Read the Motivation article and answer the questions.
Motivation What makes you tick? By Debra Dunn, MSN, MBA, RN, CNOR M Motivation is a state of mind, an attitude, or a way of thinking that inspires individuals to go above and beyond rather than simply performing a job or task well.1 Being motivated also results in better work performance.2 Individuals are motivated by both extrinsic or intrinsic rewards. However, extrinsic rewards can only go so far. Without the internal component, a person’s level of motivation is not likely to last. Motivation is derived from internal urges—needs, desires, wishes, drives, ideas, and emotions—that prompt a person to action and result in specific behaviors.3 Although external stimuli can increase the level of motivation, it is the inner urge that actually motivates a person.4 Motivation is the driving force behind a person’s intensity, direction, and persistence toward attaining a goal.5 From a manager’s perspective, motivation results in the employee acting in a manner that helps achieve departmental and organizational aims. It is to the manager’s advantage to understand employees’ personal desires and needs and help them meet those needs while working better and more effectively. Motivation is very complex and can be difficult to understand when predicting behavior. First, 38 OR Nurse 2015 March Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. www.ORNurseJournal.com www.ORNurseJournal.com March OR Nurse 2015 Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. 39 Motivation: What makes you tick? motivation is highly situational: what motivates one person in one situation may not necessarily motivate that person in a different situation. Second, people react differently to the same motivational factors. Third, people may not even be aware of what motivates them, which happens when motivation occurs at the subconscious level. Finally, motivation can be positive with a strong level of commitment or negative such as when the person is motivated to do “just enough” to be adherent but is not very engaged.3,6 Although some individuals may be more motivated than others, everyone is motivated to some extent.6 Nurses focus on the delivery of effective and efficient patient care with excellent quality outcomes; however, these outcomes are directly related to a nurse’s willingness to apply knowledge and skills in his or her work. Research shows enhanced patient outcomes when employees are motivated to perform at their highest levels.5,7 Incentives: Extrinsic and intrinsic factors Understanding motivational factors is important to design systems with the correct incentives in place to encourage motivation.8 It is important to recognize that motivation is not the same as incentive. With incentives, the same input is expected to yield greater outputs. With motivation, more inputs are needed to change the outputs of work performance, an employee’s attitude, and behavior. Incentives are external in nature, while motivation is the expression of an individual’s inner, personal needs.3 Intrinsic motivation is an internal sense of satisfaction due to some sort of achievement, such as performing a job well. This internal desire or drive is expressed as behavior designed to accomplish a goal. Extrinsic motivation is the same as intrinsic motivation except that the motivator is external to the individual. An example of a combined effect is when someone is recognized for a job well done (extrinsic), resulting in an increased sense of self-worth, selfesteem, and self-confidence (intrinsic). This symbiotic reaction increases the likelihood the employee will be willing to take on new challenges and contribute new ideas in the future. Extrinsic rewards can only go so far when they do not match an employee’s internal needs. For example, compensation is rarely the number one motivating factor that gets an individual out of bed in the morning to go to work.2 Creating a type of environment where employees can grow and contribute is more of a motivator than financial gain because most employees want to feel they are part of something bigger than themselves. They want to learn, evolve, and create new and exciting things in their workplace.1-3,9,10 The desire to excel on the job comes from within when an employee is internally incentivized to reach for a goal.2 Although external motivational forces have their benefits and should not be discounted, they are subject to each employee’s individual, intrinsic concerns, and the individual needs to “buy into” them for them to have a positive impact.2 Many employees rate motivating factors such as good working relationships with colleagues, training opportunities, and environmental factors (such as, good physical conditions) as more important than income.8 A review of 12 empirical studies of motivation found that seven major job characteristics were important determinants of motivation. These are the work itself, healthy relationships with others, workplace conditions, opportunities for personal development, pay/rewards, management practices, and organizational