCBs

based on cultural expectations of behaviour and reactions to

stimuli may not be entirely possible. It can be suggested,

therefore, that managers consider culture as one possible

contextual factor to understand behaviour, rather than the

primary factor.

An additional finding stems from respondents suggesting that

organisational and national culture are equally important,

with some respondents so far suggesting that organisational

culture is slightly more important while at work, as

illustrated by the following sentiments:

I think the organizational culture is better because it’s the same rules for

everyone. You’re treating everyone the same (Nurse 3, Hospital A,

Irish Female).

We are aware that we have our own and you have your own. But like they

say, “do what the Romans do”, so, if you are in Rome you will do what they

do. But it won’t change my practice and culture in my country, but because I

am here I am doing it like here because this is your culture here. They are

equally important because when you are practising nursing it’s regardless of

your race regardless of your practice or religion or whatever so for me as a

nurse I will work based on the culture of the country I am working in, the

practice of the patient or my peers in the particular culture I am in (Nurse

4, Hospital A, Filipina).

My personal identity is very important, and I think that’s much more

important that the hospital to me. My national culture, no. I think I’m proud

to work at this hospital, and as a very, to me, alien culture, it’s different than

any hospital I’ve worked in in either Ireland or the UK. I’m very proud to say

I’m a “Hospital C” nurse, while I might not have been so proud in other

hospitals (Nurse 21, Hospital C, English Male).

Ten of the 23 respondents interviewed to date were of a

similar opinion to those expressed in the quotations above.

In addition, a further five respondents suggested that both

national and organizational culture are equally important, and

coexist, while a further three indicated that they perceive no

difference between the two, or that it does not matter, as

illustrated below:

They are equally important. As long as we are respecting each other’s beliefs

and such it is OK. As long as there is respect (Nurse 2, Hospital A,

Filipino).

I wouldn’t have said that there was any difference really between the culture

of the organization and mine (Nurse 11, Hospital B, Irish

Female).

It has no bearing on me, because I have my own opinion, they have their

own opinion. I have my views, they have their views. As long as we get along

well it doesn’t matter at all (Nurse 18, Hospital B, Filipino).

They are equally important I would say. I have to follow my culture in my

home, so I can’t change my culture. Both are important, for my life and my

job and my personal life (Nurse 22, Hospital C, Indian Female).

Interestingly, only one respondent indicated that their

national culture was more important than the culture of the

hospital, but did so as they perceive organizational culture

as occasionally carrying negative connotations:

I think they coexist. They live together. But I suppose if I was to be honest I

would say I identify with my Irish culture rather than a hospital culture. To

me, an Irish culture is something that is positive, and often hospital culture

can be negative. So, one would prefer to identify with the idea of being Irish

rather than say being a nurse, or belonging to the HSE or belonging to a

hospital culture, because there can be a lot of negatives as well as positives

(Nurse 12, Hospital B, Irish Female).

Regarding using culture to increase the undertaking of OCB’s,

the above sentiments regarding the importance of culture are

significant. As illustrated, the majority of respondents

indicated the culture of the organization was more important,

while other interviewees suggested that national and

organizational cultures were equally important, or that there

was no perceived difference between them. Consequently,

organisations may be able to capitalise on this finding by

striving to develop an organisational culture that encourages

the undertaking of OCBs, rather than attempting to manipulate

an employee’s national culture to encourage said behaviours.

A further significant theme emerging from the early stages of

this research concerns the role inclusion has on employee

performance. Through the course of the interviews, nurses

were asked whether they had a sense of inclusion in the ward

or in the hospital, and whether feeling included impacted

their performance. Of the 23 respondents interviewed to date,

one interviewee was of the opinion that being, or not being,

included on the ward had no bearing on performance, while

another interviewee also stated that not feeling included

would not affect their performance, but because when they do

not feel included, they actively engage with others in the

ward to make themselves included.

Significantly, however, 21 of the 23 nurses interviewed

believe that feeling included does impact their performance,

in a positive manner. Their views are represented as follows:

Well I must say in any of the wards I’ve worked in here I’ve felt I belonged so

I’ve never really had any difficulty coming to work, I’ve always enjoyed

coming to work. I think there’s a great sense of belonging in the hospital. I

know I’m here longer than other people but I just think there’s a core thing

here in the hospital where people look after each other. I mean if people

aren’t happy in work they won’t work properly, they’ll be mooching around,

and saying “I’m not doing that, why do I have to do that’ll be slower, they

won’t go the extra little bit (Nurse 5, Hospital A, Irish Female).

