Career Commitment and Job Performance of Jordanian Nurses
Majd T. Mrayyan, RN, PhD, is Dean and an Associate Professor; and Ibrahim Al-Faouri, RN, PhD, is an Assistant Professor, Faculty of Nursing, Hashemite University, Zarqa, Jordan.
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BACKGROUND. Career commitment and job performance are complex phenomena that have received little attention in nursing research.
DESIGN AND SAMPLE. A survey was used to assess nurses’ career commitment and job performance, and the relationship between the two concepts. Predictors of nurses’ career commitment and job performance were also studied. A convenience sample of 640 Jordanian registered nurses was recruited from 24 teaching, governmental, and private hospitals.
RESULTS. Nurses “agreed” on the majority of statements about career commitment, and they reported performing “well” their jobs. Using total scores, nurses were equal in their career commitment but they were different in their job performance; the highest mean was scored for nurses in private hospitals. Using the individual items of subscales, nurses were willing to be involved, on their own time, in projects that would benefit patient care. The correlation of the total scores of nurses’ career commitment and job performance revealed the presence of a significant and positive relationship (r = .457). Nurses’ job performance, gender, and marital status were the best predictors of nurses’ career commitment: they explained 21.8% of variance of nurses’ career commitment. Nurses’ career commitment, time commitment, marital status, and years of experience in nursing were the best predictors of nurses’ job performance: they explained 25.6% of variance of nurses’ job performance.
CONCLUSIONS. The lowest reported means of nurses’ job performance require managerial interventions.
It is important to assess nurses’ career commitment for better understanding of what motivates them. Studies about careers and achievement have assumed that an unstable work history signified a lack of nurses’ career commitment (Gardner, 1992; Zangaro, 2001). Career commitment of nurses is correlated with turnover and job performance (Gardner; Somers, 2000). Low career commitment is associated with intention to leave the nursing profession and organization (Cohen, 1998; Somers). Thus, managerial interventions are needed to enhance nurses’ career commitment. For example, positive benefits would encourage nurses to perform “well” their jobs and enhance their intent to stay at their current careers.
Nurse performance has been an area of research for the last three decades; however, since the 1980s, a limited number of studies focused on how nurses actually perform their jobs. As related concepts, nurses’ career commitment and job performance have not been extensively studied (Gardner, 1992; McCloskey & McCain, 1987; Somers, 2000; Wright & Bonett, 2002). Moreover, the relationship between career commitment and job performance is not stable. Job performance is reported to influence career commitment rather than the reverse (McCloskey & McCain). Yet, Gardner reported the opposite direction; she stated that nurses’ career commitments have an important effect on work variables such as job performance. For the purpose of the present research, nurses’ career commitment and job performance are considered as dependent variables while the sample's demographics and organizational characteristics are independent variables.
Purpose and Significance
The overall purpose of this research was to study nurses’ career commitment and job performance. This study aimed at answering the following research questions:
- 1What variables influence nurses’ career commitment?
- 2What variables influence nurses’ job performance?
- 3What is the relationship between nurses’ career commitment and nurses’ job performance?
- 4What are the predictors of nurses’ career commitment?
- 5What are the predictors of nurses’ job performance?
This is one of few studies that linked career commitment of nurses to their job performance (Gardner, 1992; McCloskey & McCain, 1987; Somers, 2000; Wright & Bonett, 2002). In Jordan, this is the first nursing study about the two concepts. The results of this study can be used to create managerial interventions that will enhance the impact of the studied concepts on workplace environments.
Nurses’ Career Commitment
Research on career commitment started in psychology in the late 1950s. However, studies about career commitment in nursing were limited until the 1970s (Gardner, 1992). Career, work, and organizational commitment are distinct and different constructs (Mueller, Wallace, & Price, 1990; Zangaro, 2001). However, the terms professional, occupational, and career commitment are used somewhat interchangeably in the literature (Zangaro).
Nursing career commitment is the intent to build a career that is pursued for lifelong period (Gardner, 1992), and it is the strength of one's motivation to work (Zangaro, 2001). In the literature about management, Blau (1985) and Cohen (1998) defined career commitment as one's attitude toward one's profession.
There are various concepts used to describe commitment; however; organizational commitment is the commonly used concept. An organizational commitment is a presumed antecedent of performance and organizational change (Ingersoll, Kirsch, Merk, & Lightfoot, 2000). The various views on organizational commitment appear to reflect three general components. Affective commitment: employees remain with the organization because they want to do so (Allen & Meyer, 1990; Meyer, Allen, & Smith, 1993). Affective commitment has positive impact on the organization, especially in areas of job satisfaction and retention (Meyer, Irving, & Allen, 1998). That is, job satisfaction is a prerequisite for commitment both to the organization and to one's job and profession (Ingersoll, Olsan, Drew-Gates, DeVinney, & Davies, 2002; McNeese-Smith, 1997). Job dissatisfaction is associated with turnover and nursing shortage (Cowin, 2002). Continuance commitment: employees remain within the organization because they have to do so (Meyer et al., 1993). Normative commitment: employees remain within the organization because they feel they ought to do so (Allen & Meyer). Professional commitment is the commitment to one's profession (Cohen, 1998). Finally, an occupational commitment relates to the attractiveness of nursing as a lifelong occupational choice (Gardner, 1992).
