The first section presents the results of the discourse and content analyses performed on the interview data. In the second section, the statistical results obtained from the questionnaire data are described.
Interview results
Analysis indicated two main reward categorization possibilities. First, the codes could be grouped based on the reward source: Who initiates the reward? Different categories were: the hospital superior, patients, colleagues, the nurse her(him)self and outsiders (e.g. family, friends, society in general). The second categorization option was based on the type of reward, which was more in line with the reward identification purpose of this study. Three main reward categories were derived: financial, non-financial and psychological rewards, all containing different subcategories.
Table
1 presents an overview of these reward categories and a definition of their subcategories. For each subcategory, the number of nurses who spontaneously reported it as a reward for doing the job is presented between brackets. The first category, "financial rewards", contains all monetary rewards: monthly pay, on the one hand, and all other remunerations on the other hand, e.g. a New Years' bonus or a vacation allowance.
Table 1
Reward categories and subcategories
Monthly pay (14/20)
The take-home pay
| Presents (17/20)
Flowers, presents, chocolates
| Recognition (17/20)
Appreciation shown, respect, win the regard of others
|
Other remuneration (12/20)
New Year's bonus, vacation allowance, money from patient
| Human relations support (13/20)
Staff journey, New Year's reception
| Patient contact (14/20)
Relationship with patient, ability to help others
|
| General services (7/20)
Vacation, health insurance, free meals
| Compliments (14/20)
Receiving praise, congratulations
|
| Individualized advantages (4/20)
Attending training, comfortable work schedule
| Social utility of the work (13/20)
Socially meaningful work, good feeling from job
|
| | Gratitude (11/20)
Words and other expressions of thankfulness
|
| | Social support (8/20)
Assistance, countenance, shown sympathy
|
| | Work climate (5/20)
Positive relationship with colleagues, pleasant working conditions
|
| | Confidence (4/20)
Trust as shown from the board, possibility to work autonomously
|
The second category "non-financial rewards", contains rewards with an indirect identifiable monetary value, possibly implying a cost for the hospital, although nurses cannot exchange these rewards for the money itself. This category encompasses four subcategories: presents, human relations support (social support activities organized by the hospital for the nurses), general services (hospital services that apply to all nurses in general) and individualized advantages (services that are considered as a reward by some nurses in particular).
Finally, the third reward category, "psychological rewards", contains eight subcategories: recognition, contact with patients, compliments, the social usefulness of the job, gratitude, social support, work climate and confidence from others.
Content analysis identified the nurses' most important rewards. In general, financial rewards (M = 13/20) were more often mentioned spontaneously than psychological (M = 10.75/20) and non-financial rewards (M = 10.25/20). One nurse explained it like this: "When thinking about rewards, you immediately think about financial things. But if you give it some more thought, we receive a lot more than only these financial rewards" (nurse 9).
From all nurses, 14 perceived their monthly pay as a reward for the job: "Personally, when talking about rewards for doing my job, it is very important for me to be able to earn enough money with it" (nurse 20). In combination with their monthly pay, 12 nurses also seemed to value their other remunerations. Most nurses in our sample perceived their monthly pay as a reward for their job, but it is important to note that the reward potential of money was mainly attributed to its being necessary in order to have a comfortable life: "Your salary is of course a very important reward; without it you can't do anything at all" (nurse 7).
Some subcategories of non-financial rewards seemed to be more important than others. Almost all nurses (17/20) especially valued the presents they receive from others: "Sometimes, even when the evolution of a patients' condition was not that positive at all, we afterwards received a postcard with greetings or a box of chocolates" (nurse 3). Thirteen nurses also valued the reward of human relations support: "Every year, the hospital organizes a New Year's reception for all employees. It is becoming a tradition to thank everybody this way for cooperating successfully and I consider it as a very positive signal" (nurse 14). The other non-financial subcategories "general services" (e.g. health insurance, free meals) and "individualized advantages" (e.g. the possibility of obtaining training, having a good work schedule) were considered as a reward for the job only by smaller numbers of nurses.
