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Abstract

Management of human resources represents the sci‑ ence of elaboration and implementation of the staff strat‑ egy and policy for a most eficient attainment of the objectives of an organisation. Motivation is one of the deining activities of human resource management, as it inluences in a decisive way participation to the fulillment of objectives, both by the extent of rewards or of material/ moral‑spiritual sanctions, and by the motivation criteria applied. Motivation is deined as the sum of the internal and external energies which initiate, control and support an orientative effort for attaining an objective of the organ‑ isation, which will simultaneously satisfy one’s individual needs. The motivation function aims at stimulating the employees for reaching performance. It begins with the recognition of the fact that the individuals are unique natures, and that the motivational techniques should be adapted to the needs of each one in part. Individual moti‑ vation is maximum when the employee is conscious of his own competence, working within a structure which requires the best from his part and turns to good account his abilities.

To be motivated in his activity, an individual should have the certainty that, by developing some activity, his own needs will be also fulilled; one’s motivation as to the work he/she performs is determined by a series of moti‑ vational factors, of intrinsic (individual) and extrinsic (organisational) nature. Motivation is related to more pro‑ found feelings of growth and development; an increased particiption may indicate a higher level of motivation. Peo‑ ple are motivated or demotivated according to their inner state. Motivation is especially important in determining the behaviour, even if it is not the only element generating it; factors of biological, psycho‑social, organisational and cultural nature may also have a certain inluence.

Keywords: human resources, motivation, stimulation of employees motivational criteria

INTRODUCTION

Nowadays, common sense, benevolence or routine, civic conscience cannot be considered, any longer, the most suitable means for assuring an optimum activity in hospitals, for

THE THEORY AND PRACTICE OF HUMAN RESOURCES

MOTIVATIONS IN HOSPITAL UNITS

C. BOTEZ1, Isabella BRUJBU², Luana MACOVEI³, R.V. MURARIU4

1. Lecturer, Internal Medicine, Apollonia University of Iasi 2. Lecturer, Anatomy. Embriology, Apollonia University of Iasi

3. Lecturer, Rheumatology‑Balneophysiotherapy, “Gr. T. Popa” UMPh of Iasi

4. Dr. Direction of Communitary Assistance of Iaşi, School Medicine Dept.

motivationg or rendering faithful their employ‑ ees and for maintaining a social climate capable of limiting the occurrence and consequences of

labour conlicts [1,2]. We are now witnessing a complicate period, characterized by redeinition

of the competences and responsibilities involved in the management of the human resources. Staff representatives are now especially interested in following the motivations of the employees, in satisfying their individual needs, in their psycho‑ logical health, communication, mobilization and involvement. The main instruments utilised to such ends are the social advantages: the wages system, the leave of absence, the retirement plan.

Currently under analysis are the jobs, the iles

describing one’s obligations as an employee, the means for improving the climate and the content

of the duties to be fulilled.

In a hospital, the human resources appear as strategic factors, whose recruiting assumes a compromise between the requirements of the system and the situation on the labour market. Nevertheless, such a compromise cannot be a spontaneous action. In a way, it is similar to a grafting process of some organ, which necessi‑ tates a careful analysis on the detection and sub‑ sequent elimination of the rejection causes. Any decision should be taken with extreme precau‑

tion, on the basis of a well-deined logical pro‑ cess. The message thus put forward and the corectness of the action are of paramount impor‑ tance [3,4].

USUAL MANAGERIAL STRATEGIES

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adjustements. Motivation represents an internal process, and not an imperative action with exter‑ nal causes.

The managers should understand exactly the motivational strategies, the manner in which they are successful or fail, on the basis of the

manner in which they succeed in inluencing the

internal motivations of the employees. The theo‑ ries on human needs offer a detailed perspective on what motivation really means; equally, they should indicate the ways to reach satisfaction

and self-fulillment, otherwise the employees

will remain non‑motivated [5,6].