Few studies linked nurses’ career commitment to job performance (McCloskey & McCain, 1987; Somers, 2000). Career commitment can be studied as a dependent or an independent variable. In models of employees’ turnover, a causal relationship was found between job satisfaction and organizational commitment (Currivan, 1999; Price & Mueller, 1981; Tett & Meyer, 1993). Job satisfaction, productivity, and organizational commitment are influenced by leadership styles (Chiok Foong Loke, 2001; Corser, 1998; Dahlke, 1996; McNeese-Smith, 1995), which may influence nurses’ job performance. Job satisfaction and organizational commitment are crucial elements of nurses’ empowerment (Janney, Horstman, & Bane 2001; Kuokkanen, Leino-Kilpi, & Katajisto, 2003); nurses need to be empowered to perform “well” their jobs. Organizational environments and educational preparations of currently employed nurses influence their current job satisfaction, organizational commitment, and career intent (Ingersoll et al., 2002).
Many personal and organizational variables influence career commitment. These variables include gender (Karrasch, 2003), and education and loyalty (Sikorska-Simmons, 2005). Quadagno (1978) found that career interruptions occurred for female more than male physicians, which may also apply to nurses. Moreover, Quadagno reported that career interruptions were relatively meaningless in predicting career commitment. Competence and motivation are other variables that influence career commitment. Buscherhof and Seymour (1990) reported that nurses valued intrinsic forms of success such as achieving competence in clinical practice. Nurses in intensive care units, medical–surgical wards, and women's health and psychiatric/mental health specialty areas were the least committed to the organization (Ingersoll et al., 2002). The current nursing shortage negatively influences nurses’ commitment to their careers (McNeese-Smith, 2001).
Job satisfaction and organizational culture are strong predictors of career commitment (Sikorska-Simmons, 2005). Career commitment has positive outcomes, such as decreased incidents of job tardiness or absenteeism from work (Corser, 1998; Dahlke, 1996).
Nurses’ Job Performance
Schwirian (1978) took the lead to develop a model for nurses’ job performance. Job performance is defined as how well the job is done in accordance to established standards. Furthermore, job performance is defined as an action that can be observed and measured (McConnell, 2003).
Job performance is a complex phenomenon (Popovich, 1998). Multiple variables influence nurses’ job performance. These variables include young age (Wright & Bonett, 2002), recognition of achievement (Cronin & Becherer, 1999; Fort & Voltero, 2004), work satisfaction and employee's educational level and training (McConnell, 2003; Tzeng, 2004), social support (AbuAlRub, 2004), supportive communication and feedback (Fort & Voltero), and competent nursing practice (Meretoja, Eriksson, & Leino-Kilpi, 2002; Meretoja, Isoaho & Leino-Kilpi, 2004; Meretoja & Leino-Kilpi, 2001; Meretoja & Leino-Kilpi, 2003). All these variables would positively influence nurses’ job performance. Career competencies such as experience are important for better performance of jobs. These competencies predict nurses’ job performance (Tzeng). On the other hand, long working shifts and heavy workload (Fitzpatrick, While, & Roberts, 1999; Josten, Ng-A-Tham, & Thierry, 2003; Reid & Dawson, 2001), job stress (AbuAlRub), punitive corrective actions and motivational and skill difficulties (McConnell), and older shift workers (Reid & Dawson) are reported to negatively influence nurses’ job performance.
Problems of employees’ performance usually stem from shortcomings of systems; however, “no matter what the manager does, it is always the worker who makes the real change” (McConnell, 2003, p. 56).
Sample and Settings
A convenience sample of 640 Jordanian registered nurses was recruited. To be familiar with the measured concepts, the selection criteria stated that registered nurses should be working in hospital settings for at least 6 months. This study was conducted in three types of hospitals: 2 teaching hospitals, 11 governmental, and 11 private hospitals. These hospitals covered the middle, northern, and southern parts of Jordan.
Data Collection Procedures
Data were collected to determine what variables influence nurses’ career commitment and nurses’ job performance, and assess the relationship between the two concepts as well as their predictors.
