MOTIVATION AND ITS EFFECT ON PERFORMANCE

ON NURSES IN ARAMCO HEALTH CENTER

By:

HALA ABDULHADI AL JISHI

OPEN UNIVERSITY MALAYSIA

(2009)

MOTIVATION AND ITS EFFECT ON PERFORMANCE

ON NURSES IN ARAMCO HEALTH CENTER

By: HALA ABDULHADI AL JISHI

Project Paper Submitted in Partial Fulfillment of the Requirement for the Degree of Master of Business Administration

Human Resources

Open University Malaysia

(2009)

ii

ABSTRACT This project explores the effects that motivation has on the job performance of nurses. Several need and motivation theories have been discussed in the study to clarify what might affect the motivation of nurses. The results showed that nurses who are more motivated in their jobs are more satisfied with their performance, and less likely to leave the profession, but negatively affects the performance if the nurses are de-motivated. It is also focuses on the dissatisfaction factors that cause nurses to leave the profession such as, workplace violence, workplace hazard and injuries, long working hours, effect of night shift, shortage problem, feeling under paid, unreasonable workload and lack of appreciation. The findings from this study provide information as to what changes can made so that nurses are more motivated in their profession.

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Open University Malaysia Center for graduate studies

APPENDIX VII

RESEARCH PROPOSAL APPROVAL FORM Project Title: Motivation and Its Effect on Performance on Nurses in

Aramco Health Center Name of the student: Hala Abdulhadi Al-Jishi Matriculation No.: 51060588 Director Center for Graduate Studies Open University Malaysia Dear Sir, Attached are the following documents of your evaluation and approval: Chapter 1: Introduction Chapter 2: Literature Review Chapter 3 Research Methodology Chapter 4: Data Analysis and results Chapter 5: Recommendations Chapter 6: summery and conclusion Appendixes References I have thoroughly checked my work and I'm confident that it is free from major grammatical errors, weaknesses in sentence constructions, spelling mistakes, referencing mistakes and others. I have checked with CGS Guideline for Writing Project Paper, and I'm satisfied that my project paper proposal satisfies most of its requirements. Thank you, Student Signature: _______________________ I have read the student research proposal and I'm satisfied that it is in line with the CGS Guideline for Writing Project Proposal. It is also free from major grammatical errors, sentence construction weaknesses, citation and others. Supervisor's Signature: ____________________

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Appendix IV

DECLERATION Name: Hala Abdulhadi Al-Jishi Metric Number: 51060588

I hereby declare that this project paper is the result of my own work, except for quotations and summaries which have been fully acknowledged.

Signature: _________________ Date: ________________

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Open University Malaysia Center for graduate studies

APPENDIX VI

APPLICATION TO CONDUCT RESEARCH PROJECT PART A: STUDENT PARTICULARS

1. Name of the student: Hala Abdulhadi Al-Jishi 2. Metric Number: 51060588

PART B: PARTICULARS ABOUT THE PROJECT

1. Project Title: Motivation and Its Effect on Performance on Nurses in Aramco Health Center

2. Research Objectives:

3. Proposal Research Methods:

i. Research Design ii. Research Analysis iii. Data Collection

PART C: FACULTY INPUTS

1. Topic Chosen: Acceptable/ not acceptable: ___________________

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2. Suggested Supervisor for the Student:

____________________

Open University Malaysia Center for graduate studies

APPENDIX VII

RESEARCH PROPOSAL APPROVAL FORM Project Title: Motivation and Its Effect on Performance on Nurses in

Aramco Health Center Name of the student: Hala Abdulhadi Al-Jishi Matriculation No.: 51060588 Director Center for Graduate Studies Open University Malaysia Dear Sir, Attached are the following documents of your evaluation and approval: Chapter 1: Introduction Chapter 2: Literature Review Chapter 3 Research Methodology Chapter 4: Data Analysis and results Chapter 5: Recommendations Chapter 6: summery and conclusion Appendixes References I have thoroughly checked my work and I'm confident that it is free from major grammatical errors, weaknesses in sentence constructions, spelling mistakes, referencing mistakes and others. I have checked with CGS Guideline for Writing Project Paper, and I'm satisfied that my project paper proposal satisfies most of its requirements. Thank you, Student Signature: _______________________ I have read the student research proposal and I'm satisfied that it is in line with the CGS Guideline for Writing Project Proposal. It is also free from major grammatical errors, sentence construction weaknesses, citation and others. Supervisor's Signature: ____________________

vii

ACKNOLWEDGMENT

I would like to express my gratitude to all those who gave me the possibility to complete this project.

This work would not have been possible without the support and encouragement of my supervisor Dr. Anwar Al Jawder, under whose supervision I chose this topic and began the project. He has also assisted me in numerous ways, including offering resource books allowing me to read the needed valuable data.

I cannot end without thanking my family, my parents for their endless trust, encouragement, love, and support throughout my life.

I am grateful also to my husband for his constant courage and confidence that inspire me, and I have relied on throughout my time at the University.

It is to them that I dedicate this work.

Hala Al Jishi

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TABLE OF CONTENT Chapter one…………………………………………………………………………..1 1. Introduction…………………………………………………………………………2 1.1 Background of the study………………………………………………….2

1.2 Research Problem………………………………………………………...3 1.3 Objective of the study…………….……………………………………….3 1.4 Limitations………………………………………………………………….3

Chapter Two…………………………………………………………………………..4 2. Literature review…………………………………………………………………….5 2.1 Introduction……………………………………………………….………..5 2.1.1 MARS Model…………………………………………………………..5

2.1.1.1 Motivation…………………………………………………………6 2.1.1.2 Employee Ability……………………………….………………....6 2.1.1.3 Role Perception…………………………………………………..7 2.1.1.4 Significant Factors………………………………………………..7

2.2 Motivational Theories……………………………………………………..7 2.2.1 Maslow's Theory………………………………..………………….8 2.2.2 ERG Theory………………………………………………………..10 2.2.3 Tow –Factor Theory…………………………………………...….10 2.2.3.1 Hygiene Factors………………………………………………10 2.2.3.2 Motivation Factors…………………………………………….11 2.2.4 Acquired Need Theory……………………………………………13 2.2.4.1 Need for achievement……………………………….……….13 2.2.4.2 Need for affiliation…………………………………………….13 2.2.4.3 Need for power……………………………………….……….14 2.3 Comparison of the four needs theories……………………….……….15 2.4 Process Theories of Motivation………………………………….……..15 2.5 Performance………………………………………………………..…….16 2.6 How dose Motivation Affect Performance……………………….……16 2.6.1 Motivation Formula…………………………………………….……16 2.7 Why to motivate nurses…………………………………………………17 2.8 Causes of de-motivation………………………………..………….……17 2.8.1 Work place violence……………………………………………..….18 2.8.2 Work place hazards and injuries………………………………..…18 2.8.3 Long working hours ………………………………………………...19 2.8.4 Effect of night shift…………………………………………………..19

