What is characteristic of motivation in the medical environment. Motivation of medical personnel, tested in Russian realities

Existing models of motivation are different in their focus and effectiveness. The results of the study of motivation models do not allow, from a psychological point of view, to clearly determine what motivates a person to work. The study of a person and his behavior in the process of work provides only some general explanations of motivation, but even they allow the development of pragmatic models of employee motivation in a particular workplace.

Share work on social networks

If this work does not suit you, there is a list of similar works at the bottom of the page. You can also use the search button

INTRODUCTION…………………………………………………………………..	3
Chapter 1 . STAFF MOTIVATION AS A FACTOR OF INCREASING PRODUCTION EFFICIENCY……..	5
1.1 The role and importance of staff motivation …………………………….	5
1.2 Methods of staff incentives ………………………………..	7
Chapter 2 THEORIES OF MOTIVATION ………………………………………..	9
2.1 Content theories of motivation…………………………………	9
2.1.1 Theory of needs A. Maslow…………………………………	9
2.1.2 Theory of Needs by D. Mack Clelland………………………	12
2.1.3 Two-factor theory of F. Herzberg……………………………..	13
2.1.4 The theory of existence, connection and growth of K. Alderfer…………..	14
Chapter 3 WAYS OF MOTIVATION…………………………………….	16
Chapter. 4. MOTIVATION OF THE EMPLOYEES OF MBUZ “CITY POLYCLINIC LGO”……………………………………………………….	20
4.1 general characteristics MBUZ "City Polyclinic LGO"…….	20
4.2 The structure of the administrative apparatus of the MBUZ "City Clinic of LGO"…………………………………………………………….	21
4.3 Methods of motivating the staff of MBUZ "City Clinic of LGO"………………………………………………………………………….....	22
4.4 Proposals to encourage employees of MBUZ "City Polyclinic"……………………………………………………………….	24
CONCLUSION………………………………………………………………	26
LIST OF USED SOURCES……………………...	29
APPS	31

INTRODUCTION

Management activity includes many components. Among them:

personnel policy, relationships in the team, socio-psychological aspects of management. The key place is occupied by the definition of ways to increase productivity, ways to increase creative initiative, as well as to stimulate and motivate employees.

Motivation - is a set of internal and external driving forces that encourage a person to activity, set the boundaries and forms of this activity and give it an orientation focused on achieving certain goals.

No management system will function effectively if an effective model of motivation is not developed, since motivation stimulates a particular individual and the team as a whole to achieve personal and collective goals.

The evolution of the application of various motivation models has shown both positive and negative aspects of their application, and this is a natural process, since in the theory and practice of management there is no ideal incentive model that would meet various requirements.

In Russia, there are many problems associated with motivational policy: the problem of relationships with management, dissatisfaction with the size of wages, living and working conditions in general at the enterprise. The main obstacle to resolving these issues is the unwillingness of management personnel to think about the living and working conditions of people who directly create profit. IN market conditions special attention should be paid to non-financial incentives, creating a flexible

employee benefit system.

Theme of the course work: Theories of motivation by A. Maslow, D. McKpelland, F. Herzberg, K. Alderfer.

The relevance of the chosen topic lies in the fact thatthat from a clear design effective system motivation depends not only on the increase in the social and creative activity of a particular employee (manager, worker), but also on the final results of the activities of enterprises of various organizational and legal forms of ownership, production and non-production areas of activity.

The purpose of the course workstudy the theories of motivation by A. Maslow, D. McKpelland, F. Herzberg, K. Aldefer, to analyze the motivation of employees of MBUZ "City Clinic of LGO".

To achieve the goal, the following tasks were set:

1. Define the concept of motivation.

2. Consider theories of motivation

3. To study the influence of motivating factors on the work of the staff of the MBUZ "City Polyclinic of LGO"

4. Determine possible ways to increase the motivation of employees of MBUZ "City Polyclinic of LGO".

CHAPTER 1

STAFF MOTIVATION AS A FACTOR OF INCREASING PRODUCTION EFFICIENCY

1.1 The role and importance of staff motivation

The main feature of personnel management in the transition to the market is the increasing role of the employee's personality. The current situation in our country carries both great opportunities and great threats for each individual in terms of the sustainability of his existence. That is, now there is an extremely high degree of uncertainty in the life of every person. Therefore, it is necessary to develop a new approach to personnel management. This approach is as follows:

1) creating a philosophy of personnel management.

2) creation of perfect personnel management services.

3) application of new technologies in personnel management.

4) creation and development of shared values, social norms,

attitudes that regulate the behavior of an individual.

Philosophy of personnel managementthis is the formation of the behavior of individual employees in relation to the goals of the development of the enterprise. Under these conditions, motivation labor activity employees of the company becomes especially important. In order for a person to perform the work entrusted to him conscientiously and efficiently, he must be interested in this or, in other words, motivated.

In personnel management, motivation is seen as a process

activating the motives of employees (internal motivation) and creating incentives (external motivation) to encourage them to work effectively.

The purpose of motivation is the formation of a set of conditions that encourage a person to take actions aimed at achieving the goal with maximum effect.

Over time, various psychological theories of motivation have appeared, trying to consider the determining factors and structure of the motivational process from different positions. As a result, the so-called "carrot and stick" policy was replaced by the development of more complex systems for stimulating the motivation of workers to work, based on the results of its theoretical study.

Modern theoretical approaches to motivation are based on

ideas formulated by psychological science that investigates the causes and mechanisms of purposeful human behavior. From these positions, motivation is defined as the driving force of human behavior, which is based on the relationship of needs, motives and goals of a person.

A general characteristic of the motivation process can be represented if

define the concepts used to explain it: needs, motives, goals.

Needs is the state of a person who needs an object necessary for his existence. Needs are the source of human activity, the cause of his purposeful actions.

motives these are human motivations for action, aimed at the result (goal).

Goals is the desired object or its state, which a person aspires to possess.

The motives driving a person are extremely complex, subject to frequent changes and are formed under the influence of a whole complex of external and internal factors - abilities, education, social

position, material well-being, public opinion, etc. Therefore, predicting the behavior of team members in response to different systems of motivation is very difficult.

Motivation as a control function is implemented through a system of incentives, i.e. any actions of the subordinate must have positive or negative consequences for him in terms of meeting his needs or achieving his goals. The study of the team can allow the leader to create a motivational structure with which he will carry out the education of the team in the right direction.

Staff incentive methods

Methods of staff incentives can be very diverse and depend on the development of the incentive system at the enterprise, the general management system and the characteristics of the enterprise itself.

Depending on the orientation to the impact on certain needs, management methods are divided into:

Economic methods of management, due to economic incentives. They involve material motivation, that is, an orientation towards the fulfillment of certain indicators or tasks, and the implementation of economic rewards for the results of work after their fulfillment.
Organizational and administrative methods based on directive instructions. These methods are based on imperious motivation, based on obedience to the law, the rule of law, senior officials, etc., and based on the possibility of coercion. They cover organizational planning, organizational rationing, instruction, direction, control.
Socio-psychological methods used to increase the social activity of employees. With the help of these methods, they influence mainly the consciousness of workers, the social, aesthetic, religious and other interests of people and carry out social stimulation of labor activity.

In management practice, various methods and their combinations are simultaneously used. For effective management of motivation, it is necessary to use all three groups of methods in enterprise management. Thus, the use of only power and material motivations does not allow mobilizing the creative activity of staff to achieve the goals of the organization. For achievement maximum efficiency spiritual motivation is needed.

CHAPTER 2

THEORIES OF MOTIVATION

The most widely known theories of motivation are:

Maslow's theory of needs;

Alderfer's theory of existence, connection and growth;

McClelland's theory of acquired needs;

Herzberg's theory of two factors.

2.1.1 Maslow's theory of needs

Abraham Maslow is one of the leading scientists in the field of motivation and psychology.