The first step in conducting this study was obtaining the approval of the university that funded the current research, as well as the participating hospitals’ administrators and nurses. Data were collected during the summer of 2005. All nurses working in large teaching, governmental, and private hospitals were invited to voluntarily participate in this study. Nurses were contacted through their nurse managers. Invitation letters that included a brief description of the study's purpose along with the questionnaire and demographic form were sent. Nurses’ anonymity and confidentiality of participants’ information were assured. To obtain the consent form, the following statement was written in the invitation letter: “Answering and returning back the questionnaire is your consent form.”
Nurses’ career commitment was measured by Gardner's career commitment scale (1986). It is a 5-point Likert scale rated as: 1 = strongly disagree; 2 = disagree; 3 = undecided, 4 = agree, and 5 = strongly agree. The higher the mean score, the greater the level of nurses’ career commitment was considered. In the original scale, the psychometric testing using exploratory factor analysis resulted in a Cronbach's alpha of .82, which indicated an internal consistency (Gardner). In the current research, the reliability coefficient was .85.
Schwirian's (1978) Six-Dimension Scale of Nursing Performance was used to measure nurses’ job performance. This scale consists of 52 items grouped into 6 subscales: Leadership (5 items), Critical Care (7 items), Teaching/Collaboration (11 items), Planning/Evaluation (7 items), Interpersonal Relations/Communication (11 items), and Professional Development (10 items). The scale is rated as: 0 = not at all; 1 = not very well; 2 = satisfactory; 3 = well, and 4 = very well. The Professional Development subscale is rated as: 0 = never; 1 = seldom; 2 = occasionally; 3 = frequently, and 4 = consistently.
The Six-Dimension Scale of Nursing Performance is a reliable scale; Cronbach's alphas reported by Schwirian (1978) ranged from .84 for the Leadership subscale to .98 for the Professional Development subscale. In the present study, the reliability coefficient of the overall scale was .93, and for subscales was: Leadership = .72, Critical Care = .70, Teaching/Collaboration = .83, Planning/Evaluation = .75, Interpersonal Relations/Communication = .84, and Professional Development = .74.
The demographic form was developed by the researchers to collect data about gender, marital status, shift worked, time commitment for work, level of education, age, experience, area of work, average daily census, organizational structure, model of nursing care, and decision-making style.
SPSS (version 11.5, 2001) was used to generate descriptive and inferential statistics at a significance level of .05. Means, standard deviations, and frequencies were reported for sample's variables. On a 5-point Likert scale, any item that had a mean value above 3 was considered a factor that positively contributes to nurses’ career commitment. On a 4-point Likert scale, any item that had a mean value above 3 was considered a factor that positively contributes to nurses’ job performance.
Using the total scores of the two concepts, nurses’ career commitment and nurses’ job performance were correlated. Stepwise regression analyses were performed to assess whether demographics are predictive of nurses’ career commitment and job performance. A stepwise regression was used in this study since there were few studies that used these independent variables to predict the variance in nurses’ career commitment and job performance. This procedure was used to estimate the relationships between the dependent and the independent variables (Polit & Beck, 2004). In the stepwise regression, it is common to enter the studied variables one at a time from the best to the worst predictor to explain the variance of the dependent variable. However, because the variables that weighted more in explaining the variance of the dependent variables were not known for the researchers, all independent variables were entered at the same time. In the current study, there were two dependent variables, nurses’ career commitment and job performance, while the independent variables were sample's demographics and organizational characteristics.
Description of Demographics
Of the possible 1,100 nurses, 640 nurses completed the questionnaire, with a response rate of 58.1%. Nurses were recruited from 2 teaching (65.0%), 11 governmental (19.4%), and 11 private hospitals (15.6%).
The sample of the current study consisted of 58.7% male nurses and 41.3% female nurses. The majority of nurses were single (63.0%), and the average age was less than 34 years (88.5%). The majority of nurses were working mainly on rotating shifts (62.1%) on a full-time basis (76.7%) in critical care units (69.3%). The majority of nurses held a baccalaureate degree as their higher educational level (77.7%), and had 4 years or less of experience in nursing (71.4%).
Nurses reported a daily census of 20 patients or more per day (25.2%), worked in a unit or ward that used a vertical organizational structure (34.0%), and used a mixed decision-making style that depends on the situation (41.9%). Of nursing care delivery systems, team nursing was commonly used (45.0%) (Table 1).
