Journal of Nursing Management, 2014, 22, 1054–1064

The perfectly motivated nurse and the others: workplace and

personal characteristics impact preference of nursing tasks

SVEN H. KOCH P h D , R N 1, RUMYANA PROYNOVA MSc

2
, BARBARA PAECH PhD
3
and
THOMAS WETTER P h D 4,5
1
Postdoctoral Research Associate, Institute of Medical Biometry and Informatics, Unit of Medical Informatics,,
2
Research Associate, 3Professor, Institute of Informatics, 4Professor, Institute of Medical Biometry and
Informatics, Unit of Medical Informatics, Heidelberg University, Heidelberg, Gemany and 5Department of
Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA

Correspondence KOCH S.H., PROYNOVA R., PAECH B. & WETTER T. (2014) Journal of Nursing Management
Thomas Wetter 22, 1054–1064.
Institute of Medical Biometry and The perfectly motivated nurse and the others: workplace and personal
Informatics characteristics impact preference of nursing tasks
Im Neuenheimer Feld 305
Heidelberg 69120 Aims To identify whether motivation of nurses coincides with personal values,
Germany workplace or personal characteristics.
E-mail: thomas.wetter@urz.uni-hd. Background Shortage of nursing workforce compromises patient care. Motivation
de
and job satisfaction are factors considered to make nurses quit. Little is known
about measurement and variation of nurses’ motivation. Funding for human
resource programmes is limited – effective programmes could focus on nurses in
need of motivational support.
Methods Exploratory study with nurses using questionnaires in an academic
hospital in Germany. Work motivation was approximated through preference of
nursing tasks. Questionnaires measured personal values, preference of generic
nursing tasks, and workplace and personal characteristics.
Results A total of 212 questionnaires were usable. Higher motivation was found
in groups of nurses with the dominant personal value ‘Benevolence’, with high
self-rated expertise, in the middle of their career or working in surgical or general
wards. Motivation was low in nurses with the dominant value ‘Hedonism’, or
nurses in internal medicine or with low to medium self-rated expertise or who
used computers infrequently.
Conclusions Motivation coincided with dominant personal values, workplace and
personal characteristics. The results should be validated in other settings.
Implications for nursing management Human resource programmes could focus
on nurses whose motivation is at risk. Prospectively highly motivated individuals
should be hired with priority.
Keywords: nurses, personal values, population characteristics, task preference, work
motivation

Accepted for publication: 4 February 2013

(Hasselhorn et al. 2003, Zarea et al. 2009, Hill

Introduction
2011). Research suggests that nurses’ motivation
The shortage in nursing staff compromises quali- and job satisfaction is among the contributing fac-
fied patient care in many countries worldwide tors to high turnover of nurses and low enrolment