Maslow's needs theory is one of the most famous theories of motivation.

The essence of the theory is reduced to the study of human needs. This is an older theory. Its supporters, including Abraham Maslow, believed that the subject of psychology is behavior, not human consciousness. Behavior is based on human needs, which can be divided into five groups:

1. Physiological needs.

This group includes the needs for food, water, air, shelter. These are the needs that a person must satisfy in order to survive, in order to keep the body in a vital state. People who work primarily to meet the needs of this group have little interest in the content of the work. To manage such people, a minimum wage was necessary to ensure their survival, and the working conditions did not burden their existence too much.

2. The need for security.

The needs of this group are related to the desire of people for stability and security: to have good housing, to be protected from pain, disease and other suffering. For a person influenced by these needs, job security, pensions, and health insurance are important. To manage such people, it is necessary to create a reliable system of social insurance, apply fair rules for regulating their activities.

3. The need to belong to social group . A person seeks to participate in joint actions, he seeks friendship, love, membership in a certain group of people, seeks to participate in social events. Good results can be achieved with a brigade form labor organization, using group activities that go beyond work, as well as reminding employees of how much they are valued by colleagues at work.

4. Needs for recognition and respect. This group of needs reflects the desire of people to feel competent, self-confident, strong. People strongly influenced by this need aspire to a leadership position or to a position of recognized authority in solving problems. When managing such people, it is necessary to use various forms of moral encouragement, expressions of recognition of their merits. For this, the following can be used: assignment of titles and titles, publications in the press and mention by the management in public speeches of their merits, presentation of honorary awards.

5. Needs of self-expression. This group combines the needs expressed in the desire of a person to use his knowledge, abilities and skills for self-affirmation in business and management. People with this need are open to the perception of themselves and the environment, creative and independent. When managing such people, it is necessary to realize their abilities to the maximum, strive to give them original tasks, provide greater freedom in choosing means and involve them in work.

All these needs can be arranged in a strict hierarchical sequence in the form of a pyramid, at the base of which are primary needs, and the top is secondary.

Pyramid A. Maslow

The meaning of the hierarchical construction lies in the fact that the needs of lower levels are priority for a person, and this affects his motivation. In other words, in human behavior, the satisfaction of needs at first low levels is more decisive, and then, as these needs are satisfied, the needs of higher levels become a stimulating factor.

The highest need - the need for self-expression and growth of a person as a person - can never be fully satisfied, so the process of motivating a person through needs is endless.

The duty of the manager is to carefully observe his subordinates, find out in a timely manner what active needs drive each of them, and make decisions on their implementation in order to increase the efficiency of employees.

2.1.2 Theory of needs D. Poppy Clelland

Emphasizes the needs of higher levels.

D. McClelland believed that people have three needs:

power,
success,
involvement.

The need for power is expressed as a desire to influence other people. People with a need for power are not necessarily power-hungry careerists in the negative and most commonly used sense of these words. When people need power in its purest form, according to this theory, there is no inclination to adventurism, the main thing is the need to manifest one's influence.

The need for success is not satisfied by proclaiming that person's success, but by the process of bringing the work to a successful conclusion. People with a highly developed need for success like situations in which they can take responsibility for finding a solution to a problem, and they want to be rewarded for their results in a very specific way. To motivate people with a need for success, you should set them tasks with a moderate degree of risk or the possibility of failure, delegate them enough authority to unleash their initiative, regularly and specifically reward them in accordance with the results achieved.

Motivation based on the need for belonging determines the interest of people in the company of acquaintances, establishing friendships, helping others. People with a developed need for belonging will be attracted to work that will give them extensive opportunities for social interaction. The leader can also ensure that their needs are met by devoting more time to them and periodically bringing such people into separate groups.

2.1.3 Herzberg's two-factor theory

This theory appeared in connection with the growing need to find out the influence of material and non-material factors on human motivation.

Frederik Herzberg created a two-factor model that shows

job satisfaction.

Factors affecting job satisfaction

hygiene factors	Motivation
Company policy and administration	Success
Working conditions	Career advancement
earnings	Recognition and approval of the result
Interpersonal relationships	High degree of responsibility

Hygiene factors are related to the environment in which the work is carried out. The absence or insufficiency of hygiene factors causes a person to be dissatisfied with work. But the sufficiency of these factors in itself does not cause job satisfaction and cannot motivate a person to do anything. These factors include earnings, working conditions, administration policy, degree of control, relationships with colleagues and supervisors, subordinates.

The applicability of Herzberg's theory in practice has been tested in many organizations. The results of the experiments showed that in order to effectively use Herzberg's theory, it is necessary to compile a list of hygiene and especially motivating factors and give employees the opportunity to determine and indicate what they prefer.

2.1.4 Alderfer's theory of existence, connection and growth

K. Alderfer believes that human needs can be combined into separate groups. However, unlike Maslow's pyramid of needs, he believes that there are only three such groups of needs:

the needs of existence;
communication needs;
growth needs.

Needs of Existenceaccording to Alderfer include two groups of needs of Maslow's pyramid: the need for security and physiological needs.

The need for communicationaccording to Alderfer, it includes the social nature of a person, the desire of a person to be a member of a family, a team, to have friends, enemies, bosses and subordinates. Therefore, this group should include the needs to belong to a social group, recognition and respect, which are associated with a person’s desire to occupy a certain position in the world around him, as well as that part of the security needs of Maslow’s pyramid that is associated with group security.

Growth Needsare similar to Maslow's self-expression needs and also include those needs of the recognition and self-affirmation group that are associated with a person's desire to develop confidence, to self-improvement.

These three groups of needs, as well as in Maslow's theory, are arranged hierarchically. However, there is one fundamental difference between the theories of Maslow and Alderfer. According to Maslow, there is a movement from need to need only from the bottom up: only when the needs of the lower level are satisfied, the person moves to the need of a higher level. Alderfer believes that the movement goes both ways: up if the need of the lower level is not satisfied, and down if the need of the higher level is not satisfied. At the same time, Alderfer thinks that in case of dissatisfaction of the need of the upper level, the degree of impact of the need of the lower level increases, which switches the person's attention to this level. For example, if a person has not been able to satisfy the needs of career growth, his communication needs are again "turned on".

Alderfer's theory reflects a hierarchy of needs in the direction from more specific to less specific needs. He believes that every time a need is not satisfied at the top level, there is a switch to a more specific need at the bottom level, which determines the reverse movement from top to bottom.

So, the effectiveness or viability of a particular model can only be verified by testing them in practice, taking into account the environment where they will be implemented. One thing is certain, that the lack of motivational models at our enterprises will reduce the effectiveness of existing management systems and the socio-economic activity of labor collectives.

CHAPTER 3

WAYS OF MOTIVATION

The strategic theories of human resource management discussed above, each organization adapts to specific features its functioning. Whether the subordinates will strive to work well or simply serve their attendance hours depends on the success of solving this issue.

Ways to improve labor motivation.

They are grouped into five relatively independent areas:

financial incentive,
quality improvement work force,
improvement of the organization of work,
involvement of personnel in the management process,
non-monetary incentives.

Financial incentive reflects the role of the motivational mechanism of remuneration in the system of increasing labor productivity. It includes as elements the improvement of the wage system, the provision of opportunities for staff to participate in the property and profits of the enterprise.

Of course, the motivational mechanism of remuneration plays a large role, but a constant increase in the level of remuneration does not contribute to both maintaining labor activity at the proper level and increasing labor productivity. The application of this method can be useful for achieving short-term increases in labor productivity. In the end, there is a certain imposition or addiction to this type of exposure. Unilateral influence on workers only by monetary methods cannot lead to a lasting rise in labor productivity.

The next direction for improving motivation - improving the organization of labor - contains setting goals, expanding labor functions, enrichment of labor, production rotation, the use of flexible schedules, improving working conditions.

