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

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

1 NGO HPE "Saratov Branch of the Samara Medical Institute" REAVIZ "

2 GOU SPO "Engels Medical College", Engels

As a result of the theoretical and practical studies carried out, based on the analysis of various theories on the study of motivation, it can be concluded that the motivational sphere of a person is very complex and heterogeneous. With knowledge motivational factors, highly valued by employees, leaders of nursing teams can think over and build a system of encouragement and incentives that meets the requirements of efficiency. As can be seen from the study, even if there is employee satisfaction with the working conditions, it is possible to highlight a number of points based on a qualitative analysis of individual questionnaires that will allow the manager to increase the efficiency of his management. So, the scope of knowledge on motivation is very extensive. And the result from practical application This knowledge is really huge in various fields of activity, including in health care.

nurse

motivation

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

2. Antipova I.N., Shlykova I.N., Matveeva E.V. Motivation management labor activity nurses of health care facilities // Chief nurse. - 2010. - No. 6.

3. Aseev V.G. Motivation of behavior and personality formation. - M., 1976.

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

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

6. Dvoynikov 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 // Chief 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 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 impel to action are outside and inside a person and force him to consciously or unconsciously perform certain 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 completely differently to the same effects 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. This is where the concept of motivation comes in. Motivation is the process of influencing a person in order to induce him to certain actions by awakening certain motives in him.

The purpose of the work: to determine the practical application of psychological knowledge about motivation in the management of nursing staff in healthcare facilities.

In order to identify motivational factors for nurses of the urological department, we conducted a survey of the nurses of the department. 20 respondents took part in the survey. The survey used the Martin-Ritchie Motivational Profile test, aimed at identifying the needs and aspirations of each employee, and thus getting some idea of his motivational factors. As such, the authors identified 12 needs.

In high wages and material rewards.

V good conditions work and a comfortable environment.

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

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 winning 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 desire for competition and influence.

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

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

In improvement, growth and development as a person.

In the feeling of being in demand, in interesting work filled with meaning and significance with an element of social utility.

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

The data obtained by us allow us to characterize the motivational environment as follows: for employees, high and Fixed salary, the opportunity to work in good conditions, the need for recognition by management and colleagues of their merits, achievements and successes (Fig. 1). Among the factors, the stimulation of which will be considered ineffective, employees noted the need for socially useful work, for maintaining and shaping long term relationship with a small circle of colleagues, as well as the need for power, a clear structuring of work, the manifestation of creative non-standard approach(Fig. 2).

Rice. 1. Motivational factors highly valued by employees

With such data, the head nurse can think through and build a system of encouragement and incentives 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. Satisfying the dominant needs will help to improve the efficiency and quality of work.

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

For our study, we used the Job Satisfaction Test. This is a standard test used in the study of factors influencing motivation, and allows you to identify parameters that satisfy or dissatisfy employees of the organization with working conditions, management organization and relationships in the work team.

Rice. 2. Non-dominant motivational factors

This test contains 14 statements, each statement can be evaluated from 1 to 5 points. When evaluating job satisfaction labor collective average values are used. In this case, the results are evaluated according to the following scale:

15-20 points are quite satisfied with the work

21-32 points satisfied

33-44 points are not quite satisfied

45-60 points are not satisfied

over 60 points highly dissatisfied

The respondents were given the following instructions:

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

1 - quite satisfied;

2 - satisfied;

3 - not quite satisfied;

4 - not satisfied;

5 - extremely dissatisfied.

	Statement
	Your satisfaction with the company where you work
	Your satisfaction with physical conditions (heat, cold, noise, etc.)
	Your job satisfaction
	Your satisfaction with the coherence of the actions of employees
	Your satisfaction with your boss's leadership style
	Your satisfaction with the professional competence of your boss
	Your salary satisfaction in terms of matching with your labor costs
	Your satisfaction with your salary compared to how much other companies pay for the same job
	Your satisfaction with official (professional) promotion
	Your satisfaction with your promotion opportunities
	Your satisfaction with how you can use your experience and abilities in your job
	Your Satisfaction with Job Requirements to Human Intelligence
	Your satisfaction with the duration of the 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 interviewed along with the admissions department nurses. Therefore, the test result can be applied to everything structural unit. But I immediately wanted to note the fact that those nurses who took part in the study took the proposed task seriously. They carefully listened to the instructions, enthusiastically and thoughtfully began to complete 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. And 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, in general, the team is satisfied with the conditions and characteristics of work on this enterprise and specifically in the admissions department (Fig. 3).