DOI: 10.1111/jonm.12083
1054 ª 2013 John Wiley & Sons Ltd

rates in nursing schools (Toode et al. 2010, Lu
et al. 2011).
Many approaches have been suggested to deal with
the nursing shortage. They include open communica-
tion, improving technology, nurse empowerment,
building long-lasting and fulfilling partnerships, and
efficient workplace organisation (Hussain et al. 2012).
However, limited funds are available to improve
nurses’ motivation, although more targeted spending
might boost return on investment. Currently, funds
are often spent indiscriminately on the whole nursing
workforce and on unfocused hiring activities. Possibil-
ities for focused spending include (1) investing in
training or workplace improvements for nurses who
are less motivated than the others and (2) focused
hiring of prospectively highly motivated nurses. How-
ever, there is no consensus about which nurses are
perfectly motivated, and should be hired with priority,
and which nurses are currently less motivated and
would benefit from additional spending to improve
their work situation.
Factors that affect nurses’ work motivation can be
categorised as (1) workplace characteristics, (2) work-
ing conditions, (3) personal characteristics, (4) individ-
ual priorities and (5) internal psychological states
(Toode et al. 2010). A recent review summarized find-
ings on factors that increased nurses’ motivation
(Toode et al. 2010). Workplace characteristics (cate-
gory 1) were good team collaboration (Hertting et al.
2004), high autonomy or opportunities to learn (Jans-
sen et al. 1999) and high workload (van den Berg
et al. 2006). Working conditions (category 2) included
suitable working hours (De Cooman et al. 2008),
rewards and promotions (Hertting et al. 2004, Ozturk
et al. 2006, Peters et al. 2010). Personal characteris-
tics (category 3) demonstrated that higher age in non-
intensive care unit (ICU) nurses (van den Berg et al.
2006) or lower age in general (Koivula et al. 1998)
increased motivation, as did higher-level college
education (Koivula et al. 1998) but not years of nurs-
ing experience (Kivimaki et al. 1995). Among individ-
ual priorities (category 4) that increased motivation
were having control over own time (Hertting et al.
2004) and the opportunity or personal calling to help
others (Raatikainen 1997, Ozturk et al. 2006, De
Cooman et al. 2008). Internal psychological states
(category 5) included experiencing meaningfulness of
the work (Hertting et al. 2004, Ozturk et al. 2006)
and experiencing responsibility for outcomes (Edgar
1999, Ozturk et al. 2006).
However, current research about factors affecting
nurses’ work motivation is fragmented and insufficient
ª 2013 John Wiley & Sons Ltd
Journal of Nursing Management, 2014, 22, 1054–1064
The perfectly motivated nurse and the others
(Toode et al. 2010), and systematic research into the
influence of personal values on motivation of nurses
seems to be lacking. The framework of ‘Motivation to
Care’ for professional nursing work by Moody and
Pesut (2006) defines motivation as a ‘values-based…
inner urge that activates and guides human behavior’.
Personal values are concepts that guide individuals
during their life, such as the concepts of benevolence,
self-direction and power, and have been systematically
researched by Schwartz (1992) and others. Personal
values significantly influence preferences and beliefs.
In our research, we rely on the validated personal val-
ues theory of Schwartz and co-workers (Schwartz
et al. 2001), which has specific descriptions of each of
the 10 personal values (see Table 1). Schwartz (1992)
showed that all these different values are to some
extent present in individuals of different races, nation-
alities and social or cultural backgrounds, and pro-
vided validated value measurement questionnaires.
However, no research has been found that systemati-
cally investigates nurses’ motivation in relation to a
fundamental model of personal values.
Objectives of the study
The objective of this study was to determine whether a
connection exists between motivation of nurses and
their personal values. Furthermore, we aimed to increase
Table 1
Personal values determined by Schwartz and their characteristics*
Personal value Characteristics
Achievement Personal success through demonstrating
competence according to social standards
Benevolence Preservation and enhancement of the welfare
of people with whom one is in frequent personal
contact.
Conformity Restriction of actions, inclinations and impulses
likely to accept or harm others and violate social
norms or standards.
Hedonism Pleasure and sensuous gratification for oneself
Power Social status and prestige, control and dominance
over people and resources
Security Safety, harmony and stability of society, of
relationship and of self
Self-direction Independent thought and action-choosing,
creating, exploring
Stimulation Excitement, novelty and challenge in life
Tradition Respect, commitment and acceptance of the
customs and ideas that traditional culture or
religion provide the self.
Universalism Understanding, appreciation, tolerance and
protection for the welfare of all people and for
nature
*Table modified from Schwartz et al. (2001).
1055
S. H. Koch et al.
knowledge on other motivational factors in the work-
place characteristics (hospital department, ward type)
and personal characteristics (age, years of nursing
experience, professional expertise, gender, and, because
of the focus of our study, computer use and
preference).
Methods
Attitudes towards a job (e.g. job dissatisfaction) have
been shown to influence behavioural intentions (e.g.
intention to reduce effort) (Fishbein & Ajzen 1975,
Steers & Porter 1983). As behavioural intentions are
concrete mental outcomes of underlying forces that
used to be called motivation, we subsequently worked
with the assumption that attitudes towards specific
tasks can be used as proxies for the level of motiva-
tion. An exploratory study using questionnaires was
performed during 55 days in August and September
2011. According to the regulations of the Human
Subjects Review board, no approval was needed.
Rather, the workers’ council was involved and gave
consent.
Study context and participants
The study was performed at the tertiary care hospital
of the University of Heidelberg, which acts as a regio-
nal referral centre and is one of the largest and most
renowned medical centres in Germany. Specialized
care is provided to about 700 000 patients yearly. At
the time of the study, the hospital employed 2851
nurses.
The study was performed with nurses working in all
areas except psychiatry and paediatrics because their
organisational structure differed from the others. All
nurses working in eligible areas were invited to
participate.
Data collection and measurement
Questionnaires were developed in cooperation with
nurses working at the hospital and tested by five stu-
dents and nurses. The Evasys survey system (Electric
Paper, L€uneburg, Germany) was used for layout,
printing and later scanning of the 10-page question-
naires.
Nursing managers of the 63 wards included were
contacted and individually visited by the first author.
During the visit, nurse managers were informed about
the aims, procedures, time-frame, potential incentives
and available support during the study, and then
1056
selected the number of questionnaires they wanted for
their ward. They then explained the study and made
the questionnaires equally available to nurses working
in each shift.
After completing the questionnaires, participants
returned them in sealed envelopes to the study office
where questionnaires were anonymized. Participants
could opt in for a lottery draw and wards with high
overall return rates received small rewards. For this
purpose, identifying and ward cover information was
recorded before and separately from accessing the
questionnaire contents. The anonymized question-
naires were scanned and answers were automatically
processed and tabulated using Evasys. A test with a
subset of the questionnaires confirmed the accuracy of
automatic scanning. Answers that Evasys could not
scan were processed manually.
Outcome measures
Study outcome measures were (1) the participants’
dominant personal values, (2) their motivation and (3)
their workplace, and personal characteristics. Out-
come measures were assessed through questionnaires,
which consisted of a total of 137 questions of which
95 were relevant to this paper. An additional section
not covered here measured preference of hypothetical
software features.
Dominant personal values
The dominant personal values of the participants were
determined through the portraits values questionnaire
(PVQ) (Schwartz et al. 2001) in the German version
(Hinz et al. 2002). The questionnaire included 40
questions, asking the participant to indicate his or her
agreement to 40 value-relevant properties on six-point
Likert scales. It asked participants to compare them-
selves with a certain person. One example statement
from the English PVQ which measures power is: ‘It is
important to her to get respect from others. She wants
people to do what she says’.
Motivation
Motivation was measured as the nurses’ attitude
towards generic nursing tasks. A total of 45 questions
about generic nursing tasks were developed based on
literature review and expert consultation. According
to nursing workplace textbooks and own experience
(first author) these tasks are performed throughout
the hospital, although we did not collect data on
whether some tasks occur rarely in some settings. An
example of a question to measure task preference is:
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Journal of Nursing Management, 2014, 22, 1054–1064