policies.8 Two other important factors include being given choices and being involved in decision making.9 Managers need to identify each employee’s intrinsic motivators and align these needs with the needs of the department. Managers are key people who can help their employees behave in ways that positively meet their personal, internal needs as well as perform at higher levels and work more effectively with others.2 (See Extrinsic and intrinsic motivational factors.) Demotivators Demotivators decrease employees’ desires to contribute positively to the organization. Managers must find demotivators within their departments and work to eliminate them. If a demotivator is an employee who thrives on complaining, for example, the manager should allow that employee 5 minutes to air a grievance and then ask that person to suggest a solution. This moves the conversation away from the drama and toward the harmony of moving forward. Managers also can cause demotivation when they micromanage, play favorites, pass their work off to their staff, display coercive types of control, and are manipulative.2,3,6 Demotivation can lead to frustration, hostility, laziness, defensiveness, selfdoubt, judgment of others, inflexibility, misplaced 40 OR Nurse 2015 March Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. www.ORNurseJournal.com Extrinsic and intrinsic motivational factors Job content characteristics External factors Internal factors • Challenging nature of the work • Skill variety–degree to which a job utilizes a mix of employee knowledge, skills, and abilities • Task identity–degree to which job involves completing a complete project versus a piece of work • Task significance–degree to which job makes a recognizable impact or contribution • Ability to provide quality care • Job enlargement–makes job structurally bigger; improves job horizontally • Opportunity to advance • Career development opportunities that cultivate skills (professional growth) • Authority level • Level of job control–influence in planning work and reviewing results and setting standards for performance targets • Clearly defined nursing roles and responsibilities • Explicit in departmental or organizational goals • Constructive and objective system of performance appraisal and merit rating • Meaningful work (skill variety, task identity, and task significance) • Job enrichment (challenging job) • A sense that one’s expectations can be filled • Creativity opportunities • Decision making • Sense of control over work • Setting own goals • Job pride • Delegated authority • Sense of competence • Perceived increased work effectiveness Work environment • Well-defined and humanistic personnel policy where the workforce is valued and their needs and aspirations can be satisfied • Good working relationships • Teamwork • Adequate staffing • Culture that supports professional growth, leadership development, and mentorship • Enthusiastic and warm work environment where ideas and goals can be shared • Staff included on councils • Increased power and authority • Autonomy • Empowerment • Trusting • Positive reinforcement • Resources (tools, information, support) to perform the job • Pleasant physical conditions of environment • Safe and respectful work environment • Distributive justice • Job security • Sound and fair promotion and transfer policies • Well-planned, need-based training, and development programs • Strong interpersonal work relationships • Social acceptance • Positive interactions with physicians • Minimal perceived environmental turbulence • Set own work schedule and breaks • Feelings of accomplishment and making a difference; taking pride in work performed • Feel like valued member of team • Professionalism • Work-life balance with manageable and suitable workloads • Hardiness (resilience) — able to deal with turbulent work environment because see uncertainty in the environment as challenging, not threatening; ability to improvise and adapt to significant change (Continued) www.ORNurseJournal.com March OR Nurse 2015 Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. 41 Motivation: What makes you tick? Extrinsic and intrinsic motivational factors (continued) Leadership • • • • • • • • • • • • • • • • • Two-way communication that is respectful and open Be a good listener–appreciate what others have to say Maintain visibility Demonstrate trust and respect Show others that you value their perspectives– seek their opinions and ideas and implement them Show confidence in employee’s ability to perform at a high level Encourage participation in decision making Delegation of responsibility Help staff set ambitious goals and help them work toward these goals–extend people beyond their comfort zone Coaching, role modeling, mentorship Eliminate obstacles for employees to succeed Accurate, honest, and constructive feedback on work effectiveness; should be corrective but not punitive; also point out the positive and provide encouragement Honest praise; sincere compliments Good performance rewarded adequately Treat people consistently and fairly