But we could see the full picture only by conducting a qualitative analysis of the results. It should be noted that against the background of overall job satisfaction in general, there is a differentiation of results for individual questionnaires.

So, one person is completely satisfied with all the parameters of labor activity, that is, each proposed statement, he estimated at 1 point - “quite satisfied”; four more people rated each statement either at 1 point or at 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 study participants, a negative assessment of working conditions appears.

For three employees, this dissatisfaction is manifested only once, that is, they rate any parameter at 3 points - “not quite satisfied”. Moreover, these parameters are not related to these survey participants. So, one of them is not satisfied with the length of the working day at the enterprise, the other is not satisfied with the salary, in comparison with other organizations, and the third is not fully satisfied with the requirements of work to the human intellect. 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 their work, that is, we can combine them into the previous group.

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

The first of the employees (27 points) is not fully satisfied with the coherence of the actions of 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 dissatisfied with career advancement and opportunities for their advancement, and one of them is not completely satisfied with the length of the working day and is not satisfied salary compared to other organizations, the other is not satisfied with the work at all.

Thus, it can be concluded that along with nurses who are satisfied with their work, there are employees who are not completely satisfied with some parameters of work, although they are generally satisfied with their work, and also one employee is not completely satisfied with the work as a whole and is not satisfied with some of its parameters. Moreover, it is interesting to note that all of them are not satisfied, in general, with the possibility of promotion. Although two of them are dominated by dissatisfaction with the content of the work (job satisfaction, the use of their experience and abilities), one employee, against the background of the same dissatisfaction with promotion, clearly dominates external motivating factors (working hours, wages).

So, we can conclude that even with general satisfaction with the work of the entire team, based on a qualitative analysis of the results of the survey, it is possible to see a number of features of the motivation of individual employees and, with the help of properly 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 beginning will be the opportunities provided for realizing their potential, recognizing 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 to the work, while not obliging the administration to anything). Unlike the previous example, for an employee focused on external incentives, external incentives (bonuses, benefits, compensatory leave, etc.) will serve as a strong motivational factor, respectively.

Rice. 3. Satisfaction with the work of nurses in the admission department

Staff 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 motivation structure and their application in practice.

The art of management is to clearly represent human needs and create the necessary conditions to satisfy them.

Conclusion

As a result of our theoretical and practical research, based on the analysis of various theories on 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 opposed.

When studying various theories of motivation, when determining the mechanism and structure motivational sphere we came to the conclusion that human motivation is indeed a complex system, which is 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 management activities management of an organization interested in increasing the productivity of its employees, their full return at the enterprise. Understanding and putting into practice the system of motivation of your employees will lead not only to a general 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 result, again, an increase in the productivity of the organization itself. A competent leader must clearly know that not all employees are motivated equally. Therefore, he must accurately recognize the actual motives of each of his employees and try to meet the needs of each as far as possible.

With knowledge of the motivational factors that are highly valued by employees, leaders of nursing teams can think over and build a system of encouragement and incentives that meets the requirements of efficiency.

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

So, the scope 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, Saratov State Medical University named after V.I. Razumovsky Ministry of Health and Social Development of the Russian Federation, Saratov;

Novokreshenova I.G., Doctor of Medical Sciences, Associate Professor, Head. Department of Economics and Management of Health Care and Pharmacy, Saratov State Medical University named after V.I. Razumovsky of the Ministry of Health and Social Development of the Russian Federation, Saratov.

The work was received by the editors on February 2, 2012.

Bibliographic link

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 ENVIRONMENT OF NURSES // Basic Research. - 2012. - No. 3-2. - S. 352-357;
URL: http://fundamental-research.ru/ru/article/view?id=29607 (date of access: 01/04/2020). We bring to your attention the journals published by the publishing house "Academy of Natural History"

Description

The purpose of the study is to analyze the factors of motivation of the work of the nursing staff of the health center. Research objectives:
1. Consider and systematize theoretical basis studying the motivational orientation in work.
2. Summarize information about the motivational orientation of medical workers.

INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
1. THE CONCEPT OF SATISFACTION WITH WORK AND INCREASING THE INDUSTRIAL MOTIVATION OF NURSES. . . 7
1.1 Problems of labor motivation in medicine. . . . . . . . . . . . . . . . . . . 7
1.2 The concept and essence of staff motivation. . . . . . . . . . . . . . . . . . . . . . . eleven
1.3 Basic theories of motivation ……………….................................................. 17
1.4 Motivation factors for the work of nurses in healthcare facilities and the main directions of its increase ……………………………. . . . . . . . . . . . . 26
1.5 Measuring methods and indicators of job satisfaction of nurses ………………………………………………………… 32
2. CHARACTERISTICS OF THE HEALTHCARE POINT

2.1 Management structure of the health center
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
2.2 Analysis of performance indicators of the health center. . . . . . . . . . . . . . . . . . . . . …………… 40
2.3 Analysis human resources health center. . . . . . . . . 41
3. WAYS TO STUDY WORK SATISFACTION AND IMPROVE THE INDUSTRIAL MOTIVATION OF NURSES. . . ………………………………………………………………………... 42
CONCLUSION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
LIST OF USED LITERATURE. . . . . . . . . . . . . . . . . . . . . . . .
APPS

The work consists of 1 file

Federal Agency for Health and Social Development

Extramural

Specialty 060108-Nursing

Department of Nursing

COURSEWORK IN MANAGEMENT

MOTIVATION OF WORK OF NURSING STAFF

IN THE MEDICAL INSTITUTION

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

INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1. THE CONCEPT OF SATISFACTION WITH WORK AND INCREASING THE INDUSTRIAL MOTIVATION OF NURSES. . .
	Problems of labor motivation in medicine. . . . . . . . . . . . . . . . . . .
	The concept and essence of staff motivation. . . . . . . . . . . . . . . . . . . . . . .
	Basic theories of motivation ……………………………………………………………………………………………….
	Factors of motivation of 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 POINT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
	Health center management structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
	Analysis of performance indicators of the health center. . . . . . . . . . . . . . . . . . . . . ……………
	Analysis of the personnel potential of the health center. . . . . . . . .
3. WAYS OF STUDYING JOB SATISFACTION AND INCREASING THE INDUSTRIAL MOTIVATION OF NURSES. . . …………………………………………………………………………...
CONCLUSION. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
LIST OF USED LITERATURE. . . . . . . . . . . . . . . . . . . . . . . .
APPS

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 results.
	- motivating causes of human behavior and actions that arise under the influence of his needs and interests and represent the image of the good desired by the person, which satisfies the needs, provided that certain labor actions are performed.
Labor motivation (labor motivation)	- this is the desire of the employee to satisfy needs (to receive certain benefits) through labor activity
	- medical and preventive institution
	Public corporation

INTRODUCTION

The stability of the staff is one of the conditions for the effective operation of any company, and the struggle for low staff turnover is a problem that is especially relevant for areas such as healthcare and pedagogy. To solve it, one must be able to predict the situation, learn to manage the process of staff turnover. And one of the first steps here can be a study showing how satisfied employees are with their jobs. Often, satisfaction is understood as the retention of an employee in the enterprise.
The problems of increasing the labor motivation of medical workers are the most important function of healthcare management. Without their solution, it is hardly possible to really improve the quality and culture of providing medical care to the population, as well as increase the efficiency of the activities of medical institutions (HCIs) 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 induce a person to work harder (although no one downplays the role of material interest!). The problems of increasing labor motivation are systemic character 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 staff attachment to the enterprise. Here it is appropriate to talk about material and moral incentives for employees. Job satisfaction data is information about personnel risks. It is important for any leader who does not want to be a hostage to the current situation. The problems of motivation and stimulation of personnel are widely considered today in the scientific and journalistic literature. However, attempts to adapt the classical theories of motivation to the present are largely not systematized, which makes it difficult to use the technologies and methods of motivation in practice. The complexity of the practical organization of the personnel motivation system is also determined by the poor study of the characteristics 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 in health care, which has largely retained the features of management that are characteristic of the socialist planned system and do not fit into modern market conditions. In most health care institutions, the possibilities of material stimulation of labor are limited by the lack of funds, so special attention should be paid to the means of non-material motivation of nurses. Considering the limited material resources of health care, the effective and adequate value orientation of the staff of a particular medical institution, non-material 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 arise before the heads of medical institutions. Increasing the work motivation of nurses is an urgent problem, the significance of which is especially high in connection with the healthcare reform and the implementation of the National Health Project. Managers should clearly understand the importance of motivation as one of the management functions and use every opportunity to reduce the factors that demotivate nurses