2.8.5 Shortage and turnover problem…………………………………....19 2.8.6 Feeling underpaid……………………………………………….…...20

2.8.7 Lack of appreciation………………………………………………....21 2.9 Factors Affecting Motivation and Performance..…………………..….…23 2.10 Relationship between Motivation and Performance of Nurses……….23 2.11 How employee Motivation affects Employee Performance………...…24 2.12 Types of Rewards…………………………………………………………25 2.12.1 Monetary………………………………………………………………25 2.12.2 Non- monetary…………………………………>……………………25

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Chapter Three………………………………………………………………………….26 3. Research Methodology…………………………………………………………...…27 3.1 Research Design…………………….…………………………………………..27 3.2 Research Analysis…………………….………………………………………...27 3.3 Data Collection…………………………………………………………………..27 3.4 Data Sampling……………………………………….………………………..…28 Chapter Four…………………………………………………………………………....34 4 Data Analysis and Results..........................................................................….....34 Chapter Five………………………………………..……………………………………53 5. Discussion and Recommendation…………………………………………………..53

5.1Discussion…………………………………………………………………….54 5.2Recommendation…………………………………………………………….54

Chapter Six...................................................................................................….....55 6. Summery and conclusion……………………………………………………………56 APPENDIX I…..………………………………………………………………………….57 REFERENCES…………………………………………………………………………...60

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List of Figures: Figures 1: Mars Model of Individual Behavior Figures 2: Internal forces that affect a person’s behavior: Figures 3: Hierarchy Needs of Abraham Maslow's Figures 4: Two Factors Theory Figures 5: McClelland’s Acquired-Needs Figures 6: Process Theories Of Motivation Figures 7: Relationship Between Motivation And Performance Of Nurses List of Tables: Table 1: Table-1: Classification Of The Herzberg's Two Needs Factors Table 2: Table-2: Comparison of The Four Needs Theories

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CHAPTER ONE INTRODUCTION

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1. INTRODUCTION 1.1 BACKGROUND OF THE STUDY "In order to become good in anything, the only talent you need is motivation" Charles de Gaulle Motivation is the key of a successful organization to maintain the continuity of the work in a powerful manner and help organizations to survive. Motivation is finding a need inside the employees and help to achieve it in a smooth process. Motivating the staff leads to broaden their skill to meet the organizational demands.Each manager should have the responsibility to work with the staff to find out their individual needs and put them side by side to the organization needs. Dissatisfaction also, might work as guidance for the manager to explore the need of the staff and start with it to motivate them and attract them to do better performance. Motivation drives the human beings to reach their goals and organization goals through every challenge and constraint they face in their workplace; considering it as an advantage to go ahead in the direction they have put for themselves. The need of achievement always results in a desire to do extra effort to have something done butter, and have the desire for success. The manager should motivate the employees to get things done through them without asking them what to do. Motivation creates a productive employee who saves time and effort. The motivated employee volunteers to do more than what is expected and more successful achievement than others. Such employee could be a good recourse and a model to be followed by other staff and adds positive input to the work within the organization. It is not just the matter of how motivated the staff are, but also how prepared they are for the job. Good performance depends on whether staff able to do things, or whether they are welling to do things. The level of performance depends on the level of motivation that stimulates someone to work and carry out the necessary tasks to achieve the goals. The managers have to learn to place the right person in the right place. A person should be given the role where they can use their skills and abilities and be concentrated towards the organization's goals and personal goals. Misplacements can cause dissatisfaction, less motivation, less concentration that leads to turnover and shortage of staff, commitment of mistakes, and loss to the organization. The motivation is important in any workplace and it is personal and different for each employee. Depends on different needs; different strategies will be created to satisfy these needs. Several need and motivation theories have been discussed in the study to clarify what might affect the motivation.

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So, without motivation nothing unique will ever happen that allows the organization to specialize with its production.

In the project the nursing organization was chosen because it is a sensitive career that affects patient's life; if it dose not given the important consideration that is supposed to be. 1.2 RESEARCH PROBLEM The aim of this research is to explain and describe how motivation of nurses in Aramco Health Center affects the performance and the delivery of care. It also discusses the problems of de-motivation and how adverse effects they have on the delivery of health services. That will ensure that, nurses have a work environment with the characteristics of work known to be linked to job satisfaction, motivation and good outcomes. 1.3 OBJECTIVE OF THE STUDY In this project, the primary objective is to assess the quality of performance in nurses and motivation process used with them, categorized the different types of motivation theories, emphasize how importance of the relationship between motivation and the performance, and finally to create some solutions to motivate the nurses. 1.4 LIMITATION

The results of this study clearly showed that there were motivational effects on the performance of the nurses. There was limited time to have face to face meeting to explain any confusion with the questionnaires. There was some difficulty getting the nurses answer the survey questions because of their workload and the responsibility they have. Some nurses were unsure if it is legal with the company to answer such questions through their e-mail or to give true answers that might affect their job.

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CHAPTER TWO LITERATURE REVIEW

4

2. LITERATURE REVIEW 2.1. INTRODUCTION The success of any organization depends on the ability of managers to provide a motivating environment for its employees. The challenge for managers today is to keep the staff motivated and performing well in the workplace. The manager has to know the behavior of each employee and what might motivate each one individually. By understanding employees' needs, managers can understand what rewards to use to motivate them. The goal of most companies is to benefit from positive employee behavior in the workplace by promote a win–win situation for both the company and workers. The MARS model of Individual Behavior is an excellent medium for creating the win-win relationship between the employer and employees to understand motivation we have to know MARS Model of individual behavior.

