Exploring the differential impact of individual and organizational factors on organizational commitment of physicians and nurses

Abstract

BackgroundPhysician and nursing shortages in acute and critical care settings require research on factors which might drive their commitment, an important predictor of absenteeism and turnover. However, the degree to which the commitment of a physician or a nurse is driven by individual or organizational characteristics in hospitals remains unclear. In addition, there is a need for a greater understanding of how antecedent-commitment relationships differ between both occupational groups.Based on recent findings in the literature and the results of a pilot study, we investigate the degree to which selected individual and organizational characteristics might enhance an employee’s affective commitment working in the field of neonatal intensive care. Moreover, our aim is to examine the different antecedent-commitment relationships across the occupational groups of nurses and physicians.MethodsInformation about individual factors affecting organizational commitment was derived from self-administered staff questionnaires, while additional information about organizational structures was taken from hospital quality reports and a self-administered survey completed by hospital department heads. Overall, 1486 nurses and 540 physicians from 66 Neonatal Intensive Care Units participated in the study. We used multilevel modeling to account for different levels of analysis.ResultsAlthough organizational characteristics can explain differences in an employee’s commitment, the differences can be largely explained by his or her individual characteristics and work experiences. Regarding occupational differences, individual support by leaders and colleagues was shown to influence organizational commitment more strongly in the physicians’ group. In contrast, the degree of autonomy in the units and perceived quality of care had a larger impact on the nurses’ organizational commitment.ConclusionsWith the growing number of hospitals facing an acute shortage of highly-skilled labor, effective strategies on the individual and organizational levels have to be considered to enhance an employee’s commitment to his or her organization. Regarding occupational differences in antecedent-commitment relationships, more specific management actions should be undertaken to correspond to different needs and aspirations of nurses and physicians.Trial registrationGerman Clinical Trials Register (DRKS00004589, date of trial registration: 15.05.2013).

The relationship between health care providers' perceived work climate, organizational commitment, and caring efficacy at pediatric intensive care units, Cairo University

“…The discrepancy between the above results and the present study findings might be related to generally low organizational commitment level among the study participants, as larger organizations had a lower individual commitment. Moreover, lower commitment of intensive care staff in hospitals with more beds was indicated because of low salaries, OS, and critical care work conditions, which all apply to Abou Elreesh Teaching Children hospital …”

“…Moreover, lower commitment of intensive care staff in hospitals with more beds was indicated because of low salaries, OS, and critical care work conditions, which all apply to Abou Elreesh Teaching Children hospital. 27 Also, the current study showed that the commitment mean score was significantly higher in nurses than in physicians and that commitment score was significantly directly correlated to sources of stress score in nurses; however, no significant correlation was detected between them in physicians, a finding that could be explained by a study that examined the effect of stress on employees with different degrees of commitment and found that staff who had a high organizational commitment level experienced more stress than staff who were less committed. 28 Alternatively, other researchers as Kobasa and Antosrusk observed in 1998 that organizational commitment protected the individual from stress, either because committed individuals had connected strongly to the individuals at work or because they had found meaning in the work they do.…”

Antecedents of Organizational Commitment: A Review of Personal and Organizational Factors

“…Autonomy has been defined as "the ability to choose how to do one's work; having influence over one's work; and flexibility in workload decisions" [23]. Autonomy is found to significantly and positively influence organizational commitment [12] [24]. Leadership empowerment in the form of autonomy on the job has a favorable effect on affective organizational commitment and turnover intentions [13].…”

“…Leadership empowerment in the form of autonomy on the job has a favorable effect on affective organizational commitment and turnover intentions [13]. A study of the relationship between autonomy and organizational commitment revealed that the degree of autonomy given on the job is a strong predictor of organizational commitment [24]. The provision of training and development to employees may result in a supervisor having more trust in the subordinate and granting him or her autonomy on the job.…”

What drives hospital wards’ ambidexterity: Insights on the determinants of exploration and exploitation

“…In particular, the adjusted R 2 was examined in order to control the explanatory power of each model [56]. Three different models were developed, defining the influence of the different variables (control, independent and moderator variables), as suggested by other authors [3,57]:…”