The expansion of labor functions implies the introduction of diversity into the work of personnel, that is, an increase in the number of operations performed by one employee. As a result, the work cycle for each employee is lengthened, and the intensity of labor is growing. The use of this method is advisable in case of underloaded workers and own desire them to expand the range of their activities, otherwise this may lead to strong resistance from workers.

The enrichment of labor implies the provision of such work to a person that would enable growth, creativity, responsibility, self-actualization, inclusion in his duties of some functions of planning and quality control of the main, and sometimes related products. This method it is expedient to apply in the field of work of engineering and technical workers.

Improving working conditions is the most acute problem of today. At the stage of transition to the market, the importance of working conditions as one of the most important human needs increases. The new level of social maturity of the individual denies adverse conditions working environment. Working conditions, acting not only as a need, but also as a motive that encourages work with a certain return, can be both a factor and a consequence of a certain labor productivity and its efficiency.

In management, 6 methods of non-monetary incentives are used:

1. Approval.

Approval is an even more powerful reward than money, which of course will always mean a lot. Almost all people respond positively if they feel valued and respected. Exist following rules managers:

"praise immediately"

"praise the man's work"

“say that you are satisfied and you are pleased that the employee did this

after that, you should not stand over the soul of the worker, therefore, having completed your mission, leave."

2. Action . Employees who purchase shares and become co-owners behave like owners. But in order to use this method of remuneration, the enterprise must use group acceptance management decision, instead of authoritarian and produce a competitive product.

3. free time reward. This will help keep employees from forming the habit of wasting time and will allow the employee to spend more time on himself and his family if he completes work ahead of schedule. This method is suitable for people with a free schedule. Otherwise, management will be tempted to increase the volume of work.

4. Mutual understanding and interest in the employee. The method of remuneration is most significant for effective professional employees. For them, the intrinsic reward is big weight. This approach requires managers to have good informal contact with their subordinates, as well as knowledge of what excites and interests them.

5 Career advancement. This method of remuneration requires a significant financial outlay for top management.

6 Independence in your favorite work. This method is especially good when employees aspire to become professionals, but feel the pressure of control over themselves or feel that they would do other work much more professionally, with more dedication and better results. Here, the manager's art lies in the ability to identify such an employee, which can be difficult to accept these actions as another control event. Very often, such people could work effectively without supervision from above, but lack of some courage does not allow them to turn to management about this.

7. Profit sharing.

The most common form of collective reward is the so-called “system” PARTICIPATION IN PROFIT". The essence of the system “ participation in profits” lies in the fact that a bonus fund is formed at the expense of a predetermined share of profit, from which employees receive regular payments. The amount of payments is made dependent on the level of profit, the overall results of production and commercial activities enterprises. Payments to workers and employees (including representatives of the highest administration) in the order " participation in profits” are not taxed. Thus, entrepreneurs are encouraged by the state to spread this system. In many cases " participation in profits” provides for the payment of all or part of the premium in the form of shares.

In the “participation” system in profits” bonuses are awarded for achieving specific results production activities enterprises: increasing labor productivity and reducing production costs. Bonuses are accrued, as a rule, in proportion to the salary of each employee, taking into account personal and labor characteristics performer: work experience, lack of delays and absenteeism, rationalization activities, as well as a tendency to cooperate, loyalty to the company, etc.

This system is good for large firms.

CHAPTER 4

STAFF MOTIVATION

MBUZ "CITY POLYCLINIC"

4.1. General characteristics of MBUZ "City Polyclinic"

Municipal state-financed organization of health care "City polyclinic", abbreviated name MBUZ "City polyclinic" is a medical and preventive, specialized health care institution designed to implement a set of preventive measures to improve and prevent diseases and provide medical care to the adult population. The clinic is located at:

The polyclinic is organized according to the precinct-territorial principle in the prescribed manner in municipality"Lysvensky urban district". The polyclinic has the necessary details for its activities and is an independent healthcare institution with the right of a legal entity.

In its work, MBUZ "City Polyclinic" is guided by the current legislation, orders and instructions of the Ministry of Health of Russia, this regulation and other regulatory documents.

4.2. The structure of the administrative apparatus

MBUZ "City Polyclinic"

Staff motivation methods

MBUZ "City Polyclinic"

The MBUZ "City Polyclinic" uses non-economic and psychological methods of motivation, but prevails economic method, i.e. financial incentives.

Based on the program for the modernization of healthcare in a constituent entity of the Russian Federation, developed in 2011, the purpose of which was to improve the quality and ensure accessibility medical care population in the regions, the salaries and working conditions of medical personnel have improved significantly. Thus, a doctor with a narrow focus with 10 years of experience received an average of 8,500 rubles, and after the implementation of the program, the salary increased to 25,000 rubles. The nurse initially had a salary of 3,800 rubles to 4,480 rubles, but as a result of payments for modernization, the salary increased to 13,000 rubles. Payments were made on the basis of the reports of the heads of departments, where the responsible person evaluated the work of subordinates according to the criteria.

But unfortunately the modernization program was introduced temporarily, its deadline is 07/01/2013, these dates are indicated for the completion of repairs, construction and procurement medical equipment. With regard to wages, from 01.04.2013 the remuneration of medical workers will be charged from the funds of Compulsory Medical Insurance. In the clinic, such an innovation as "Fund holding" was introduced. This means that funding will be per capita.

The aim of the project is to encourage primary care physicians to focus more on preventive work, reduce hospitalization, and reduce the number of calls to the ambulance. If positive results are achieved, the clinic will receive additional funds from the hospital fund. This is the meaning of fundraising.

The employees of the polyclinic have already felt the changes in funding.

If we return to the payment for the modernization of a doctor in a narrow specialty of 25,000 rubles, then in April 2013, according to the new payment scheme, the doctor received 21,000 rubles. At nurses reduction of salary by an average of 2000 rubles.

The pay cut is obvious.

What caused the decline?

On this moment the clinic fund contains about 4.5 million rubles, according to the calculations for payment utility bills, tests for patients, salaries of employees, purchases of medicines for day hospitals and injection rooms, as well as daily expenses for gasoline and expenses for household needs, 6 million rubles are needed. Where to get the missing funds?

Here, the administration comes to the aid of total savings on: stationery, for the payment of bonuses to personnel, for staff reductions, etc.

But in any case, the innovation in the clinic is not a personal desire of the administration, but an order "from above" that must be followed.

In 2012, cosmetic repairs were made in the branches of the polyclinic, equipment was purchased for 6.5 million rubles, computers were installed in the offices of general practitioners and specialized doctors to facilitate documentation.

Every year, on the day of the medical worker, the administration of the polyclinic honors the most responsible and conscientious physicians by presenting them with a cash prize and certificates of gratitude.

Leisure activities are held.

Employees are provided with vouchers for sanatorium treatment.

4.4 Employee incentive offers

MBUZ "City Polyclinic"

If we take into account the fact that labor activity occupies a significant place in the life of almost every person, then medical workers are engaged in their activities after the working day, advising neighbors, relatives and providing assistance in force majeure circumstances. Therefore, constant experience negative emotions dissatisfaction with one's job, working conditions have significant implications for human health and general well-being.

Accordingly, if you properly motivate a person, create comfortable working conditions for him, the efficiency of the staff will increase significantly.

In MBUZ "City Polyclinic", doctors and nurses would work much better in clean, renovated rooms, where there would be comfortable furniture swivel chairs and new tables, as well as full provision of stationery with what is currently a tense situation.

I would like there to be held for children recreational activities,

after the birth of a child, women would be presented with a small present from the administration, as well as a timely application to the kindergarten.

There is a catastrophic shortage of young specialists doctors in the polyclinic.

But they do not go, because the salary does not suit the novice doctor. Attracting young people is a very important goal.

Therefore, specialists need to create conditions for work, provide housing, guarantee a place in kindergarten for their children, etc.