2.1.1. MARS MODEL OF INDIVIDUAL BEHAVIOR: MARS model is a model that explain individual behavior as a result of internal and external factors or influences acting together The name of the model is an acronym of the four major factors that have an affect on employee performance Motivation, Abilities, Role perception and Situational Factors. Individual values, personality, perceptions, attitudes, and stress form a basis on which the factors interact. ("MARS model of individual behavior" <http://en.wikipedia.org/wiki/MARS_model_of_individual_behavior>)

Figure- 1: MARS MODEL OF INDIVIDUAL BEHAVIOR

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Values

Personality

Perceptions

Attitudes

Stress

Motivation

Abilities

Role perception

Situational Factors

Individual behavior

and results

These factors are highly interrelated in organizations. Unless all of the elements of the MARS model are satisfied, employee behavior and performance will be affected and negatively impacted. For example, enthusiastic and employee with high motivation level who is skilled in running the work (ability), and understands the job duties (roles perception) well, will not be able to perform their job well if there is a lack of the adequate and sufficient resources (situational factors). 2.1.1.1 Motivation The word motivation is derived from the word motivate which means to move, or to act to satisfy a need or want. Any consideration, idea or object prompting the individual to act or move to do what needs to be accomplished is what motivation is. Motivation may therefore be defined as a willingness to exert effort to achieve a goal or objective for rewards. Internal forces that affect a person’s voluntary choice of behavior:

1. Direction: is directed by goals 2. Intensity: is the amount of effort allocated

Direction

PersistenIntensity

3. Persistence: is the amount of time that effort is exerted

Figure-2: Internal forces that affect a person’s behavior:

2.1.1.2 Employee ability Aptitudes, skills, or personal characteristics and the learned capabilities required to complete a task successfully

Job matching is to put the right person in the right place 1. Select qualified people 2. Develop employee abilities through training

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3. Redesign job to fit person's existing abilities

2.1.1.3 Role perception It is the behavior that required to achieve the desired results

The employee has to:

1. understanding what tasks to perform 2. understanding relative importance of tasks 3. understanding preferred behaviors to accomplish tasks

The employer has to:

1. Provide information about tasks and priorities 2. Provide frequent performance feedback 3. Provide training on preferred work processes

2.1.1.4 Situational factor Environmental conditions that constrain or facilitate behavior

1. Time 2. People 3. Budget 4. Work facilities

2.2 MOTIVATIONAL THEORIES Several research studies on motivation have been undertaken by industrial psychologists and behavioral scientists. As a result, some theories about motivation and human behavior have been developed by researchers. Theories of motivation explore the sources of pleasure that people experience when they maintain equilibrium and preserve homeostasis by avoiding pain and over stimulation. The dynamic process of change in and of itself has important implications for employees in modern organizations. In particular, it affects their basic need to know who they are as a secure anchor amid incessant change. Frequent changes in organizations and in technology influence the power structure, the skills needed to excel on the job, an organization's values, and its managerial philosophy. Work motivation research began, as did the psychology of motivation in general, as a branch of individual psychology.

7

However, more than theories of personality and human abilities, theories of work motivation traditionally have encompassed both individual and situational characteristics.

2.2.1 HIERARCHY NEEDS OF ABRAHAM MASLOW'S THEORY OF NEED Abraham Maslow proposed the theory called hierarchy of needs theory. Maslow believed that within every individual, there exists a hierarchy of five needs and that each level of need must be satisfied before an individual pursues the next higher level of need. The five levels of needs, according to Maslow are: 1. Physiological Needs. These needs are essential to sustain life include food, water, air and sleep. According to Maslow's theory, if these needs are not met, then all other needs will not felt or be a source of motivation. 2. Safety Needs. This refers to the need to feel safe from physical and emotional harm. These needs include medical insurance, job security, financial reserves. 3. Social Needs. These needs are concerned with social interactions with others. The individual needs to feel a sense of belonging, affection, acceptance, and friendship. 4. Esteem Needs. Esteem is concerned with the feelings of self-confidence derived from achieving something and the sense of belonging. Esteem needs may be classified as internal or external. Internal esteems are these related to respect and achievement. External esteem needs are those such as social status and recognition that comes with the achievement. 5. Self-Actualization Needs. This level of needs is concerned with achieving ones full potential and dreams. Unlike lower level needs, this need is never fully satisfied; as one grows psychologically there are always new opportunities to continue to grow. This needs include truth, justice, and wisdom.

Self

actualization

Esteem

Love/ Belonging

Safety

Physiological

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Figure-3: HIERARCHY NEEDS OF ABRAHAM MASLOW'S

According to Maslow, only a small percentage of the population reaches the level of self-actualization.

The organization can satisfy its employees’ various needs. In the long run, physiological needs may be satisfied by the person’s paycheck, but it is important to remember that pay may satisfy other needs such as safety and esteem as well. Providing generous benefits that include health insurance and company-sponsored retirement plans, as well as offering a measure of job security, will help satisfy safety needs. Social needs may be satisfied by having a friendly environment and providing a workplace conducive to collaboration and communication with others. Company picnics and other social get-togethers may also be helpful if the majority of employees are motivated primarily by social needs. Providing promotion opportunities at work, recognizing a person’s accomplishments verbally or through more formal reward systems and job titles are ways of satisfying esteem needs. Finally, self-actualization need may be satisfied by the provision of development and growth opportunities on or off the job, as well as by work that is interesting and challenging. By making the effort to satisfy the different needs of each employee, organizations may ensure a highly motivated workforce. The important aspect of Maslow's model is that it provides for constant growth of the individual. The individual is always striving to do things to the best of one's ability, and best is always defined as being slightly better than before.

There has been a great deal of debate over Maslow's hierarchical concept of motivation. It has a basic attraction to most people because it seems to be logical, to make sense. ("Business Management Articles", April 10, 2009, <http://www.envisionsoftware.com/articles/>)

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2.2.2 ERG Theory ERG theory, developed by Clayton Alderfer, is a modification of Maslow’s hierarchy of needs. Instead of the five needs that are hierarchically organized; Alderfer proposed that basic human needs may be grouped under three categories, Existence, Relatedness, and Growth. The theory's name is based on the first letter of each need.

Existence: Refers to our concern with basic material existence motivators. Physiological and safety needs (such as hunger, thirst and safe condition)

Relatedness: Refers to the motivation we have for maintaining interpersonal relationships. Social and external esteem needs (such as involvement with family, friends, co-workers and employers).

Growth: Refers to an intrinsic desire for personal development. Internal esteem and self actualization need (such as the desire to be creative, productive and to complete meaningful tasks).

The implication of this theory is that we need to recognize the multiple needs that may be driving individuals at a given point to understand their behavior and properly motivate them. ("Business Management Articles", April 10, 2009, <http://www.envisionsoftware.com/articles/>)

2.2.3 Two-Factor Theory of Fredrick Herzburg The two-factor theory of motivation includes hygiene factors and motivators. The theory explains the factors that motivate individuals through identifying and satisfying their individual needs, desires and the aims pursued to satisfy these desires. Herzberg labeled factors causing dissatisfaction of workers as “hygiene” factors, and factors that causing satisfaction of workers as “motivator” factors 2.2.3.1Hygiene factors This included company policies, supervision, working conditions, salary, and safety and security on the job. Examples would be when people felt they weren’t paid enough, didn’t like their supervisors, were not happy about their working conditions or were insecure in their jobs. However, if they felt that the maintenance factors were satisfactory, that is, their pay and other working conditions were good; they only maintained current levels of production and efficiency.