The hypothesis of the study is that among managers at various levels, as well as among ordinary employees, it is widely believed that the efficiency and quality of work, all other things being equal, are proportional to the amount of remuneration. However, it is obvious that high salaries are not a guarantee of protection against corruption and simply negligent attitude to work at all levels. As it turned out, motivation (i.e., the process of inducing activity to meet personal needs and achieve the goals of the organization) is the result of the influence of a complex set of factors. The priority factors of motivation include wages, working conditions, stability, professional growth, the 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 paucity of publications on motivation in healthcare institutions, served as a reason for the study.

The purpose of the study is to analyze the factors of motivation of the work of the nursing staff of the health center. Research objectives:

Consider and systematize the theoretical foundations for studying the motivational orientation in work.
Summarize information about the motivational orientation of medical workers.
To characterize and evaluate the staff potential of the health center Prepare a questionnaire for the study of job satisfaction

The object of the study is the nurses of health facilities.

The subject of the study is the features of the motivational orientation of nurses.

When conducting this study, the following research methods were used:

Analytical (analysis of received data)

Sociological (questionnaire)

Statistical (data from reporting documents)

CHAPTER 1. THE CONCEPT OF SATISFACTION WITH WORK AND INCREASING THE INDUSTRIAL 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 field of activity. Of particular importance is the solution of this problem in the field of healthcare 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 health promotion, disease prevention, psychosocial care and care for people with physical and/or mental illnesses and disabled persons of all age groups. According to the Central Research Institute of Organization and Informatization of Healthcare in 2010, the number of nurses in the Russian Federation was 1327.8 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 healthcare, at the present time in the development of nursing, there continue to be some trends that negatively affect the state of labor motivation of nurses.

One of the main reasons affecting the labor motivation of the staff is the level of material remuneration for work and the feeling of fairness of this remuneration. For employees with external motivation, this factor can be of decisive importance not only as a factor supporting and regulating the motivational state, but often play a decisive role in deciding whether to continue working in a particular organization and in medicine in general. For internally motivated workers, of course, other factors are more important, but the low level of wages makes them also experience significant dissatisfaction.

The vast majority of both patients and doctors underestimate the contribution of a nurse to the diagnostic and treatment process; doctors do not know how and are not focused on building equal partnerships with nurses, they do not recognize higher nursing education, and even more so, elevated level secondary vocational education of nurses. Historically, there was an idea of a nurse as an assistant to a doctor, his "right hand", an appendage. “[The nurse] must begin her work with the thought firmly planted in her head, the thought that she is only the instrument by which the doctor carries out his instructions; it does not occupy an independent position in the process of treating a sick person" (McGregor-Robertson, 1904).

Despite a whole century separating us from this statement, at the present time little has changed in this mentality. Many doctors directly or indirectly express their superiority, allow incorrectness in relation to the average medical staff, all this acts as a factor that significantly reduces the desire to work.

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

The low level of wages provokes 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 internally motivated workers in the structure of labor motivation, which are often doctors. The lack of recognition is compensated by replacing it with a monetary equivalent and material symbols, with a clear insufficiency of the opportunity 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 smaller opportunities, but no less desire. In this situation, nurses experience a growing sense of injustice, which leads to the disunity of the “doctor-nurse” tandem, affecting the quality of treatment and reducing the work motivation of the latter. But the problem of deformation of the value-motivational system of medical workers is of particular importance in this situation. Behind the visible side of this problem, there is another one: informal payments are beginning to be recognized as a significant incentive that encourages nurses to work better, and students to choose a medical profession, i.e. included in the system of labor motivation. The collection of unofficial payments, in addition to the legal aspect of the problem, is fundamentally contrary to the principles of biomedical ethics, discredits the public health system, and negatively affects the quality of medical care and the prestige of the medical profession.

