Speech motivation for nursing work. Modern approaches to motivating nursing staff. List of used literature

1, 2 Levina V.A. 12 E. V. Kuznetsova 12 Lunkova O.A. 12

1 NGOU VPO "Saratov branch of the Samara Medical Institute" REAVIZ "

2 GOU SPO "Engels Medical College", Engels

As a result of theoretical and practical research based on the analysis of various theories for the study of motivation, it can be concluded that the motivational sphere of a person is very complex and heterogeneous. With the knowledge of motivational factors that are highly valued by employees, nursing team leaders can think of and build a reward and incentive system that meets the requirements of efficiency. As can be seen from the study, even if the employees are satisfied with the working conditions, it is possible to single out a number of points on the basis of a qualitative analysis of individual questionnaires, which will allow the manager to improve the efficiency of his management. So, the scope of application of knowledge on motivation is very extensive. And the result from the practical application of this knowledge is really huge in various fields of activity, including healthcare.

nurse

motivation

1. Alekseeva O.D., Solovieva A.V. The role of the head of the nursing service in creating the "motivational" environment of the institution // Medical sister. - 2008. - No. 4.

2. Antipova IN, Shlykova IN, Matveeva EV. Motivation management labor activity medical nurses // Chief nurse. - 2010. - No. 6.

3. Aseev V.G. Behavior motivation and personality formation. - M., 1976.

4. Bodalev A.A. Motivation and personality. Collection scientific papers... - M .: Publishing house of APN USSR, 1982.

5. Vilyunas V.K. Psychological mechanisms of human motivation. - M., 1990.

6. S.I. Management in nursing... - Rostov n / a .: Phoenix, 2006.

7. Dessler G. Personnel Management. - M., 1997.

8. Zagorodnova G.A., Pavlov Yu.I. Characteristics of job satisfaction and production motivation of nurses // Main nurse. - 2008. - No. 3.

Motivation is a complex psychological phenomenon that causes a lot of controversy among psychologists who adhere to various psychological concepts. One of the simplest and most common definitions of motivation: motive is the intrinsic value of the activity being performed. In the most approximate sense, such a definition reflects the internal state of a person, however, it should be noted that the forces that induce action are outside and inside a person and force him to consciously or unconsciously perform some actions. At the same time, the connection between individual forces and human actions is mediated by a very complex system of interactions, as a result of which different people can react in completely different ways to the same influences from the same forces.

Based on this, it can be assumed that the process of human motivation is subject to both internal and external determination. Hence the concept of motivation stands out. Motivation is the process of influencing a person in order to induce him to certain actions by awakening certain motives in him.

Purpose of the work: to determine the practical application of psychological knowledge about motivation in the management of nursing staff in health care facilities.

In order to identify the factors of motivation of the nurses of the urological department, we conducted a survey of the nurses of the department. 20 respondents took part in the survey. During the survey, the Martin-Ritchie test "Motivational profile" was used, aimed at identifying the needs and aspirations of each employee, and, thus, to get some idea of \u200b\u200bhis motivational factors. The authors identified 12 needs as such.

High wages and material rewards.

IN good conditions work and a comfortable environment.

In a clear structuring of work, the presence of feedback and information that allows you to judge the results of your work; the need to reduce uncertainty and establish rules and guidelines.

In social contacts; in the formation and maintenance of long-term stable relationships with a small number of colleagues, while the degree of closeness of relationships, trust is important.

The need for more free time.

In gaining recognition from others, in making others appreciate the merits, achievements and successes of the individual.

In setting challenging goals and achieving them.

In influence and power, the desire to lead others; persistent pursuit of competition and influence.

In variety, change and stimulation; in an effort to avoid routine.

In creativity; desire to be an analytic, thinking worker, open to new ideas.

Improvement, growth and development as a person.

In a sense of being in demand, in an interesting job filled with meaning and meaning with an element of social utility.

The test is based on the comparison of the significance of a number of motivational factors that are important from the point of view of personnel management. Conducting local research in an organization allows us to conclude that certain motivating factors prevail and thus creates a picture of the motivational environment.

The data we have obtained allow us to characterize the motivational environment as follows: high and stable earnings, the ability to work in good conditions, the need for management and colleagues to recognize their merits, achievements and successes are important and valuable for employees (Fig. 1). Among the factors, the stimulation of which will be considered ineffective, employees noted the need for socially useful work, in maintaining and forming long-term relationships with a small circle of colleagues, as well as the need for power, in a clear structuring of work, and the manifestation of a creative non-standard approach (Fig. 2).

Figure: 1. Motivational factors highly rated by employees

With this data in hand, the head nurse can think of and build a reward and incentive system that meets the requirements of efficiency. The presence of non-dominant factors may indicate either sufficient satisfaction in this regard, or a lack of interest in this factor. Meeting the dominant needs will enhance the efficiency and quality of work.

Based on the foregoing, the urology department has a high potential for enhancing the work of nurses. These are incentive payments due to established bonuses for work performance, taking into account quality criteria.

