Ateneo de Davao University

Graduate School

Name: Dennis N. Muñoz, LPT, RM, RN Course: Nsg 707- Nursing Leadership
Student Number: 22017001253391 & Administration

Degree: Master’s in Nursing Professor: Dr. Patria V. Manalaysay

Critical Thinking Exercise – On Motivation

Reflect on several motivation theories and identify which one explains what
motivates you the best. Explain why Do any not apply to you? If so, which?

In a multimillion-dollar US medical insurance company within Metro Manila, I shall say,

majority of office workers will benefit more from the company if employees have job
satisfaction and performance are influence over three factors:

Job Performance = Motivation x Ability x Working Condition (Environment)

The equation above was a research conducted by Mitchell in 1982 and Porter & Lawler
in 1968.The equation contains one of the forces of performance called motivation.
Scholars agree that motivation is the desire to achieve a goal or a certain performance
level, leading to goal-directed behavior. In cognitive evaluation theory in psychology,
motivation, it can either be intrinsic or extrinsic form.

I am no longer connected with any clinical industries or medical insurance company

however, I have a business that I could attain to help sustained my education to attend
to, and perhaps from here, learning will grow through experience and discoveries of
many unidentifiable factors that yet to be learned. My essay today will focus on
motivation to pursue higher education. According to Dohm & Wyatt in 2002, pursuing a
graduate degree is both time-consuming and expensive but the long-term benefits far
exceed the initial investment cost.

Some people attend a graduate program such as the quest for self-improvement, while
others may attend entering occupations in which a graduate degree may be required for
better employment. Although it would be impossible to ascertain each student’s
motivation for attending graduate degree, one thing is certain those degrees have
distinct and measurable benefits as it relates to earnings, career opportunities,
healthcare insurance, and retirement savings.

Intrinsic motivators are achievement, responsibility, and competence. Intrinsic

motivation comes from the actual performance of the task or job example, the intrinsic
interest of the work. About intrinsic motivation factors, what are the reasons why I would
like to pursue my master’s degree in nursing? Here are some of my reasons for
pursuing the degree:
1. advance my personal growth
2. develop my potential
3. improve my current job condition
4. perform my job better
5. fulfill my personal & professional objectives

Whereas, extrinsic motivation may be attributed by pay, promotion, feedback, working

conditions these are things that come from a person's environment, controlled by
others. Example, here are the honest reasons that motivate me to pursue my master’s
degree in Nursing:
1. Attain social status
2. Higher pay
3. Gain a promotion for higher administrative position
4. Job security and tenure
5. A member of a university community
6. Increase the ability to save for retirement
7. Increase job opportunities – locally and abroad

In my analysis, it seems that the external factors have a strong impact on pursuing
plans in life like the example mentioned above. The reason is that intrinsic motivation is
non-tangible and can only be satisfied when the external factors are well fulfilled. In the
research study of Ryan & Deci about motivation in 2000, extrinsically motivated
behaviors mean that an individual is involved with activity with instrumental values.

Motivation is important if someone is to perform well; however, it is not sufficient. Ability

—or having the skills and knowledge required to perform the job—is also important and
is sometimes the key determinant of effectiveness. Job satisfaction and workability are
important in the nursing profession to ensure good working conditions and to reduce
work-related diseases and illnesses (Viola & Larese Filon, 2015).

Finally, environmental factors such as having the resources, information, and support
one needs to perform well are critical to determining performance. At different times,
one of these three factors may be the key to high performance.

Being motivated is not the same as being a high performer and is not the sole reason
why people perform well, but it is nevertheless a key influence over our performance
level. Therefore, Performance is a function of the interaction between an individual’s
motivation, ability, and the environment.

Of the many theories of motivation that best motivate me to pursue wants & needs and
personal satisfaction, I choose Expectancy and Two-Factor Theories. Although the
questions ask for one motivational theory, for me it best describes in setting up my
goals in life.
Let me first describe the Expectancy theory of motivation. It states that individual
motivation to put forth more or less effort is determined by a rational calculation in which
individuals evaluate their situation.

This theory answers three important questions to support product motivation. These
are:
1. Will my effort lead to high performance?
2. Will performance lead to outcomes?
3. Do I find the outcomes desirable?

Such that,

Motivation (M) = Expectancy (E) x Instrumentality (I) x Valence (V)

Wherein:

M (motivation) = the amount a person will be motivated by the situation they find
themselves in. It is a function of the following.