‘How much do you like participating in ward
rounds?’ Nurses indicated their liking on six-point
Likert scales ranging from ‘very much’ to ‘not at all’.
In addition, participants could elect not to answer for
specific tasks. This gave them the opportunity not to
vote on tasks they did not know well enough. The
choice not to answer was rarely made. Respective
items were left out and case numbers were reduced
accordingly.
Workplace and personal characteristics
The workplace and personal characteristics were cov-
ered by 10 questions. Workplace characteristics were
determined through questions about the hospital
departments (internal medicine, surgery, orthopaedics,
womens’ health and ‘Kopfklinik’ – the departments
of otorhinolaryngology, ophthalmology, neurology,
neurosurgery, radiology and dentistry) and the ward
type (general ward, intensive care unit, outpatient).
Personal characteristics were determined by eight
questions. Using nine-point Likert scales nurses were
asked about their professional expertise (‘novice’ to
‘expert’) and computer preference (‘dislike’ to ‘like
very much’). Computer use was measured in hours
per day (0, 1–2, 3–5, > 5) and in years since having
started to work with computers in general (0–1, 2–5,
> 5). Age was measured in five decades (starting at
16–25) and years working in nursing (0–1, 2–5,
6–10, 11–15, 16–20 and > 20). Gender was also
recorded.
Data analysis
A total of 265 of the originally distributed 1400 ques-
tionnaires were returned. Among these, 212 were
usable for the analysis. ‘Usable’ was defined as com-
pleted by nurses (as opposed to other hospital staff),
at least 50% of the questions answered and the PVQ
value questionnaire revealing one dominant value.
To determine a participant’s dominant personal
value, his or her answers were processed as described
by Schwartz et al. (2001), which resulted in a list of
personal values for each participant, rank-ordered by
relevance. In the sequel we only used each partici-
pant’s dominant (most important) value after having
removed participants where two or more values were
equally important. As visualization, we determined the
distribution of the three most frequently occurring
dominant personal values in relation to age (Figure 1).
Differences in motivation were identified for groups
of participants through statistical analysis. First, par-
ticipants were grouped according to their dominant
ª 2013 John Wiley & Sons Ltd
Journal of Nursing Management, 2014, 22, 1054–1064
The perfectly motivated nurse and the others
values, or characteristics of their workplace or person.
For workplace characteristics we asked for type of
ward (three groups) and hospital department (five
groups). Personal characteristics were gender, years
working in nursing (six groups), age (five groups), self-
rated work experience (nine groups) and daily com-
puter use (four groups). To ensure meaningful results,
only groups of more than 30 participants were used for
later analysis. We found 26 groups of that size from a
total of 44 groups, including the 10 personal values.
Second, for each group a two sided t-test was per-
formed using the statistical software SPSS version
19.0.0 (IBM, Armonk, NY, USA) which compared the
group with the rest of the sample and determined how
many tasks group members liked significantly more or
less, with missing answers excluded test by test. The
relevant variance-dependent t-test statistic was deter-
mined through Levene’s test and a 95% confidence
interval was used. Finally, the percentage motivation
was determined for each group: the number of tasks
with significantly different motivation (number of dis-
liked tasks subtracted from number of liked tasks)
was divided by the total number of tasks. This num-
ber multiplied by 100 was later used as the percentage
of excess or shortcoming of motivation.
While the analysis above allows one to identify the
general level of motivation or lack thereof in groups
within our sample, we sought for patterns of discrimi-
nating tasks that draw a more subtle picture because
they share the capacity of being strongly liked by
some groups and strongly disliked by others. We were
interested in groups that differed strongly from other
groups in more than one such task and whether
respective tasks could be subsumed under some
themes. Tasks were identified that satisfied two condi-
tions: for at least one group the average item value
was below the 5% quantile of that task in the whole
sample and for at least one other group it was above
the 95% quantile. For such tasks we assigned a D for
‘strongly dislike’ to that group (or groups) that scored
below the 5% quantile and an L for ‘strongly like’ to
that group (or groups) that scored above the 95%
quantile. For example, ‘advising relatives’ is one of the
discriminating tasks collected in Table 2 (below); it
scores below 5% of the average item value in the
whole sample in the group self-rated expertise = 6 and
above the 95% quantile in the groups self-rated exper-
tise = 8 and work experience > 21 years. We iterated
through all pairs of groups and identified such dis-
criminating tasks and then ranked the pairs of groups
according to the number of discriminating tasks they
were involved with.
1057
S. H. Koch et al.

