RESULTS
4.1 Qualitative Results on Scale Development
4.1.2 The Factors of Job Resources
Six main categories related to nurses perceptions of job resources in Thai private hospitals emerged from the interview data as follows.
Staff members in higher positions
Staff members in higher positions, such as directors of nursing, nurse managers, nurse assistant managers, or head nurses, were referred by participants as superiors who could provide useful advice, helped deal with work-related problems, as well as helped our team work in case of understaffing.
“The director of nursing at the hospital is very approachable. She helps deal with problems that I could not manage, such as inviting specialists to work occasionally at the hospital. My head nurse is also good-hearted. She listens to my opinions...I am going to study a Master’s degree and both of them will help organize my work schedule which makes it possible for me to be able to study.” (Nurse No.3)
“In addition to help handle problems, head nurses can substitute for nurses who have been given leave of absence…This makes it easier to get my job done.” (Nurse No.9)
Colleagues
According to the interviews, colleagues of head nurses or nurse managers meant not only staff members in the same positions but also nurses whom they supervised. On the other hand, colleagues of professional nurses meant nurses in the same level who might be younger or older than them, as well as nurse assistants. Colleagues helped encourage one another, gave some advice, or helped deal with work problems.
“My colleagues support one another. When we have problems, we encourage each other. At work, they understand me more than anyone else. Subordinates who are reliable could lighten my load.” (Nurse No.9)
In addition, colleagues helped accomplish tasks once they had completed their assignments or substituted for nurses who were on leave. All of these encouraged good teamwork.
“My colleagues will fill in for me on a day that I am not available but have been already scheduled. In addition, we work in the same direction. When the hospital formulates goals or policies, they adopt those approaches and cooperate with me and other nurses.” (Nurse No.4)
Training
Training was one of the prominent job resources that private hospitals had provided their nurses at all levels. The training involved pathology (e.g., heart disease, and interesting cases), professional skills (e.g., communication skills, and world languages) or self-improvement skills (e.g., optimism). The sources of training were from doctors, nurses, external speakers, and public in-house or external training programs. A variety of training formats, such as on-the-job training, classrooms, conferences, or presentations by research clubs, were employed. Nurses not only mentioned the quantity but also the quality of the training which meant the training was worth attending and could be applied to their jobs.
“There have been lots of training for nurses, such as positive thinking, customer service, or communication skills, which could be applied to our daily work. It is a lot better than learning through trial and error.” (Nurse No.6)
“The hospitals provide nurses with English and Japanese courses. If we want to learn something, we can make a request and the hospital will make it available, either in-house or external training. This really makes it easier to do my job.” (Nurse No.2)
“Every year the hospital plans the training schedules that we need. For example, last year, the hospital focused on a brain stroke, so all nurses will have to learn about it based on JCI accreditation [Joint Commission International]. The hospital clearly stated the level of knowledge each nurse must gain. We not only attended the training but also had to pass the test. These help us better guide our patients about the disease.” (Nurse No.3)
Equipment
Sufficient equipment was important for nurses to accomplish their work properly. In this regards, equipment could be separated into two parts. For nurses who performed medical procedures, equipment tended to be medical tools or supplies.
“Medical equipment is really important for performing medical procedures. For this hospital, it is not a problem at all. Generally, private hospitals give us a right to ask for whatever we want to serve our patients. We can quickly respond to whatever our
patients request and they are quite satisfied with the quality of the hospital.” (Nurse No.9)
For coordinating nurses, equipment meant office supplies, and computer and software systems.
“The equipment that is most relevant to my work is computer software that allows us to quickly retrieve patient data. All patient records are on the computer. If the computers crash, it will slow down every task. The hospital provided us with a new computer system which helps us to work faster.” (Nurse No.3)
Rules and standards
In nursing work environments, clear rules and standards were very important because nursing jobs in private hospitals were mainly relevant to patients’ safety, as well as favorable, appropriate, and immediate responses to doctors’ and patients’
requests which were tied to accreditation standards of each hospital.
“Work policy is really clear and makes our work easier. For example, there are clear details of relatives of a patient who are authorized to sign the consent form. If this relative is not available, I know exactly who is the second relative whom I could contact
…Just consult the work manual to complete our tasks and we do not have to use our brain to think too much” (Nurse No.9)
“Rules are what we must learn. Most of the rules are about patients. For example, when patients arrive, their ID cards are required. If we do not ask for the ID card, we will not know whether he fakes his own information or not. It makes us more cautious.” (Nurse No.7)
Career advancement
The recognition of a clear path of career advancement and the opportunity of getting a promotion when criteria were met could motivate nurses to develop their professional skills and continue to work in this career.
“The hospital established certain criteria for promoting nurses to higher levels and the performance appraisal is quite fair. This motivates me to develop myself.”
(Nurse No.10)
“Career advancement is the driving force for self-improvement. I plan to go to a graduate school and the nurse director really encourages me to do so and said that she would find a better position for me after I graduate.” (Nurse No.3)
“Career advancement encourages us to develop ourselves. If we work but never get promoted, we do not know why to work. But if we see that we have a chance to get promoted, we would like to work and develop ourselves continuously.” (Nurse No.7)
Compensation was an aspect brought up during the interviews; however, it was not clear whether compensation was the important factor to motivate nurses to achieve work goals or not because more than half of the participants were satisfied with the compensation and benefits they had been provided and argued that they would remain their work performance levels even if satisfaction with compensations were not met because they had already selected to pursue this career.
In addition, the lack of job resources could turn out to be job demands.
“When I have problems at work, I need someone to rely on. My boss could not be that person. She does not have the power to deal with the problems for me…she does not conform to the overtime pay regulations of the hospital…this is an obstacle.”
(Nurse No.8)
“Sometimes several pieces of training in a day are an obstacle because we will have not enough nurses to work in our team and will be loaded down with more work.” (Nurse No.9)