The most traumatic and stressful moments of an individual’s life are when he or she is taken ill. Nurses are synonymous with care and attention in times of need such as these. In a world mostly driven my personal ambition and corporate profit, nurses with their commitment to patient welfare and selfless service, provide a contrasting study. A nurse acts as a savior in distress and is often called upon to make great personal sacrifices in the discharge of her duties. The profession of nursing, is therefore, not merely a ‘job’ and the potentially powerfully insights about commitment to work that they could provide encouraged us to choose them as our subjects of study. As part of the Phase I of the project, we interviewed four nurses who were diverse in the amount of experience each had, the hierarchy in which they were working in the hospital and the backgrounds from which each of them came. This was done to study the commitment of employees towards an organization and understand the various factors which cause the same we have selected a study of nursing staff in hospitals.
From the interviews, many broad themes emerged, all of which point correlate positively with their high commitment level to the organization. These points logically lead us to our hypothesis as to what keeps them committed to their place of work. However, there were some key themes which we noted across all four of our respondents. All the nurses were very excited by the kind of recognition that the hospital was willing to give them. They seemed to treat this as a reward for their hard work and dedication and were motivated by it. All nurses were also impressed by their working relationship with their superiors (Head Nurse/Doctor) in the hospital who treated them as members of a family and with much respect. Nurses were also willing to stay on with the hospital because it provided them with opportunities for personal development. Accordingly our hypotheses are as follows:
* There is a positive correlation between the amount of recognition that the nurses receive for their work and their commitment to the organization * There is a positive correlation between the positive relationship between the doctors/supervisors and the nurses and the commitment of the nurses to the organization * There is a positive correlation between the opportunity for learning and personal development that the organization provides and the commitment of the nurses to the organization
Based on our earlier survey of 4 respondents, we determined that the following three variables play a key role in determining the commitment of nurses to their respective hospitals:
* Relationship with superiors
* Learning and Development
We have then tried to identify whether these three variables actually affect commitment levels of nurses at various nursing organizations. For the same, we carried out a survey of 30 nurses with diverse backgrounds (a detailed description of the respondents is covered in the following section) and questioned them on a scale of 5 to 1 (5: Strongly Agree, 1: Strongly Disagree) on 24 questions. Since our hypothesis determines 3 variables as affecting commitment, we tested the existence of each these three independent variables by framing four questions for each variables. Similarly, we determined commitment levels of the nurses through a set of 12 questions. By using a 5-point scale, we have captured not only the existence, but the extent of existence of these variables. Since we found the responses to be reliable, we determined the correlation between the three independent variables and the dependent variable ‘commitment’ to see whether our hypothesis of is correct.
Hospitals chosen for the survey
We surveyed nurses from 4 different hospitals to ensure diversity. The organizations range from a large hospital located in a city like Bangalore, to mid-sized hospitals located in Tier-2 cities like Ajmer and Allahabad and a focused surgical-specialty hospital located in a smaller town like Varanasi. This selection lends diversity to our respondents through differences in location, specialization of hospitals, daily footfall (reflecting magnitude of work for the nurses), number of departments etc. Refer Appendix 1 for a description of the hospitals used for out survey.
General Profile of the Nurses
We have ensured diversity in our respondents while choosing nurses at all of the survey hospitals. The diversity ranges age, number of years worked at the organization and departments worked in.
QUESTIONS IN THE SURVEY
The questions in the survey were aimed at understanding the extent to which each of our three independent variables and our dependent variable ‘commitment’ was present in these organizations. We captured the different parameters relating to these variables by framing questions addressing various facets of these variables. Refer to Appendix 2 for detailed discussion on questions used for the survey.
ANALYSIS OF RESULTS OF THE SURVEY
Reliability of scales
Reliability is used to check the consistency of the question set under consideration. In this survey we are testing if the 3 hypothesis that we have come up with are explaining the commitment of employees towards organization. Reliability in a survey is measured by lot of ways and here we are checking internal consistency reliability which indicates reliability within the survey for the responses of similar type of questions.
Reliability of dependent variable
* Affective Commitment: In affective commitment the questions that are all trying to test for one feature- Attachment to Organization. The questions are direct and straight forward bringing out the required feature thus making it a set of good reliability. We have obtained a reliability scale of 0.6 for this set which is the highest amongst the 3 different commitments scales that we have obtained. * Continuance Commitment: In this set we are trying to test the commitment by knowing the dependence of the person on the organization and how much of a change it would mean to him to switch jobs. The reliability that we obtained for this set is 0.53 which is a high value for a one time survey result.
This is a good indication of question set focusing on the same core question. * Normative Commitment: This question set mainly tries to identify the belongingness the person has towards the organization. The question set is clear in conveying the same objective but this attribute is not so direct and easy to understand from an individual’s perspective. Hence the survey respondents’ answers in this set have a lower value reliability of 0.39.
Reliability of independent variables
For first and third variables (recognition and learning & development), the reliability is low at 0.46 and 0.47 respectively while for the second variable (relationship with superiors), the reliability is relatively high at 0.66.
