Motivation, job satisfaction and attitudes of nurses in the public health services of Botswana

Abstract

The aim of the study was to investigate motivation, job satisfaction and attitudes of nurses in the public health services of Botswana. The objective was to discover how nurses felt about a wide range of variables in their work environment and ultimately to distil them into what they conceived as the mainstay motivators, job satisfiers and positive attitudes. The non pariel (unrivalled, unique) role of the government in creating both the hardware and the software of national health services was acknowledged and recognised with a particular reference to the primacy it placed on developing the human resources in the form of nurses, in order to realize the goals of administering the public health services efficiently and effectively. It was noted that nurses were the change agents and the axis in promoting quality standards of healthcare but in partnership with the government, which must be seen to be responsive and proactive in discharging its fiduciary responsibilities, in respect of both the content and the context of nurses’ occupational ambience. For the purposes of constructing a database from which both the government and the nurses can draw, the most salient thematic details of the theories of motivation, job satisfaction and attitudes were studied and examined and were used as a scaffolding for the empirical survey of nurses. Nine hundred questionnaires were distributed to both registered and enrolled nurses with a minimum of two years work experience in the public health sector and 702 of these were returned constituting a return rate of 78%. The findings indicated that a majority of nurses enjoyed job satisfaction in certain areas of their work namely autonomy, participating in decision-making, choice of type of nursing, change of wards or departments or work units, interpersonal relationships amongst nurses themselves and between nurses and their supervisors. Nurses also perceived the hospital as an environment in which they could continually learn and they were moreover satisfied with the nursing job or the work itself. The other end of the spectrum revealed an overwhelming majority of 92.2% of nurses who were dissatisfied with the level of pay and 88.5% who were not happy with the fringe benefits including the provision of accommodation. Working conditions were viewed as generally disliked by 67.3% of the nurses. Low pay, workload, lack of viii recognition for outstanding performance and or delayed promotional chances were singled out as being particularly disliked by 67.2%, 64.9%, 42.6% and 44.4% of the nurses respectively. Interviews held with 31 nurses yielded similar results. The research further showed that the most important motivators to nurses were dominated by competitive salary which was mentioned by 80.9% of the respondents, attractive or sufficient working conditions which were stated by 71.2% of the nurses, opportunity for continuous education which was rated by 63.8% of the nursing candidates, reduced workload which was claimed by 59.3% of the nursing cadres, opportunity for the recognition of outstanding performance and opportunity for promotion which were scored by 54.1% and 53.4% of the nurse respectively. Job satisfiers were also represented by competitive salary which received 76.1% of the nurses’ votes. Risk allowance occupied the second position with 69.1% and competitive working conditions were awarded a third ranking by 68.2% of the nurses. Those nurses who derived job satisfaction from the fact of each nursing shift being manned by an adequate number of nurses accounted for 63.1% of the sample. Competitive fringe benefits attracted 60.1% of the nurses. Opportunity to attend workshops and the need for high morale in nursing team-work were chosen as job satisfiers by 53.7% and 49.6% of the nurses respectively. In the section on recommendations the government was exhorted to invoke corrective or remedial measures in view of the detailed exegesis of the satisfactions and dissatisfactions in the nurses’ work environment and the ensuing problematique (doubtful, questionable) of raising the standards of health care in the public health services. Living up to these sanguine expectations should be the cherished longterm vision of the government if it is to meet and quench the soaring aspirations of its modernizing society for quality health care delivery and the escalating needs of the nurses.