Table 1. Sample's Profile
|Gender||Area of work|
| Male||374||58.7|| Critical care units||432||69.3|
| Female||263||41.3|| Wards||191||30.7|
|Marital status|| || ||Type of hospitals|| || |
| Single||399||63.0|| Governmental||124||19.4|
| Married||220||34.8|| Teaching||416||65.0|
| Separated/divorced and widowed|| 14|| 2.2|| Private||100||15.6|
|Shift worked||Unit's average daily census|
| Day||176||27.9|| 1–5 patients||113||18.1|
| Evening|| 15|| 2.4|| 6–10 patients||155||24.8|
| Night|| 48|| 7.6|| 11–15 patients|| 93||14.9|
| Rotating||391||62.1|| 16–20 patients||106||17.0|
|Time commitment|| More than 20 patients||157||25.2|
| Full-time||487||76.7||Units or wards’ organizational structure|
| Part-time||148||23.3|| Vertical||210||34.0|
|Level of education|| || || Horizontal||180||29.2|
| Diploma||115||18.1|| Matrix||129||20.9|
| Baccalaureate||494||77.6|| Unclear|| 98||15.9|
| Master's and above|| 27|| 4.3||Model of nursing care provision|
| Younger than 25 years||306||48.0|| Team||280||45.0|
| 25–34 years||258||40.5|| Functional||112||18.0|
| 35–44 years|| 71||11.1|| Unclear|| 50|| 8.1|
| 45–54 years and older|| 2|| 0.4||Decision-making style|
|Experience|| Authoritative|| 93||15.0|
| Less than 1 year||140||22.2|| Participative||211||34.0|
| 1–2 years||166||26.3|| Mixed||260||41.9|
| 3–4 years||145||22.9|| Unclear|| 56|| 9.1|
| 5–9 years|| 98||15.5|| || || |
| 10 years or longer|| 83||13.1|| || || |
Based on the total scores, the mean of nurses’ career commitment in the whole sample was 3.53: 3.42 in governmental hospitals, 3.54 in teaching hospitals, and 3.64 in private hospitals; all these figures indicated that nurses “agreed” to remain committed to their careers. Based on the total scores, the mean of nurses’ job performance in the whole sample was 2.75: 2.65 in governmental hospitals, 2.75 in teaching hospitals, and 2.85 in private hospitals; all these figures indicated that nurses perceived they were performing “well” their jobs. Based on the total scores, nurses did not differ significantly in their career commitment scores; however, they did differ in their job performance scores (p = .043); the highest mean was for nurses employed in private hospitals (Table 2).
Table 2. Comparisons of Total Scores of Nurses’ Career Commitment and Job Performance Between Whole Sample, Governmental, Teaching Hospitals, and Private Hospitals (N = 640)
|Nurses’ career commitment||3.53||.78||3.42||.81||3.54||.77||3.64||.76||2.28||.102|
|Nurses’ job performance||2.75||.54||2.65||.61||2.75||.53||2.85||.49||3.16||.043a|
Nurses’ Career Commitment
To assess nurses’ career commitment, means of subscales were listed in descending order. The highest and lowest means for each subscale were: while nurses were willing to become involved on their own time in projects that would benefit patient care (X̄ = 3.70), nurses reported that they will not encourage their children to pursue a career in nursing (X̄ = 2.88) (Table 3).
Table 3. Means, Standard Deviations, and Frequencies of Variables of Nurses’ Career Commitment (N = 640)
|Nurses would be willing to become involved on their own time in a project that would benefit patient care||3.70||1.06|| 3.6||10.0||23.7||37.8||24.9|
|Advancement opportunities in nursing are important to nurses||3.69||1.15|| 3.1||11.9||22.5||36.6||25.9|
|Nurses would be willing to become involved on their own time in a project that would benefit nurses and nursing||3.68||1.06|| 3.5|| 9.6||27.4||34.1||25.4|
|Nurses have long-range career goals||3.64||1.15|| 5.4||11.8||22.6||33.1||27.1|
|Nurses plan to be continuously active in a nursing career throughout their lives||3.63||1.28|| 9.6||11.0||20.5||25.7||33.2|
|Nurses’ present work assignment is closely related to their career interests and goals||3.52||1.15|| 6.9||12.8||21.9||37.9||20.5|
|Providing care to patients/clients is the reason that nurses chose nursing as a career||3.52||1.21|| 7.1||13.3||26.4||26.5||26.7|
|Nursing career is a central interest in nurses’ lives||3.46||1.15|| 5.5||15.9||27.0||30.1||21.5|
|Working in nursing is important to nurses||2.69||1.24|| 8.4||10.4||15.5||34.9||30.8|
|Nurses would encourage my child to pursue a career in nursing||2.88||1.35||21.5||19.2||23.9||20.7||14.9|
Nurses’ Job Performance
Nurses’ job performance was assessed using the subscales of Leadership, Critical Care, Teaching/Collaboration, Planning/Evaluation, Interpersonal Relations/Communication, and Professional Development. The means for the subscales were listed in descending order. The highest and lowest means for each subscale were as follows: Leadership: leaders remain open to the suggestions of staff under their direction and use them when appropriate (X̄ = 2.75), and leaders give praise and recognition for achievement to those under their direction (X̄ = 2.40); Critical Care: nurses perform technical procedures such as oral suctioning and tracheotomy care (X̄ = 2.97), and nurses function calmly and competently in emergency situations (X̄ = 2.78); Teaching/Collaboration: nurses teach a patient's family members about the patient's needs (X̄ = 2.81), and nurses use teaching aids and resource materials in teaching patients and their families (X̄ = 2.45); Planning/Evaluation: nurses develop a plan of nursing care for a patient (X̄ = 2.83), and nurses initiate planning and evaluation of nursing care with others (X̄ = 2.61); Interpersonal Relations/Communication: nurses promote the patient's right to privacy (X̄ = 3.10), and nurses promote the inclusion of the patient's decisions and desires concerning his or her care (X̄ = 2.64); and Professional Development: nurses demonstrate self-confidence (X̄ = 3.08), and nurses use learning opportunities for ongoing personal growth (X̄ = 2.51) (Table 4).