Shows concern for employee as an individual Provides rewards (bonuses, gift certificates, certificates of appreciation, thank-you notes, day off with pay, parking spot closest to facility for a month, articles in local paper or internal newsletter) • Sense of self-efficacy • Recognition of efforts when successful, or when attempted to improve effectiveness or productivity, or overcame an obstacle • Earned respect • Input is sought for decision making • Feel empowered • Autonomy–independence and freedom • Knowing what is expected to do the job (preparedness) • Knowledge of results (feedback) Benefits • • • • • • Fair wages and salary administration Financial incentives Paid time off Medical and life insurance benefits Retirement pension Location of facility • Feel appreciated and rewarded financially Sources: http://www.egyankosh.ac.in/jspui/bitstream/123456789/38773/1/unit-15.pdf; Bruce A. Manager’s Guide to Motivating Employees. 2nd ed. Madison, WI: McGraw-Hill; 2011; Callicutt D, Norman K, Smith L, Nichols A, Kring D. Building an engaged and certified nursing workforce. Nurs Clin North Am. 2011;46(1):81-87; Gambino KM. Motivation for entry, occupational commitment and intent to remain: a survey regarding registered nurse retention. J Adv Nurs. 2010;66(11):2532-2541; Brady Germain P, Cummings GG. The influence of nursing leadership on nurse performance: a systematic literature review. J Nurs Manag. 2010;18(4):425-439; Hahn JJ, Butz KP, Gavin JG, Mills RS, Welter CJ. Recognizing professional and volunteer activities. AORN J. 2004;79(5):1006-1010; Lambrou P, Kontodimopoulos N, Niakas D. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital. Hum Resour Health. 2010;8:26. http://www.human-resources-health.com/content/8/1/26; Llanos EB. Motivating co-workers. Advance for Nurses, Northeast. 2013;28-30; Mone E, Eisinger C, Guggenheim K, et al. Performance management at the wheel: driving employee engagement in organizations. J Bus Psychol. 2011;26:205-212; Newcomb P, Smith A, Webb P. Relationship of nurse job satisfaction to implementation of a nursing professional practice model. Southern Online Journal of Nursing Research. http://www.resourcenter.net/images/SNRS/Files/SOJNR_articles2/Vol09Num03Art11.pdf; Peters DH, Chakraborty S, Mahapatra P, Steinhardt L. Job satisfaction and motivation of health workers in public and private sectors: cross-sectional analysis from two Indian states. Hum Resour Health. 2010;8(27):1-11; Shermont H, Krepcio D, Murphy JM. Career mapping: developing nurse leaders, reinvigorating careers. J Nurs Adm. 2009;39(10):432-437; Sledge S, Miles AK, van Sambeek MF. A comparison of employee job satisfaction in the service industry: do cultural and spirituality influences matter? Journal of Management Policy and Practice. 2011;12(4):126-145; Utriainen K, Kyngäs H. Hospital nurses’ job satisfaction: a literature review. J Nurs Manag. 2009;17(8):1002-1010. 42 OR Nurse 2015 March Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. www.ORNurseJournal.com priorities, absenteeism, poor staff retention, low productivity, and apathy.3 Managers can combat demotivation by holding regular staff meetings, soliciting feedback from employees, offering incentives, praising successful employees, celebrating victories, and showing concern about employees beyond the workplace. Multigenerational influences Multigenerational differences among employees need to be considered when discerning which extrinsic and intrinsic factors might be more likely to motivate certain people. Nurses raised in different generations may respond differently to extrinsic forces cultivated in the work area. Understanding these additional differences will help managers choose more appropriate actions to motivate employees. It is important to always take a closer look at where the individual “is coming from” based on their age-group, which can offer new ways to change attitudes and increase motivational levels.7 The employee’s role Thoughts and behaviors, which are derived from internal urges, result in actions to fulfill current or future personal goals or desires. A sense of purpose results when an employee’s activities align with his or her values and beliefs. Employees should understand and attend to their internal forces in order to build on their motivation levels. The higher the need satisfied by an activity in the workplace, the greater the motivation will be to perform that activity.2,11 Nurses have their own internal working styles that drive them to achieve and satisfy personal desires. These motivational forces can be positive, neutral, or negative, which directly impact the level of success nurses will have within the healthcare facility. Positive internal motivational forces result in “organizational citizenship” where the nurse is results-oriented, believes the organization and the nurse are part of an integrated unit, and views his or her assigned tasks as a fundamental duty. Nurses who feel neutral may function at a subsistence level where they perform their required duties but only at a minimal level. These nurses