60%
50%

MoƟvaƟon
40%
30% Benevolence
20% Hedonism
10% Self-direcƟon
0%
< 25 26–35 36–45 >46
Age

Figure 1
Percentage of nurses with the three most frequent dominant values in relation to their age – a cross-section of prevalent values of the current
nurses’ population. Note that the figure does not show the longitudinal development of personal values of individuals over time.

Table 2
Tasks that discriminate

Results
Workplace and personal characteristics,
dominant personal values and other study
coverage data
Some of the characteristics of our sample have already
been described in the data analysis section above. We
had a higher proportion of men (23%) apparently par-
ticipating. About 18% of the nursing workforce of the
university are male, although we did not check whether
this proportion also holds for the individual wards
where the questionnaires had been distributed. Other
potential sampling biases did not show. Unexpected
events during the study were that two callers expressed
privacy concerns during the study based on the per-
sonal value part of the questionnaires and indicated
that they did not want to participate, and that three
questionnaires were submitted in which the personal
value part was removed.
The prevalence of dominant personal values in relation
to age is not equally distributed over nurses with different
ages (see Figure 1). Rather, with increasing age, the prev-
alence of ‘hedonism’ decreases, ‘self-direction’ increases,
and ‘benevolence’ is high through all age groups with a
moderate peak at ages 36–45 years. The figure aggre-
gates the age groups 46–55 years and 56+ years because

ª 2013 John Wiley & Sons Ltd

1058 Journal of Nursing Management, 2014, 22, 1054–1064
 The perfectly motivated nurse and the others

of a low number of participants at ages 56–65 years. A presented for illustrative purposes. In workplace charac-
total of 152 (71%) participants had one of three domi- teristics, nurses working in surgery had the highest moti-
nant personal values. Each of these values occurred in at vation (+29%) among the groups identified, while
least 15% of the participants. The others (n = 60, 29%) nurses in internal medicine ( 9%) were less motivated.
had one of the remaining seven dominant values, which These differences cannot be explained as being caused
occurred less frequently and because of the small group through organisational structure, work atmosphere or
sizes were not further analysed. other characteristics of individual wards, because several
organisational units each (17 surgical and 16 internal
medicine wards) contributed to both percentage motiva-
Work motivation of groups with specific personal
tion values above. Using computers infrequently coin-
values, workplace or personal characteristics
cided with lower motivation ( 9%). For the remaining
An interesting correlation can be seen with respect to measurements (computer preference, computer use in
work experience and age. While only slight deviations years, and gender) and the groups not shown in Figure 2,
from the average motivation exist for work experience no difference exceeded the threshold of 9%.
below 15 years, motivation increases above 16 years For self-rated expertise, an interesting trend can be
(4% for 16–20 years and 16% for 21+ years). How- seen. Figure 3 shows that nurses with a low self-rated
ever, this trend seems to reverse with age: nurses aged expertise (item values 1–3, n = 22) had a slightly lower
36–45 (9%) were found to be motivated clearly above motivation when compared with other nurses with
average while ages 46–55 years had a small excess higher self-rated expertise. For medium self-rated exper-
motivation of 2% with further decrease to 4% in tise, (item value 4, n = 23) motivation rose to an average
ages 56–65 years, although here the sample size n = 8 proficiency, but with higher expertise (item values 5–7,
is far too small to be conclusive. n = 104) decreased again down to 15%. Finally, with
Figure 2 shows the results for groups of nurses with very high self-rated expertise (item values 8 and 9,
specific dominant personal values, or specific workplace n = 35 and n = 28, respectively) motivation sharply
or personal characteristics. To keep the results focused, increased to up to 24%. In addition, when all partici-
a threshold of +9% (for excess) or 9% for reduced pants with expertise above a threshold were compared
motivation is pragmatically suggested to designate a with the participants below the threshold, excess moti-
meaningful deviation from medium motivation. Among vation was 29% for expertise item values  7
personal values, ‘benevolence’ was found to coincide (n = 107) and excess motivation was 49% for expertise
with higher motivation, while ‘hedonism’ ( 9%) coin- item values  8 (n = 63). Although the groups with an
cided with lower motivation. Self-direction did not expertise of 1–5 and 9 had a low number of participants,
exceed the threshold but its lower motivation ( 7%) is they are shown in the figure for illustrative purposes.