Table 4. Means, Standard Deviations, and Frequencies of Variables of Nurses’ Job Performance (N = 640)
| Remains open to the suggestions of those under leaders’ direction and uses them when appropriate||2.75||0.98||2.4|| 8.7||23.1||43.1||22.7|
| Guides other health team members in planning for nursing care||2.67||1.07||4.9|| 9.9||20.5||42.2||22.5|
| Delegates responsibility for care based on assessment of priorities of nursing care needs and the abilities and limitations of available healthcare personnel||2.64||1.02||4.6|| 7.7||25.6||42.6||19.5|
| Accepts responsibility for the level of care provided by those under leaders’ direction||2.64||1.59||3.6||11.1||27.2||37.8||20.3|
| Gives praise and recognition for achievement to those under leaders’ direction||2.40||1.09||8.0||10.9||27.6||40.2||13.3|
| Performs technical procedures: e.g., oral suctioning, tracheotomy care, intravenous therapy, catheter care dressing changes, etc. ||2.97||1.05||2.2|| 9.1||16.0||34.8||37.9|
| Performs nursing care required by critically ill patients||2.92||1.58||2.4|| 7.2||20.9||39.3||30.2|
| Uses mechanical devices: e.g., suction machines, cardiac monitor, respirator, etc. ||2.90||1.15||2.5|| 8.9||21.0||32.3||35.3|
| Performs appropriate measures in emergency situations ||2.89||0.98||2.2|| 6.2||22.7||37.4||31.5|
| Gives emotional support to family of dying patient||2.85||1.06||3.3|| 8.0||20.5||35.6||32.6|
| Recognizes and meets the emotional needs of a dying patient||2.79||1.59||3.5|| 8.4||24.2||37.3||26.6|
| Functions calmly and competently in emergency situations||2.78||0.98||2.7|| 7.5||22.3||43.2||24.3|
| Teaches a patient's family members about the patient's needs||2.81||1.01||2.4|| 8.3||22.9||38.4||28.0|
| Encourages the family to participate in the care of the patient||2.76||1.04||3.7|| 8.1||22.8||39.3||26.1|
| Identifies and uses resources within your healthcare agency in developing a plan of care for a patient and his or her family||2.65||0.98||2.8|| 8.8||27.6||41.0||19.8|
| Adapts teaching methods and materials to the understanding of the particular audience: e.g., age of patient, educational background, and sensory deprivations||2.63||0.99||3.0||10.0||27.1||40.6||19.3|
| Communicates facts, ideas, and professional opinions in writing to patients and their families||2.58||1.61||5.7||10.1||27.4||38.6||18.1|
| Plans for the integration of patient needs with family needs||2.57||1.00||3.6|| 9.7||29.8||39.3||17.6|
| Promotes the use of interdisciplinary persons||2.57||0.96||2.9|| 9.4||31.2||40.1||16.4|
| Identifies and uses community resources in developing a plan of care for a patient and a family||2.50||1.06||4.1||12.7||30.5||34.1||18.6|
| Develops innovative methods and materials for teaching patients||2.48||1.02||4.3||12.0||30.8||37.3||15.6|
| Uses teaching aids and resource materials in teaching patients and their families||2.45||1.11||5.9||13.2||28.6||34.0||18.3|
| Develops a plan of nursing care for a patient||2.83||1.81||3.6|| 6.3||23.2||42.3||24.6|
| Coordinates the plan of nursing care with the medical plan of care ||2.80||0.95||2.1|| 6.7||24.4||42.1||24.7|
| Evaluates results of nursing care||2.78||1.03||3.5|| 7.7||22.3||39.9||26.6|
| Identifies and includes immediate patient's needs in the plan of nursing care ||2.74||1.03||3.3|| 9.7||20.3||42.4||24.3|
| Identifies and includes in nursing care plans anticipated changes in patient's condition||2.71||0.99||4.1|| 6.8||22.8||45.8||20.5|
| Contributes to the nursing care for the patient||2.63||1.08||6.9|| 6.9||21.8||44.5||19.9|
| Initiates planning and evaluation of nursing care with others||2.61||1.02||3.9||10.2||25.1||42.0||18.8|
| Promotes the patient's right to privacy ||3.10||0.96||1.4|| 5.2||17.2||33.9||42.3|
| Contributes to productive working relationships with other health team members||2.95||1.39||1.3|| 5.2||22.0||44.5||27.0|
| Contributes to an atmosphere of mutual trust, acceptance, and respect among other health team members||2.93||0.97||2.2|| 6.4||18.7||41.4||31.3|