survive in the organization but do not have any concern for longterm results. Finally, nurses who harbor negative beliefs about themselves, their capabilities, the people around them, or how things are viewed in the www.ORNurseJournal.com world will find their abilities to be successful to be stunted and limited.4,11 Nurses should participate in the creation of their workplace cultures by engaging in activities that enhance the work experience. Nurses are responsible to communicate professionally with their nurse leaders about what they need to complete their tasks efficiently and expertly.12 In other words, everyone has an inherent responsibility to make their work experiences better for themselves and for their patients. The manager’s role Managers should seek to understand what motivates each of their employees and then help them make the connection between those inner drives and the needs of the department.2 Nurses with greater internal needs for professional growth, for example, might demonstrate a more positive response to job enrichment than other nurses might.13 Nurses who view their work as a 9-to-5 job might be more enticed by financial rewards. One of the characteristics of a leader is the ability to influence the actions of others toward accomplishing specific goals. Before a manager can do this, however, he or she needs to be motivated. This internal desire within the manager ultimately will ignite the passion in the employees. A manager’s attitudes, behaviors, and practices directly influence those of the employees. If a leader is not motivated, how can the staff be?2,3,14 Only when a leader understands his or her own internal motivation can he or she more readily understand the employees’ motivational forces and the best way to guide and motivate them.11 Employee motivation is of great concern to leaders, as it directly impacts human behavior and attitudes toward work. Just as employees have certain desires the organization is expected to satisfy, the organization also expects certain types of behaviors from employees. The task for the leader is to make the work more interesting, purposeful, and acceptable to employees so they perform it more enthusiastically and with a greater sense of responsibility. Leaders need to search for opportunities to create, develop, and improve processes and to enable others to act to feel competent and dedicated. Employees are motivated to do a job well when it helps them meet one or more of their personal needs, aims, objectives, and values. The challenge for managers is that different people have different March OR Nurse 2015 Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. 43 Motivation: What makes you tick? needs, and these needs change over time and according to the context of the situation.2,12 “There is no single magic wand to motivate employees, as their needs and priorities of satisfaction differ. What may motivate one may not motivate the other.”3 Managers can assist their nurses uncover their motivational forces to reach their highest level of performance and productivity. A first step is to ask the nurse what motivates him or her. If the answer lies buried, then the manager needs to get to know the nurse on a more personal level to learn these inner desires. This also can be accomplished by observing individual actions and behaviors and interpreting them in terms of some underlying motivation.3 Motivated managers see their role as facilitators, trainers, and coaches; they provide inspirational motivation through enthusiasm and challenge. These managers clearly articulate a vision, encourage the evolution of the individual and team spirit, and support goal achievement. Effective leaders develop and maintain a trusting and positive motivational climate so that nurses feel satisfied and motivated to consistently perform at their highest level of productivity. This is accomplished by understanding nurses’ desires, appealing to their sense of self-improvement and selfworth as human beings, and working to elevate their level of effectiveness to accomplish departmental goals. It is up to the manager to assist their nursing staff to connect their intrinsic motives to the organization’s goals.2 Employees will surprise their managers with their levels of motivation to perform high-quality patient care when their assignments meet their inner drives (see Stimulating motivation in employees).2,6,12,14,15 Leadership styles Leadership styles directly impact the manner in which managers brings out the best in their employees. There are three types of leadership styles: transactional, passive avoidant, and transformational. The transactional leadership style is based on a reciprocal exchange between the leader and employees. In this relationship, leaders specify the standards of performance with a strong focus on deviations from this standard, and employees are given something in return for their adherence and acceptance of authority (incentives, pay raises, status increases). The leader is an authority figure, and staff members are motivated by the reward for their