Effects of cutbacks on motivating factors among nurses in primary health care

Scand J Caring Sci. 2018 Mar;32(1):397-406. doi: 10.1111/scs.12474. Epub 2017 Aug 24.


Background: When financial cuts are made, staff redundancies and reorganisation in the healthcare system often follow. Little is known how such cutbacks affect work motivation of nurses in primary health care.

Aim: Examine the effects of cutbacks on motivating factors among nurses in primary health care.

Methods: A phenomenological approach involving a purposeful sample of ten nurses in primary health care. Average age 44.

Results: The participants identified the job itself, autonomy, independence, good communication with co-workers, and the potential for professional training, learning and development as the main internal motivational factors related to their work. However, increased stress and uncertainty, growing fatigue and understaffing were starting to have a negative impact on these internal motivational factors. Moreover, reduced opportunities for professional training and development had negative effects on the participants. Many saw these opportunities as a vital part of recognition for their job performance. Regarding external motivation, the factors identified were job security, salaries and rewards, and interaction with management. The participants expressed their interest in more consultation with managers and most preferred an increased flow of information from managers to staff members during cutbacks. Salaries, professional training opportunities and appreciation were rewards named by participants for a job well done. All agreed that salaries are stronger motivational factors than before cutbacks.

Conclusions: In the case of cutbacks, nursing managers should increase consultations with staff and make sure that nurses maintain their independence, autonomy, opportunities for professional training as well as appreciation for job well done.

Keywords: cutbacks; external motivation; internal motivation; nurses in primary health care.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Female
  • Humans
  • Job Satisfaction*
  • Male
  • Middle Aged
  • Motivation*
  • Nursing Staff / psychology*
  • Personnel Staffing and Scheduling / economics*
  • Primary Health Care / economics*