Those of us who have worked in jobs that involve caring for others—children, the elderly, and especially the sick—know that such work is both emotionally and physically draining. This has never been more true than in the past few years as the COVID-19 pandemic has placed unprecedented pressure on care workers around the world. Nurses, in particular, were on the most intense front lines of the pandemic. In addition to dealing with a potentially deadly virus on a daily basis, nurses have also been forced to put their mental and emotional health at risk. According to one study, approximately 34% of nurses experienced burnout—debilitating emotional exhaustion—during the first year of the COVID-19 outbreak. This record attrition rate also poses a serious threat to public health, as high levels of nurse burnout are associated with threats to patient safety and survival.
Most recently, more than 7,000 New York City nurses went on strike to protest poor working conditions and understaffing at their hospitals. Cost-cutting and high levels of nurse burnout have created a vicious cycle in hospitals across the country, exacerbated by the COVID-19 pandemic, where poor working conditions have led to reduced retention, which in turn has led to even worse working conditions and therefore. even lower retention. The strike, which organizers say was aimed at ensuring patient safety, called for measures to make the job more manageable and attractive, such as higher pay for nurses and an end to staff shortages. Ultimately, these measures can recruit more nurses (many of whom left at the height of the pandemic) and increase nurses’ mental well-being on the job.
Given all these challenges, it is difficult to understand how hospital nurses managed to stay motivated. A long tradition of scientific research on organizational behavior recognizes two types of motivations that motivate people to commit to their work: intrinsic and extrinsic motivation. Intrinsic motivation refers to the joy or satisfaction we can get from actually doing the work itself, while extrinsic motivation refers to any benefit or satisfaction we derive from work that is not based on the actual tasks of the job. For example, my intrinsic motivation as a PhD student might be that I enjoy doing research (doing surveys, analyzing data, etc.), and my extrinsic motivation might be the satisfaction I will feel after receiving my PhD. Getting a degree is external to the actual tasks I do every day, but it’s a benefit that depends on me doing the work.
Previous research on this topic has understood that care workers, such as nurses, are primarily driven by intrinsic motivation. Of course, the nursing profession can have many different intrinsic motivators, such as the joy of helping people, saving lives, meeting and talking to people, feeling needed, or feeling appreciated by patients. However, as we have seen with recent retention issues and strikes, even strong intrinsic motivation may not be enough for nurses who have left or are considering leaving the profession. For example, in pursuit of higher wages, unions and nurses across the country are now working to increase the extrinsic motivation of nurses in the hopes that more people will be attracted to and stay in nursing.
In the article in Sociological forum, Fumilayo Showers shifts the narrative of what motivates care workers by highlighting some important extrinsic motivators. Focusing specifically on West African immigrants entering care work, Fumilayo shows that the prevalence of racial discrimination in other sectors and the possibility of career mobility are two important extrinsic motivations for entering a career in care. In other words, they see nursing as a viable career path because they are less likely to be discriminated against on the basis of race and less likely to be stuck in a low-status job because they can acquire qualifications and licenses to move up. Although the nursing staff interviewed in the study ultimately derived intrinsic rewards from the profession, it was primarily these extrinsic motivators that drove them into care work. This is an important finding because it suggests that one possible solution to staff shortages in hospitals across the country could be to further increase opportunities for nursing job mobility. If, eventually, it is easier for those entering the workforce to find stable, well-paid, and reasonably demanding jobs, people will have more extrinsic motivation to enter entry-level care jobs, allowing us to fill much-needed positions in hospitals in the long run.