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

One of the main health problems is the lagging of the material and technical base of medical institutions from modern requirements. In addition to the problem of the quality of medical care lying on the surface, 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 support for healthcare, 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 to be improved. Currently, there is practically no hierarchy in the system of organization of nursing. Opportunities career development very limited: nurse, elder sister, head nurse. Only in some health facilities there are such positions as a specialist in training nursing staff, a specialist in quality control of nursing activities. For example, positions such as foreman or shift supervisor, nurse-mentor are not provided. 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 one of the significant roles in the structure of the labor motivation of nurses. Most of the reasons listed above are directly or indirectly related to the position that this profession occupies in society. Raising the prestige of the profession is not so easy, and this is common goal not only the health care system, but also the cultural state of the whole society, the hierarchy of social values. Western-style labor motives and values introduced into the mass consciousness of Russians from the outside do not correspond to the model of attitude to work that has been formed over the centuries-old history of Russia on the basis of internal prerequisites and requirements for economic development. The decrease in the general cultural level of the population, of which nurses are a part, leads to the primitivization of needs, the underdevelopment of the motivational sphere. There is no widespread propaganda of the social significance 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 work motivation of nurses is an urgent problem, the significance of which is especially high in connection with the healthcare reform and the implementation of the National Health Project.

The paper provides a theoretical analysis of approaches to understanding labor motivation, highlights external and internal factors affecting its decrease and increase. Based on the analysis of the model of a nurse specialist (professiogram, psychogram, job descriptions), the specifics of their professional activity, which consists in increased responsibility for the life and health of people, which leads to psychophysiological stress of 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 typical for nurses with an optimal motivational complex, while medical staff with an undesirable motivational complex have such unfavorable mental states as a high level of anxiety and rigidity. Correlation analysis according to Spearman between indicators of motivation of professional activity and manifestations of mental states showed that with an increase in internal motivation and the motive of the social significance of work, the level of frustration, rigidity and anxiety in nurses decreases. That is, the more (less) nurses realize the social significance of their work, the less (more) they experience internal stress and anxiety.

work motivation

motivational complex of personality

mental states

psychogram

anxiety level

frustration

rigidity

specifics of 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 health care system, nursing staff is the most significant part 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 characterized 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, the 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 medical procedures. In this regard, it becomes important to study the socio-psychological factors that provoke a decrease in the motivation for professional activities among nurses, as well as to find mechanisms that increase their motivation to work, which leads to the manifestation of positive mental states.

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

The theoretical and methodological basis of the study was scientific approaches to the study of labor motivation (G. S. Abramova, T. G. Butenko, E. A. Klimov, A. N. Leontiev, S. L. Rubinshtein, V. D. Shadrikov, S. Adams, F. Herzberg, E. Locke, D. McClelland, A. Maslow, etc.); 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); studies devoted to the study of the mental states of the individual (V. A. Ganzen, A. O. Prokhorov, V. N. Yurchenko, etc.), studies on the professional study of professions (S. G. Gellershtein, E. F. Zeer, A. K. Markova and others).

The positions of specialists on the problem of mental states and the definitions corresponding to them 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 mental sphere of a person that characterize the personality at a given moment in time (N. D. Levitov). Other authors consider the mental state as a background against which mental activity unfolds, the level and direction of the mental activity of the individual (S. L. Rubinshtein, 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 (EP 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, negative mental states of nursing staff include special forms of states such as: stress, anxiety, frustration, a state of tension, etc.

With all the variety of approaches to understanding labor motivation, two groups of theories of motivation are distinguished in the literature: content and process. Content theories of motivation are based on the identification of those internal motives (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). At the same time, most authors understand labor motivation as a set of internal and external driving forces that encourage a person to work and give this activity an orientation focused on achieving certain goals. Following A. I. Zelichenko and A. G. Shmelev, we will distinguish between external and internal factors of motivation for 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 opportunities for human self-development. It follows that the positive motivation of the personnel, especially in such a field as healthcare, largely contributes to an increase in the favorable psychological background of interaction between a medical worker and a patient, affecting the effectiveness of the application of medical procedures.