For our research, we used the Job Satisfaction Test. This is a standard test used to study the factors that influence motivation, and allows you to identify parameters that are satisfactory or not satisfactory to the employees of the organization with the working conditions, the organization of leadership and relations in the work team.

Figure: 2. Non-dominant motivational factors

This test contains 14 statements, each statement can be rated from 1 to 5 points. When assessing the satisfaction with the work of the labor collective, the average values \u200b\u200bof the indicators are used. In this case, the results are assessed according to the following scale:

15-20 points are quite satisfied with the job

21-32 points satisfied

33-44 points not quite satisfied

45-60 points are not satisfied

over 60 points extremely dissatisfied

The following instructions were offered to the respondents:

Make your choice for each of these statements by ticking the corresponding number.

1 - quite satisfied;

2 - satisfied;

3 - not completely satisfied;

4 - not satisfied;

5 - extremely dissatisfied.

	Statement
	Your satisfaction with the business where you work
	Your satisfaction with your physical conditions (heat, cold, noise, etc.)
	Your job satisfaction
	Your satisfaction with the teamwork
	Your satisfaction with your boss's leadership style
	Your satisfaction with your boss's professional competence
	Your salary satisfaction in terms of being in line with your workload
	Your satisfaction with your salary versus how much is paid for the same job in other enterprises
	Your satisfaction with career (professional) promotion
	Your satisfaction with your promotion opportunities
	Your satisfaction with how you can use your experience and abilities in your work
	Your satisfaction with the human intelligence requirements of your job
	Your satisfaction with the length of your working day
	To what extent would your job satisfaction affect your decision if you were currently looking for a job?

11 nurses took part in the testing. It should be noted that 7 nurses were absent at the time of the survey (vacation, sick leave, etc.) and one person refused to take part in the survey, explaining his refusal by the fact that nothing would change from his answers. The structure of the admission department includes a trauma center. The emergency room nurses were questioned along with the emergency department nurses. Therefore, the test result can be attributed to everything structural unit... But immediately I would like to note the fact that those nurses who took part in the ongoing study took the proposed task seriously. They listened attentively to the instructions, and with enthusiasm and thoughtfulness set about the task. This can serve as an indicator of the significance of the test results for them, as an opportunity to express their opinion on these issues. For us, this can serve as an indicator of the importance of conducting this kind of research.

In the course of the study, we obtained the following result: the average value obtained by dividing the sum of the results for each individual questionnaire by the number of survey participants is 24.5 points, which corresponds to the “satisfied” indicator on the test scale. Thus, on the whole, the team is satisfied with the conditions and characteristics of work at this enterprise and specifically in the admission department (Fig. 3).

But we were able to see the full picture only by conducting a qualitative analysis of the results obtained. It should be noted that against the background of general satisfaction with the job as a whole, there is a differentiation of the results according to individual questionnaires.

So, one person is completely satisfied with all parameters of labor activity, that is, each proposed statement, he assessed at 1 point - "quite satisfied"; four more people rated each statement either as 1 point or 2 points - “satisfied”, that is, they are also satisfied with the conditions that the organization offers them.

In the questionnaires of the rest of the research participants, a negative assessment of working conditions appears.

For three employees, this dissatisfaction manifests itself only once, that is, they rate any parameter at 3 points - “not completely satisfied”. Moreover, these parameters are not related for these survey participants. So, one of them is not satisfied with the length of the working day at the enterprise, the other - the wages, in comparison with other organizations, and the third is not fully satisfied with the requirements of work for human intelligence. But in general, according to the sum of points (24.25 and 26) obtained as a result of processing the questionnaires of these employees, they belong to the category of employees who are satisfied with the work, that is, we can combine them into the previous group.

Thus, three more questionnaires remain in our field of vision. Immediately we will make a reservation that two of them have total points (27 and 31), corresponding on the key scale to the indicator "satisfied", but since many statements are assessed as not quite satisfactory, we will consider them in more detail together with the questionnaire, the result of which the sum of points (34) corresponds to the indicator “not quite satisfied”.

The first of the employees (27 points) is not completely satisfied with the coherence of the actions of the employees and those parameters that characterize the possibility of using their potential and the possibility of promotion. The second and third employees (31 and 34 points) are also not satisfied with their career advancement and their opportunities for promotion, and one of them is not completely satisfied with the length of the working day and is not satisfied wages compared to other organizations, the other is not satisfied with the work at all.

Thus, we can conclude that, along with nurses who are satisfied with their work, there are employees who are not completely satisfied with some parameters of work, although in general they are satisfied with the work, and also one employee is not completely satisfied with the work in general and is not satisfied with some of its parameters. Moreover, it is interesting to note that all of them are not satisfied with, in general, the possibility of promotion. Although in two of them, dissatisfaction with the content of the work prevails (satisfaction with the job, the use of their experience and abilities), in one employee, against the background of the same dissatisfaction with career advancement, external motivating factors clearly prevail (length of the working day, wages).

