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Motivation in Health Care
Desire is inbuilt in man. Our life and its furtherance through breeding are dependent on desire. Achievement of desire is what motivates us. On different levels, one might consider motivators and incentives. Often, the expeditious and efficient completion of a project is associated with a bonus. Motivation theory is a field of study that has established formalism for one important aspect of human behavior -- fulfillment of need. In fact, these needs are designed in a hierarchy. At the basic level, there is a motivation to live. Therefore, any act on the part of the person is generally motivated by this desire. Among basic needs are the need to eat, the need for shelter and the need to procreate. The dynamics of the "need to eat" is also worthy of consideration. Many aver that an American's need to eat will often coincide with the need to fulfill an appetite: that very few Americans or most Americans only a few times in his or her life would truly identify with the need to eat with the other option being starvation.
Once the basic human needs are met, a person is driven or motivated to fulfill other intrinsic needs. These are needs of emotional and physical safety.
In addition, one should also consider social needs. This is the need to be accepted and to belong to a domain or group; and, also to gain friendship and love. Consider the act of eating, which for many today fulfills, additionally, the need to find social acceptance. Next, is the need for esteem. This is an important need especially in the case of the health system. Esteem is the recognition of one's worth and the acclaim and attention it deserves. Maslow, who was the first to suggest the hierarchical theory of motivation, used the famous words to describe man's motivation to achieve his (or her) highest desires: the need for self-actualization. (Gwynne, 1997) He averred: "A musician must make music, an artist must paint, a poet must write, if he is to be ultimately at peace with himself. What a man can be, he must be." This is the need to fulfill what human's perceive as their "manifest destiny."
The above theory is generally called the content model of motivation where the primary motivator is fulfillment of personal intrinsic needs that may or may not reach the highest point -- self-actualization. Contrast this theory then, with a cognitive model of motivation as opposed to the more "needs-based" content model. This model is called the process model of motivation. This model proposed by Porter and Lawler (Albany.edu, 2003) A person's motivations are governed by the ultimate rewards. The cognition of the effort-reward cycle is what drives this person's work. In essence, therefore, a person who perceives that the rewards are not justified by the effort will not be motivated to perform to the best of his or her abilities. The Process Model is also based on a perception of how much better another person's reward are for similar or lesser work. This is where the cognition of inequity enters the picture. There is a complex dynamic whereby the needs in each step of Maslow's motivational hierarchy can be conceived as a reward system in the process theory. This is an important consideration, especially in the health care industry. Merely considering higher salaries and better benefits will not motivate a health care industry worker to produce at an optimal level.
Today's health care industry is the vast enterprise. Consider America's hyper-power status as the world's richest and most powerful nation. America's health care is the seventh largest aspect of its economy. Everybody agrees that there is a problem in the health care system. Most solutions however, fall far short. Problems from price gouging to inadequate healthcare-on-demand abound. Nearly a decade ago, former President Clinton put his wife in charge of creating a health care plan that would be all things to all people. Unfortunately, the plan mostly called for socialized medicine enjoyed by most European countries and Canada. This proposal was soundly defeated because it went against the grain of the free-capitalist, market-based economy that America espouses and celebrates. In any case, this work is not dedicated to "macro" considerations. It is dedicated to a "micro" perspective: What motivates people to continue to work in a health care setting? The applications of purely content and purely process models will be discussed. The primary aim of this work will be designed to identify motivational factors that would be necessary to hire and, more importantly, retain workers in this industry.
The ramifications of the health care industry are primarily: to take care of the health care needs of patients. This means that the system is a universe all to itself. Workers within the health care system range from would be Nobel laureates to lowly orderlies and custodial staff. Subunits within the health care system are hospitals, nursing homes and medicine-based research institutions. They employ doctors, researchers, scientists and nurses to take care of the medical side of things. In addition, each of these subunits has, like any organization or corporation contains administrative staff. From an employee perspective, human resources departments oversee medical and non-medical staff. The pharmaceutical industry, which also thrives, and is dependent for its survival, on health care, is a critical adjunct to the health care industry.
At its basic level, of course, the health care system is predicated on the Hippocratic Oath for doctors and the (Florence) Nightingale Oath for nurses. This means that a natural altruism is part of the health care industry. The end result is the physical, mental and emotional welfare of the patient. While it should never be possible to completely divorce the "health" aspect from the health care industry, it is worthwhile to assume a hypothetical situation where the entire industry is built as a business where the pursuit of profits is primary. In such a scenario, one must also recognize that intrinsically linked to this money-making notion is the idea that good care to customers (patients) will automatically result in higher revenues -- due to a superior product.
The health care industry is currently undergoing a crisis. Typical employment statistics do not apply to health care which is seeing a drain of employees. This places undue burdens on those who choose to remain. The remaining workforce is aging with less infusion of younger workers. The staffing gets tighter. This results in occupational anxiety. Often, one of the fears within the health care system is the limited upward mobility. There is also a lack of motivation within an organization to provide advanced training. Some of these problems are caused due to inadequate compensation often due to merging and greater responsibilities. The health care worker is also frustrated and this frustration overcomes the charitable nature of these workers who believe that they cannot adequately serve the patients needs. This results in workers leaving the industry to work in better climes. This problem also has other repercussions. As the health care crisis scenario is presented in the media, students and youngsters who might consider going into health care reevaluate their career options.
If one considers the problems mentioned in the previous paragraph, and then there is no doubt that, the situation is ripe to promulgate a Process Theory solution to the problem of motivating people to remain in health care. One might assume that since there is available business, there are enough funds. Or funds might be procured. Salary hikes might be considered as incentives for workers to stay. These higher salaries will then attract workers from other fields. Knowing that the health care industry has an upswing, students will also opt for courses that will allow them to seek futures in the health care sector. In addition to salary hikes, the institution of a better way of financing health care will parallelly and additionally achieve the same results. This system would enable hospitals to increase caregiver time and lower patient-to-staff ratios, thus reducing burnout among workers. Hiring an adequate number of people to staff health care institutions will also result in better patient care thus establishing a better case for self-fulfillment. Another system of reward would be better training and educational facilities that would help workers keep abreast of the requirements of their jobs. If a program was also put into place to promote from within (unless absolutely essential), a feature that many companies use today, then the worker will be motivated to stay, obtain the training and work towards a promotion, knowing that such an opportunity is at least available. Another reward is a forum whereby a health care worker can input his or her opinions into identifying means whereby the health care provision can be reorganized such that the worker can more efficiently and "happily" do his or her job. Good training facilities, good management, clear working protocols, guidelines, and openness to change, when established or at least pursued, are good reward-motivators for health care workers.…[continue]
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