Recognition and Learning & Development
It’s easy to see why responses to questions around Recognition and learning and development score so low in reliability. They are quite different from each other and same person can have very different responses to each of them, if they interpret the different questions to indicate different things. In comparison the questions related to relationships were fairly interrelated and are able to fetch more consistent responses. Overall reliability of all the responses is still lower than 0.7 which can be attributed to the fact that no pilot study was done, which could have been used as input for framing questions in a better way as to improve reliability of responses.
Relationship with superiors
We obtained highest reliability for responses for this hypothesis. Reliability for this was found to be 0.66, which is near acceptable range. The reason for higher reliability in this question set (Appendix 2) is attributable for ease of understanding the questions. Every person has a fair idea about relationships and these questions although quite different from each other give a fairly good direction the responder in terms of what is being asked. So they maintain consistency and hence higher comparative reliability.
Correlation between predictor and dependent variables
a) Affective Commitment – According to our expectation before the actual test results we came up with all 3 predictors are going to affect the Affective commitment. Recognition was one factor because the appreciation helps the employee (nurse) develop a connect with the organization. Also opportunities for personal development and training opportunities to assist this makes employees feel good which is essential to improve the commitment levels. Good relationships with superiors definitely help people develop an emotional bond with the organization. b) Continuance Commitment
Continuance commitment describes how the employee feel about staying longer in the organization and for this one of the most important reasons is economic considerations which are to some extent explained by rewards and recognition. The recognition obtained will motivate them to work better and stay longer in an organization. Also constant opportunities for growing and training will help them stay committed to organization. c) Normative Commitment This form of commitment mainly explains the sense of giving back to the organization and the predictor which we identified was most important was the relationships with supervisor (Head nurse/Doctor). Training and developments reflect investment done by organization on employees, so employees feel an obligation to stay committed to organization to pay it back, which increases their normative commitment.
Statistical Significance of correlations
With the acceptable alpha level being 0.05 for social science research and no. of responders being 30, (Dof = 28) gives critical value of correlation as 0.361. When compared with the results we obtained we notice that out of 9 correlations, 3 are not significant (value less than 0.361) and 6 are significant (Value higher than 0.361). When it’s significant we reject null hypothesis of no relationship and accept alternative hypothesis of existence of relationship. Hypothesis 1: From the results it’s apparent that hypothesis 1 is partially supported as only one correlation is significant out of 3. That is with affective commitment. So we can interpret that Recognition affects affective commitment but not the other two types of commitments. Hypothesis 2: For second hypothesis 2 out of 3 correlations are significant so it’s also partially supported.
Relationship with doctors is not related to continuance commitment but related to affective and normative commitment. Hypothesis 3: Hypothesis 3 is completely supported as all the correlations are significant i.e. higher than 0.361. It means learning and development is related to all the dependent variables and affects all three dimensions of commitment i.e. Affective, Continuance, & Normative which are considered here. Plausible explanation of variations between correlations
Recognition: Recognition showed the highest correlation with affective commitment, while significant correlations were not established with the continuance and normative commitment. When nurses are recognized by the organization they tend to develop an emotional connect with the organization. They feel happier working in the hospital and a sense of belonging is nurtured within them. The appreciation received for the work translates into an attachment with the organization. This explains the correlation with affective commitment. The recognition is mostly in the form of awards and words of praise not monetary in nature. Therefore a significant continuance commitment has not been established. Similarly, recognition for work does not lead to a feeling of obligation towards the organization. Rather, the positivity generated by the appreciation of work manifests itself as an emotional attachment towards the organization, which is reflected in the correlation with affective commitment.
Relationship with superiors: This independent variable showed highest correlation with normative commitment and lower correlations with affective commitment, while correlation with continuance commitment was insignificant. The nurses tend to view the exceptionally good relationships with the doctors as being facilitated by the hospital. They therefore feel indebted to the hospital for providing them with an excellent working environment, which would be missing at other places. The moral obligation that they feel towards their hospital for the respect and dignity with which doctors and supervisors treat them is translated into a high correlation for normative commitment. Learning and development: It is seen from the results of the survey that learning and development has a high correlation with Affective Commitment to the organization and comparatively low correlation with continuance and normative Commitment. Intuitively we expected high correlation between learning and development and normative commitment to the organization.
This is because employees would feel an obligation towards an organization that invests time and resources to train its employees and ensure their personal development. However, we realize these may not necessarily hold true once we take into account the atypical nature of the nursing profession. Nurses feel sense of duty towards their patients and ethical and moral obligation to serve the sick to the best of their capacity. In fact, nurses who have been trained well, dealt with varied patient cases and experience a great deal of learning would perhaps experience higher motivation to the society. Hence perhaps they would experience low moral responsibility to staying back in the organization.
We believe existence of a caring and people centric management could be the reason for the high correlation between affective commitment and learning and development. An organization that has caring and people friendly management would earn emotional loyalty from its employees due to care and good treatment given to employees. Such an organization would also take efforts to ensure that its human resources constantly learn and develop so as to contribute to the success of the organization.