Of course, it gives you morale, good morale. And it keeps you happy, and if

you are happy you perform well. You are going to the maximum of your

performance and you are happy with the job and you are happy with the

patient and the patient will feel that you are happy and they are happy

(Nurse 6, Hospital A, Filipino).

I am happy, so I don’t feel tired. The physical job makes you tired, but still I

feel light when I am happy, in the sense that my mood is good. And that

gives me job satisfaction. If I didn’t feel I belonged I would feel heavy inside.

The day flies because you were with good staff (Nurse 7, Hospital A,

Indian Female).

It has contributed to my career significantly. It encourages me to give more.

They give you this flexibility, which is how any unit should work. You have to

be flexible; give and take. You do something for the unit, they do something

for you. They very much encourage that, so that is how things are working

(Nurse 10, Hospital B, Indian Male).

Yes. It’s very stressful not to feel included (Nurse 21, Hospital C,

English Male).

It is evident, therefore, that for these respondents,

inclusion is rated as important in terms of their daily

performance. It can be recommended, therefore, that

hospitals, and organizations as a whole, build on this

finding and aim to foster a culture of inclusion, with a

view to enhancing and encouraging performance. Such a feat

may be more readily achievable in hospitals where wards

could be considered as teams or groups. It can also be

suggested that creating a culture of inclusion, for

example, an organizational-wide ‘team’ or ‘family’ could be

encouraged for organizations which do not readily lend

themselves to dividing employees into groups in order to

give a sense of inclusion and belonging.

CONCLUSION

Although this research is on-going, a number of themes have

begun to emerge. Three of the most significant themes

uncovered to date have been outlined above, concerning (i)

individuality as opposed to cultural constraint,(ii) the

importance of organizational culture, and(iii) the impact of

employees’ perceptions of inclusion on performance.

In particular, the findings of the research indicate that the

interviewed nurses are shaped by their individual contextual

factors, rather than by cultural constraint. Indeed, the

nurses indicated that while they acknowledge that their

respective country has a culture, individuals within cultures

can be, and are, different from each other. This carries

significance for managers who are attempting to understand

employee behaviour by applying cultural dimensions to them.

It also indicates that employees may be capable of adapting to

the culture of other countries far more readily than

previously thought.

A further finding emerging from the research is that

organizational culture is considered more important than

national culture by almost half of the respondents.

Additionally, organizational and national cultures were deemed

to be of equal importance by a further five nurses. This

finding suggests that organizations can use organizational

culture to encourage and reinforce appropriate, desired

behaviours, or perhaps “positively manipulate” the behaviour

and perceptions of employees with a view to encouraging the

undertaking of valuable OCBs.

Finally, inclusion is emerging as a factor of importance for

increasing employee performance. Indeed, 20 of the 23 nurses

interviewed so far deem it to have a positive impact of their

performance. As such, organizations are encouraged to

actively foster inclusion, by creating a culture which moves

beyond simply accepting the presence of differences among

employees towards integrating them into the very seams of the

organization, with a view to capitalising on the importance of

organizational culture to employees.

To conclude, each of the three themes which have emerged from

the research to date carry significance for both hospitals and

for organizations in general. One finding indicates that

individuality is stronger than cultural constraint, signifying

that attempting to understand employees, and shape or predict,

their performance by considering cultural dimensions may be

ineffective. As outlined, organizational culture, however,

was deemed more important than, or as important as, national

culture by the majority of employees. Moreover, feeling

included on the ward has a positive impact on work performance

according to 21 of the 23 respondents interviewed to date.

This constitutes one of the main finding of this paper, as it

indicates that organizations attempting to encourage

Organizational Citizenship Behaviours may do so by creating an

organizational culture of inclusion, and by further using that

culture to positively manipulate employee behaviour. It can

be recommended, therefore, that organizations should aim to

move beyond diversity management, in the traditional sense,

and steer their organizations towards creating a real sense of

inclusion for all employees irrespective of their national

origins.

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