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2.2.3.2 Motivator factors They are factors that are intrinsic to the job, such as achievement, recointeresting wor

gnition, k, increased responsibilities, advancement, and growth

opport1. Achievement – Personal accomplishment or the feeling of having

2. ents by receiving a company reward, promotion, or salary

3. e work like

ills,

e job

becomes more satisfying and the employees more productive.

e

nt pportunities, and a job where their subordinates can feel successful.

,

alized in a relatively short time span,

(the on-job related ones.

2009,

unities.

done a job well. Recognition – Being recognized for the efforts and accomplishmof the workincrease. Participation – being involved in some responsibility of thmaking decisions and suggestions for the organization..

4. Growth – challenge of the job itself; and the chance to learn skacquire knowledge, and achieve development and advancement.

As more varied tasks are included in the job under the job enrichmentprogram, the work is made more interesting and challenging, th

According to Herzberg’s research, motivators are the conditions that truly encourage employees to try harder. Focusing on hygiene factors will not benough, and managers should also enrich jobs by giving employees opportunities for challenging work, greater responsibilities, advancemeo In applying Herzberg’s Two-Factor Theory to create a high level of performancecertain measures must be adopted by management such as job enrichment or restructuring the job to make it more interesting and challenging to the worker. This application of job enrichment is popular because it can easily be adopted by all levels of management, payoffs can be reand it cam be measured in specific terms. These two separate needs are the need to avoid unpleasantness and discomfort and, at the other end of the motivational scale, the need for personal development. A shortage of the factors that positively encourage employeesmotivating factors) will cause employees to focus on n ("Business Management", articles, April10,http://www.envisionsoftware.com/articles/)

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Dissatisfaction and

de-motivation

Not dissatisfied but not

motivated

Positive satisfaction and

motivation

Figure-4: Two Factors Theory

Herzberg classified the two needs factors as follows:

Hygien ctors Motivation Factors e or Maintenance Fa(Job Environment) (Job Content)

Intr rs insic FactoExtrinsic Factors

Work itself Company policy and administration

Achievement Supervision

Responsibility Interpersonal relations

Growth and advancement Working conditions

Table-1: classification of the Herzberg's two needs factors

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2.2.4 Acquired-Needs Theory of David McClelland’s Acquired Needs Theory is also known as the Three-Need Theory or Learned

eed Theory. According to acquired-needs theory individuals acquire three types f needs as a result of their life experiences.

ome needs could be learned; these needs are:

2.2

chievers seek to appreciate frequent recognition of how well they are doing. They p

o chance of gain.

provides feedback and recognition

ificant chance of failure.

They set moderate, realistic, achievable goal.

2.2

Aff eople.

an recognition.

that occur in social

mage.

They enjoy lots of social activities.

groups and organization.

No S

.4.1 Need for Achievement (nAch)

Arefer working alone rather than in teams

They will avoid low risk activities that have n

Money is a weak motivator among these achievement, except when it

They will avoid high risks where there is a sign

.4.2 Need for Affiliation (nAff)

iliation seekers look for harmonious relationships with other p

They tend to conform and shy away from standing out.

They seek approval rather th

They try to project a favorable image of themselves and take other steps to be liked by others.

They support others and try to smooth out conflicts sitting.

They try to project a favorable self-i

They prefer working with others rather than alone.

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They seek to belong, join

.4.3 Need for Pow2.2 er (nPow)

Po r to achieve higher goals.

sing

agreement and compliance.

They enjoy competition and winning, and do not like to lose.

ll individuals possess on of these needs, and the dominant needs re thought to drive employee behavior. Heller, J., Goulet, L., Mohr, E., (2004)

Figure-5: McClelland’s Acquired-Needs

wer seekers want power either to control other people o

They seek to make more suggestions in meetings.

They seek to help others, such as improving society or increaorganizational effectiveness.

They seek neither recognition nor approval from others; only

They are willing to confront others. A a combinatia

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Need for achievement (nAch)

N

Need for Power (nPow)

eed for affiliation(nAff)

OF FOU RI

2.3 COMPARISON THE R NEEDS THEO ES

MASLOW NEED CHY HIERAR

THEORY

ALDERFER HERZBERG TOW-FACTOR THEORY

MCCLLAND ERG MANIFEST NEED

THEORY THEORY Self – actualization Growth Power

Esteem Social

motivators Relatedness Achievement

safety Physiological Existence Hygiene affiliation

Table-2: COMPARISON OF THE FOUR NEEDS THEORIES

describes how e iors to meet eir needs and determine whether they made the most successful choice. rocess explanations of motivatio suggest that motivation varies from situation situation.

Figure-6: PROCESS THEORIES OF MOTIVATION

2.4 PROCESS THEORIES OF MOTIVATION It mployees are motivated or how they select behavthP nto

Rewards

Satisfaction

Motivation

Behavior

Performance

Need or dissatisfaction

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The Employee

2.5 PERFORMANCE Herzberg says "Having fewer dis-satisfiers does not motivate a worker to do agood job, but only to stay in it".

e

ance of ve to develop and test relevant methods of assessment, which will

etter help to design context-specific strategies for improvement. Aramco Health enter is using SAP System that evaluates the achievement and the erformance.

TION AFFECT PERFORMANCE

t satisfies needs.

, S., Shelton, M., The Performance Equation - What makes truly reat, sustainable performance", Apter Development LLP (2009) http://www.apterinternational.com/articles/PerformanceEquationArticle060.pdf>)

Worker performance clearly depends on their level of motivation, which stimulates them to come to work regularly, work diligently, be flexible and bewilling to carry out the necessary tasks. The performance and quality of a health system depend on the quality and motivation of health human resources. Therefore, nurses' motivation is likely to have effects on the delivery of health services and the outcome of care and performance of work.

here, low motivation and poor job satisfaction have a negative impact on thThealth sector, harmfully affecting job performance as well as the quality of care. The productivity of nurses is not just a matter of how motivated they are for the job, it is also a matter of how well trained and prepared they are for the job. To better understand the factors influencing the motivation and performursing, we han

bCp 2.6 HOW DOSE MOTIVA Motivation is the internal process that leads to behavior tha

.6.1 Performance formula 2 Performance = Ability ×Motivation ×Resources (2x2x2=8) Without motivation performance is usually below potential. (2x0x2=0) "Carter(

g<9

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2.7 WHY TO MOTIVATE NURSES? Nursing is a sensitive career that plays an important role in society. It is a multi

th ld

ecause of the long working hours, shift working they

y of a patient who died,

to orm

l mistakes rk

that their

otivating the nurses is not the only issue, but motivating them in a way having eir sense of responsibility toward their work to ensure the safety of the patients.