With regard to psychological rewards, "recognition" was perceived as a reward by 17 nurses, as important as the non-financial "presents": "For me, the recognition from others is very important. The fact that they like you and that your work means something to them, is a sufficient feeling for me" (nurse 17). Contact with patients was also considered as a reward by 14 nurses, together with compliments from others. Having good contacts with the patients seemed to be of crucial importance: "For me it is a privilege, a reward, that I can be part of the last precious moments of one's life" (nurse 9). Thirteen participating nurses also perceived the social utility of their job as a personal reward, indicating that they like to perform a job that is relevant to people in need and to society in general: "It gives me a good feeling about myself when I can help a patient, help people" (nurse 10). Finally, a smaller number of nurses also perceived gratitude, social support, a good work climate and confidence from others as non-tangible psychological rewards of their job.
In sum, nurses spontaneously mentioned financial rewards more often. However, when looking beyond the reward categories, at subcategory level, the most important rewards indicated were presents and recognition from others, followed by the monthly pay, the contact with patients and the compliments from others and also the human relation support activities as well as the social utility of the job.
Questionnaire results
The mean scores of the nurses on the 34 reward items are presented in Table
2. They can range from 1 to 5. The reward "appreciation of the work by others" received the highest mean score of 4.20, whereas "participate in recreational activities" received the lowest mean score of 2.60.
Table 2
Mean scores on questionnaire items
Pay | 3.85 | Appreciation of work by others | 4.20 |
Vacation allowance | 3.75 | Compliment from patient | 4.10 |
Allowance for travel expenses | 3.20 | Compliment from colleague | 4.05 |
| | Respect from colleague | 4.00 |
Non-financial rewards
|
M
| Compliment from superior | 4.00 |
Follow training | 3.85 | Respect from superior | 4.00 |
Good work schedule | 3.74 | Achieve own goals | 3.90 |
Promotion | 3.45 | Responsibility | 3.85 |
Job security | 3.40 | Good contacts with colleagues | 3.85 |
Vacation | 3.35 | Respect from patient | 3.80 |
Participate to recreational activities | 2.60 | Pleasant work environment | 3.75 |
| | Self fulfilment | 3.70 |
| | Involvement in hospital | 3.70 |
| | Challenging work | 3.70 |
| | Involvement in decision making | 3.65 |
| | Help with personal problems | 3.65 |
| | Varied work | 3.55 |
| | Social standing of job | 3.50 |
| | Opportunity to be creative | 3.45 |
| | Freedom to make own choices | 3.45 |
| | Pleasant working conditions | 3.45 |
| | Social utility of the work | 3.42 |
| | Personal contacts with patient | 3.40 |
| | Autonomy | 3.30 |
| | Good reputation of hospital | 3.30 |
First of all, the first two authors independently grouped the 34 items according to the three reward categories identified in the interviews, easily reaching a consensus for each item. A non-parametric Friedman test was performed (Chi2 = 1.33, p > .05), to examine whether these three categories received significantly different mean scores. The rewarding potential of the three reward categories was not statistically different, the average values being 3.71, 3.60 and 3.40, respectively, for the psychological, financial and non-financial rewards.
When looking at the item level, the psychological rewards "appreciation for the work by others", "compliments from patients", "compliments from colleagues", "compliments from superior" and "respect from colleagues", "respect from superior" received the highest mean scores from the nurses. Other important rewards were the financial rewards "pay" and "vacation allowance" and the non-financial rewards "training" and "having a good work schedule".
To examine whether demographical variables raised differences in rewarding potential between groups of nurses (i.e. gender, age, experience), the questionnaire data were subjected to non-parametric Mann-Whitney tests. Concerning age, two independent groups of nurses were formed, based on whether they were above or below the median age of 33 years. For experience, the same procedure was used, based on whether the nurses were above or below the median years of experience of 11 years. Moreover, these groups based on age and experience overlapped perfectly.
Gender did not seem to have any effect on the reward importance, as no significant difference in reward perception was found between male and female nurses. Older and more experienced nurses reported feeling significantly more rewarded by having job security (U = 18.50, p < .05) and working for a hospital with a good reputation (U = 24.00, p < .05) than their younger and less-experienced colleagues. These younger and less-experienced nurses, on the other hand, valued the reward promotion more than the older and more experienced ones (U = 18.50, p < .05).