35% Dominant Workplace characteristics Personal characteristics

personal value
25%

15%

5%

–5%

–15%

–25%
Benevolence
(n = 77)

General ward
Hedonism
(n = 34)

(n = 106)

Surgery (n = 87)

Internal Medicine
(n = 59)

ExperƟse = 6
(n = 34)

ExperƟse = 8

Work experience
(n = 35)

>21 y (n = 49)

(n = 36)

Use 1..2 hrs (n = 94)

Age 36…45 y

Daily Computer

Figure 2
Motivation for specific dominant personal values, self-rated expertise, work area and other individual traits. Only characteristics above the
threshold of 9% and groups with at least 30 participants are reported. Numbers of distinct organisational units in the workplace characteristics
block where respondents worked were 39 (general wards), 17 (surgical wards) and 16 (internal medicine wards). For a Likert scale of 1 to 9
self-rated expertise = 6 means a medium self-esteem, while 8 means high self esteem. For daily computer use 1–2 hours is the second
lowest possible choice while 0 hours was below the 30-person threshold.

ª 2013 John Wiley & Sons Ltd

Journal of Nursing Management, 2014, 22, 1054–1064 1059
S. H. Koch et al.
Figure 3
Motivation (% of the overall tasks) in relation to self-rated expertise.
We now take a closer look at pairs of groups among
the groups of Figure 3, in search of pairs whose
discriminating tasks form an intelligible pattern and
suggest some underlying cause. Overall, we found 26
discriminating tasks (i.e. tasks that were strongly dis-
liked by at least one and strongly disliked by another
group of nurses). Four discriminating tasks were sin-
gle: each such task discriminated just one pair of nurse
groups. Ten discriminating tasks could be grouped as
pairs of two: each of such two tasks discriminated
between the same groups of nurse. However, none of
these 14 revealed meaningful themes. In contrast,
Table 2 displays those tasks that were involved in
identifying pairs of groups characterized through at
least three discriminating tasks.
Table 2 lists nine of those 45 tasks that were most
involved in discriminating. It presents the task’s inter-
nal identifier, the task itself, those groups from
Figure 3 that were discriminated by that task and the
indicator D or L. The Table shows that the already
described largest swing from low to high general moti-
vation with increasing self-rated expertise carries
through to the detailed analysis. Through the tasks T3,
T18, T40, T39 and T19 the nurse group self-rated
expertise = 6 formed five discriminating pairs (D) with
group self-rated expertise = 8 (L), and it was four times
D in discrimination from work experience 21+ years
(L), where three tasks (T3, T18 and T40) led to dis-
criminations in both pairs. Thus, we see a first pattern
here of little vs. much knowledge or experience on the
part of the nurses leading to disliking or liking tasks
T3, T18, T40, T39 and T19. A second pattern is seen
in the discrimination between nurses working in inter-
nal medicine (three times D) vs. surgery (three times
L) in tasks T21, T30 and T12.
When trying to characterize the tasks of the two
patterns above, information and communication are
the common theme of tasks that discriminates
between more and less knowledgeable nurses while
patient case-related action tasks are the common dis-
1060
criminating theme between nurses in internal medicine
versus surgery.
Discussion
The study could show an empirical connection between
nurses’ motivation in terms of preference for nursing
tasks and their personal values, workplace or personal
characteristics. The perfectly motivated nurse seems to
be one with dominant personal value of ‘benevolence’,
or high self-rated expertise, or in the middle of his/her
career or who works in surgical or general wards. By
contrast, lower motivation was found in nurses with
the dominant value of ‘hedonism’ or nurses who
worked in internal medicine, had a low to medium
self-rated expertise or who use computers infrequently.
These are cliches, of course, and all variations exist
between these extremes. It should be noted, however,
that sample broadness was wide enough to claim that
results are not determined through local workplace
characteristics of individual wards. Each column of
Figure 2 represents  30 subjects from several wards
each. Therefore, we believe that our findings deliver
some material for both targeted recruiting and human
resource programmes directed to those whose motiva-
tion may be at risk. Below, we address first how our
findings relate to those of others.
Relationship to other studies
Appropriateness of our taking preferences for nursing
tasks as a proxy for motivation may not appear
straight forward. Few other approaches to concepts
such as motivation have been taken in other investiga-
tions two of which will now be compared.
Simpson (2009) worked on the related concept of
work engagement. She refers to an approved approach
of measuring work engagement by Schaufeli et al.
(2006), which, according to Simpson, has been
applied to all kinds of professions other than nursing.
She presented the respective questionnaire to 167
nurses in six hospitals and arrived at three major
determinants of work engagement in nurses: vigour,
dedication and absorption. At first glance, mainly ded-
ication relates to our approach as we ask how much
nurses like certain nursing tasks. However, Simpson’s
items are more distant and abstract. She asked about
attitudes towards work in general rather than attitudes
towards nursing work. Her investigation allows com-
parison across professions, but lacks the opportunity
of a closer look into the subtleties of nurses’ work.
Furthermore, Simpson investigated the more dramatic
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Journal of Nursing Management, 2014, 22, 1054–1064