minor psychiatric morbidity, and may contribute to some forms of physical illness, with particular reference to musculoskeletal problems,

skill career that should be rewarded because nurses are the eye of health care staff about patients' condition. Nurses are placed in a work which forces them to deal with pain, sickness, deaand depression. They deal with human beings, no mistakes are allowed; it coube a patient life or the patient might be at risk for suffering. The nature of their work is tough and stressful, bhours, and they have to work during holidays and other occasion time, soloose their normal life style. At the same time, the expression of feeling in front of the patients is not acceptable. The nurse should have the skills and abilities to deal with situationslike doing care after death and be sympathy with the familand continue her work with another patient having a smile on her face. It is the ability and the art of handling stress in a positive attitude. At the end, nurses are human beings who need to be rewarded for their great job in reducing suffering of patients and saving lives at least with a thankful wordabsorb their stresses during their work and allow them to be motivated to perfhigh standard of care, work harder, and move along with their tough career. Unmotivated staff has a bad effect on the delivery of care of patients and the quality of care. If a nurse cannot find anything motivates him/her to do the work, leaving the workplace could be the butter idea; instead of doing medicathat could affect their dignity. This may occur as a result of lack of interest to woor work under stress and being less concentrated and less productive. That can explain the presence of shortage within nursing allover the world. So, hospitals need to know how to motivate their nurses and show them effort was of value to keep them from burning off. Motivation works as supportivetool that enhances nurses to success and go along with their work. Mth 2.8 CAUSES OF DEMOTIVATION The role of nursing is associated with multiple health care professionals andforced by nurse supervisors and managers, and by medical and administrative staff which increase work overload and conflicting demands and stresses. Role conflict of this kind may be most obvious when dealing with patients who are critically ill and dying. stress generally detracts from the quality of nurses’ working lives, increases

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stress and depression.

Shortages, overwork and unequal pay can lead to resentment and low morale at hospitals. This in turn undermines the quality of medical care patients receive.

2.8.1 WORKPLACE VIOLENCE

"violence is threats, or a threatening statements or threatening behaviors that give a reasonable cause to believe that the employee is at risk of physical injury, as well as attempted conduct of a person that endangers the physical health or physical safety of the employee" Occupational Health and Safety Act (1996).

Violence can occur in many forms. The nurses are at an increased risk for being victims of violence. These include physician to nurse, nurse to nurse, client to nurse and family to nurse violence. This violence can be manifested through physical, sexual, verbal, emotional and psychological actions, violence can occur in other forms such as excessive workloads, unsafe working conditions, and inadequate support. Some findings suggest a direct link between aggression and increases in sick leave, burnout and staff turnover. The costs of improving nursing protection in the workplace should be balanced against the costs associated with the lost hours and turnover resulting from violence against nurses.

2.8.2 WORKPLACE HAZARDS AND INJURIES

There are many risks in healthcare that have the potential to cause serious injury. One of the most common risks healthcare professionals, including nurses, may encounter are sharps injuries. Some of these injuries can expose nurses to blood borne infections that are potentially life threatening, such as Human Immunodeficiency Virus (HIV) Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV).

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2.8.3 LONG WORKING HOURS

Work patterns of long working hours can also affect nurses' social life. As nurses often has less time to be spent with loved ones. This can lead to impaired relationships. Lack of quality interaction with friends and family also increases the risk of isolation and loneliness.

Shift workers may also experience difficulty in accessing adequate childcare services and care. Long working hours has effect on family and social life of the nurses.

2.8.4 EFFECT OF NIGHT SHIFT

Being that shift workers are required to function against their body’s natural rhythm. On average, shift workers get two to four hours less than the recommended eight hours of sleep in twenty-four hours. The human body normally follows a 24-hour cycle called the circadian rhythm. This cycle regulates sleeping, waking, digestion, secretion of adrenalin, body temperature, pulse and many other important aspects of body functions. If a person alters his or her activity patterns, these rhythms can go out of sync, leading to disorientation and feelings of fatigue. Nurses need to increase awareness of shift work’s effect on performance and patient safety. (Abdalkader, R., Hayajneh,F., (2008), Effect of Night Shift on Nurses

al Working in Intensive Care Units at Jordan University Hospit<http://www.eurojournals.com/ejsr_23_1_07.pdf>)

2.8.5 SHORTAGE AND TURNOVER PROBLEM

Nursing used to be about caring for sick patients, fixing what was wrong so that they could return to their lives. The challenge of nursing now relates more to wellness approach, accessing information, guiding, teaching, counseling, linking,

19

and collaborating with clients to change their lifestyles.

The nursing is a distinct scientific field and autonomous profession whose skilled practitioners save lives and improve patient outcomes every day in a wide variety of settings.

Staff shortage is inadequate quantity of skilled nurses in clinical settings that has a significant negative impact on patient outcomes, including mortality. The nursing shortage is literally taking lives, and impairing the health and wellbeing of many millions of the world's people. It is a global public health crisis that has been reported in most countries of the world.

The causes of short staffing include poor work conditions, inadequate resources for nursing research and education, nursing is mostly female nature, training of new staff and increased overtime and use of temporary agency staff to fill gaps, and the increasing complexity of health care and care technology.

Turnover expresses the percentage of nurses that are lost each year through retirement, death, international migration or moving to work in another sector of the economy, or due to employees leaving for their own reasons like; career progression, overtime and use of temporary agency staff to fill gaps, better pay in a new job, or dissatisfaction in the current job.

Shortage and turnover may lower quality and productivity of nursing care, due to the loss of work group efficiency and organizational performance.

Various indicators can be used to assess the degree of shortages, related to both such as absenteeism, retention rates, vacancy rates and turnover.

2.8.6 FEELING UNDER PAID

"The nurse does for the patient (only) what they would do for themselves if they were healthy" Virginia Henderson, the famous nursing theorist.

It is struck how multi-skilled nurses have to be, and how little this was reflected in their pay. The salary is one of the motivators. Most nurses feel underpaid and undervalued.

Nurses have to learn the role of a clerk, counselor, teacher, auxiliary, doctor, psychologist, housemaid and mortician. They have to administer m

20

edicines, advise patients and care givers, perform observations, write handover reports,

change beds, work hoists, bath patients, scrub dentures and wash dead bodies. Nursing must be one of the world’s most multi-sided occupations.

Comparing with other health professionals and the level of responsibility nurses having, they are paid an unfair wage that is not reflecting their workload and level of responsibility.

