Research on the consequences of various forms of motivation on nurses’ commitment to offering quality healthcare services have revealed that prosocial factors of motivation, especially willingness to help reduce suffering, including in formal settings, are arguably the best reasons for being a nurse and result in better outcome for both patients and nurses (Dill, Erickson, & Diefendorff, 2016). Therefore, extrinsic forms of motivation for caregiving are presumed to result in sub-standard outcomes merely because they deviate from prosocial model of caregiving. These contrasting sources of motivation for caregiving have varied consequences on nurse burnout and turnover intentions. Highly Intrinsically and extrinsically motivated nurses have better employment and health outcome because they are likely to experience lower burnout, less likely to leave, and experience less negative physical symptoms compared to their counterparts with higher prosocial motivation who are likely report job burnout. Early literature on turnover intentions cited emotional exhaustion and work design challenges as the common reasons for increased nurse turnover in Canada, England, the USA, German, and Scotland (Hayes et al. 2006)
Emerging studies postulate that job burnout and pay satisfaction significantly influence intrinsic motivation and turnover intention among geriatric nurses working in nursing homes (Hayes et al. 2006; Lasater et al. 2021; Wang et al., 2019). Also, Ngo-Henha (2017) discovered that factors like annual pay, though important, were not significant mediators between intrinsic motivation and pay satisfaction among geriatric nurses working in the nursing home settings. However, intrinsic motivation substantially influenced geriatric nurses’ turnover intentions (Wang et al. 2019). While pay might be low, geriatric nurses’ job was found to be very rewarding in terms of helping nurses achieve the expectations and values, including emotional intimacy, meaningfulness of working closely with the elderly, and fulfilment of moral obligation. Burnout contributed to turnover intension as opposed to intrinsic motivation because it is presumed that intrinsically motivated geriatric nurses have freedom of choice, making decisions, and seeking devotion in their work, and enjoy positive emotions of fulfilment from their work. Likewise, they are more likely to be more satisfied with their wages. Contrary, their counterparts in the health tourism are motivated by career development, job enhancement, and autonomy (Ngo-Henha 2017) coupled with interventions such as training, guidance, counselling (Hee et al. 2016), promotional opportunities, and work schedules (Hayes et al. 2006)
Leadership, work environment, compensation, and job satisfaction jointly or to some degree, influence turnover intentions among employees by 67% while the rest is influenced by other factors. However, job satisfaction ranks as the greatest contributing factor of turnover intentions (Hayes et al. 2006; Ongori 2017; Santoni & Harahap 2018). Turnover intentions can be lowered when employees are satisfied by the work itself, not merely the fear of not getting a better job (Hayes et al. 2006; Ngo-Henha 2017). Their feelings of satisfaction can be reinforced by both internal and external factors such as improving compensation or sense of security or good leadership based on participative managerial activities (Santoni & Harahap 2018). Similarly, Shah and Asad (2018) asserted that Perceived Organizational Support (POS), an important leadership attributes, mitigates voluntary turnover because it enhances employee commitment based on the belief that their high performance will be recognized and result in rewards to enrich their wellbeing.
Besides, other organizational factors, including organizational instability, unfair labor practices, inefficiency, increase turnover as employees will feel the need to seek for stable working environments that can support their career development (Hayes et al. 2006; Ngo-Henha 2017; Senek et al. 2020). Also, strong communication systems, where employees are not only informed but also participate in some degree of decision-making experience less turnover compared to organizations with poor personal policies and poor motivation (Ongori 2007). Likewise, Hayes et al. (2006) observed that professional commitment is effective in influencing nurses to leave the profession than the organization.
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