| Verbally communicates facts, ideas, and feelings to other health team members||2.92||0.92||0.6|| 7.4||20.8||41.2||30.0|
| Explains nursing procedures to a patient prior to performing them ||2.91||0.98||2.1|| 6.3||21.6||38.2||31.8|
| Seeks assistance when necessary||2.86||1.02||4.4|| 5.2||17.9||44.3||28.2|
| Helps a patient meet his or her emotional needs ||2.86||0.98||2.7|| 7.2||18.5||44.0||27.6|
| Uses nursing procedures as opportunities for interaction with patients ||2.84||0.94||2.4|| 6.3||20.7||45.8||24.8|
| Helps a patient communicate with others||2.77||0.97||3.0|| 6.8||23.0||44.2||23.0|
| Uses opportunities for patient teaching when they arise||2.75||1.00||3.5|| 7.9||21.3||44.3||23.0|
| Communicates a feeling of acceptance of each patient and a concern for the patient's welfare||2.65|| .99||3.8|| 6.5||30.0||39.7||20.0|
| Promotes the inclusion of the patient's decisions and desires concerning his or her care||2.64||1.00||4.9|| 7.7||22.6||47.8||17.0|
| Demonstrates self-confidence||3.08||0.92||1.9|| 3.8||15.5||41.0||37.8|
| Demonstrates knowledge of legal boundaries of nursing||3.02||1.88||1.9|| 5.6||17.7||44.6||30.2|
| Accepts responsibility for own actions||3.01||0.95||2.5|| 4.4||16.0||43.0||34.1|
| Maintains high standards of self-performance||3.01||0.88||1.3|| 5.2||15.1||47.2||31.2|
| Displays a generally positive attitude||3.01||1.51||1.9|| 5.1||18.3||43.3||31.4|
| Demonstrates knowledge of the ethics of nursing||3.00||0.91||0.9|| 6.3||17.4||42.1||33.3|
| Assumes new responsibilities within limits of capabilities||2.87||0.88||1.1|| 6.2||20.3||48.3||24.1|
| Accepts and uses constructive criticism||2.81||1.01||1.9|| 7.4||22.7||44.4||23.6|
| Displays self-direction ||2.66||0.98||3.6|| 7.1||27.3||42.6||19.4|
| Uses learning opportunities for ongoing personal growth||2.51||1.05||5.7|| 9.0||30.3||37.6||17.4|
The Relationship Between Nurses’ Career Commitment and Nurses’ Job Performance
Correlation of total scores of nurses’ career commitment and job performance revealed the presence of a significant and positive relationship (r = .457).
Predictors of Nurses’ Career Commitment and Job Performance
Stepwise regression model indicated the following predictors of nurses’ career commitment: nurses’ job performance (R2 change = .203), gender (R2 change = .008), and marital status (R2 change = .008) (Table 5). The previous variables explained 21.8% of the variance of nurses’ career commitment. In addition, the stepwise regression model revealed the following predictors of nurses’ job performance: nurses’ career commitment (R2 change = .203), time commitment (R2 change = .017), marital status (R2 change = .014), and years of experience in nursing (R2 change = .021) (Table 6). The previous variables explained 25.6% of the variance of nurses’ job performance.
Table 5. Stepwise Regression Analyses of Nurses’ Career Commitment (N = 640)
|1||Nurses’ job performance||.450||.203||.203|| 0.0116||150.120||< .001|
|2||Gender||.459||.211||.008|| 1.591|| 78.639||< .001|
|3||Time commitment||.467||.218||.008||–1.621|| 54.791||< .001|
Table 6. Stepwise Regression Analyses of Nurses’ Job Performance (N = 640)
|1||Nurses’ career commitment||.450||.203||.203|| 1.499||150.12||< .001|
|2||Time commitment||.469||.220||.017|| –8.020|| 83.17||< .001|
|3||Marital status||.484||.235||.014||–10.35|| 60.08||< .001|
|4||Years of experience in nursing||.506||.256||.021|| 3.727|| 50.49||< .001|
The results of the current study revealed that nurses are committed to their careers and they agreed to keep this commitment. This result is better than what was reported by Gardner (1992), who found a significant drop in nurses’ career commitment scores at 6 months of employment. Nurses in the present study reported they were performing “well” their jobs, which is also better than the marginal performance of nurses in the study of McCloskey and McCain (1987).