There is a huge difference between nurses’ salaries and those of more narrowly specialized personnel like doctors, radiology, and lab technicians. Nurses may acquire ever more skills but it does nothing to improve their status or their income.

From unfair salary rankings to understaffing, nurses frustrated and distressed by a system which does not support their concerns and needs.

The report of the survey that was done on some of Aramcos' nurses is showing that nurses have received lower payment on a lower grade code than other health professional 86% indicated that, they are receiving unfair salary comparing with other health staff.

Nursing pay calculations would provide a basis for quantifying and rewarding a nurse’s range. It might also motivate them to broaden their skill base constantly to meet changing healthcare demands.

2.8.7 LACK OF APPRECIATION

Many people think that a nursing degree is not as respected as a medical school. It is important to realize that nurses are needed in growing numbers throughout the world.

Nurses take care of patients and do a fairly large amount of the physical work involved. As nurses progress through their education, they are placed into clinical settings to obtain real hands on experience.

Nurses are not stuck behind a desk for 8 hours a day staring at a computer. They get to interact with many different people on a daily basis. They can specialize in

21

areas such as renal therapy, emergency room nursing, or surgical nursing. The specialties available are endless.

Appreciation is an acquisition of a positive feedback. It is the innate feeling that the work of employees is valued and makes a difference to their performance. Nurses need to feel that, their profession should be seen as important to the workings of the whole team and the effort they do is appreciated. Lack of appreciation has a negative effect on stress and job satisfaction and could adversely influence staff turnover.

Respect from supervisor and other staff by acknowledging their contribution, recognition of their skills, and respection for their work is consider a way of appreciation. Being part of a team and the sense of belonging is another way makes the employee feel more valued.

Nursing appreciation could be a simple thank you from a patient, a respect from a co-worker, or recognition from a supervisor.

(Johnson, J. A. (2009) Health Organizations, Theory, Behavior, and Development) & (Clavreul G., M., (2004), Demotivation in the Nursesing profission the Causes, Working Nurse).

22

2.9 FACTORS AFFECTING NURSING MOTIVATION AND PERFORMANCE Motivation at work is widely believed to be a key factor for performance of individuals and organizations and is also a significant of intention to turnover. There is a strong link between job dissatisfaction, lack of motivation and intentito turnover.

on

Incent There are three factors play a

of staff to put in effort to do the job (The ability or "will

other words, performance depends on whether the staff perceive themselves s able to do things, whether they are willing to do things and whether they have

.10 RELATIONSHIP BE TION AND ERFORMANCE OF NURS

The hospital managers has to keep the right nurses in the right place, which requires identifying and understanding the factors affecting nurses' motivation and performance.

ives and rewards are important because they can influence performance.

key role in nursing performance: The ability of staff to do their job;(The capacity or "can do" factors)

The motivationdo" factors)

The organizational support or opportunity to do the job well (availability of resources)

Inathe means to do them. 2 TWEEN MOTIVAP ES Individual factors Capacity or

"Can do"

Performance Motivation factors

Ability or

"Will do"

Figure-7: Relationship between Motivation And Performance Of Nurses

Organizational

"Resources" factors

23

Employee's

need

2.11 HOW EMPLOYEE MOTIVATION AFFECTS EMPLOYEE PERFORMANCE The extent to which employees are motivated in their work depends on how well those employees are able to produce in their job. Motivation is expected to have a positive effect on quality performance; employees who are characterized by a high level of motivation show a higher work and life satisfaction. Having a high level of motivation is therefore in itself valuable for employees and a decrease inmotivation might affect employees n

s

e

, ctively about how the organization they work for could be

proved. ast items that measure the performance of the nurses are the number of days ey were absent.

egatively. The motivation leads to high level of initiative and creativity from the employeeand where monitoring is difficult, motivation is therefore extremely important for ensuring high quality performance. In Armco Health Center the quality of employee performance is measured by three individual measures of employee performance. The first measure of the individual performance items is a self-rating measure of employee performance through a program called SAP. The performance of the employee asks to indicate eight-points scale how well themployee is doing the job. The second measure of the performance of the Armco Health Center is the extent to which the nurses are willing to conduct tasks that are not part of theirjob description. The employees are asked to report on the SAP about their willingness to perform additional tasks that are not expected from them regularlyand to think construimLth

24

2.12 TYPES OF REWARDS "You get more of the behavior you reward. You don't get what you hope for, wish for or beg for. You get what you reward." Michael le Boeuf eward system is much more than just bonus plans and stock options. It is a rocess that reinforces behavior to hit the target and meet the standards.

and performance. inancial rewards include direct or indirect payment such as wages or salary,

llowances, loans and tuition reimbursement.

ors, so employee will feel their efforts are noticed and alued. Career development and Professional growth opportunities will help

employees to develop new skills, expand their knowledge, and increase their ,

(Kotelnikov, v., "Effective Reward Systems Increasing Performance and

reating Happier Employees" http://1000ventures.com/business_guide/crosscuttings/motivating_reward

RpRewarding performance should be an ongoing managerial activity, not just an annual ritual. 2.12.1 Monetary rewards Monetary rewards are certainly the most common approaches used to improve ecruitment, retention, motivationr

Fbonuses, insurance, merit pay, aProviding adequate and timely reward is important to guarantee the recruitment of motivated and qualified staff. 2.12.2 Non-monetary rewards There are different types of non- monetary rewards, such as work autonomy, recognition from supervisv

visibility within the organization, internal promotion opportunities as a long planand shift work flexibility.

C<_system.html>)

25

CHAPTER THREE RESEARCH METHODOLOGY

26

3. RESEARCH METHODOLOGY

nd its effect n their work and production. The research design is quantitative data. The

gement to explore the factors affecting hanges to motivate the nurses.

o l.

he questionnaire method was used to generate high number of data and at the e and effort required of the respondents, rather dividually.

Out of total 30 questionnaires distributed nly 20 questionnaires were received cused on the auses that might affect the motivation

NG The target audient for this research includes Saudi Arab, Westerns, and Asians nurses work in Saudi Aramco Health Center. The questionnaires were distributed through their e mail.

3.1 RESEARCH DESIGN

he current research is conducted to determine nurses' motivation aToresults obtained will help the manamotivation and make appropriate c 3.2 RESEARCH ANALYSIS The model was tested with nurses working in Aramco Health Center. The data were collected through questionnaire that was done on 30 nurses wh

ork at Aramco health center and were distributed to them through their e maiwTsame time it minimizes the timthan interviewing each nurse in 3.3 DATA COLLECTION

, o cback. The questionnaires fo

and the level of satisfaction of the nurses.