situation of breaking up with one’s job, while we con-
sider motivation within ongoing professional work.
Finally, the work engagement questionnaires that
Schaufeli et al. (2006) developed for scientific research
settings may be rejected as being too intrusive for rou-
tine personnel screening outside scientific research sit-
uations. Schaufeli’s questions share this risk (Schwartz
et al. 2001) with value questions that we applied and
that initiated the idea of using other less intrusive
questions as proxies.
In an investigation of impressive size (8556 of
approximately 13 000 invited nurses completed their
questionnaires) Tourangeau and Cranley (2006) also
investigated motivational determinants in the context
of keeping or leaving a job. Among the major factor
groups they found personal characteristics and organi-
sational commitment apparently related to factors we
tried to cover. However, in their research, personal
characteristics primarily means age or level of educa-
tion and, as it appears, values. However, values are not
meant in the theoretically and experimentally approved
Schwartz sense (Schwartz 1992, Schwartz et al. 2001),
but in a common sense ad hoc understanding of ‘loy-
alty’, ‘seniority’, ‘job security’ and ‘career security’. In
Tourangeau and Cranley’s (2006) work organisational
commitment is even more immediate and ad hoc: it is
number of years with the current hospital. We do not
address organisational commitment explicitly but it
may be found in some of our items (organise processes
at the ward, control pharmacy stock) and we would
have added more if it had been our core interest.
To summarize, to the best of our knowledge, there
are no investigations that come really close to captur-
ing motivation as such, detached from the question of
whether nurses will stay or leave. This does not mean
that we perfectly map motivation through the prefer-
ences for nursing tasks, but at present it seems to be
the best approximation, especially as the low intru-
siveness of our common nursing work task-related
questions suggests appropriateness outside of the con-
text of scientific research.
Our findings about the influence of personal values
on motivation coincide with individual traits, which
were found to increase motivation in other studies. The
concept of ‘benevolence’, which we found to coincide
with higher motivation, is described by Schwartz et al.
(2001) as the ‘Preservation and enhancement of the wel-
fare of people with whom one is in frequent personal
contact’. This concept seems to relate to the opportu-
nity or personal calling to help others that previous
research found to increase motivation (Raatikainen
1997, Ozturk et al. 2006, De Cooman et al. 2008).
ª 2013 John Wiley & Sons Ltd
Journal of Nursing Management, 2014, 22, 1054–1064
The perfectly motivated nurse and the others
Although no research was found that systematically
links nurses’ motivation to personal values, other stud-
ies partly second our findings of the influence of per-
sonal values on motivation. Two concepts that relate to
‘benevolence’ were found to increase motivation in
other studies: experiencing meaningfulness of the work
(Hertting et al. 2004, Ozturk et al. 2006) and experi-
encing responsibility for outcomes (Edgar 1999, Ozturk
et al. 2006). Another concept that relates to ‘self-direc-
tion’ was found to coincide with increased motivation:
having control over one’s own time (Hertting et al.
2004). In contrast, our study found that participants
with a predominant value of self-direction had slightly
lower motivation (7%). These results are not shown in
Figure 2 because they did not meet the threshold inclu-
sion criteria for significant influence on motivation.
This may mean that the concepts actually measured by
Hertting et al. (2004) were more superficially practical
than the deeply rooted ‘self-direction’.
Our findings of workplace characteristics that
increased motivation, such as working at general
wards vs. ICU or outpatient departments might relate
to research about greater work satisfaction in interme-
diate care nurses compared with ICU nurses (Goetz
et al. 2012), although another study did not find moti-
vational differences in ICU/non-ICU nurses (Tummers
et al. 2002). In our investigation, internal medicine
and surgery nurses differed in their general level of
motivation and specifically in their motivation for
patient case-related action tasks.
Among personal characteristics, our findings about
increased motivation in nurses aged 36–45 years are
inconclusive with other studies which, on one hand,
found higher motivation with greater age in non-ICU
nurses (van den Berg et al. 2006) but, on the other
hand, with lower age in nurses in general (Koivula
et al. 1998). Our finding of higher motivation corre-
lated with high self-rated expertise or lower motiva-
tion correlated with low to medium self-rated
expertise could potentially relate to a study that found
higher motivation in nurses with higher-level college
education (Koivula et al. 1998). This consideration is
supported by the pattern of information and knowl-
edge tasks that strongly contrast the medium self-rated
expertise with the high self-rated expertise group. For
nursing experience our results of higher motivation
with higher experience seem to be contrary to a study
that did not find a correlation with nursing experience
(Kivimaki et al. 1995), but seem to correlate with