As indicated by the total scores, Jordanian nurses from the different hospitals were equal in their career commitment. This situation could be explained by the presence of a stagnate financial status in Jordan. Nurses are responsible about meeting daily living requirements of their extended families. Thus, nurses could have commitment to their careers by “duty” rather than by “choice.”
There were significant differences between the three types of hospitals in nurses’ job performance; the highest mean was scored for nurses employed in private hospitals. It is important to mention that governmental hospitals in Jordan are centralized in their decision-making processes, while the teaching hospitals are characterized by the presence of rigid rules and procedures. As a result, governmental and teaching hospitals may not be favorable areas of work for nurses. Private hospitals could be preferable work settings for newly graduated nurses. Private hospitals have better work environments, which could be a main contributor to high levels of job performance. Thus, work environments must be strengthened to enhance nurses’ job performance.
In the present study, as a consequence of their nurses’ career commitment, nurses were willing to become involved, on their own time, in projects that would benefit patient care as well as the nursing profession. Career commitment, and in turn job performance, would positively influence the quality of care (Tzeng, 2004).
In the present research, nurse managers’ leadership styles influenced nurses’ job performance. In the leadership subscale of the job performance scale, several items had high scores. Leaders should remain open to suggestions from nurses who are under their direction and use these suggestions when appropriate. Such results are supported by other studies; McCloskey and McCain (1987), Pincus (1986), and Fort and Voltero (2004) reported the presence of significant correlations between job performance and components of communication. In the Interpersonal Relations/Communication subscale of the job performance scale, several items also had high scores. Leaders who use two-way communication positively will promote staff's high spirits and their encouragement to perform their jobs with high standards. Positive and continuous feedback and participative leadership are conducive for high job performance (Cronin & Becherer, 1999; Fort & Voltero). Furthermore, in their course of communication and as a part of their job performance, nurses should promote patients’ privacy. Applying nursing ethics is not an option but a must; ethics is a core component of professional commitment (Cohen, 1998; Somers, 2000).
In regard to Critical Care, nurses were performing “well” many technical procedures, and reported a high level of involvement in Teaching/Collaboration, especially in teaching patients’ family members about patients’ needs. Consistent with McCloskey and McCain (1987), it is expected that nurses performed more critical care skills and fewer teaching skills as more patients were more acutely ill. In turn, nurses’ involvement in Planning/Evaluation activities, especially developing and coordinating plans of nursing care for patients, will be influenced. However, regardless to how busy nurses are, it is very important that nurses focus on family/community involvement. This factor was significantly correlated with nurses’ job performance (McCloskey & McCain). Family/community involvement is a variable that Price and Mueller (1981) hypothesized to be related to turnover: the more involvement with the family and the community, the less is the turnover, which may indicate a high level of job performance.
Nurses’ professional development should not be compromised under any situation; nurses should always demonstrate self-confidence and self-direction. These characters are prerequisites for autonomy, job satisfaction, job performance, retention, and career commitment. Autonomous nurses accept responsibility and they are accountable for their actions. Moreover, autonomous nurses always work hard to promote their personal growth. McCloskey and McCain (1987) reported that when the number of staff is fewer than required, and less teaching, planning evaluation, and professional development were done. Focusing on the latent two variables would positively reflect on the quality of performed jobs.
There was a significant and positive correlation between nurses’ career commitment and nurses’ job performance, which is consistent with other studies (McCloskey & McCain, 1987; Somers, 2000; Wright & Bonett, 2002). More specifically, McCloskey and McCain found that nurses’ career commitment was the best predictor of the following aspects of nurses’ job performance: Leadership, Teaching/Collaboration, and Interpersonal Relations/Communication. However, job performance influenced the commitment rather than the reverse (McCloskey & McCain). On the other hand, Gardner (1992) reported the opposite relationship between the two concepts. We believe that no matter what is the direction of the relationship between nurses’ career commitment and job performance, nurses should be given incentives to participate in professional activities and to be involved in career planning. Consistent with Gardner, a performance appraisal system should be used to reward nurses’ positive attitudes, such as high job performance, professionalism, and autonomy, which may result in high career commitment.