E (expectancy) = The person's perception that effort will result in performance. In other
words, the person's assessment of the degree to which effort correlates with
performance.

I (instrumentality) = The person's perception that performance will be

rewarded/punished. I.e., the person's assessment of how well the amount of reward
correlates with the quality of performance. (Note here that the model is phrased in terms
of extrinsic motivation, in that it asks, 'what are the chances I'm going to get rewarded if
I do a good job?'. But for intrinsic situations, we can think of this as asking, 'how good
will I feel if I can pull this off?').

V(valence) = The perceived strength of the reward or punishment that will result from
the performance. If the reward is small, the motivation will be small, even if expectancy
and instrumentality are both perfect (high).

A Reward system is one of the crucial ways of motivating employees to make them
productive and to attain the desired organizational objectives. People are attracted to
jobs that match their goal priorities and if a job fails to satisfy these aims then it can lead
to frustration and long-term negative effects on their behavior. Parallel to employee
goals and expectations, an organization on the other hand also expects certain
behaviors from its employees before rewarding them, which is mostly determined by the
job. Individuals must be attracted to a particular job that meets staff as well as
organizational needs. The employee must always be ready to react spontaneously and
appropriately to any upcoming situations. Any organization must realize that none of
their expectations and goals can be met without the input from their employees and for
attaining the desired organizational objectives, one should create motivation among the
employees and create a balance between organizational and individual goals

Intrinsic rewards motivate workers by appealing to their sense of contribution and self-
importance for example pride, feeling of accomplishment, public praise, etc.
Researchers found that intrinsic rewards are positively related to project success in
terms of client satisfaction. On the other hand, extrinsic rewards are external factors
offered externally by others to the workers- for example, job security, financial bonuses,
time off, technical training flexible work schedule, promotions, etc. Rewards can be
offered individually or to a group of people.

Personal Scenario:

In my First years with Aetna, one of the leading medical insurance companies in the US
I worked as Utilization Management Nurse where my job is to ensure that health care
services are administered with quality, cost efficiency, and compliance. By continuously
reviewing and auditing patient treatment files, the utilization management nurse will
ensure that patients will not receive unnecessary procedures, ineffective treatment, or
unnecessarily extensive hospital stays.

With this kind of job, it demands higher critical thinking in 8 hours back office job,
dealing with volumes of clinical documents, labs, and medical literature. I am working
behind the scene while services are rendered to the patient to ensure medical
procedure, medication and medical services are appropriate and non-experimental and
ensure medical coverage otherwise, denial of insurance benefit. Patients in the US are
spending so much money annually for medicalization and other health services;
therefore, it can be abused by those in authority particularly the health facility and
physicians. This where my role as a nurse is highlighted as a patient advocate.

How is this related to human satisfaction and rewards system of expectancy theory?
The answer is simple, as an agent in the company Technically, I am legally bound with
accountability, responsibility, confidentiality, and secrecy with the business trades of the
institution. And for the employee to stay long with satisfaction with our monthly
performance a metrics were devised to ensure 100 quality,100% productivity, and 100%
attendance.

The table below represents an instrument to assess our weekly performance and will
serve as the summary of performance for monthly evaluation before a reward is given to
a deserving agent only upon meeting the metrics of 100% quality,100% productivity,
and 100% attendance.

1. Concurrent review of patient’s clinical 10%

information for efficiency
2. Ongoing review of precertification 10%
requests for medical necessity
 3. Monitor the activities of clinical and non- 10%
clinical staff
4. Coordinates patient’s discharge planning 10%
needs with the healthcare team
5. Employ effective use of knowledge, 10%
critical thinking, and skills to:
o Advocate quality care and
enhanced quality of life
o Prevent patient complications
during hospital stay
o Advocate decreased hospital stay
when appropriate
6. Maintain accurate records of all patient 10%
related interactions
7. Ability to stay organized and interact well 10%
with others in any situation
8. Prepare monthly patient management and 10%
cost savings report
9. Work in an intensive, fast-paced 10%
environment with minimal supervision
10. Provide daily updates to Manager of 10%
Utilization Management for review
100%

When it comes to rewarding, yes, you will be compensated 5x more the minimum wage
of a regular employee per month in the National Capital Region (NCR). If someone
asks, Why I left the company? I am study Master’s in Nursing as a Fulltime student.
 