Among the managerial strategies applied

along the history, considered as highly eficient,

special mention should be made of: fear (expected to modify performances); punishment, reward – on the basis of the pleasure‑pain principle (as every‑ one wants to experiment pleasure and to avoid pain); guilt (a higher performance level is a modality of reducing the feeling of guilt); crisis (in situations of crisis, people will work harder).

MOTIVATIONAL THEORIES

Human beings have characteristic needs, so that people may be motivated when/if they receive what they want for the efforts made.

♦ Physiological needs (air, water, food, clothes,

etc.);

♦ Security needs (physical and psychic safety); ♦ Afiliation needs (social contact);

♦ Esteem needs (to be well-known, to feel one’s

own value, to be considered competitive and appreciated);

♦ Self-fulillment needs (maximum develop‑ ment of one’s potential). Some people avoid using their full potential for attaining their loftiest objectives and aspirations ‑ a tendency known as the complex of Iona, the prophet of the Bible who, trying to escape his personal mission, was swollen by a whale and then released only to meet his destiny.

MOTIVATIONS OF HUMAN RESOURCES

1. Native talent does not represent a suficient

condition for becoming an accomplished special‑ ist. The opportunity of its exploitation is granted

by the millieu and also by the historical moment. The French philosopher Jean‑Paul Sartre was lit‑ erally born in a library, his imagine of God being always superposed on that of his grand‑father, the owner of that immense world of books.

Along time, on the Trotuş Valley there

appeared tens of virtually brilliant gymnasts, but

only one of them, Nadia Comăneci, caught the

most favourable moment and the material condi‑

tions available in the ’70 at Oneşti, having also

the chance of meeting a trainer as Bela Karoly. At such a level, motivation of the human resource begins when one becomes aware of his endowements.

The child curious to know everything on the anatomy and behaviour of animals, the adoles‑ cent interested in understanding the secrets of the human machinery can meet success only when having an adequate stimulus (a professor, a physician, a researcher), during his high‑lev‑ elled school years. Otherwise, he will remain only a quack doctor treating people as ignorant as he himself is, an old peasant recommending empiric treatments, an unreliable person with paranormal powers or, maybe, a visionary crea‑ ture. It is only in too few cases that a native talent

– capable of manifesting at cosmic level, inds his

way by himself (Einstein) or may impose himself

as an eficient self-taught person (I.L. Caragiale).

2. Professional orientation is one of the irst concerns in the family. The parents – accom‑ plished in their domains of activity – expect their children to continue their professional route. In some situations, things go apparently naturally (Al. Philippide, the poet, son of the great linguist; Matei Caragiale, follower of the famous play‑ writer).

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daughter – tallented singer of light music. Usu‑ ally, restrictions do not give the expected results. On the contrary. Exasperated by the efforts required by a tormenting work in a strange and non‑attractive domain, being conscious exclu‑ sively of their defects, many parents do not want their children as possible successors, cultivating in them repression or even contempt.

Their ambition is to orient their children towards „noble” or at least well‑paid profes‑ sions, even if, in many cases, the socio‑economic evolution may destroy their dreams. The idea

that a mechanic or an electrician will always ind a job is no longer applicable in practice. The irm

belief that a doctor is always necessary is contra‑ dicted by the image of his social status, by the manner in which he is appreciated (or not) in the society. The declaration of the President of Roma‑ nia: Romanian doctors should have higher wages means nothing, once everybody knows that the present conditions do not permit this! How can be appreciated a Government which promul‑

gates the law permitting 50% higher salaries for

the Romanian teachers, only to abrogate it, almost immediately? Where is nowadays the „nobleness” of the professions of actor, musi‑ cian, painter, for which parents had made con‑ siderable investments, paying reputed professors for private sessions? Also in the family, mention should be made of the contempt – sometimes

justiied – for certain jobs (”Do you want to

become a street sweeper?” or „Do you think that I will educate and invest in a future prostitute?”, „You will be nothing that a cow attendant!”). Instead, those who acquired rapidly and unex‑ plainably rich fortunes in the years after 1989 are given as examples to be followed.