So, we can conclude that even with general satisfaction with the work of the entire team, on the basis of a qualitative analysis of the survey results, it is possible to see a number of features of the motivation of individual employees and, with the help of correctly selected management techniques, increase the efficiency of each employee in order to optimize the work of the entire health facility. So, in our case, for two employees the greatest motivating start will have the opportunities provided for realizing their potential, recognition of their labor contribution and praise for responsible work, as well as the opportunity to see the prospect of development, advancement in the future (this should not be understood as an immediate increase, but putting their candidacy on the reserve list will serve as a powerful impetus for work, while not obliging the administration to anything). In contrast to the previous example, for an employee oriented to external incentives, external incentives (bonuses, benefits, time off, etc.) will serve as a strong motivational factor, respectively.

Figure: 3. Satisfaction with the work of the admissions nurses

Personnel motivation is an important component in personnel management, as well as a direct way to improve the quality of nursing care with the skillful use of knowledge of the structure of motivation and their application in practice.

The art of management is to clearly understand the needs of a person and create the necessary conditions for their satisfaction.

Conclusion

As a result of our theoretical and practical research based on the analysis of various theories for the study of motivation, we can conclude that the motivational sphere of a person is very complex and heterogeneous.

In modern psychology, there are currently many different theories, the approaches of which to the study of the problem of motivation are so different that sometimes they can be called diametrically opposite.

When studying various theories of motivation, when determining the mechanism and structure motivational sphere we came to the conclusion that indeed human motivation is a complex system based on both biological and social elements, therefore, it is necessary to approach the study of human motivation, taking into account this circumstance.

It is also important to note the importance of knowledge about motivation in the management activities of the management of an organization interested in increasing the productivity of its employees, their full return to the enterprise. Understanding and applying in practice the system of motivating one's employees will lead not only to an overall increase in the efficiency of the organization, but also to satisfaction with the work of the employees themselves, and an improvement in the psychological climate. And, as a consequence, again, an increase in the productivity of the organization itself. A competent leader must be clear that not all employees are motivated equally. Therefore, he must accurately recognize the current motives of each of his employees and try, whenever possible, to satisfy the needs of each.

With the knowledge of motivational factors that are highly valued by employees, nursing team leaders can think of and build a reward and incentive system that meets the requirements of efficiency.

As can be seen from our research, even if the employees are satisfied with the working conditions, it is possible to single out a number of points based on a qualitative analysis of individual questionnaires, which will allow the manager to improve the efficiency of his management.

So, the scope of application of knowledge on motivation is very extensive, and the result from the practical application of this knowledge is really huge in various fields of activity, including healthcare.

Reviewers:

Andrianova E.A., Doctor of Social Sciences, Professor, Head. Department of Philosophy, Humanities and Psychology GOU VPO "Saratov State Medical University named after V.I. Razumovsky Ministry of Health and Social Development of the Russian Federation ", Saratov;

Novokreschenova I.G., MD, DSc, Associate Professor, Head. Department of Economics and Management of Healthcare and Pharmacy, GOU VPO Saratov State Medical University named after V.I. Razumovsky Ministry of Health and Social Development of the Russian Federation ", Saratov.

The work was received on 02.02.2012.

Bibliographic reference

Maslyakov V.V., Maslyakov V.V., Levina V.A., Levina V.A., Kuznetsova E.V., Kuznetsova E.V., Lunkova O.A., Lunkova O.A. MOTIVATION IN THE MEDICAL NURSES // Fundamental research. - 2012. - No. 3-2. - S. 352-357;
URL: http://fundamental-research.ru/ru/article/view?id\u003d29607 (date of access: 04/01/2020). We bring to your attention the journals published by the "Academy of Natural Sciences"

Description

The purpose of the study is to analyze the factors of motivating the work of nursing staff at a health center.
1. Consider and systematize the theoretical foundations of the study of motivational orientation in work.
2. Summarize information about the motivational orientation of medical workers.

INTRODUCTION ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 4
1. THE CONCEPT OF LABOR SATISFACTION AND INCREASING THE PRODUCTION MOTIVATION OF NURSES. ... ... 7
1.1 Problems of labor motivation in medicine. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 7
1.2 Concept and essence of personnel motivation. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... eleven
1.3 Basic theories of motivation ……………… .................................. 17
1.4 Factors of motivation for work of nurses in health care facilities and the main directions of its increase ……………………………. ... ... ... ... ... ... ... ... ... ... ... ... 26
1.5 Methods of measuring and indicators of satisfaction with the work of nurses ................................................................................. 32
2. CHARACTERISTICS OF THE HEALTHCARE

2.1 Management structure of the health center
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
2.2 Analysis of the performance indicators of the health center. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... …………… 40
2.3 Analysis of the personnel potential of the health center. ... ... ... ... ... ... ... ... 41
3. WAYS OF RESEARCHING WORK SATISFACTION AND INCREASING PRODUCTION MOTIVATION OF NURSES. ... ... …………………………………………………………………… ... 42
CONCLUSION. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
LIST OF USED LITERATURE. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
ANNEXES