The stepwise regression model yielded that nurses’ job performance, gender, and time commitment were the best predictors of nurses’ career commitment. The stepwise regression model showed that predictors of nurses’ job performance were nurses’ career commitment, time commitment, marital status, and years of experience in nursing. Career patterns are different for women than for men (Quadagno, 1978). Women as compared to men view differently their careers and the definition of success in their work. Yet, such a trend may not exist in current days as well as in a developing country such as Jordan. In Jordan, nurses, regardless of their gender, have to work to support their extended families. Furthermore, the majority of nurses in the current study were single; thus, the influence of marital status on job performance is difficult to interpret. Single nurses may have less social and family responsibilities, and in turn they have more time and concentration while performing their jobs. It is expected that nurses who work on a full-time basis will perform their jobs better than part-time nurses; there is a continuity of jobs performed by full-time nurses, which may have the same trend in regard to career commitment. As evidenced in the current study, years of experience in nursing influence nurses’ job performance (McCloskey & McCain, 1987; Wright & Bonett, 2002). McCloskey and McCain reported that years of nurses’ experience were related significantly to several types of performance: highest critical care performance (r = .24), leadership skills (r = .15), and planning/evaluation. In addition, the researchers reported that years of total experience was the best predictor of critical care skills (r = .2). Career competencies such as experience and job stage are important for better performance of jobs (McNeese-Smith, 2000; Tzeng, 2004; Wright & Bonett). These competencies predicted nurses’ job performance (Tzeng) and nurses’ job retention (McNeese-Smith).
In the present research, there is a relatively small explained variance of nurses’ career commitment as a result of nurses and hospitals’ characteristics, which is supported by the literature. For example, Cooper-Hakim and Viswesvaran (2005) reported that most of the 94 meta-analyzed correlation of “work commitment” were small. Sociodemographics failed to account for a significant amount of variance in organizational commitment, which is a part of career commitment (Sikorska-Simmons, 2005). This small explained variance is expected to apply also for nurses’ job performance.
Nurses make choices on a continuum from one extreme of true career orientation to the other of minimal job commitment (Gardner, 1992). Committed nursing professionals should make differences in provided care and nurse–patient relationships (Gardner). The way nurses’ career commitment is viewed will influence the interpretation of work behaviors (Gardner). For example, nursing as a profession is not fully accepted in developing countries such as Jordan; thus, nurses need to make visible their value to society by emphasizing the hidden work of nursing. This will provide nurses with many opportunities to promote nursing as a positive career. Publicizing the nursing profession is a key strategy for career commitment (Gardner).
For career commitment, some nurses reported that they will not encourage their children to pursue a career in nursing; such attitudes should be changed. Self-confidence and being proud to be a nurse are the milestones to have and maintain a strong commitment to the nursing profession.
Characteristics of work environments in private hospitals should be studied to determine why nurses report higher job performance in these hospitals, and assess whether these characteristics be implemented in government and teaching hospitals.
Managerial interventions are needed to enhance nurses’ job performance. To enhance their leadership, nurses must be given praise and recognition for their achievement. To enhance their critical care skills, nurses should be provided with work environments that help them function calmly and competently in emergency situations. To enrich their teaching/collaboration, nurses must be provided with teaching aids and resource materials to teach patients and their families. To enhance their planning/evaluation skills, nurses should initiate planning and evaluation of care with others. To enhance their communication skills, nurses should promote the inclusion of patients’ decisions and desires concerning their care. To promote their professional development, nurses should be provided with learning opportunities to keep their professional growth.
Nurses’ career commitment and nurses’ job performance appear to be susceptible to the influence of organizational factors; thus, further studies in this area are warranted with the inclusion of a wide variety of variables. Results of the present study also demonstrated that nurses’ career commitment and nurses’ job performance should be measured at different times. Measurement of the same variable over time may help to determine causal relationships (McCloskey & McCain, 1987). A random sample of nurses from different Jordanian hospitals should be recruited in future research studies.
As it is the situation in many national and international healthcare institutions, preceptorship programs are available for all nurses, particularly the new ones. The use of a preceptor during the first few months on the job should be evaluated in future studies to assess the influence of these programs on nurses’ job performance and nurses’ career commitment.
The results of the present study point to the importance of nurse managers’ leadership skills. These skills along with the communication style of nurse managers are important for their nurses’ effective performance (Gardner, 1992). Recognition from management, supportive communication, and continuous feedback positively influence job performance (Fort & Voltero, 2004).
Career competencies such as experience are important for job performance. These competencies were reported as predictors of nurses’ job performance (Tzeng, 2004). Thus, academic courses in nursing and on-the-job training should be developed to build on nurses’ competencies for better outcomes.
Summary and Conclusions
Nurses “agreed” to keep committed to their careers, and they reported performing “well” their jobs. Although hospitals were different, nurses were equal in their career commitment. As compared to teaching and governmental hospitals, private hospitals scored the highest in nurses’ job performance scores. Time commitment was the shared predictors of nurses’ career commitment and nurses’ job performance.
Nurses’ career commitment is important for nurses’ job performance. Enhancing nurses’ career commitment will be beneficial for both individuals and their employing organizations. Nurses’ job performance has several components; thus, further studies are needed to determine the interrelatedness of variables.
The researchers would like to thank the Hashemite University for funding this research. Special thanks are sent to Professor Emeritus Sonia Acorn, the University of British Columbia School of Nursing, for her insights on this manuscript. Also, the researchers would like to thank all the nurses who participated in this study.