Such situations leave space for serious moral defaults in education, which explains the cynical and aggressive behaviour of today, the psychic depressions and suicidal actions of the more labile ones.

School provides consultancy on problems of professional orientation, but frequently formally and in a demagogic manner, as none of the teach‑ ers believes any longer in the splendid future of a graduate of any form of education. The com‑ munist society used the syntagm „social com‑ mand”, prospections being made for estimating the number of specialists some domains will

need in the coming decades. Market economy has different laws, the moment we are now liv‑ ing being characterized by aberrant perturba‑

tions. Labour market was looded by thousands

of graduates in economy and law, coming from private universities. Unfortunately, they do nothing but complete the number of unemploy‑ ees [7,8].

Any serious candidate should analyze him‑ self, for an exact determination of his real capa‑ bilities, tastes, competences and type of personality, as this is the only means for deciding on the type of activity he will practise, he wants and for which he is suitably endowed, as well as on the routes to be followed.

3. Stability represents a motivating factor that cannot be ignored.

It assumes continuity in some position or in a preferred company, besides the well‑being of the family and integration in the community. The main element is the locality here involved (urban center, the capital). The context of work becomes more important than the nature of the activity.

Country life is not suitable to anyone, the apostleship of some young doctors representing a really heroic option. Running shuttle service for the medical staff is a disaster, indeed, espe‑ cially for patients, frequently left alone, deserted. Creation of suitable material conditions hardly improved the situations, as the brain worker feels he is a prisoner in a world he wants to leave at all costs.

4. Respect for one’s profession evidences the altruism of some doctors, always ready to work

within a system which responds to and fulills

their needs and aspirations. Is this the case of contemporary Romania? The image of the hos‑ pital, the conditions it offers for professional advancement, as well as its results at national level are also especially important.

5. Career means material advantages, social

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The need to be detached, different from the others, the need to go beyond one’s limits moti‑ vate a career attaining at least the competition level. The motivation of a career assumes elastic‑ ity (personal capacity to go beyond failure), power of discernment (the extent of a realistic choice), identity (to what extent selection of the profession appeared as having been a correct one). Career may be also understood as a hierar‑

chical advance, sometimes deserved and benei‑ cial, otherwise a manifestation of self‑seeking, which demonstrate that the love for positions is more powerful than the love for one’s profes‑ sion. Power frequently affects our intrinsic humanity [9,10].

6. Autonomy is the objective of a person who cannot bear organisational constraints, hates the team‑work, and the contact with noisy crowds. Working alone is possible only if the sanitary system offers positions in research units, labora‑ tories or in geographically‑remote areas.

7. The power of one’s example might be a good motivation, especially if considering the following piece of advice: a model is not to be copied, but to be compared with. Apprenticeship in the company of a great professor, a master, may stimulate one’s desire to distinguish him‑ self. In practice, however, the cases in which a prominent specialist prepares his successors get rarer and rarer. Egoism, envy, various com‑ plexes, arrangements, nepotism, prevent such noble attitudes. It may also happen that, in the end of substantial efforts, unpleasant surprises appear. Mention should be here made of the joke on the way in which the jobs were once distrib‑ uted: the best student, on top of all, was sent to

the hamlet of Coţuşca, as he represented a pro‑ fessional token, while the laziest student of the faculty remained in the university, as an univer‑ sity assistant, for being given the chance of improving his knowledge. A master might also favourize emulation, another factor with moti‑ vational implications.

8. Creativity expresses the need to realize

something new, the irrepresible desire of discov‑ ering epochal things. Failures are only lost bat‑ tles, but not the end of the war. Mr. and Mrs.

Curie demonstrated what passion may achieve in an almost natural selection of the human resources. Theoretically, this type of people rep‑ resent national treasures. Unfortunately, in most cases, governmental ungratefulness prevents the evolution of careers already seen as exceptional, favourizing „brain exodus”, the respective val‑ ues becoming „international treasures”. That is why, we do not feel comfortable at all when speaking about the Romanians awarded with the Nobel Prize: dr. George Emil Palade (represent‑ ing the USA) and Herta Müller (Germany).