When studying the enterprise, it turned out that the average age of doctors is 48 years old, the average age of nurses is 36 years old, which means that the team is qualified and works smoothly, so it is not desirable to allow “churn” and the solution to this may be an increase in wages.

It is also necessary to train personnel in working with a computer and programs, in connection with the transfer of all reporting and document management to an electronic version.

I would also like to note thatThere are absolutely no rest areas for staff.

I would like to fix this.

CONCLUSION

The real effectiveness of any economic measures is determined by their impact on the attitude of people to work. It is impossible to change this attitude legislatively, since this is a long evolutionary process, but it can be accelerated if a specific situation is soberly assessed and the reasons that gave rise to it are taken into account.

Unfortunately, managers rarely take into account the social consequences of their decisions, and the decisions themselves are often not complex, but purely economic or technical.

Any leader is always aware that it is necessary to encourage people to work for the organization, but at the same time believes that a simple material reward is enough for this. Sometimes such a policy is successful, although, in essence, it is wrong.

The main conclusions on the theoretical part:

Labor motivation, despite the difference in approaches, is one of the fundamental methods of personnel management, encouraging employees to achieve the goals set for them and the organization. The development of market relations forces managers to change the existing methods and forms of management in all areas of modern management, and primarily in the management of staff motivation. These changes must be based on the existing needs of employees, who, despite the difficult economic situation, are not limited to the material component, but are presented in all their diversity. Therefore, managers who want to achieve the effective work of their employees apply not only methods of economic incentives and administrative influence, but also pay great attention socio-psychological methods.

To create a positive socio-psychological climate in any team, it is necessary to study the characterological features of employees (typology of characters). The effectiveness of the work performed by the staff largely depends on this. Such studies should be carried out using a variety of tests already at the time of employment (Appendix 1). In addition, it is necessary to take into account the factors of motivation identified as a result of diagnostics. Such factors are, first of all, the feeling of envy of some workers towards others who receive more remuneration for similar work, and an overestimated self-esteem by workers of the results of their work. This requires either psychological help specialists, or explanatory work of direct management, implementing a particular policy of differentiated incentives.

In case of ineffectiveness of the methods of motivation used, it is necessary to change the approaches to the implementation of the motivational policy, based on the needs, interests and desires of employees. However, relying entirely on calculated indicators is wrong. In personnel management, as well as in other areas of management, a situational approach is needed to determine the effectiveness of the policy being pursued based on the specific state of affairs in the organization.

The main conclusions on the practical part and recommendations:

The situation in the team is quite favorable. The performance is at a decent level, as shown by the latest audit of the CHI Fund.

The main attention of management should be paid to the fair remuneration of employees according to their contribution to the collective labor process. The greatest value for employees is material incentives - salary increases, as well as working conditions.

Management should take some psychological work in the team, given that the value is not only external material reward, but also internal satisfaction, as well as skillfully combine economic incentives with moral encouragement.

List of used literature

1. Vikhansky O.S., Naumov A.I. Management, - M.: Gardarika, 1998.

2. Burmistrov A., Gazenko N., What methods of increasing staff motivation are the most effective? Personnel management - 2002.- No. 7.

3. Tsvetaev V.M. Personnel Management. St. Petersburg: Piter, 2002. S. 127.

4. Bogdanov Yu. N., Zorin Yu. V., Shmonin D. A., Yarygin V. T. Personnel motivation Methods of quality management. - 2001. - No. 11.

5. Shepelya V. "Labor stimulation" - "Archimedes lever" 1999

6. M.Kh. Mescon, M. Albert, F. Hedouri. "Fundamentals of Management", M.: Delo, 1992

7. Campbell R. McConnell, Stanley L. Brew - "Economics", 2 vols., M.: Respublika, 1992.

8. Blinov A. Staff motivation corporate structures Marketing. - 2001.

9.Agaptsov, S.A. Motivation of labor as a factor in improving the efficiency of production and economic activity of the enterprise: textbook. manual for universities - M.: Misanta, 2003.

10. Dryakhlov, N.I. Personnel motivation systems in Western Europe and the USA. St. Petersburg: Peter 2003

11. Maslow, A. Motivation and personality textbook, St. Petersburg: Peter 2002

12. Meskon, M. Kh., Fundamentals of Management, textbook M. Albert, F. Hedouri. Per. from English. M.: Delo, 2002

13. Utkin, E.A. Motivational management, textbook - M.: TANDEM: EKMOS, 1999.

14. Khoroshiltseva, N.A. Study of the structure of motivation of specialists in the construction of a wage system - Corporate management http://cfin.ru

15. B.M. Genkin, G.A. Konovalova, V.I. Kochetkov, Fundamentals of personnel management textbook - M.: graduate School, 1996.

Annex 1

Test

In order to determine the level of satisfaction with the work of employees at the enterprise MBUZ "City Polyclinic of LGO", a survey of employees is conducted. Please answer the test questions as truthfully as possible.

1.Your age ____________

2. Work experience in this organization ___________

3.Education ____________

Please indicate to what extent you are satisfied with the following aspects of your work (write the appropriate number next to the question using the scale):

5 quite satisfying

4 more satisfying than not

3 can't tell if it's satisfying or not

2 rather unsatisfactory

1 Totally unsatisfactory

Salary
The work process itself
Prospects for professional and career growth
Relationship with immediate supervisor
The importance and responsibility of the work performed
Working conditions (noise, lighting, temperature, cleanliness, etc.)
The reliability of the place of work, giving confidence in tomorrow
Opportunity to perform a job respected by a wide range of people
How effectively the work is organized in general
Relationships with work colleagues
Opportunities for independence and initiative in work
Working mode
Work matching your abilities
Work as a means to success in life

If possible, indicate your wishes and suggestions on the listed issues ________________________________________________________________________________________________________________________________________________

Thank you for your help with the research!

I therapeutic department

II therapeutic department

Narrow specialists:

ENT, Oculist,

Dermatologist

Neurologist,

Surgeon, Venereologist

Traumatologist,

Endocrinologist,

Urologist,

Physiotherapist.