adherence. In the passive avoidant leadership style, the leader avoids involvement in important issues or making decisions. Staff generally experience lack of empowerment and are not committed to established goals.15 A strong relationship has been demonstrated between the transformational leadership style and clinical nurse job satisfaction.15 Transformational leadership, which is an inclusive and participative management style, is a process where leaders raise the aspirations and motivations of staff members to higher levels by appealing to ideals and values. A transformational leader engages others by finding a common purpose and meaning to achieve a common set of goals. When a leader models a higher level of ideas, values, and behaviors, staff members begin to do so as well. Employees are motivated because the leader helps them meet their individual needs. Transformational leaders challenge employees to excel, establish accountability, and create a collective team spirit with shared ownership to attain goals. They ensure a trusting environment with an open door policy, display confidence, actively listen and address concerns, provide a clear mission and set of values, seek creative approaches to problem solving, provide a supportive climate for professional growth, and act as mentors and teachers.2,7,15 In this environment, staff members feel empowered to share and openly discuss their concerns and to participate in decision making. An important concept within transformational leadership is “empowerment,” which is a heightened state of motivation that is caused by optimistic effort-reward expectations.16 Empowered nurses expect their efforts to succeed and are therefore motivated to exert high levels of effort. They also have a sense of accountability for their work and the results they achieve. Motivated employees work hard when they feel empowered to make decisions about their work and when they feel supported and have the resources.2,16 Empowerment makes the employee feel trusted and valued, which then fosters a sense of confidence.2 Empowerment challenges managers to share their formal and informal power with their nursing staff.12 Transformational leaders delegate and give their employees more discretion and choices. This helps them expand their minds, develop their talents and skills, discover untapped abilities, and ultimately leads to feelings of a greater sense of self-efficacy, selfdetermination (control), and self-responsibility for improving the way they do their jobs and contribute 44 OR Nurse 2015 March Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. www.ORNurseJournal.com Stimulating motivation in employees • Share the overall organizational strategy and discuss with the staff. • Employees should understand how their work supports organization strategy and direction. • Visibility, interaction, and communication with the staff should be advocated. • Raising the bar regarding the expectations from the staff. Employees will perform better if the manager expects high-level performance. • Collaboratively set performance and development goals with the employee. • Employees who have been successful in their work or accomplishing specific goals should be recognized. • Stretch goals should be determined with the employee to enhance personal growth, professional development, and to improve organizational effectiveness. • Employees should be allowed to tackle surmountable assignments before engaging in more difficult tasks. • Employees should be treated as partners to increase buy-in and to achieve better performance. • Cross-training–employees appreciate each other more when they have walked in each other’s shoes. • Opportunities for training and development (such as in-house education) should be provided • • • • • • • • • • • • • • • along with career development and advancement efforts. Guidance and coaching should be provided. Staff should be mentored for long-term professional development. Performance appraisals are to be objective, measurable, and transparent. Tie raises to performance, not seniority. A climate of trust, ownership, empowerment, and autonomy should be fostered. Creativity and innovation should be encouraged. Employees should be included in the decisionmaking process. Improvement in work processes and productivity should also be encouraged. Fairness and respectfulness of the staff should be paramount. The resources and authority needed for the staff to perform effectively should be provided. The staff should be advocated for. An interest in the staff should be displayed. Reinforcement, recognition, and rewards should be provided. An atmosphere where working relationships and interactions are valued and emphasized should be promoted. Employees should share responsibility for improving work processes. Sources: Bruce A. Manager’s Guide to Motivating Employees. 