9. Devotion for a cause springs from one’s inner strive for valourising his potentialities to

the beneit of the whole mankind, to educate, ori‑ ent or save people.

Devotion determines the preference of some people for the professions of school master, lawer, priest, doctor.

Reality also provides cases in which an indi‑ vidual builds his life as a competition, always in seek of solutions to the so‑called unsolvable

problems, dificult obstacles, dangerous rivals.

Risk becomes his passion and his manner of liv‑ ing, the adrenalin of a fully‑lived life: as a doctor, he joins polar or trans‑Saharian expeditions, pre‑

fers the battleields or the places affected by

natural calamities, or, in normal periods, SMURD or Emergency Services.

10. The wage system is the motivation had in view by any political or administrative system. The old saying „money is everything” is espe‑ cially/more than valid in our days.

Money is the symbol of freedom, when one wants to impress the others, and of slavery – when you do not have it, but want to have it.

Grown up in a society dominated by the inan‑ cial Fata Morgana, numerous youths choose a remunerative profession, others are advised by parents, relatives, friends, etc. to do this. Which are such professions? Business (even if not any‑ one has a capital and the talent to do business), politics (assuming, nevertheless, moral conces‑

sions), law (high wages, 90% pension of the last

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Last, but not least there exist the so‑called ”noble” professions, transformed nowadays into antirooms of poverty (education, culture). It goes

without saying that any inancial support and

reward always stimulate the human resources. Best expected results will be obtained only by a

student eficiently and permanently supported

either by his parents or by the state (by means of satisfactory scholarship grants), having optimum lodging and food, the possibility of buying the books he needs, as well as clothes and all neces‑ sary personal objects, and the possibility to par‑

ticipate to national and international scientiic

manifestations of reputed level [11,12].

Viewed from the perspective of the inancial beneits, the medical student will choose a spe‑ ciality in demand (surgery, diabetology), avoid‑

ing the less proitable sector (family medicine).

Money will also stimulate passing of exams and of contests for obtaining good professional posi‑ tions. Truth must be at last uttered, on leaving aside the fairy tale about the young aspirant of humble origin, studying at the light of a feeble

candle, having no suficient food and no heating in his squalid room, yet passionate and conident

in his forces, suffering six years which will assure him a life‑time happiness.

However, he will not be happy, as the wages of a Romanian brain worker represents one third of that obtained in Western countries, whereas the working conditions in Romanian hospitals are wholly dissapointing [13].

And here appears the mirage of the foreign land, even if accompanied by some other depres‑ sive factors: the postion of working as a subal‑ tern of a boss, under humiliating conditions, the complex of inferiority generated by the manner in which colleagues and even patients appreciate you, the surprise of being underpaid, the uncom‑ fortable context of a foregin environment. How‑ ever, the huge number of Romanian medical specialists now settled in West Europe accepts and even enjoys the condition of modern bond‑ age. In this way, the humanistic slogan „Medi‑ cines sans frontieres” is devoid of any meaning, money imposing a different type of barriers. The solution?

Appreciation in one’s own country, work in suitable conditions. Unfortunately, we are still far from reaching this ideal. In Romania, the

mean wages of a medical worker is of 200 euros, versus the at least 1,200 euros paid in West Europe; a specialist receives in Romania 700 euros, in the civilized world, ten times more – 7,000 euros. Who could deny the undisputable role palyed by money?

Renumeration does not include only wages. It also refers to remunerated extra‑hours of work,

activity in the emergency room, gratiications, experience and years of work, security beneits,

extra payment when working in dangerous con‑ ditions (in the departments of infectious dis‑ eases), extra food tickets, the 13th salary (not paid in Romania, any more), lodging and car offered by the employer, psychological situa‑ tions (the pleasure to create, the feeling of suc‑ cess), the accumulation of new competences as a result of a continuous improvement process,

power and inluence.