The work consists of 1 file

Federal Agency for Healthcare and Social Development

Extramural

Specialty 060108-Nursing

Department of Nursing

COURSE WORK ON MANAGEMENT

NURSING STAFF MOTIVATION

IN A MEDICAL INSTITUTION

candidate of Medical Sciences, Associate Professor of the Department of Nursing

INTRODUCTION ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
1. THE CONCEPT OF LABOR SATISFACTION AND INCREASING THE PRODUCTION MOTIVATION OF NURSES. ... ...
	Problems of labor motivation in medicine. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
	The concept and essence of staff motivation. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
	Basic theories of motivation ……………… ........................ ..........
	Factors of motivation for work of nurses in health care facilities and the main directions of its increase ……………………………. ... ... ... ... ... ... ... ... ... ... ... ...
	Methods of measuring and indicators of satisfaction with the work of nurses ...................................................
2. CHARACTERISTICS OF THE HEALTHCARE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
	Management structure of the health center . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
	Analysis of the performance indicators of the health center. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ……………
	Analysis of the personnel potential of the health center. ... ... ... ... ... ... ... ...
3. WAYS OF RESEARCH SATISFIED WITH LABOR AND INCREASING PRODUCTION MOTIVATION OF NURSES. ... ... …………………………………………………………………… ...
CONCLUSION. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
LIST OF USED LITERATURE. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...
ANNEXES

DEFINITIONS AND ABBREVIATIONS

Motivation	- motivation of a person to activity, which is determined by the presence of needs and the creation of conditions for their implementation and obtaining a result.
	- the incentive reasons for the behavior and actions of a person, arising under the influence of his needs and interests and representing the image of a person's desired good, which satisfies the needs, provided that certain labor actions are performed.
Labor motivation (labor motivation)	- this is the desire of the employee to satisfy the needs (to receive certain benefits) through work
	- medical and preventive institution
	Public corporation

INTRODUCTION

The stability of the workforce is one of the conditions for the effective work of any company, and the struggle for low staff turnover is a problem that is especially relevant for such areas as healthcare and pedagogy. To solve it, you need to be able to predict the situation, learn to manage the process of staff turnover. And one of the first steps here can be research showing how satisfied employees are with their jobs. Satisfaction is often understood to mean retention of an employee in the enterprise.
Problems of increasing labor motivation of medical workers are the most important function of healthcare management. Without their solution, it is hardly possible to realistically improve the quality and culture of providing medical care to the population, as well as to increase the efficiency of the activities of medical and preventive institutions (LPI) and the industry as a whole based on the rational use of financial, material and human resources. It has now been proven that money does not always encourage a person to work harder (although no one belittles the role of material incentives!). The problems of increasing labor motivation are systemic in nature and require an integrated approach to their solution.

The relevance of the study lies in the fact that by studying satisfaction, one can obtain information about the strength of the staff's attachment to the enterprise. Here it is appropriate to talk about both material and moral incentives for employees. Employee satisfaction data is information about personnel risks. It is important for any leader who does not want to be hostage to the current situation. The problems of staff motivation and incentives are widely considered today in scientific and journalistic literature. However, attempts to adapt classical theories of motivation to the present are largely not systematized, which complicates the practical use of technologies and methods of motivation. The complexity of the practical organization of the personnel motivation system is also determined by the poor knowledge of the features of the motivation of workers employed in certain sectors of the economy and types of production. It is quite obvious that in different fields of activity there is a professional specificity of motivation. The urgency of the problem is also due to the rigidity of the management system itself in health care, which has retained in many ways the features of management characteristic of the socialist planned system and did not fit into modern market conditions. In most health care institutions, the possibilities for material stimulation of labor are limited by a shortage of funds, therefore, special attention should be paid to the means of non-material motivation of nurses. Taking into account the limited material resources of health care, an effective and adequate value orientation of the personnel of a particular medical institution, an intangible form of motivation, is of particular relevance. As the material and technical base of health care is strengthened, the issues of personnel management in its not material, but socio-psychological aspect will increasingly come up before the heads of medical and preventive institutions. Increasing the labor motivation of nurses is an urgent problem, the importance of which is especially high in connection with the reform of health care and the implementation of the National Health Project. Leaders must clearly understand the importance of motivation as a management function and use every opportunity to reduce demotivating factors for nurses.

The hypothesis of the study is that among managers of different levels, as, indeed, among ordinary employees, there is a fairly widespread opinion that the efficiency and quality of work, other things being equal, are proportional to the amount of remuneration. However, it is clear that high salaries are not a guarantee of protection against corruption and simple negligence at work at all levels. As it turned out, motivation (that is, the process of motivation to act to meet personal needs and achieve the goals of the organization) is the result of the influence of a complex set of factors. Priority factors of motivation include wages, working conditions, stability, professional growth, social significance of work, interest in work, etc.

The imperfection of the existing system of motivation for the work of medical workers, in particular nurses, the small number of publications devoted to motivation in health care institutions, served as a reason for the study.