results in experimental social psychology in a non-
nursing population, where task attractiveness (the way
in which we measured motivation) correlated with
1061
S. H. Koch et al.
expertise (Trope 1980). This relates to our second
strongest contrast between medium self-rated expertise
vs. long work experience. No study could be identified
with results resembling our findings of lower motiva-
tion in nurses who use computers infrequently. This
lack of evidence may be because spending hours and
hours at the computer is a relatively new phenome-
non. Investigations may be underway but results have
not yet reached the journals.
Work motivation theories (Latham & Pinder 2005)
might suggest explanations for the discrepancies
between our findings and other studies for the differ-
ent workplace characteristics – for example our
findings of higher motivation on surgical or lower
motivation on internal medicine wards, as well as dif-
ferences in ICU vs. non ICU nurses. Job design charac-
teristics were found to influence an individual’s
motivation (Locke & Latham 2002), offering a poten-
tial reason for the differences we found in surgical vs.
internal medicine nurses. Such job design characteris-
tics might include a difference in job autonomy, work-
load, rewards policy, work organisation, decision
authority and team collaboration, which were found
to influence motivation in other studies (Janssen et al.
1999, Tummers et al. 2002, 2006, Hertting et al.
2004, van den Berg et al. 2006, Ozturk et al. 2006,
De Cooman et al. 2008).
Our finding of different percentages of dominant val-
ues for nurses with different ages seems to contradict
the research of Schwartz (1992) who found that per-
sonal values do not change over time. However, differ-
ent percentages of dominant values in our research
were not measured longitudinally over time in one
cohort of nurses. Our measurement is a cross-section,
which might show that the nursing profession has
attracted persons with a different set of dominant val-
ues in past decades. For example, during the 1960s
‘benevolence’ and ‘self-direction’ clearly dominated,
whereas during the 2000s ‘hedonism’ almost reached
the level of ‘benevolence’, reflecting that the perception
of nursing tasks at the time when the decision is made
to become a nurse changes over time. Another potential
explanation could be that nurses with certain dominant
values have a higher probability of remaining within
the nursing profession.
Our findings of three dominant values (‘benevolence’,
‘self-direction’, ‘hedonism’) is partly seconded by other
research in nurses in Hungary, Italy, the UK and the
USA (Glazer & Beehr 2002). Our approach used differ-
ent methods to determine personal values: we deter-
mined the dominant, single most important value of
each individual and then formed subsets of the sample
1062
by dominant value. In contrast, Glazer and Beehr’s
(2002) research determined the average personal values
of the whole population. However, their globally domi-
nant values were similar to ours: ‘benevolence’, ‘self-
direction’, as in our sample, followed by ‘universality’,
which was fourth in our sample but was not followed
up because of our smaller group size. They determined
‘conformity’ instead of ‘hedonism’ to be among the
four most important values. A potential explanation
might be cultural difference or a difference in the value
determination methods. Another possible explanation
is that the ‘hedonistic’ nurse has entered this stage after
the end of their investigation (in our sample it predomi-
nantly is the youngest generation, which was still in
high school when Glazer & Beehr collected their data)
whereas the conformant nurse may have left this stage
in our investigation and would have become visible if
we had interviewed retired nurses.
Regarding such ‘generations’ arguments, our
research is in accord with Tourangeau and Cranley
(2006) who identified a silent generation born before
1945 and Generation X born between 1965 and 1980.
In their work, silence means loyalty and acceptance of
seniority and is a way of conforming with one’s work
environment. We did not find this ‘conformity’ fre-
quently as a dominant value in our sample of nurses,
who were, however, mostly born after 1956. Touran-
geau and Cranley’s (2006) ‘Xers’ overlap with our age
groups 26–35 years and 36–45 years. Our age groups
are characterized by a strong ‘self-direction’ value. In
our categorization of values according to Schwartz
(1992) ‘self-direction’ is central in Schwartz’ quadrant
‘openness for change’. This is precisely what Touran-
geau and Cranley (2006) report about their Xers.
Future research
Future research should replicate our study in other
populations and other settings and with a larger popu-
lation to determine motivational influences for other
less prevalent personal values. In addition, future
research might use other personal factors (e.g. paren-
tal leave). In addition, propensity to perform nursing
tasks has been used as proxy for motivation
throughout this investigation. From our findings it
can, at best, be a proxy for professional motivation
and other methods to measure motivation in general
should be also used for comparison.
Limitations
The low return rate of 212 usable questionnaires of
1400 distributed to eligible clinical units is a clear lim-
ª 2013 John Wiley & Sons Ltd
Journal of Nursing Management, 2014, 22, 1054–1064