The series of motivations continues. A young person, eager to develop a sportive or musical career, should be given the argument that this may not lead directly to celebrity, a possible alternative being that of mediocrity and poverty. That is why, it is safer to attend studies known as assuring a sound material basis, and also the conditions for one’s personal hobby. Numerous examples, from quite various domains of activ‑ ity, may be provided in this respect: literature (famous writers who are doctors – from Vasile Voiculescu to Augustin Buzura), sports (the great footballer palyer Ladislau Böloni ‑ a stom‑ atologist), music, painting, etc.

CONCLUSIONS

Motivation is an internal process, and not an imperative with external causes.

Managers should understand the motivations strategies, the manner in which they are success‑ ful or fail, due to the manner in which they suc‑

ceed in inluencing the intimate motivations of

the employees.

The theories on human needs provide a detailed image on the concept of motivation, known as related to most intimate feelings of growth and development.

Fulillment of the organisational objectives

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attitude of the employees versus the tasks they are expected to achieve.

References

1. Abrudan, D.B., Serratore, M. Motivaţia şi motivarea resurselor umane pentru performanţă. Timişoara:

Editura Solness. 2002

2. Abrudan, M.M., Deaconu, A., Lukács, E. Echitate şi

discriminare în managementul resurselor umane.

Bucureşti: Editura A.S.E. 2010

3. Adams J. S., Toward an Understanding of Equity, Journal of Abnormal and Social Psychology, noiem‑ brie 1963

4. Andreş, S., Managementul resurselor umane: sin‑

teze, teste, îndrumări. Reşiţa: Editura Eftimie

Murgu. 2009

5. Bostan, I., Recompensarea factorului muncă. Iaşi:

Editura Media‑Tech. 1999

6. Cîrnu, D., Managementul resurselor umane în orga‑

nizaţiile europene. Târgu Jiu: Editura Academica Brâncuşi, 2010.

7. Cohen, E.,Responsabilitatea socială corporatistă în

sprijinul resurselor umane: un parteneriat necesar pentru dezvoltarea unor practici responsabile în afa‑

ceri. Bucureşti: Editura Curtea Veche. 2011

8. Cole, G.A – Managementul personalului, Editura

CODECS, Bucureşti, 2000.

9. Deaconu, A.,Factorul uman şi performanţele orga‑

nizaţiei. Bucureşti: Editura ASE. 2004

10. Heider F., The Psychology of Interpersonal Relati‑ ons, John Wiley and Sons, 1958

11. Herzberg F., Mansner B., Synderman B. B., The Motivation at Work, Chapman and Hall, 1959.

12. Ilieş, L., Osoian, C., Petelean, A., Managementul

resurselor umane. Cluj‑Napoca: Editura Dacia. 2002 13. Locke E. A., Towards a Theory of Task Motivation

and Incentives, Organizational Behavior and Human Performance, vol. 3, 1968

14. Manolescu, A.,Managementul resurselor umane.

Bucureşti: Ed. Economică. 2003

15. Maslow H., A Theory of Human Motivation, Psycho‑ logical Review, iulie 1943; “Motivation and Perso‑ nality”, Editia a 3‑a, Harper & Row, 1987.

16. Mazilescu, C.A.,Sisteme informaţionale în manage‑

mentul resurselor umane: aplicaţie în selecţia de personal. Timişoara: Editura Politehnica 2009.

17. Noe, R., Hollenbeck, J., Gerhart, B., Wright, P.,Fundamentals of human resource management. 3rd edition. Boston: McGraw‑Hill/Irwin. 2009

18. Pânişoară, G., Pânişoară, I.O., Motivarea eicientă. Ghid practic. Iaşi: Editura Polirom. 2005

19. Petrescu, I., Konrad, C.,Teorie şi aplicaţii în mana‑

gementul resurselor umane. Bucureşti: Editura Fun‑

daţiei “România de Mâine”.2010.

20. Prodan, A.,Managementul resurselor umane: ghid

de practică. Bucureşti: Editura Economică. 2011.

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