The aim of the study is to analyze the factors of motivation for the work of nursing staff at a health center.

Consider and systematize the theoretical foundations of the study of motivational orientation in work.
Summarize information about the motivational orientation of medical workers.
Describe and assess the personnel potential of the health center Prepare a questionnaire for the study of job satisfaction

The object of the study is the nurses of the medical institution.

The subject of the research is the peculiarities of the motivational orientation of nurses.

When conducting this study, research methods were used:

Analytical (analysis of the received data)

Sociological (questionnaire)

Statistical (data from reporting documents)

CHAPTER 1. DEFINITION OF WORK SATISFACTION AND INCREASING PRODUCTION MOTIVATION OF NURSES.

1.1. Problems of labor motivation in medicine.

Increasing the labor motivation of personnel is one of the priority tasks of management in any area of \u200b\u200bactivity. The solution of this problem in the healthcare sector is of particular importance in connection with the tasks set in the "Concept for the development of the healthcare system in the Russian Federation until 2020" ...

Nursing is an integral part of the health care system aimed at solving the problems of individual and public health of the population in a changing environment environment... Nursing includes activities to promote health, prevent disease, provide psychosocial assistance and care to people with physical and / or mental illness, as well as those with disabilities of all age groups. According to the Central Research Institute of Organization and Informatization of Health Care, in 2010 the number of nurses in the Russian Federation was 1,327.8 thousand people. Nursing is part of the health care system, which has significant human resources and real potential opportunities to meet the needs of the population in quality and affordable medical care.

Despite the tasks set for health care, at present, in the development of nursing, some trends continue to exist that negatively affect the state of work motivation of nurses.

One of the main reasons influencing the labor motivation of personnel is the level of material remuneration for work and a sense of the fairness of this remuneration. For workers with extrinsic motivation, this factor can be of decisive importance not only as a supporting and regulating factor of motivation, but often play a decisive role in deciding whether to continue working in a particular organization and in medicine in principle. For internally motivated workers, other factors are undoubtedly more important, but low wages makes them feel significant dissatisfaction too.

An overwhelming number of both patients and doctors underestimate the contribution of a nurse to the treatment and diagnostic process; doctors do not know how and are not focused on building equal partnerships with nurses, do not recognize higher nursing education, and even more so, the increased level of secondary vocational education of nurses. Historically, the idea of \u200b\u200ba nurse as a doctor's assistant, his "right hand", an appendage has developed. “[The nurse] should begin her work with a thought firmly embedded in her head, the thought that she is just a tool with which the doctor carries out his instructions; it does not take an independent position in the treatment of a sick person ”(McGregor-Robertson, 1904).

Despite a whole century that separates us from this statement, at present such a mentality has changed little in what. Many doctors directly or indirectly express their superiority, admit incorrectness in relation to nursing staff, all this is a factor that significantly reduces the desire to work.

A high degree of physical and psychological stress on nurses, underdevelopment of copping strategies, as well as a number of organizational factors contribute to the rapid development of professional burnout syndrome, which, according to various authors, affects 40 to 95% of paramedical workers. The burnout of health workers significantly deforms the system of personal value orientations, emphasizing material values \u200b\u200bto the detriment of spiritual values, and shifts the motivation of labor from internal to external.

Low wages provoke informal sources of income, with the help of which workers try to satisfy not only the need for fair material remuneration for work, but also the need for recognition and respect. It is she who is one of the leading in the structure of labor motivation of internally motivated workers, which are often doctors. The recognition deficit is compensated for by replacing it with a cash equivalent and material symbols, with an obvious lack of the ability to do this with the help of wages, there is a shift in emphasis to unofficial sources. Although it should be noted that we are talking more about doctors; paramedical workers are much less able to use informal means of remuneration. Moreover, it is the lesser opportunities, but no less desire. In this situation, nurses experience a growing sense of injustice, which entails dissociation of the doctor-nurse tandem, affecting the quality of treatment and reducing the work motivation of the latter. But in this situation, the problem of deformation of the value-motivational system of medical workers is of particular importance. Behind the visible side of this problem lies another one: informal payments are beginning to be recognized as a significant incentive for nurses to work better, and students to choose a medical profession, i.e. is included in the system of labor motivation. The collection of unofficial payments, in addition to the legal aspect of the problem, fundamentally contradicts the principles of biomedical ethics, discredits the public health care system, negatively affects the quality of medical care and the prestige of the medical profession.

Opportunities for self-improvement and training of nurses remain very limited: compulsory advanced training is carried out once every 5 years, opportunities for exchange of experience between the average staff of various medical institutions are not used enough, methods of intra-organizational training are little used: horizontal rotation of personnel, "school of a young nurse" other forms of education. Meanwhile, the fulfillment of the need for training and development, on the one hand, and the participation of the nurses themselves in teaching activities, on the other hand, have a powerful motivational potential for a significant part of employees.