2nd ed. Madison, WI: McGraw-Hill; 2011; Harvey P, Martinko MJ. Chapter 7: Attribution theory and motivation. In. N. Borkokwski (ed) Organizational Behavior, theory and Design in Health Care. Sudbury, MA:Jones and Bartlett Publishers, LLC. pp. 147-164. http://samples.jbpub.com/9780763763831/63831_08_CH07_final.pdf; Kuokkanen L, Suominen T, Härkönen E, Kukkurainen ML, Doran D. Effects of organizational change on work-related empowerment, employee satisfaction, and motivation. Nurs Adm Q. 2009;33(2):116-124; Mone E, Eisinger C, Guggenheim K, et al. Performance management at the wheel: driving employee engagement in organizations. J Bus Psychol. 2011;26:205-212; Sikroria R, Srivastava V. Shaping employee oriented human resource policies through analyzing motivational needs. European Journal of Business and Management. 2012;4(14):177-181; Utriainen K, Kyngäs H. Hospital nurses’ job satisfaction: A literature review. J Nurs Manag. 2009;17(8):1002-1010. to the organization’s goals. As a result, nurses have greater job satisfaction, are more motivated and committed to their work, and involve more of themselves. These attributes are associated with patient satisfaction, patient care, and patient safety.2,7,17 Nursing leadership behaviors directly influence nurses’ abilities to exceed their employer’s expectations in meeting organizational goals.12 Leadership practices affecting motivation and work performance include: • encouraging the heart: providing encouragement and celebrating accomplishments www.ORNurseJournal.com • inspiring a shared vision through commitment • enabling others to act • challenging the process • modeling the way • leadership with building, coaching, and mentoring.12 Employee engagement is an important outcome of working for a transformational leader. An engaged employee is not only fully involved in and enthusiastic about work but is also “inspired by it, committed to it, and fascinated by it.”9 Engaged employees align their own purpose with the organization’s values and goals so that they are personally March OR Nurse 2015 Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. 45 Motivation: What makes you tick? invested in their tasks and outnurses take exceptional pride in comes.2 Engagement is distheir work. When they experiplayed with personal initiative, ence this, they work at a consisbeing adaptable, effort, and tently higher capacity and are persistence toward achieving more motivated and satisfied at the organizational goals.18 High their job. Employees work hardlevels of trust and fairness in er and smarter, not for their the organizational culture are manager or the organization, necessary to create and sustain but for themselves. Managers, an engaged workforce. however, are the link between Interventions for driving nurses meeting their own needs engagement include: and doing exceptional work for Nurses should • building confidence, resiliency, the healthcare facility. Nurses participate in the and social support networks need to understand how their creation of their • renewing or restoring employown and the healthcare facility’s workplace cultures by ee energy values connect to bring meaning engaging in activities • empowerment to their life through work. Those that enhance the work • providing control over work managers who work to build experience. • enhancing the motivation and hope and trust will find a motifreedom to engage vated workforce.2,11 • involving staff in decision making • providing effective recognition and rewards and Job satisfaction fair and equitable treatment.18 Employee motivation and job satisfaction are related Building engagement is based on “knowing, but distinct phenomena. Job satisfaction is an individgrowing, inspiring, involving, and rewarding employual’s emotional response to his or her job condition; ees,” which can produce organizational commitmotivation is the driving force to pursue and satisfy ment and increased employee satisfaction levels.15,18 needs.5 Employees are more likely to feel satisfied Engagement is a prerequisite before an employee when they perceive that their efforts are rewarded can increase motivation levels.18 based on their standards and internal motivators.19 Organizations with engaged employees have Motivational levels and job satisfaction are positively employees who are 20% more likely to perform correlated and both work together to increase job better and 87% less likely to leave the organization.9 performance.5,10,13,19 The following themes are relatThe 10 Cs of employee engagement require leaders ed to nurses’ job satisfaction: to do as follows: • positive interpersonal relationships and communica• connect with employees tion between nurses and other healthcare providers • provide opportunities for career advancement • nurses who believe they provide high-quality care • provide a clear vision and have a strong connection to patients • convey meaningful feedback • a culture where management and employees con• congratulate strong performance sult together on decision making • allow for employee contributions and control over • teamwork and peer support their work • control over nursing practice • encourage collaboration among team members • empowerment and autonomy • establish credible standards • participation and open discussion • create confidence.9 • sensitivity for employees’ ideas Managers need to create a trusting environment • loyalty and trust.10,19 where nurses can flourish, get swift feedback and Meeting the needs and achieving the goals of recognition, and earn rewards for their good ideas.2 both the nurse and the healthcare facility provide the They also need to build confidence, cultivate feelings “cornerstone” for job satisfaction.5 “Job satisfaction is of ownership, and allow their nurses to question, inextricably linked to motivation, and both involve challenge, influence, and make decisions. Motivated cognitive, affective, and behavioral processes, with 46 OR Nurse 2015 March Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. www.ORNurseJournal.com Advertisers Index ORN March • Volume 9, Number 2 PRODUCTS & SERVICES Page PRODUCT employee motivation commonly understood as the reason why employees behave as they do towards achieving personal and organizational goals.”8 OR BONE FOAM INC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C2 REFERENCES EPS, INC. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9, 11, 13 1. Hahn JJ, Butz KP, Gavin JG, Mills RS, Welter CJ. Recognizing professional and volunteer activities. AORN J. 2004;79(5):1006-1010. LCNC CONFERENCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2 2. Bruce A. Manager’s Guide to Motivating Employees. 2nd ed. Madison, WI: McGraw-Hill; 2011. 3. http://www.egyankosh.ac.in/jspui/bitstream/123456789/38773/1/ unit-15.pdf. 4. Sikroria R, Srivastava V. Shaping employee oriented human resource policies through analyzing motivational needs. European Journal of Business and Management. 2012;4(14):177-181. 5. Lambrou P, Kontodimopoulos N, Niakas D. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital. Hum Resour Health. 2010;8:26. http://www.human-resourceshealth.com/content/8/1/26. 6. Wysocki AF, Kepner KW, Glasser MW. Associates and motivation, University of Florida. http://www.edis.ifas.ufl.edu/pdffiles/HR/HR00400.pdf. CLOROX SERVICES CO. . . . . . . . . . . . . . . . . . . . . . . . . . . C4 NURSINGCENTER.COM . . . . . . . . . . . . . . . . . . . . . . . . . . . .7 NURSINGJOBSPLUS.COM . . . . . . . . . . . . . . . . . . . . . . . . .5 ORNURSEJOURNAL.COM . . . . . . . . . . . . . . . . . . . . . . . . C3 TUCSON MEDICAL CTR . . . . . . . . . . . . . . . . . . . . . . . . . . .17 WK/LWW OR NURSE APP . . . . . . . . . . . . . . . . . . . . . . . . .15 7. Llanos EB. Motivating co-workers. Advance for Nurses, Northeast. 2013;15(7):25-27. 8. Peters DH, Chakraborty S, Mahapatra P, Steinhardt L. Job satisfaction and motivation of health workers in public and private sectors: cross-sectional analysis from two Indian states. Hum Resour Health. 2010;8(27):1-11. 9. Callicutt D, Norman K, Smith L, Nichols A, Kring D. Building an engaged and certified nursing workforce. Nurs Clin North Am. 2011;46(1): 81-87. 10. Utriainen K, Kyngäs H. Hospital nurses’ job satisfaction: a literature review. J Nurs Manag. 2009;17(8):1002-1010. 11. Coombes F. Motivate Yourself and Reach Your Goals. Blacklick, OH: McGraw-Hill; 2010. 12. Brady Germain P, Cummings GG. The influence of nursing leadership on nurse performance: a systematic literature review. J Nurs Manag. 2010;18(4):425-439. 13. Sledge S, Miles AK, van Sambeek MF. A comparison of employee job satisfaction in the service industry: do cultural and spirituality influences matter? Journal of Management Policy and Practice. 2011;12(4):126-145. 14. Feltner A, Mitchell B, Norris E, Wolfle C. Nurses’ views on the characteristics of an effective leader. AORN J. 2008;87(2):363-372. 15. Schwartz DB, Spencer T, Wilson B, Wood K. Transformational leadership: implications for nursing leaders in facilities seeking Magnet designation. AORN J. 2011;93(6):737-748. 16. Harvey P, Martinko M. Attribution theory and motivation. http:// samples.jbpub.com/9780763763831/63831_08_CH07_final.pdf. 17. Kuokkanen L, Suominen T, Härkönen E, Kukkurainen ML, Doran D. Effects of organizational change on work-related empowerment, employee satisfaction, and motivation. Nurs Adm Q. 2009;33(2):116-124. 18. Mone E, Eisinger C, Guggenheim K, et al. Performance management at the wheel: driving employee engagement in organizations. J Bus Psychol. 2011;26(2):205-212. 19. Newcomb P, Smith A, Webb P. Relationship of nurse job satisfaction to implementation of a nursing professional practice model. Southern Online Journal of Nursing Research. http://www.resourcenter.net/ images/SNRS/Files/SOJNR_articles2/Vol09Num03Art11.pdf. National Sales Representatives Debra Dunn is the Perioperative Nurse Director at East Orange General Hospital, East Orange, N.J. The author has disclosed that she has no financial relationships related to this article. DOI-10.1097/01.ORN.0000460902.65598.e0 www.ORNurseJournal.com Product Advertising: Heather Landesman, 646-674-6515; e-mail: Heather.Landesman@wolterskluwer.com Careers and Events Advertising: Linda Barta, 800-237-1342; e-mail: Linda.Barta@wolterskluwer.com March OR Nurse 2015 Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. 47