Physiotherapy Department

Women's consultation

Clinical laboratory

x-ray

Registry

Electronic registry

older sisters

Accounting

Human Resources Department

Department of Statistics

CHIEF DOCTOR

deputy chief economics doctor

Deputy head business doctor

Chief Accountant

Deputy head medical doctor

Ch. nurse

Economists

Operators

Sisters are housewives

Other related works that may interest you.vshm>
21085.		Personnel management system of the State Enterprise "Polyclinic No. 1"	205.73KB
	The external environment of the organization. Internal environment organizations. Analysis of the personnel potential of the organization. At present, interest in a person as the main factor of production, an income factor in increasing labor productivity as a valuable resource, and the property of an organization in the competitive struggle, has increased significantly.
5704.		Designing a WEB-portal on the example of the State Enterprise "Kostanay City Children's Hospital"	2.71MB
	Portal development tools The main tool for creating the WEB portal of the Kostanay City Children's Hospital is the common PHP programming language. Description of software modules The Electronic Registry module is a separate file that is processed by the PHP interpreter and serves as a router for displaying personal pages of specialists with the ability to make an appointment...
13235.		PSYCHOLOGICAL SUPPORT OF PREGNANT WOMEN IN WOMEN'S CONSULTATIONS (ON THE EXAMPLE OF MBE "MATERNAL HOSPITAL No. 2")	415.36KB
	PSYCHOLOGICAL SUPPORT OF THE PERSON; PSYCHOLOGICAL PECULIARITIES OF PREGNANT WOMEN; MODELS OF PSYCHOLOGICAL SUPPORT OF PREGNANT WOMEN. The purpose of the work is to identify the effectiveness of psychological support for pregnant women in a antenatal clinic. The subject of the study is the effectiveness of psychological support for pregnant women in the conditions of the antenatal clinic. The results obtained and their novelty: a study was made of the effectiveness of psychological support for pregnant women in a antenatal clinic; revealed...
21048.		Research and improvement of the conflict management system on the example of the MBUZ of the city of Magadan "MSCh" Aviamedicine "	356.06KB
	These problems are relevant primarily because conflicts can be present in any sphere of society, and a conflict left to chance can lead to undesirable consequences for both individuals and society. To find the optimal solution, you need to have knowledge of how such conflicts develop. To develop the right line of conduct in various conflict situations, it is very useful to know what conflicts are and how people come to an agreement. Many managers prefer to solve emerging ...
8192.		IMPROVEMENT OF THE MOTIVATION SYSTEM AND INCENTIVES OF EMPLOYEES OF MUNICIPAL ORGANIZATIONS IN THE SECTOR OF HUSAL UTILITIES (ON THE EXAMPLE OF "UMUP CITY HEATING NETWORK")	410.46KB
	When writing the work, legislative acts, monographs, scientific and educational publications on management and personnel management, materials from periodicals devoted to the issues of personnel motivation, the formation of remuneration systems and career management were used. The initial basis for the analysis of the system of labor motivation
17619.		Motivation in the structure of personality	39.42KB
	This happens because it is long overdue to introduce into the practice of research by psychologists a way to human behavior in the reality of knowing its laws, the importance of revealing the connection between internal and external motivations of a person with the social component. The subject of this work is the motivational sphere of a person as a structural component of personality. Target control work explore the place of the motivational sphere of a person in the structure of personality. They are stable, unique for each person, they are the foundation of personality ...
7966.		Motivation of labor activity	309.79KB
	Maslow's pyramid of needs includes scheme 31 of the following groups: 1. Stages of group development. He is not only the performer of a certain role corresponding to his position, but also a member of the group within which he acts. At the same time, the group influences his behavior of a person, and his behavior affects the life of the group.
20137.		Motivation for trade union membership	22.14KB
	Work to strengthen the trade union ranks, to motivate trade union membership requires constant improvement of its forms and methods, giving it a certain systemic nature, attributing the motivation of trade union membership to the priority areas of activity of all structural organizations of trade unions.
2026.		Staff training and motivation	15.24KB
	The main potential of an organization's enterprise lies in its employees. The implementation of both strategic tasks and goals and short-term plans of any organization involves the performance of certain actions by its personnel, the totality of which can be called production behavior. The main meaning and purpose of personnel management of an organization's enterprise is to ensure the behavior of each employee required to achieve organizational goals. Usage efficiency human resources in an organization depends both on the ability...
20683.		The cohesion of the employees of the organization	108.14KB
	The concept of cohesion, which is considered A, is closely related to the problem of the team. Hypothesis: We assume that socio-psychological training can serve as an effective means aimed at forming the cohesion of the employees of the organization. To study the theoretical aspects of the work of a practical psychologist in the formation of cohesion among employees of an organization.

Svetlana Koroleva, a medical psychologist at the City Clinical Hospital No. 67 named after L. A. Vorokhobov, of the Moscow City Health Department, talks about how heads of medical institutions can motivate their employees.

To the top of the pyramid

Olga Zhukova, LekOboz: Svetlana Valerievna, there is a lot of talk about staff motivation these days. How relevant is this problem for medical workers?

Svetlana Koroleva: Motivation is an impulse to act, which is aimed at satisfying a person's needs. This process is inherent in each of us, any human activity begins with it, and it cannot be underestimated: it is motivation that controls human behavior, makes him work, perform actions and develop as a person, and this problem is relevant for everyone.

— But at different people there may be different needs.

Motivation can also be different. It is internal and external. With internal motivation, the stimulus to action is the internal desires of a person - such motivation is typical for strong-willed people. But very often a person needs an external stimulus or external circumstances to perform certain actions: someone must, relatively speaking, beckon him with a carrot or create a threat so that the person himself runs in the right direction. This motivation is called extrinsic.

What is the best motivation?

- This is determined individually: each person himself knows how best to motivate him. It shows up in everything. In the absence of strong internal motivation, external motivation begins to predominate. What makes a person go to work? This may be his inner interest and love for the profession, or maybe just good salary. But according to my observations, I concluded that one material incentive for the good work of employees is not enough. If a person goes to work, spends his strength and energy, gets tired and overcomes difficulties in the process of labor activity only in order to receive a salary twice a month that will provide him social guarantees and the ability to satisfy his further needs, then such a motivation for labor activity will sooner or later show its inconsistency. To avoid this, it is necessary to create higher-level needs in the working environment.

The American psychologist A. Maslow created a hierarchical model of human needs, which shows which needs are considered low and which are high. Needs of the lowest level are needed to maintain life - this is the need for food and security. At the next level are the needs for love and respect. At the top of this pyramid are the needs for which, in fact, a person lives - in self-expression and personal growth. The nature of motivation is to slide up the ladder of needs, and the best motivation for action is to stimulate higher-level needs: the need for knowledge, aesthetic needs, and self-actualization. If we are talking about staff motivation, then it is necessary to motivate people not to satisfy needs such as food or buy some thing, but to achieve a higher personal level, which entails recognition, respect, development of personal resources.

Personality above all

— How can this be achieved?

- To increase the motivation of employees of healthcare institutions, the administration needs not only to pay attention to the precise performance of the work duties of each employee, but also to push the staff to realize their own uniqueness in their profession. Each of us has certain character traits that we can bring to our professional field: someone is seething with enthusiasm for research - it will suit him scientific work, someone has a large and pronounced level of empathy and compassion - such a person is indispensable in communicating with people, he can even help them with a kind word, and someone has energy in full swing - such a person needs to be loaded with complex tasks as much as possible and not entrusted to him simple or routine work. Understanding the personal characteristics of employees will help ignite their professional interest and push them to personal growth and the desire to increase their status and prestige in this profession.

The prestige and uniqueness of the medical professions lies not only in educational programs. Unfortunately, some professions in medicine are considered of little prestige - for example, the profession of a nurse. Despite the fact that the medical process is impossible without a nurse, the doctor is considered the main thing in medicine, and nurses remain on the sidelines. I would argue with this and put these professions on a par, because a doctor in a hospital, having taken responsibility for treating a patient, delegates this responsibility to a nurse, and it is she who deals with the patient most of the time: the nurse provides treatment, provides care, and even to some extent plays the role of a psychologist. This is a huge, colossal work that requires strength, compassion, and professionalism from a person.

A nurse, as a person of a helping profession, can show the strength and beauty of her personality in communicating with patients and show a certain personal growth, and the task of leadership medical institution is to encourage her to do so and maintain her professional interest. If a nurse is not interested in personal growth, if she is a weak and uninteresting person, then communication with her will be poor, not meeting the expectations of patients. Now, during the period of reform Russian healthcare, patients are given the right to choose their own medical institutions, therefore, when providing medical services we must focus on consumer needs and take into account all aspects of working with patients. Under these conditions, the role of the nurse has increased significantly, so in this profession it is important not only to show their professional quality but also develop them. And this requires external motivation.

Individual approach

- How can the management of a healthcare institution motivate employees?

