Debbie’s Dilemma
HCA 340
Instructor Eric Oestmann, PHD, PT
Tika Devereux
March 18, 2015

The Herzberg two factor theory is also known as motivation-hygiene theory. It addressed two issues found within the workplace: hygiene factors and motivational factors. Hygiene factors include one’s satisfaction or dissatisfaction with matters like wages, hours, working conditions, relationships with co-workers or supervisors. Motivational factors are someone’s satisfaction or dissatisfaction with achievements, recognition, the actual job, responsibility, or advancement. Debbie’s motivators derived from her own hard work, effort, and performance. After just two years of being with the company, she began her master’s program to get her degree as a clinical nurse specialist with an understudy of children health. Even though the organization paid for half of her tuition and books, she devoted money and time to attain the degree. Through her obtaining her degree she expected a raise in pay as well as a higher status level. This theory helps to explain workplace dissatisfaction in healthcare settings. With Debbie’s dissatisfaction with hygiene factors within the company such as wages and relationships with peers, is the cause of her seeking other employment. Hearing how the LPN’s went behind her back and demanded that they to receive a raise in pay not to mention the treatment and disrespect she receives from them are all stressors that lead to Debbie’s dissatisfaction. Debbie made the decision to seek employment elsewhere. Among the influence of a person’s behavior on the job is the opinion that the process is fair. This theory, Adam’s Equity Theory, explains how employees act to the perception fairness and inequity. Keep in mind that people at work exchange inputs for outcomes. Debbie put in time and money to obtain her clinical nurse specialist degree (input) with the expectation that upon completion she would receive a raise in pay as well as in status.
When the ratio comparison is perceived as being equitable or balanced, equity occurs. But many times a review of personal analysis can lead someone to perceive that the formula is imbalanced. This disequilibrium is a strong motivational force to restore balance. In other words, Debbie was compelled to restore equilibrium. She wanted to adjust the components in the input/output ratio. One form of disequilibrium or negative inequity is shown as:
Personal outcomes Referent other outcomes
Personal inputs < Referent other inputs

Vroom’s Expectancy Theory is based on relationships between the organizational conditions and the motivation of the employees. It is made up of three primary elements which are expectancy, instrumentality, and valence. Expectancy is one’s belief that with a level of effort the result is successful performance of task. In Debbie’s case, she expressed a high expectancy and complete confidence that she would achieve her master’s degree of clinical nurse specialist. The expectancy value was very high for her. Instrumentality is an individual’s belief that the successful performance of a task would result in a reward. Debbie expected that if she successfully finished her studies and got her degree it would result higher wages and other perks and benefits. The instrumentality was set very high. Valance is made up of two components. The first is the value of the reward to the individual. In Debbie’s dilemma, the valance of the outcome was high. She felt if she furthered her studies she would be recognized and rewarded for her hard work. Valence is related to doing the best job during a specific time period on any given task. If I were the three physicians I would not let the two LPN’s strong arm me into giving them raises. I believe that a person’s hard work should be rewarded. Debbie put in a lot of time, money, and effort to complete studies. The two LPN’s she be reprimanded for their blatant disrespect and insubordination. Debbie is at the top rank of registered nurse. It is not her fault that due to the difference in education that she was appointed to supervise the LPN’s. Even though LPN’s has more seniority, Debbie was hired for the supervisory position. In order for her to manage them effectively, some repercussions have to be put in place.
References:
Buchbinder, S. B. & Shanks, N. H. (2011). Introduction to health care management (2nd ed.). Sudbury, MA: Jones and Bartlett Publishers.

Baack, D. E. & Fischer, A. (2013). The essentials of managing in the healthcare industry. San Diego, CA: Bridgepoint Education, Inc.