One of the main health problems is the lag of the material and technical base of medical institutions from modern requirements. In addition to the surface problem of the quality of medical care, this leads to a decrease in the prestige of the profession. nurse, to insufficient use of the motivational potential of the need for self-improvement. In the "Concept for the development of the health care system in Russian Federation until 2020 " one of the priority tasks is the development of "infrastructure and resource provision of health care, including financial, material, technical and technological equipment of medical institutions based on innovative approaches and the principle of standardization", which is designed not only to improve the quality of medical care, but also to promote the development labor motivation of personnel.

The personnel management system needs improvement. Currently, there is practically no hierarchy in the nursing organization system. Capabilities career growth very limited: nurse, elder sister, head nurse. Only in some health care institutions such positions as specialist in nursing personnel training, specialist in quality control of nursing activities appear. For example, there are no positions such as foreman or shift supervisor, nurse mentor. The introduction of a number of such positions could serve the career aspirations of some nurses and a more differentiated approach to the issue of remuneration.

The prestige of the profession of a nurse, as noted earlier, plays a significant role in the structure of work motivation for nurses. Most of the above reasons are directly or indirectly related to the position that this profession occupies in society. It is not so easy to raise the prestige of the profession, and it is common task not only the health care system, but also the cultural state of the whole society, the hierarchy of social values. The labor motives and values \u200b\u200bof the Western model, introduced into the mass consciousness of Russians from the outside, do not correspond to the model of attitudes towards labor that was formed over the centuries-old history of Russia on the basis of internal prerequisites and requirements of economic development. A decline in the general cultural level of the population, of which nurses are a part, leads to the primitivization of needs, underdevelopment of the motivational sphere. There is no widespread propaganda of the public importance of the nursing profession at all levels. Insufficient attention in health care institutions is paid to the development and maintenance of the culture of the organization, in particular, the popularization of the mission of the institution, the formation of loyalty and commitment to the organization of personnel, and other specific aspects of the formation of organizational culture. Increasing the labor motivation of nurses is an urgent problem, the importance of which is especially high in connection with the reform of health care and the implementation of the National Health Project.

The paper provides a theoretical analysis of approaches to understanding labor motivation, identifies external and internal factorsinfluencing its decrease and increase. Based on the analysis of the model of a specialist nurses (professiogram, psychogram, job descriptions), the specificity of their professional activity, which consists in increased responsibility for the life and health of people, which leads to psychophysiological stress of the nursing staff. Based on the results of an empirical study, the relationship between the motivation of the professional activity of nurses and their mental state was revealed. It was concluded that the most favorable mental states are characteristic of nurses with an optimal motivational complex, while nurses with an undesirable motivational complex were found to have such unfavorable mental states as a high level of anxiety and rigidity. Correlation analysis according to Spearman between indicators of motivation for professional activity and manifestations of mental states showed that with an increase in intrinsic motivation and motivation for the social significance of work in nurses, the level of frustration, rigidity and anxiety decreases. That is, the more (less) nurses are aware of the social significance of their work, the less (more) they experience internal stress and anxiety.

labor motivation

motivational personality complex

mental states

psychogram

anxiety level

frustration

rigidity

the specifics of the professional activity of nurses

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The relevance of this problem is due to the fact that labor motivation of personnel is a key area personnel policy any organization, and in the healthcare system, nursing personnel are the most significant part of labor resources... The work of nurses is associated not only with great physical exertion, but also with great emotional stress. The latter occurs when communicating with patients who are distinguished by increased irritability, painful exactingness, resentment, etc. All this leads to the fact that nurses experience internal stress, which leads to frustration, anxiety, and poor health. On the other hand, high motivation of nurses contributes to the emergence of positive mental states, which prevents the development of professional burnout, psychosomatic diseases, and also increases the effectiveness of treatment procedures. In this regard, it becomes important to study the social and psychological factors that provoke a decrease in motivation for professional activity in nurses, as well as to find mechanisms that increase their motivation to work, which leads to the manifestation of positive mental states.

The aim of our study was to identify the specifics of motivation for professional activity in nurses, as well as the relationship between motivation to work and manifestations of mental states. The subject of our research was the mental states of nurses (the level of aggressiveness, anxiety, frustration and rigidity) with different motives of professional activity.

The theoretical and methodological basis of the study was formed by scientific approaches to the study of work motivation (G. S. Abramova, T. G. Butenko, E. A. Klimov, A. N. Leontiev, S. L. Rubinstein, V. D. Shadrikov, S. Adams, F. Herzberg, E. Locke, D. McClelland, A. Maslow and others); theoretical and empirical studies of professional activity and psychological characteristics of nursing staff (N.N. Aniskina, E.M. Avanesyants, L.A. Korchinsky, A.F. Krasnov, A.N. Semenkov, B.A. Yasko, A. A. Chazova); research on the study of mental states of the individual (V.A.Ganzen, A.O. Prokhorov, V.N. Yurchenko and others), research on the professional study of professions (S.G. Gellershtein, E.F. Zeer, A. K. Markov and others).