- As I said, the types of motivation should be selected individually, depending on the psychological characteristics and needs of each employee. American psychologist Murray described more than 20 types of human needs that can motivate behavior. Understanding the needs of each employee will help you find the key to him that will become the motivation for his work. The most common needs are:

the need to demonstrate, to attract attention - such people need constant admiration and recognition of their uniqueness;
the need for affiliation is the need for friendship, support, and approval from others. If such a person is not praised and supported, he cannot work well, since for him the most powerful motivation is emotional support from the team;
the need for veneration - if a person needs priority (“praise me, praise me - I deserve it more than anyone else”);
the need for autonomy - when a person wants to exist outside the team ("do not dictate the rules to me, I myself know them very well"). Such a person cannot be pressured;
the need for dominance - when a person strives for a leadership position, wants to influence others, convince them or forbid something to them. Such a person is helped by others in the realization of his needs, if they obey his requirements. But if such an employee stumbles upon any barrier, he is dissatisfied and very exhausted;
the need to avoid guilt - employees with this motivation are very good for management, they try to do their job carefully and avoid possible mistakes. But, if they are still mistaken and claims are made to them, then for them it becomes a real disaster;
the need for support - such employees are eternal subordinates, and they constantly need a mother hen who will support and approve them. They never show initiative, they constantly need to be pulled, just like a locomotive pulls a cart. But this cart will always be loaded and will carry everything that it is supposed to. They know how to work and are the keepers of history and traditions;
the need for the game is the desire to carry out labor activities in the game, to bring diversity, pleasure, fun and laughter to the life of the team. They are important for the team, as they bring a certain amount of celebration to the work and help to better cope with the routine. To artificially create such motivation, it is useful to hold corporate events, celebrate birthdays and various holidays, but in such a way that it does not harm the working environment;
the need for knowledge is an extremely important need that can be attributed to the needs of a higher order - a person seeks to grow in his professional environment. The thirst for knowledge provides a person with an intellectual growth that benefits not only himself, but also his institution.

If the head of a medical institution clearly knows what types of needs people have, then he will be able to better understand what needs each of his subordinates has. Then he will be able to select for each employee one or another resource that will push him to expand the motivational sphere, or transfer the employee to the place that best suits his needs.

Tatarnikov M.A. Research Institute of Public Health and Health Management of the Moscow Medical Academy. I.M. Sechenov

Increasing the work motivation of medical workers is the most important problem of healthcare management. Without its 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 on the basis of rational use 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 in nature and require integrated approach in their decision. The article presented to your attention discusses the main theories of labor motivation. The analyzed theories are universal in nature and applicable in healthcare management.

Classification of theories of labor motivation

Modern methods of labor motivation are based on the results of sociological and socio-psychological research. It is believed that for effective motivation workers, it is necessary to determine their needs in order of importance and ensure the possibility of their satisfaction in the process of labor activity. However, it should be borne in mind that the true motives of human behavior are quite complex and not always accessible for understanding, incl. and by the individual himself. From the point of view of cognitive psychology, labor motivation is the process of influencing the installation system or its individual components in order to stimulate a person to activities aimed at achieving the goals of the organization.

Currently, there are two main groups of theories of motivation:

2. Process theories of motivation, which are primarily based on the study of the cognitive characteristics of the perception and interpretation of information and people's cognition.

The content theories of motivation are based on the works of A. Maslow, F. Herzberg and D. McClelland.

A. Maslow developed the most important theoretical provisions on the types of needs, self-actualization and mechanisms of personality development. According to his theory, needs can be divided into five main categories:

1) physiological needs - for food, water, sleep, etc.;

2) needs for security and confidence in the future;

3) social needs (the need for love, affection, support, belonging to something or someone);

4) the need for respect, self-respect, recognition;

5) the need for self-actualization (a person's need for the development of his personality, self-expression, development of abilities, realization of his potentialities).

According to A. Maslow, needs form a hierarchical structure, which, as a dominant, determines human behavior. At each particular moment in time, a person will strive to satisfy the need that is most important or strong for him. Higher level needs do not motivate a person until the lower level needs are at least partially satisfied. However, this hierarchical structure is not absolutely rigid and strict. Therefore, A. Maslow subsequently combined all existing needs into two classes - the needs of need (deficit) and the needs of development (self-actualization).

There is no universal method of labor motivation that is effective in all situations and for all employees. What is successful today may not be successful tomorrow. What works for some people may not work for others. What works in one situation may have the opposite effect in another. That is why for effective motivation it is necessary to use a situational approach. It should be borne in mind that the needs of a person and the ways to satisfy them are determined by his installation system, place in the social structure and previously acquired life experience.

Thus, there are many needs that determine the motivation of people and their subsequent behavior, which, in their opinion, can lead to the satisfaction of these needs. Since needs can change over time, it is necessary to periodically adjust the motivation process. The task of the manager is to determine the dominant needs of his subordinates and, in accordance with the goals of the organization, contribute to their full or partial satisfaction.

D. McClelland's theory of motivation focuses on the needs of higher levels. According to it, people have three basic needs: power, success and belonging. In Maslow's hierarchical structure of needs, the desire for power is located between the needs for respect and self-actualization and manifests itself as a desire to influence other people.

People with a need for power often show themselves as energetic people who are not afraid of confrontation. These are not necessarily careerists striving for power in the negative sense of the word. According to McClelland himself, those people who have the highest need for power and no propensity for adventurism or tyranny, and the main one is the need to exercise their influence, should be prepared in advance for leadership positions. Personal influence can only be the basis of leadership in very small groups. If a person wants to become the leader of a large team, he must use much more subtle and socialized forms to manifest his influence. The positive properties of the leader are manifested in his interest in achieving the goals of the organization, in taking the initiative to provide the members of the managed team with the methods and means of solving the tasks set, in shaping subordinates' self-confidence and competence, which will allow them to work effectively.

The need for success in Maslow's hierarchy of needs is also located between the needs for respect and self-actualization and is satisfied by the process of bringing the work to a successful completion.

To motivate people with a need for success, you need to:

Set them tasks with little risk of failure;

Delegate enough authority to them to unleash their initiative;

Regularly and specifically encourage them in accordance with the results achieved.

People with a need for belonging are interested in social relations, companies of acquaintances, establishing friendships, helping others. To motivate them, you can:

Attract with work that provides opportunities for social communication;

To create a working atmosphere that does not limit interpersonal relationships and contacts.

Of practical interest is the theory of motivation by F. Herzberg. As a result of the research, it was revealed that the motivational factors for increasing labor productivity and the factors that make work more attractive are different in nature and do not always coincide with each other.

The first (they are called motivations) include:

Good chances for promotion;

Recognition and approval of a job well done;

Payment related to the results of work;

Opportunities for creative and business growth;

High degree of responsibility.

The second (they are called hygiene factors) include:

Working conditions (convenient work schedule, sanitary and hygienic conditions, comfort and location of the workplace, work without great tension and stress);

The amount of earnings and the availability of additional material benefits;

Interpersonal relationships with superiors, colleagues and subordinates.

Thus, motivations are associated with the nature and essence of the labor activity itself, and hygienic factors - with working conditions and working environment.

Considering that job satisfaction and work motivation are influenced by different factors(or the same, but to varying degrees), their analysis, taking into account local conditions, is extremely important for the labor motivation of medical workers.

The absence or insufficiency of hygiene factors causes job dissatisfaction. However, by themselves they do not motivate a person to work. It is possible to increase wages, introduce additional benefits, improve working conditions, thereby increasing the degree of job satisfaction, and not get the corresponding labor return. However, we must not forget that job satisfaction in itself, to one degree or another, is a motivating factor in effective labor activity.

The relationship between job satisfaction and job performance is not always present. For example, some employees are highly satisfied with their jobs because they have ample opportunities for social interaction with colleagues. At the same time, they may not be interested in improving the quality and productivity of labor.

The task of the leader is to identify and satisfy, first of all, those needs of subordinates that contribute to the achievement of the goals of the organization.

Despite the fact that the content theories of A. Maslow, D. McClelland and F. Herzberg do not take into account numerous behavioral aspects and features of human perception environment, their importance for understanding the motivational mechanism is still great. The main provisions of meaningful theories are presented in Table. 1.

Table 1

The main provisions of the content theories of A. Maslow, D. McClelland and F. Herzberg

A. Maslow's theory

1. Needs are divided into primary and secondary and represent a five-level hierarchical structure in which they are arranged in accordance with priority.