The other theory of motivation I am most interested in the theory of two factors for
motivation. Frederick Herzberg extended the work of Maslow and proposed a new
motivation theory popularly known as Herzberg’s Motivation Hygiene (Two-Factor)
Theory.
 
Frederick Herzberg’s studies indicated that certain job factors are consistently related to
employee job satisfaction whereas others can create job dissatisfaction. According to
Herzberg, two kinds of factors affect motivation, and they do it in different ways, see
table below.
 

 
Motivating factors (also called satisfiers) are primarily intrinsic job elements that lead to
satisfaction such as achievement, recognition, interesting nature of work, increased
responsibilities, advancement, and growth opportunities. The conditions that truly
encourage employees to try harder. These factors whose presence motivates. Their
absence does not cause any particular dissatisfaction, it just fails to motivate.
Examples are all the things at the top of the Maslow hierarchy, and the intrinsic
motivators.

What Herzberg termed hygiene factors (also called dissatisfiers) are extrinsic elements
of the work environment such as company policy, relationships with supervisors,
working conditions, relationships with peers and subordinates, salary and benefits,
and job security. These are factors that can result in job dissatisfaction if not
professionally managed. One of the most interesting results of Herzberg’s studies
was the implication that the opposite of satisfaction is not dissatisfaction. These
factors whose absence motivates, but whose presence has no perceived effect.
They are things that when you take them away, people become dissatisfied and act
to get them back. Herzberg believed that proper management of hygiene factors
could prevent employee dissatisfaction, but that these factors could not serve as a
source of satisfaction or motivation.

How do Managers eliminate job dissatisfaction (Dartey-Baah & Amoako, 2011)?

According to Herzberg (1987) managers need to eliminate the dissatisfaction by doing
the following:
• Fix poor and obstructive company policies
• Provide effective, supportive, and non-intrusive supervision
• Create and support the culture of respect and dignity for all team members
• Ensure that wages and salaries are competitive
• Provide job security
• Build job status by providing meaningful work for all positions.

The above actions help in eliminating job dissatisfaction in organizations and there is no
point trying to motivate people or employees until these issues are addressed.
Addressing the above issues should not be an end in itself but rather managers are
to be aware that just because someone is not dissatisfied does not mean one is
satisfied either. It is crucial in the work environment to identify conditions for job
satisfaction.

How then do managers create conditions for job satisfaction (Dartey-Baah &
Amoako, 2011)?

Herzberg (1987) advanced that there is the need to address the motivating factors
associated with work, this he called job enrichment. His premise was that every job
should be examined to determine how it could be made better and more satisfying to
the person doing it. Hence, managers need to consider and include:

• Providing opportunities for achievement

• Recognizing workers contributions;
• Creating work that is rewarding and that matches the skills and abilities of the
employee;
• Giving as much responsibility to each team member as possible;
• Providing opportunities to advance in the company through internal promotions;
• Offering training and development opportunities so that people can pursue the
positions they want within the company.

Herzberg's theory is largely responsible for the practice of allowing people greater
responsibility for planning and controlling their work, as a means of increasing
motivation and satisfaction. The relationship between motivation and job satisfaction
are not overly complex. The problem is many employers and managers look at the
hygiene factors as a way to motivate when in fact, beyond the noticeably short term,
they do extraordinarily little to motivate. Perhaps managers like to use this approach
because the thinking is that people are more financially motivated than they are, or it
takes less management effort to raise wages than it does to reevaluate company
policies and redesigning jobs for maximum satisfaction. In seeking to motivate
people, first management in organizations must identify and address things that
make workers unhappy about the workplace environment. Furthermore,
management has a responsibility to ensure that workers are treated fairly and with
 respect including helping workers to grow within their jobs and giving them
opportunities for achievement.

Ask the nurse manager what she or he does to motivate workers. Ask some staff
nurses and colleagues what motivates them.

Here are some of the gathered information on how nurse managers motivate nurses to
work and stay in the hospital:
1. An Educational plan for those who wish to pursue a graduate program
2. Salary increments per annum
3. Match them with positions that fit their talents
4. Provide positive feedback
5. Show understanding and let your nurses do their jobs
6. Provide the right technical training for the job
7. Take advantage of staff scheduling
8. Workload management to reduce fatigue
9. Commit to positive communication
10. Involve nurses in leadership
11. Introduce rewards through a performance bonus
 
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