The positions of specialists on the problem of mental states and the corresponding definitions can be reduced to one of three directions. Within the framework of the first direction, the mental state is considered as a set of indicators of the human mental sphere that characterize the personality at a given time (ND Levitov). Other authors consider the mental state as the background against which mental activity unfolds, the level and direction of the mental activity of the individual (S. L. Rubinstein, V. D. Nebylitsyn, T. A. Nemchin). In the third direction, the authors consider the mental state as a systemic reaction of the human psyche to changes in conditions (E.P. Ilyin). However, despite the variety of approaches to the definition of mental states, most authors understand them as integral characteristics of mental activity over a certain period of time. Based on the classification of mental states, we will refer to the negative mental states of nursing personnel as special forms of states such as stress, anxiety, frustration, tension, etc.

With all the variety of approaches to understanding work motivation, the literature distinguishes two groups of motivation theories: content and process. Substantial theories of motivation are based on the identification of those internal motivations (called needs) that make people act in a certain way (F. Herzberg, A. Maslow, D. McClelland, etc.). Process theories of motivation are based primarily on how people behave, taking into account their perception and life experience (B. Skinner, A. Bandura, V. Vroom, S. Adams). Moreover, most authors understand labor motivation as a combination of internal and external driving forces, encouraging a person to work and giving this activity an orientation focused on achieving certain goals. Following AI Zelichenko and AG Shmelev, we will distinguish between external and internal factors of motivation to work. The first are divided into factors of pressure, attraction - repulsion and inertia. The latter arise from the process and working conditions, as well as from the possibilities for human self-development. Hence, it follows that the positive motivation of the personnel, especially in such a field of activity as healthcare, largely contributes to an increase in the favorable psychological background of the interaction between the medical professional and the patient, influencing the effectiveness of the application of medical procedures.

Based on the analysis of the model of a specialist of nurses (professiogram, psychogram, job descriptions), we described the specifics of their professional activity, which is accompanied by increased responsibility for the life and health of people, physical activity (work in night shifts, in constant movement); violation of the social need for aesthetic sensations in the perception of another person (age and physical characteristics of the patient). All this leads to psycho-emotional stress, combined with responsibility in making decisions in various extreme situations. Therefore, a nurse needs to possess not only professional skills, organizational skills, but also mental stability, interest in work. In other words, motivation to work stimulates nurses to perform their duties efficiently, which, in turn, leads to the achievement of the assigned tasks, and, consequently, to the manifestation of positive mental states. If nurses are in a state of well-being, balance, then they project these same feelings onto the outside world, including colleagues and patients.

In order to identify the specifics of motivation for professional activity in nurses, as well as the relationship between motivation to work and manifestations of mental states, we conducted an empirical study in which 50 nurses of the City Clinical Hospital took part, working in the following departments: neurological, rheumatological , maxillofacial surgical, therapeutic and anesthetic and resuscitation. Age - from 22 to 63 years, medical experience - from 1 to 40 years.

Analyzing the results of the methodology for studying the motivation of professional activity (K. Zamfir), the motivational complex of the personality of nurses was identified. This complex is a type of relationship between three types of motivation: internal motivation (IM), external positive (VPM) and external negative (PTO). Based on this methodology, it was concluded that the majority of nurses have an intermediate motivational complex (66%), that is, their own satisfaction from work is most important for them, and incentives are less important. For nurses with an undesirable motivational complex (14%), external negative stimuli in the form of punishments and possible troubles acquire the greatest importance. For subjects with an optimal motivational complex (20%), internal stimuli have a greater influence than external ones, which has a positive effect on the quality of work and on the mental state. It was also revealed that external negative motivation is of the greatest importance in the professional activity of nurses. This indicates that such external negative factors as the fear of being reprimanded and making mistakes have a great negative effect on the employee's mental state, causing anxiety. To a lesser extent, external positive stimuli in the form of rewards, high salaries, etc., are exerted on the activities of nurses. This suggests that for nurses, it is less important to perform activities for her own sake, therefore, interest in work, self-confidence decreases, professional activity causes negative mental states.

Based on the results of the methodology for the study of the leading motives of professional activity (L. A. Vereshchagina), we can conclude that the most important for nurses are motives of self-affirmation in work, the implementation of which in this profession is difficult (Fig. 1). Less important are the motives of the social significance of labor, that is, the awareness of the social usefulness of their activities. The least important for nurses are the motives of the process of work and skill. Perhaps this is due to the fact that the labor process is accompanied by psychophysiological stress, and mastery is achieved rather quickly.

Figure: 1. Dominant motives of nursing work (L.A. Vereshchagina)

Analysis of the results of the methodology for measuring the level of anxiety (J. Taylor) made it possible to find out that more than half of the nurses (66%) have a low and medium-low level of anxiety, that is, most are indifferent to others. One third (34%) of the subjects have a medium-high level of anxiety, that is, the state of anxiety depends on the circumstances.