2. Human behavior is determined by the lowest unsatisfied need in the hierarchical structure.

3. After the need is satisfied, its motivating effect ceases.

Theory of D. McClelland

1. Three needs that motivate a person are the need for power, success and belonging (social need).

2. Today, these above-mentioned higher-order needs are especially important, since the needs of the lower levels, as a rule, have already been satisfied.

Theory of F. Herzberg

1. Needs are divided into hygiene factors and motivations.

2. The presence of hygienic factors only prevents the development of job dissatisfaction.

3. Motivations that roughly correspond to the needs of the highest levels in Maslow and McClelland actively influence human behavior

4. In order to effectively motivate subordinates, the manager himself must delve into the essence of the work

Source: Meskon M., Albert M., Hedouri F. Fundamentals of management: Per. from English. - M.: Delo, 1997. - S. 375.

Process theories of motivation

Process theories consider not only the existing needs of a person, but also the process of choosing a possible behavior based on the characteristics of his perception of the environment, expectations and evaluation of the possible results of the selected behavior. There are three main process theories motivation:

Theory of expectations;

Theory of justice;

Porter-Lawler model.

According to expectation theory, a person expects that the type of behavior he chooses will lead to the satisfaction of his needs. If, according to the subjective opinion of the individual, the probability of achieving the desired result is small, the motivation to act decreases.

Expectancy theory considers the following relationships:

● labor costs - results of labor;

● results of work - remuneration;

● reward - satisfaction with the reward, its subjective value for the individual.

People hope that their efforts will lead to the planned result, the achieved result will lead to a reward, and that the reward will be valuable and desirable for them. Otherwise, the motivation of employees begins to weaken.

Work motivation is often associated with money or other material gain. In modern theories of motivation, the concept of reward is interpreted more broadly. It is understood as everything that a person can get as a result of a certain behavior and considers valuable for himself. Since the value system of each person is unique, the assessment of the significance of the reward will depend on many external (situational) and internal (dispositional) factors. What is valuable to one person may not be of great value to another. What is significant in one situation may lose value in another. Therefore, the motivation of employees should be carried out in a differentiated way. There are 2 types of reward:

1. Internal reward (feeling of achievement of the result, meaningfulness and significance of the work performed, self-respect). The internal reward comes from the work itself.

2. External reward (salary, promotion, symbols of official status, prestige, social recognition). External remuneration is given by the organization in which the person works.

The optimal ratio of internal and external rewards is determined by the needs of people. Despite the low salaries of medical workers, their work motivation should not be limited to material remuneration.

According to the expectancy theory, work motivation will decrease if people feel that:

● there is no direct connection between the efforts expended and the results achieved;

● there is no connection between the results achieved and the desired reward;

● results achieved will be rewarded, but with a reasonable effort, these results cannot be achieved;

● the subjective value of the expected remuneration is not too high and does not satisfy the current needs of the employee.

To increase productivity, leaders must set high but realistic expectations for subordinates and convince them that they can achieve them if they put in the effort.

Management practices confirm the strong influence exerted by the expectations of one person on the behavior of another. The assessment of employees of their capabilities largely depends on what management expects from them. If the requirements of management are high enough, but justified and understandable to subordinates, productivity and quality of work, as a rule, increase.

The theory of justice is based on the position that people evaluate (extremely subjective!) the ratio of the remuneration they received and their own efforts expended, and compare it with the remuneration of other workers for similar work. If it turns out that his colleague received more, then there is a psychological (and often physiological!) Feeling of discomfort, trampled on justice. To restore the balance, it is necessary either to achieve an increase in the level of remuneration received, which is not always possible, or to reduce the efforts made, which is easier. People who feel they are underpaid tend to work less intensively. However, if they feel they are being overpaid, their work behavior generally does not change.

It should be emphasized once again that assessments of labor contribution and remuneration are extremely subjective. As a rule, comparison occurs with employees of one's own organization or with employees of other organizations performing similar work. Health professionals must clearly understand why another person is paid more for similar work, and accept these reasons as fair, otherwise internal discomfort will persist.

The theory of justice is extremely important practical value in the motivation of healthcare workers. To reduce socio-psychological tension in labor collectives, not only reasonable explanations about material support are required, but also a fair (according to the workers themselves) distribution of material benefits in the compared social groups. It is not for nothing that the level and procedure for remuneration of medical workers throughout the country is approximately the same and correlates with the salaries of other public sector employees on the basis of a single tariff scale. A medical worker is much more influenced by the size of wages in a neighboring health facility than the income of other social groups.

The Porter-Lawler model includes elements of expectation theory and equity theory. In accordance with it, the results of labor depend on three variables:

Effort expended;

human abilities;

Evaluation of their role in the labor process.

The amount of effort expended depends on the employee's assessment of the value of the reward and the confidence that it will be received. According to the Porter-Lawler model, performance and a sense of accomplishment lead to a sense of satisfaction. Previously, it was believed that job satisfaction determines high performance. However, practice has shown that high performance is the cause of satisfaction, and not a consequence of it. Satisfied employees do not always perform better.

In the course of work, money is the most common reward. Although the analysis of remuneration schemes for medical workers is not within the scope of this publication, it should be noted that when developing them, it is necessary to use not only economic approaches, but also socio-psychological methods. Many people attribute material rewards to hygiene factors. A simple salary increase may not have a motivating effect. However, money makes it possible to satisfy not only the physiological, but also the social needs of a person (the desire for security, confidence in the future, the need for respect, self-respect, recognition). Financial reward should follow only effective work. Wages that are not related to the results of labor lose their motivating value. However, the implementation of the principle of payment according to the final result in healthcare is hardly possible due to the difficult to formalize criteria for evaluating the performance of medical workers and healthcare facilities.

The remuneration received affects the future work behavior of a person. People tend to repeat the behavior that they associate with the satisfaction of their needs and avoid those that in their minds are associated with their lack of satisfaction. In psychology, this process, based on the mechanism of reward and punishment, is called social learning. If certain actions receive positive reinforcement, they are repeated and reinforced. Conversely, people stop doing things that do not bring any valuable return for them (there is no positive reinforcement) or that has negative consequences.

When working motivation is extremely important normative social influence, aimed at the adoption of the prevailing norms, beliefs, ideas and rules of conduct in society or a particular social group. The rejection of generally accepted norms by an individual, including the rules of labor behavior, as a rule, leads to his social disapproval and coldness from others. And social approval refers to basic human needs. Therefore, the formation of positive values and a culture of work activity in the team is the most important task heads of healthcare institutions. In addition, people feel the need to compare their own assessments with others and to receive confirmation from others that they are correct.

Assessment by medical workers of their financial situation and working conditions

The results of sociological studies of the financial situation and working conditions of medical workers, the degree of their satisfaction with their work and profession are extremely important for studying their work motivation. Unfortunately, there is no system of medical and sociological monitoring in the industry, which does not allow obtaining sociological data in dynamics in different regions and promptly presenting the data to the heads of health authorities and institutions.

According to a survey conducted by the author of 1919 medical workers in the Moscow Region in 2002, only 0.9% of the respondents were completely satisfied with their financial situation, 22.8% - partially, and not satisfied - the vast majority (73.1%). Medical workers have no doubts about this - the number of those who found it difficult to answer was only 3.2%. The majority (84.1%) believe that their salary is underestimated and does not correspond to the labor contribution.

There is an extremely low level of respondents' assessment of the material security of their families. Only 2 people (0.1%) rated it as high and 15 (0.8%) as above average. The rest rated it as average (27.6%), below average (42.7%) and low (25.8%). Only 3.0% found it difficult to answer or did not answer this question.

27.8% of respondents are completely satisfied with their work, 59.9% are partially satisfied, 6.1% are dissatisfied, and 6.2% found it difficult to answer this question.

About half of the respondents (45.1%) are completely satisfied interpersonal relationships in their team, 47.3% are partially satisfied, only 2.7% are dissatisfied. The rest (4.9%) found it difficult to answer.

