Performance Related Pay for Nurses and Motivation: an ethical dilemma?

There was a belief that the new pay model, “Agenda for Change” would recognise the performance and achievements of staff, while improving patient care. However there are reports that there have been mixed responses regarding the implementation of this pay model. Concerns have been raised regarding fairness and pay, resulting in low morale and a poor feeling of worth. Yet there is an argument that it is the nurse’s duty and obligation to demonstrate virtues of care, compassion and courage and not focus on monetary value. With the boundaries of ethical care constantly being challenged together with the increase in the expectations of patients and society, this highlights the subject of ethics and the implications of performance related pay and motivation within nursing. The aim of this dissertation was to explore the relationship between performance related pay and motivation, and the ethical implications relating to nursing. For the design of this dissertation a non-empirical research method was chosen to facilitate the examination of the key themes. A literature review with qualitative critical reflection and analysis was performed. The results suggested that it is recognised that staff motivation and pay models are complex matters. The current healthcare environment is facing a number of challenges including a demotivated workforce and financial constraints. It was highlighted that it was important to communicate a message of shared goals and objectives to help facilitate the motivation of staff by working towards the ‘Greater Good’. Although poor pay was an issue relating to poor motivation, there were other contributing factors including; lack of recognition, limited facilitation of development and training, poor communication between the organisation, management and staff, and a poor feeling of worth. It was proposed that this would impact on society as a whole as there is now a critical struggle in the recruitment and retention of nurses, which could lead to insufficient nurses in the future. This dissertation recommended 4 key areas of focus, suggesting that communication, training and development, the perception and image of nursing and pay were primary issues which needed to be explored. In conclusion, this dissertation has managed to establish that if used correctly and with clear training, guidelines and management, performance related pay could help motivate the nursing workforce and may have a positive influence on nursing ethics and professional practice.