Why Money Won’t Motivate Your Nurses
It’s another one of those days. Kathy has more patients than she knows what to do with, and each one is demanding in a way that is especially tiring.
Suddenly, her manager stops her in the hallway with a smile and says, “Hey, I know this is a tough shift. I wanted to thank you for taking care of the patient in 139—he’s trying in a special way and nobody else seems to be able to get through to him like you can. You have an amazing talent, and I’d like to have you mentor some of our other staff in how to work with some of these difficult patients. I appreciate you and what you do, and don’t ever forget that.”
With renewed energy, Kathy continues on with a bounce in her step, knowing that despite the challenges around her, she is highly valued and appreciated by her manager and her team.
Motivation: It’s More than Money
When the concept of motivation comes up, the first thing people turn to is pay and benefits. However, research shows that this only motivates to a certain extent, and then people look for other factors to keep them going.
This is highly applicable in the healthcare field, where nurses are aggressively pursued by recruiters with big budgets to bring on additional staff. Megan Younkin, a consultant at People Element, explained, “One of the healthcare leaders we met with said there is another hospital locally that is hiring nurses away with offers of two times the pay. This has happened historically, but what we’re seeing now are big sign-on bonuses to get nurses to accept the offers.”
The challenge for nurses, especially newly qualified ones, is that they don’t have the experience to know how to navigate these conversations, often accepting one of these higher-paying positions and then returning to the original employer months later. The reason? The higher paying job didn’t meet their needs on a fundamental level.
In a recent discussion with the CHRO of a healthcare organization, she mentioned that even if nurses left, the company would always accept them back because they are always short staffed on the nursing team.
Here’s a radical idea. Why not coach employees on how to deal with this recruiting scenario instead of acting like it won’t happen? Younkin said that she would use the opportunity to help employees understand the various pieces of the employment relationship and the value of each. While recruiters put much emphasis on pay, there are additional factors to consider that can outweigh even a significant bump in compensation.
If we step back and look at this from a psychological perspective we can frame the discussion around motivators and other elements in the workplace. Looking at Frederick Herzberg’s work on the two-factor theory of motivation, we see that things like pay, benefits, and vacation time are what we would call hygiene factors, and not true motivators as we commonly think of them.
In addition to comp and benefits, hygiene factors include things such as supervisory practices, company policies, and workplace relationships. The impact of these factors is not the same as we might expect when it comes to the general discussion of motivation. Hygiene factors can cause dissatisfaction by their absence, but we can’t increase motivation by giving someone any combination of these hygiene factors.
What’s interesting is that things like pay, benefits, and vacation time are the primary ones recruiters leverage to capture the attention of the nursing population in an attempt to sway them away from their current employer. We will explore the true motivators below and how companies can leverage them to make the work relationship more “sticky” for their employees.
True Workplace Motivators
If aspects of the employment relationship like compensation, company policies, and supervisory practices don’t drive motivation, then what does? That’s where we get to the other half of Herzberg’s model. The motivators he outlined in his research point to aspects such as achievement, recognition, advancement, growth, and responsibility. If we look back at our example of Kathy and the conversation with her manager, it’s easy to see how these pieces can bring true motivation to a harried healthcare workforce.
It’s important to note that in many cases, motivation comes from within, not from without. This is echoed by Dan Pink’s exploration of research around motivation. Giving someone an extra dollar doesn’t drive them to perform better, especially when the job involves judgment and independent thinking, such as within the nursing profession. The three keys to motivation examined in Pink’s study are:
- Autonomy-the level of control a person has over how the job is performed
- Mastery-the need to feel a sense of progress or mastery over a domain or subject matter
- Purpose-the urge to find work that fulfills a deeper, more impactful mission
Like Herzberg, Pink points out that factors like achievement, advancement, and responsibility can greatly increase someone’s motivation and engagement.
“These elements are what bring people back if they do leave. There is so much shifting around in the healthcare world, and it’s common to see a nurse leave for higher pay and come back a few months later because they realize the higher pay doesn’t outweigh the lack of advancement and recognition,” said Younkin.
To continue our recruiting discussion, healthcare firms should be explaining to their staff the value of these types of elements in the employment relationship. In Younkin’s words, “Company leaders should strongly communicate the intangible aspects of the relationship, including teaching, learning, support from leadership, etc. That way when a recruiter calls them they can ask the right questions to dig into the offer, and they can ask about the cultural aspects to see if it’s a fit.”
She said that this competitive hiring environment is a reality for many healthcare organizations, but it’s quite common for the firms to look the other way and hope for the best. However, the best strategy might not be avoiding the conversation, but rather putting it front and center and educating staff on how to talk with recruiters when they are contacted.
“Instead of saying ‘don’t answer when the recruiter calls you,’ give them some talking points and explain how to properly evaluate the offer and what it entails. Tell them to ask questions about things that matter beyond the compensation, including cultural aspects of the business.”
Addressing specific motivators and how these affect populations differently provides a key that companies can use to help create a highly engaged workforce with long-term retention prospects. Rather than taking a one-size-fits-all approach to motivation, it’s important for healthcare organizations to diversify their approach. The right combination of hygiene and cultural aspects builds a strong foundation for a lasting relationship.