The method of diagnosing self-assessment of mental states (G. Eysenck) made it possible to determine the following: in almost one third (34%) of nurses, anxiety is at a low level, which can manifest itself as indifference to their work. The absence of a high level of anxiety indicates that nurses do not experience feelings of helplessness, hopelessness and excessive anxiety, which, in turn, has a beneficial effect on professional activities related to the provision of emergency first aid. The level of frustration in half of the subjects is at a low level (48%), that is, they are able to overcome unforeseen difficulties. A small number of nurses have a high level of frustration (10%), that is, they worry about possible failures. Almost half of the subjects (48%) showed an average level of aggressiveness, which indicates that they can protect themselves in case of danger. A third of the nurses (32%) have a low level of aggressiveness, that is, they are apathetic. A small number of subjects (10%) have a high level of aggressiveness, which manifests itself in the form of difficulties in communicating with colleagues and patients.

The majority of nurses (72%) have an average level of rigidity, which indicates stability of attitudes and judgments, which can change depending on the situation. A small number of subjects showed high and low levels of rigidity (12% and 16%). With high rigidity, it is difficult for a person to change beliefs, views, that is, it is difficult for these nurses to adapt to changing conditions of life, which, in turn, causes anxiety, negative mental states, etc. Nurses with low rigidity are easier to switch mental processes, they adapt faster to new circumstances, which is beneficial for work.

A comparative analysis of the above methods showed that in the group of nurses with an undesirable motivational complex (when external circumstances have a greater influence than internal stimuli), the motive of self-affirmation in work is of paramount importance (30%), the motive is less significant professional excellence (26%), even less important are the motives of labor itself (22%) and the social significance of labor (22%). That is, among nurses who seek to avoid punishment, failures, the desire to obtain a high social status prevails. In Russia, the implementation of this motive for nurses is difficult.

Feeling frustrated by nurses also depends on the motivation for work. So, nurses with an undesirable motivational complex have a high level of frustration, which indicates an acute experience of emerging troubles. In the group of nurses with an optimal motivational complex, the majority (80%) easily cope with unforeseen difficulties (Fig. 2).

We see a similar picture with regard to aggressiveness. The majority of nurses (70%) with an undesirable motivational complex have a low level of aggressiveness, that is, they are passive. In the group of subjects with an intermediate motivational complex, more than half (60%) with an average level of aggressiveness, that is, they show aggressiveness depending on the circumstances. Nurses with an optimal motivational complex did not have a high level of aggressiveness, the majority (80%) have an average level of aggressiveness, that is, they can defend themselves if necessary, do not show aggression towards others without reason.

Figure: 2. Correlation of the level of frustration (G. Eysenck) among nurses with different motivational complex in percentage

Correlation analysis according to Spearman between indicators of motivation for professional activity and manifestations of mental states showed that there are moderate connections between intrinsic motivation and frustration (rigidity) (r \u003d -0.33 and r \u003d -0.32), that is, with an increase in internal motivation, the level of frustration (rigidity) decreases and vice versa. That is, the higher the nurses' desire to achieve their own goals, the less they worry about the difficulties that arise and the faster they adapt to changing circumstances.

There is an inverse correlation between the motives of the social significance of work and the level of anxiety (r \u003d -0.33), which suggests that the more nurses realize the social significance of their work, the lower their state of anxiety and anxiety.

Thus, the following conclusions can be drawn:

- More than half of the nurses have an intermediate motivational complex corresponding to the specifics of the nursing profession, namely, an orientation towards strict fulfillment of appointments. The desire to act strictly according to instructions has a positive effect on the quality of work, but manifests itself in the form of negative mental states (the level of anxiety, frustration, aggressiveness and rigidity).

- For nurses with an undesirable motivational complex, motives for self-affirmation in work, the implementation of which is difficult, as well as a high level of frustration and a low level of aggressiveness (which leads to passivity) are of the greatest importance.

- For nurses with an average motivational complex, mental states are at an average level, the motive of self-affirmation is of paramount importance. Frustration, rigidity, aggressiveness, and anxiety are moderate.

- For nurses with an optimal motivational complex, the motive of the social significance of work is of the greatest importance. Frustration - low, aggressiveness, anxiety, rigidity - medium.

- There are moderate connections between intrinsic motivation and frustration, rigidity, that is, while striving to achieve their goals, nurses decrease anxiety about possible failures and improve their adaptability to changing circumstances and vice versa.

- There are moderate connections between the motive of the social significance of work and the level of anxiety, that is, the more nurses realize the social significance of their work, the lower their anxiety, and vice versa.

Reviewers:

Cheremisova I.V., Doctor of Psychology, Associate Professor, Head. Department of Psychology VolSU, Volgograd;

Chernov A. Yu., Doctor of Psychology, Associate Professor, Professor of the Department of Psychology of VolSU, Volgograd.

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Ovcharova E.V. FEATURES OF MOTIVATION OF THE PROFESSIONAL ACTIVITY OF NURSES AND ITS INFLUENCE ON THE MANIFESTATION OF MENTAL STATES // Contemporary problems science and education. - 2015. - No. 2-2 .;
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