Things are somewhat worse with regard to the assessment of working conditions. Only 14% of medical workers are completely satisfied with them, 58.8% are partially satisfied, 21.8% are dissatisfied and 5.4% found it difficult to answer.

Despite low wages and not always satisfactory working conditions, only 4.6% of respondents would like to move to another job. 40.6% are willing to do so if available good offer. However, the majority (41.4%) do not want to change their place of work under any circumstances. The share of those who found it difficult to answer this question was 13.4%.

The increase in wages for employees of the primary outpatient clinic link has not yet received a proper sociological and socio-psychological assessment. According to numerous statements by representatives of the medical community and publications in the media, it can be assumed that the increase in wages for certain groups of health workers has led to a certain social tension in a number of labor collectives of health care facilities, which cannot favorably affect labor motivation, quality and culture of providing medical care to the population.

The desire of the industry management to staff the primary link by a significant increase in wages is understandable and understandable, however, the desire of an employee to take a position with a higher salary and the desire to work productively and efficiently in it are far from the same thing. As noted above, an increase in material remuneration does not always lead to an increase in labor motivation and the desire to work better. In addition, according to the theory of justice, overloaded narrow specialists, especially those working in central district hospitals, performing a large amount of work, often having considerable labor experience and a fairly high level vocational training and those who, in their opinion, did not receive proper remuneration, labor motivation may decrease. To develop an effective system of motivation for medical workers, sociological and socio-psychological research is required, including the study of the phenomenon of cognitive dissonance in the course of work.

Socio-psychological foundations of labor motivation of medical workers

New approaches in the field of social and cognitive psychology make it possible to more effectively solve the problems of increasing the labor motivation of medical workers, so health care managers should know the basic principles and methods of socio-psychological influence on their subordinates, which, along with improving the system of material remuneration, are becoming increasingly important.

At present, it is generally recognized that the behavior, thoughts, emotions and intentions (intentions) of a person do not depend on objective reality, but on its subjective interpretation based on the individual's attitudes. Therefore, it is necessary to understand how people perceive the world around them and how this affects their motivation. Labor behavior is determined by the forecast of the future, and the forecast of the future is determined by the interpretation of the information available to the employee on the basis of existing attitudes. Considering that the latter are purely individual for each person and are formed on the basis of the former life experience, values and beliefs, understand the difficulties practical application the theory of justice and the Porter-Lawler model containing elements of subjective forecasting.

According to A. Maslow's theory, the basis of motivation is human needs - from the lowest physiological to the highest needs for respect, self-respect, recognition and self-actualization. Workers expect their needs to be met through certain work behaviors. Moreover, the motivation will be stronger if the needs are subjectively perceived as extremely valuable and relevant.

The traditional methods of influencing subordinates are coercion and reward. A special place is occupied by material incentives, which are not only economic, but also socio-psychological in nature. However, at present it is becoming more and more difficult to effectively use coercion and even material rewards in labor relations. Under these conditions, the importance of socio-psychological methods of motivation increases. The ultimate goal of their application is to change the existing or the formation of new attitudes of a person and change the labor behavior of workers.

As is known, the labor behavior of people is determined by a complex interaction of internal (dispositional) and external (situational) factors. Moreover, the effect of the latter is often underestimated. The causes of human behavior are usually sought in his personality traits, neglecting the influence of the social situation. However, it is the situation and its subjective interpretation that are often the most important factors that determine the behavior and emotional state of a person. Therefore, the formation of an optimal working environment and an appropriate moral and psychological climate is the most important task for heads of healthcare institutions.

The elements of a person's attitude system (behavior, cognition, emotions and intentions) have a constant influence on each other. For example, new knowledge can lead to a change in a person's behavior or emotional state. At the same time, installations are, as a rule, a rather harmonious and ordered system. Their discrepancy to each other can lead to cognitive dissonance, which manifests itself in psychological discomfort and is the most important motivating factor in the thinking and behavior of the individual. Thus, labor motivation can be changed as a result of cognitive dissonance as a result of a discrepancy between individual attitudes or their components, which causes emotional distress, and sometimes even vegetative-vascular and other physiological disorders. Such manifestations motivate the individual to eliminate cognitive dissonance by changing behavior and (or) other components of the installation system. Remember the theory of justice discussed earlier, when not only the emotional state of a person changes, but also his labor behavior, and you will understand the importance of socio-psychological analysis in the process of labor motivation.

If a person cannot find an external reasoned justification for his actions, in order to eliminate cognitive dissonance, he will try to find the internal reason for his behavior by changing existing attitudes. For example, with a low material reward medical worker may begin to think of himself as an altruist who unselfishly helps people, or increase the subjective significance of communication with colleagues, or come up with another reason (and sincerely believe in it!), Often without an objective basis, but corresponding to existing attitudes.

Psychologists say that if you want to change people's work behavior, the more you force or encourage them, the more likely you are to get the desired result. However, if your final goal is to change people's attitudes towards work, the fewer incentives you need to motivate an employee, the better. The weaker the external motivating factors, the more the personal attitude will change in the direction of conformity with the behavior to which the person agreed under the influence of these factors. The person begins to think that he made the decision himself. Therefore, the stimulus must be strong enough to influence behavior, but weak enough for employees to feel that they are free to choose their behavior.

Thus, in order to effectively motivate employees, it is necessary to determine their attitudes and needs in order of importance and ensure the possibility of their satisfaction in the process of labor activity. At the same time, it should be taken into account that the true motives of human behavior are quite complex and not always accessible for understanding, incl. and for the individual himself.

The need is expressed in the physiological or psychological sensation of a lack of something. And although there is still no one generally accepted classification of needs, most scientists agree that needs, in principle, can be divided into primary (innate physiological needs for air, food, water, sleep, sex) and secondary (needs for success, respect, attachments, power, possessions, etc.). Primary needs are laid down genetically, while secondary ones arise and change throughout a person's life depending on the environment. As a result, the secondary needs of people are more individualized than the primary ones.

Self-actualization is understood as a person's need for the development of his personality, self-expression, realization of his potential.

Cognitive dissonance arises as a result of a discrepancy between individual attitudes of the individual or their components and manifests itself in psychological discomfort. Elimination of the phenomena of cognitive dissonance is an important motivating factor in human behavior and mental activity.

An attitude is a stable predisposition to a certain assessment, a scheme of thinking and behavior based on cognitions, emotions, intentions (intentions) and previous behavior, which, in turn, can influence cognitive processes, emotions, the formation of intentions and future behavior.

Cognitions are knowledge formed as a result of cognitive (cognitive) processes. They include beliefs, ideas, knowledge about the object and how one should behave towards it.

Intentions are the intentions that precede the actions themselves. Behavioral intentions can be realized in actions or remain in the form of intentions.

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 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 the study, even in the presence of 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 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 areas activities, including healthcare.

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. Management of motivation of labor activity of medical nurses of healthcare 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 of 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 in completely different ways 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.

IN good conditions work and a comfortable environment.

In a clear structuring of work, the presence feedback and information to judge the results of their 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 a sense of being wanted, 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, maintaining and forming long-term relationships with a small circle of colleagues, as well as the need for power, clear structuring of work, and manifestation of a 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 respect or lack of interest in this factor. Satisfying the dominant needs will help to improve the efficiency and quality of work.

Based on the foregoing, in the urological department high potential to revitalize 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 the 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. In assessing the satisfaction with the work of the workforce, average values of indicators 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 attributed to the entire structural unit. But I would also like to point out the fact that 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 as a result of 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 at 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), corresponding to the “satisfied” indicator on the key scale, 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), then 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 time, 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 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 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 of the 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 the management activities of the 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 their employees will lead not only to a general increase in the efficiency of the organization, but also to job satisfaction 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 (accessed 30.10.2019). We bring to your attention the journals published by the publishing house "Academy of Natural History"