Based on the analysis of the nurse specialist model (professiogram, psychogram, job descriptions), we described the specifics of their professional activities, which are 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 have not only professional skills, organizational skills, but also mental stability, interest in work. In other words, the motivation to work stimulates nurses to perform their duties qualitatively, which, in turn, leads to the achievement of the tasks set, and, consequently, to the manifestation of positive mental states. If nurses are in a state of well-being, balance, then they project the same feelings onto the world around them, including colleagues and patients.

In order to identify the specifics of motivation for professional activity among nurses, as well as the relationship between motivation to work and manifestations of mental conditions, we conducted an empirical study in which 50 nurses from the City Clinical Hospital took part, working in the following departments: neurological, rheumatological , maxillofacial surgical, therapeutic and anesthesiology-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), a motivational complex of the personality of nurses was identified. This complex is a type of correlation between three types of motivation: internal motivation (IM), external positive (EPM) and external negative (VOM). Based on this methodology, it was concluded that most of the nurses have an intermediate motivational complex (66%), that is, their own satisfaction from work is most important for them, and rewards are of lesser importance. For nurses with an undesirable motivational complex (14%), external negative incentives in the form of punishments and possible troubles are of the greatest importance. For subjects with an optimal motivational complex (20%), internal stimuli have a greater influence than external ones, which positively affects the quality of work and mental state. It was also found that external negative motivation is of the greatest importance in the professional activities of nurses. This indicates that such external negative factors as the fear of being reprimanded and making mistakes have a great negative impact on the mental state of the employee, causing anxiety. To a lesser extent, external positive incentives in the form of incentives, high salaries, etc., have a negative effect on the activities of nurses. negative mental states.

Based on the results of the methodology for studying the leading motives of professional activity (L. A. Vereshchagin), it can be concluded that the most important for nurses are the motives of self-assertion 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 one's activity. The least important for nurses are the motives of the process of labor and skill. Perhaps this is due to the fact that the labor process is accompanied by psycho-physiological stress, and mastery is achieved rather quickly.

Rice. 1. Dominant motives for the work of nurses (L. A. Vereshchagina)

An analysis of the results of the method 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, the majority 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 for diagnosing self-assessment of mental states (G. Eysenck) made it possible to determine the following: almost a third (34%) of nurses have a low level of anxiety, 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 positive 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 the stability of views 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, attitudes, that is, it is difficult for these nurses to adapt to changing living conditions, which, in turn, causes anxiety, negative mental states, etc. Nurses with low rigidity have an easier switchover of mental processes, they adapt faster to new circumstances, which favorably reflects on 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 incentives), the motive of self-affirmation in work is of paramount importance (30%), the motive is less significant. professional excellence(26%), the motives of labor itself (22%) and the social significance of labor (22%) are even less important. That is, among nurses seeking to avoid punishment, failures, the desire to obtain a high social status prevails. In Russia, the implementation of this motive among nurses is difficult.

The experience of frustration by nurses also depends on the motivation of work. So, among nurses with an undesirable motivational complex, the level of frustration is quite high, 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).

Regarding aggressiveness, we see a similar picture. Most 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%) have 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 protect themselves if necessary, do not show aggression towards others for no reason.

Rice. 2. The ratio of the level of frustration (G. Eysenck) among nurses with different motivational complex in percent

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

There is an inverse close relationship between the motives of the social significance of work and the level of anxiety (r = -0.33), which suggests that the more nurses are aware of 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 that corresponds to the specifics of the nursing profession, namely, an orientation towards strict fulfillment of appointments. The desire to act strictly according to the 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, the motives of 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.

- Nurses with an average motivational complex have an average mental state, 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 level, aggressiveness, anxiety, rigidity - medium.

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

— There are moderate links between the motive of the social significance of work and the level of anxiety, that is, the more nurses are aware of 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, Volgograd State University, Volgograd;

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

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Ovcharova E.V. FEATURES OF MOTIVATION OF THE PROFESSIONAL ACTIVITIES OF NURSES AND ITS INFLUENCE ON THE MANIFESTATION OF MENTAL STATES // Contemporary Issues science and education. - 2015. - No. 2-2.;
URL: http://science-education.ru/ru/article/view?id=22573 (date of access: 01/04/2020). We bring to your attention the journals published by the publishing house "Academy of Natural History"

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