itation of the investigation. Nurses may have refrained
from filling in the questionnaire because they deemed
it only minimally compensated for additional effort or
they may have perceived it as an intrusion into their
privacy. The latter especially bears the risk of a selec-
tion bias as to the personality-related objectives of the
investigation.
The generalizability of our study is limited because
our sample was recruited at a single hospital.
Although this was a large university hospital, findings
at other hospitals or in other countries might differ.
Furthermore, our findings could potentially be biased
because we offered an incentive: potentially more
nurses might have participated with dominant values
which are keen on incentives (e.g. ‘hedonism’). The
generalizability is also possibly limited because of dif-
ferent hospital settings: although generic task descrip-
tions were used, and many wards of each major type
(surgical, internal medicine, ICU, non-ICU, etc.) con-
tributed completed questionnaires, it cannot be safely
excluded that task preferences were influenced by the
way in which tasks are implemented in organisational
structures of specific clinics.
Conclusion
The tentative criteria presented to inform human
resource management about staff motivation have been
found and tested in an academic teaching hospital. The
approach fosters an indirect assessment of motivational
factors, which helps to differentiate between motiva-
tion-related needs of subpopulations of the nursing
work force. Programmes to increase motivation of
nurses currently working could be more focused and
potentially more efficient, and hiring activities could
better aim at attracting individuals with higher a priori
motivation. However, further research is required in
order to transfer this information to other care settings
and to reduce the intrusiveness of personal values
questionnaires.
What is already known about the topic:
● Motivation is influenced by factors ranging from
the individual, the workplace, working conditions,
individual priorities and internal psychological
states. However, this knowledge is still fragmented
and insufficient.
● Personal values are concepts that guide individuals
during their life (e.g. the concepts of ‘benevolence’,
‘self-direction’ and ‘power’). Although some indi-
vidual properties have been previously linked to
motivation, no systematic research about the influ-
ª 2013 John Wiley & Sons Ltd
Journal of Nursing Management, 2014, 22, 1054–1064
The perfectly motivated nurse and the others
ence of personal values on nurses’ work motivation
could be identified.
What this paper adds:
● An empirical connection exists between nurses’
work motivation and their dominant personal val-
ues: groups of nurses with the dominant personal
value of ‘benevolence’ are more motivated, while
individuals with ‘hedonism’ are less motivated.
● Higher motivation was found in nurses with high self-
rated expertise, nurses in the middle of their career
and nurses working on surgical or general wards.
● Lower motivation was found in nurses in internal
medicine, or who had a low to medium self-rated
expertise or used computers infrequently.
Implications for nursing management
The implications of our findings that nurses’ motiva-
tion correlates with their workplace and personal
characteristics can be used by hospital management to
focus efforts on increasing motivation. Training or
workplace improvements can be increased for nurses
working in internal medicine, ICUs, and functions,
and for nurses with the dominant value of ‘hedonism’
and to a lesser extent ‘self-direction’. Highly moti-
vated nurses coming from surgery or general wards,
and with the dominant values of ‘benevolence’ can be
hired with priority. Such an approach should, how-
ever, have in mind that the measurement of personal
values, as it was done in this investigation by using
the 40-item PVQ value questionnaire, is somewhat
intrusive and might raise privacy concerns when done
routinely as part of the hiring procedure. However,
asking job applicants about the amount of time they
spend with computers or about their preferences for
certain nursing tasks, does not have any stigma
attached and might be a feasible question for job
applicants. Therefore, a selection of the questions we
asked our subjects about their work and task related
preferences can take the place of the potentially too-
intrusive value-related questions.
Acknowledgement
The authors thank all nurses of the Heidelberg Univer-
sity Hospital who served as voluntary subjects.
Sources of funding
The research has been financially supported by DFG
(Deutsche Forschungsgemeinschaft) under grant
WE2467_7–1.
1063
S. H. Koch et al.
Ethical approval
According to German legislation permission was given
through the Workers’ Council of Heidelberg Univer-
sity Hospital.
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