3.4 DATA SAMPLI

27

3.3 DATA COLLECTION The model was tested with nurses working in Aramco Health Center. The data were collected through questionna

stire that was done on 30 nurses who

work at Aramco health center and were d ributed to them through their e mail. Out of total 30 questionnaires distributed nly 20 questionnaires were received back. The questionnaires focused on the causes that might affect the motivation nd the level of satisfaction of the nurses

er:

ale

i, o

. a

1. Gend M 5 Female 18

Table No. 1

ess than 30

2. Age: L 11 More than 30 12

Table No. 2

re you motivated to perform well in your work?

es

3. A

Y 11 No 12

Table No. 3

28

4. If no, what are the reasons? (Check all apply)

workplace violence 2 workplace hazard and injuries 0 long working hours 7 effect of night shift 3 shortage problem 4 feeling under paid 5 unreasonable workload 6 lack of appreciation 12

Table No. 4

ou understood what was required of you

5. Estimate how well y Not 0 Poor 1 Fair 5 Well 13 High 4

Table No. 5

he certificate to be a nurse is attractive for working as a

es 14

6. Tnurse YNo 9

Table No. 6

29

7. How satisfied are you with your job? Not 2 Poor 0 Fair 12 Well 8 Hig 1 h

Table No. 7

ur boss recognizes my efforts

8. Yo Not 2 Poor 1 Fair 13 Well 4 High 3

Table No. 8

o you think that the payment paring with other health workers?

es 2

9. D you get is fair com

YNo 21

Table No. 9

30

10. What might motivate you more

onetary reward 13

?

MNon monetary reward 10

Table No. 10

Dose shift work affects your mood?

es

11. Y 13 No 1

Table No. 11 12. Nightshift increase interpersonal conflict in your family

es Y 10 No 4

Table No. 12

Nightshift increase interpersonal conflict in your work

es

13. Y 8 No 6

Table No. 13

31

14. How would you rate your productivity? Not 0 Poor 1 Fai 0 r Well 10 High 11

Table No. 14

appened to your productivity in the last six

tayed the same 8

15. What has hmonths? SGone up 13 Gone down 1

Table No. 15

o some nurses in your company drop out from the pital?

Yes 16

16. Dhos

No 7

Table No. 16

Do you feel stressed out most the time?

17. of

Yes 13 No 10

32

Table No. 17

18. Do you miss some of your family's important events because he shift work hours?

Yes 13

of t

No 1

Table No. 18

33

CHAPTER FOUR DATA ANALYSIS AND RESULTS

34

4. ANALYSIS AND RESULTS The data collected through questionnaire that was done on nurses who work at

ramco health center. Out of 30 questionnaires distributed only 23 were nswered. The data obtained are analyzed as followed:

. GENDER:

Aa 1

Figure No. 1 The inquiry was made to find information about the gender of the nurses. Asnursing is a female job in nature; the result showed highest number of femal78% were female nurses w

e

hile the male were only 22%. Woman has major role to playing the life and they compromise their sleep to take care of their children and family tasks.

35

2. AGE:

Figure No. 2

above or less than 30 years old were responded to the questionnaires. 52% of the nurses were more than 30 years old and 48% were under 30.

The inquiry was made to find information about the rate of the age of the nurses. The data result showed almost equal percentage of age groups,

36

3. MOTIVATION TO WORK

Figure No. 3

number of nurses are not motivated which is a large percentage. This indicates that, there is a serious problem with motivation among nursing.

The inquiry was made to find how motivated the nurses with their work are. The result showed that 48% of the nurses are motivated and around 52% of them are not motivated to work. Unfortunately about half of the

37

4. FACTORS OF DE-MOTIVATION

Figure No. 4

of

eir m

e nurses are suffering from workplace hazard or injuries it could be because of the high technique used in the hospital to prevent such problems.

The research inquired to find out factors that might affect nurses' motivation and performance. The highest number agreed that lackappreciation is affecting their performance more. 31% agreed that lack of appreciation is the reason of being de-motivated. 15% seen that, unreasonable workload as a factor of de-motivation. 13% feeling that thpayment is unfair comparing with other health staff. 10% are suffering froshortage problem. 10% got a problem with night shift; while18% of the nurses found long working hours is a problem for them. 5% only agreed that workplace violence is a factor of de- motivation. None of th

38

5. UNDERSTANDING THE REQUIREMENTS

Figure No. 5

requirements are

equirement only 4% with poor understanding. nderstanding what the requirements are will help the employees to perform eir work well.

The inquired was made to find out withier the employees understand theirrequirements or not. The highest number knows well what theirit is about 57% of the nurses, 22% has a fair knowledge, 17% with highly understand the rUth

39

6. Attractiveness to work before practicing nursing in reality

Figure No. 6

This inquiry showed the rate of motiva

tion to work before practicing the

ult showed the difference in being motivated to work but later on this percentage has been changed from 61% to 52% as shown in Figure No. 3.

work with its de-motivation factors and stresses. 61% were motivated by their certificate, while 39% were not. The res

40

7. JOB SATISFACTION

Figure No. 7 This inquiry showed how satisfaction the nurses are with their work. The highest rate was given as fair satisfaction which is not the rate needed to satisfy the employees to work and be creative at their work. 52% of the nurses rate their satisfaction as fair satisfaction. 35% are well satisfied with

eir work. 9% are not satisfied with their job. 4% are satisfied but this is a ery low rate to perform a good job.

thv

41

8. RECOGNITION OF THE EFFORTS BY THE BOSS

Figure No. 8

re er. 9% of them are not recognized

hich is unfair for an employee to do effort with no appreciation. 4% feel that eir boss is poor in recognizing their effort.

This inquiry showed the recognition of the efforts by the boss. The busses need to recognize the work and the effort of the employees because they have an effect on the performance and the motivation of the workers. 57% feel that their boss is fair in recognizing their efforts. 17% agreed it is well recognized. 13% ahighly recognized, but it is a very small numbwth

42

9. FAIRNESS OF PAYMENT

Figure No. 9

ent of nurses omparing to other health workers. 91% feel that their payment is unfair which a ery huge number. Only 9% are satisfied with their salary.

The inquired was made to find out the fairness of the paymcv

43

10. REWARD SYSTEM

Figure No. 10

reed that monetary reward is portant to them. 43% seen non- monetary rewards are much important to them

ke education, promotion or growth opportunities.

The inquiry was made to find information about the reward system followed in Aramco Health Center. Monetary reward considered one of the important rewards to the nurses as seen in the figure. 57% agimli

44

11. THE EFFECT OF NIGHTSHIFT ON THE MOOD

Figure No. 11

quiry, out of 23 nurses, only 14 of the results were taken into

od. The nightshift affects the mood of 93% of the nurses that might affect their work. Only 7% do not feel changes in their mood because of the shift work.

