In the Mental Health Services, Capital Region of Denmark (RHP), like in the rest of the health care system, a number of initiatives that aim to move tasks from one profession to another is launched, and several initiatives indicate a continued shift in tasks location across the health care system. This projects aim is to examine: What motivates employees involved in task shifting – and what are the managerial consequences? The question will be examined through three approaches, which will form the basis for the selection of theory, empirical and analytical approach: The individual motivation, leadership and goals and the role of the professions. The project is confined to assessing motivation among nurses and physicians in the Central Visitation (CVI) in RHP and nurses training to become nursing specialists in psychiatric centers in RHP. The project takes on a semi-inductive approach to the use of theories. The theories are serving as prisms that allow different observations of the empirical material. The use of theories will force the analysis to take certain directions, but the analysis will not attempt to prove or falsify the theories. At the same time the project wished to be able to identify other motivation factors not embraced by the chosen theories. The theories used as inspiration were: • Management of Prima Donnas • Theories of Public Service Motivation • Goal Setting Theory • Theory of Professionalization The empirical data comprises eight interviews: with one doctor employed by CVI, three doctors working in CVI on an hourly basis, two nurses from CVI and two nurses training to become nursing specialists from two psychiatric centers. In analyzing the empirical data, the project used the program NVivo, which provides the opportunity to compare coding amongst authors, between the interviews or between coding categories. The data was coded with a combination of closed and open coding; the closed coding was inspired by the theories and the open coding by other motivational issues that seemed important to the participants. The project finds that the mark of the individual motivation is the dissimilarities in the group. Commonalities were also identified, but the most common feature is that participants are motivated in different ways. The ideal leader must be able to distinguish his or hers leadership in relation to each individual motivation profile. A part from this, every participant calls for a visible, clear, inclusive and open management. An inductive analysis across individual profiles furthermore showed that all had two needs in common; time enough and to do their job properly. Four respondents had a story of always having wanted to be in the profession. This may indicate, that people who report always having wanted to join a certain field, are people who experience a vocation. Such narrative may be used as an indicator of the presence of vocation of an employee. In a management context, this is interesting, since the presence of vocation according to Hein is strongest in the archetype of the prima donna. Respondents would like to have clear goals that make sense. Most participants felt that a number of the current goals of the company are meaningless. Whether goals would actually motivate the employees if they were developed with involvement, is not to be answered within this project. In between the professions there are disputes in relation to task shifting. The nurses understand if doctors feel that something is taking from them - but at the same time, they want new tasks that lead to development. Doctors generally experience that nurses are good at what they are doing, but not at diagnostics, and an assignment in this area is associated with risks for both patients and the profession. Both doctors and nurses have clear and consistent ideas about the core values of the profession. Nurses refer to “good nursing”, seeing the human being, and focus on the problems/symptoms the individual. Caring and compassion are the core values . For doctors, the diagnosis and treatment are the key tasks, and both must rely on evidence based facts. The overall conclusion is that nurses and doctors are motivated by a combination of the above. What perhaps dominate the motivation about task shifting is that the nurses are motivated by opportunity of developing professional skills and experiencing new professional challenges, while the doctors are motivated by retaining the core of the professional field, to maintain the monopoly. Both the nurses and doctors motivations are characterized by their profession and the values within it. On the other hand, a profession is also characterized by the individuals constituting it. In a managerial context it is important to consider that there is a relationship between the individual and the profession's motivation, meaning doctors and nurses are motivated differently. Managers therefore have to take into account both the profession and the particular employee's motivation profile. Finally, which appears to be important for all, is getting enough time to complete tasks properly. There are managerial challenges in how "enough time" should be understood, and what will it take to do the job "properly". The manager needs to explore the company's understanding of "enough time" and "properly" and compare it with the individual's understanding of what "enough time" and "properly" means. The application of knowledge about what motivate professions may guide, but it is the individual motivation that holds the essential potential.
|Educations||Master of Public Governance, (Executive Master Programme) Final Thesis|
|Number of pages||180|