In this inconsideration because 9 of them do not work nightshift but regular working hours. The research inquired to find the effect of night shift on the nurses' mo

45

12. THE EFFECT OF NIGHTSHIFT ON THE FAMILY

Figure No. 12

quiry, out of 23 nurses, only 14 of the results were taken into

ight shift on the family. The result showed 71% of the nurses are affected by nightshift. 29% has no problem with their family because of the shift wok.

In this inconsideration because 9 of them do not work nightshift but regular working hours. The research inquired to find the effect of n

46

13. THE EFFECT OF NIGHTSHIFT ON THE WORK

Figure No. 13

y nightshift. 43% has no affect on their work by the nightshift. Nurses’ work means patients’ life; so, it is very important to put this into consideration.

In this inquiry, out of 23 nurses, only 14 of the results were taken into consideration because 9 of them do not work nightshift but regular working hours. The research inquired to find the effect of night shift on the nurses' work. A rate of 57% of nurses’ work is affected b

47

14. PRODUCTIVITY RATE

Figure No. 14

d to find the productivity rate of the nurses. The result showed 50% are highly productive. 45% are well productive and 5% are poor in their productivity.

The research inquire

48

15. THE PRODUCTIVITY RATE

Figure No. 15

roductivity gone up. 36% has no motivation to raise their productivity, so it is at the same rate. 5% of the result showed the rate of productivity gone down.

The research inquired to find the rate of the productivity again, but this time in specific period of time. 59% of the result showed the rate of p

49

16. DROPPING OUT RATE

Figure No. 16 The inquiry was made to find information about dropping out and turnover problem with nurses, since it is a serious universal problem. According to the result 70% of the nurses agreed that there is a dropping out problem in Aramco

ealth Center. 30% only do not feel dropping out as a problem in the Center. H

50

17. RATE OF STRESS

Figure No. 17

ess. The percentage of the stress rate is not an easy number. If the nurses have such rate it could affect on the patient care and the organization itself.

The inquiry was made to find out how stressed the nurses are. The result indicated that 57% has stress in their work. While 43% have no str

51

1

8. THE EFFECT OF SHIFTWORK ON SOCIAL EVENTS

Figure No. 18

ily or the social events. 93% of the results cted by nightshift. Only 7% has no effect. Nightshift causes imbalance an between lifestyle and work.

The inquired was made to find out if the work shift has effect on the fam

are affe

52

CHAPTER FIVE DISCUSSION AND RECOMMENDATION

53

5. DISCUSSION AND RECOMMENDATIONS

5.1. DISCUSSION

re

are allowed; it could be a patient life or the patient might be

o understand the factors affecting nurses'

e the butter idea; instead of doing medical mistakes at could affect their dignity.

.2. RECOMMENDATIONS

re the

of the year

on or getting a new position will highly affect the

g work environment is another way to increase

the production of the workers.

The increase in attractiveness of the career system is expected to increase the quality of performance, because it is expected to increase the motivation.

Nursing is a sensitive career that plays an important role in society. Nurses athe eye of health care staff about patients' condition. They deal with human beings, no mistakes at risk for suffering. The hospital managers have tmotivation and performance. Unmotivated staff has a bad effect on the delivery of care of patients and the quality of care. If a nurse cannot find anything motivates him/her to do the work, leaving the workplace could bth 5

The finding of this project suggested that, it might be interesting to exploimpact of supervisory behavior on the employees. Since supervisors evaluating the work performance; further study is needed to explore the influence of supervisors' expectancies on the nurses work evaluation. The supervisor may identify goals to the employees in the beginning and then to evaluate the employees according to these goals

Identify opportunities to provide constructive feedback to colleagues. The opportunity of higher educatimotivation of the employee.

Provide supportive environment for nurses who work nightshift and to formulate strategies to assist the nurses who have difficulty to work nightshift.

Facilitate good team working, support, respect for the roles and contributions of others to provide a motivatin

Consultation involves others in decisions which have a direct influence on their work role, especially when their opinion has the potential to make a difference. There should be an employee plays a role of the guidance and be

54

a reference to the other employees working in the same organization.

SUMMERY AND CONCLUSION

CHAPTER SIX

55

6. SUMMERY AND CONCLUSION

re

. They eed also to recognize basic need theories that help with these issues.

n ce. In doing so; we had

cused on the quality of employee performance.

vated. De-motivated nurse can be ery hazardous to patients.

Motivation is the internal process leading to behavior to satisfy needs. Motivated employees help organizations survive as motivated employees amore productive. To be effective, managements need to understand what motivates employees within the work they perform, and to recognize motivation and performance; to find out motivation effects on employee performancen In this research, we had focused on the effects of the motivation of nurses iAramco Health Center on the employee performanfo Hospitals and other institutions need to know how to motivate their nurses to keep them from burning out or being de- motiv

56

Appendix I

onnaires

Ge

Ag

Are you motivated to perform well in your work.

If no, what are the reasons? (Check all apply)

d injuries

ad

Estimate how well you understood what was required of you

The certificate to be a nurse is attractive for working as a nurse

2. No

How satisfied are you with your job?

5. High

Questi

nder 1. Male 2. Female

e: 1. Less than 30 2. More than 30

1. yes 2. no

1. workplace violence 2. workplace hazard an3. long working hours 4. effect of night shift 5. shortage problem 6. feeling under paid 7. unreasonable worklo8. lack of appreciation

1. Not 2. Poor 3. Fair 4. Well 5. High

1. Yes

1. Not 2. Poor 3. Fair

57

4. Well

My boss recognizes my efforts

5. High

nk that the payment you get is fair comparing with other health wo

2. No

What might motivate you more?

2. Non monetary reward

Dose shift work affects your mood?

2. No

Nightshift increase interpersonal conflict in your family

2. No

Nightshift increase interpersonal conflict in your work

2. No

How would you rate your productivity?

. High

In the last six months, what has happened to your productivity? same

3. Gone down

1. Not 2. Poor 3. Fair 4. Well

Do you thi

rkers? 1. Yes

1. Monetary reward

1. Yes

1. Yes

1. Yes

1. Not 2. Poor 3. Fair 4. Well 5

1. Stayed the2. Gone up

58

Do some nurses in your company drop out from the hospital?

2. No

s? ………………………

Do you feel stressed out most of the time?

2. No

miss some of your family's important events because of the shift work hou

2. No

1. Yes

If so, what are the factor…

1. Yes

Do you

rs? 1. Yes

59

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