1. Healthcare Professionals’ Perceptions and Attitudes toward Morale in the Workplace
GROUP C:
Elizabeth Clark BA, BScN, RN
Natalie George, RD
Binh Nguyen, BN, RN
Samantha Roberts, BN, RN

2. Background
Complex healthcare environments create workplaces that contribute to low morale amongst healthcare professionals (Day, Minichiello, & Madison, 2007).
Growing workload demands, high acuity patients, and budgetary constraints have created challenging places to work in healthcare (Keogh, 2014).
Little literature exists regarding healthcare professionals perceptions and attitudes toward low morale in the workplace.

3. Hypothesis
Low staff morale is a widespread problem amongst healthcare workers (Keyko, 2014).
Low morale not only negatively affects the work environment of healthcare workers, it has led to a detrimental decline in the health and wellness of employees, and negatively affects patient care (Lowes et al., 2015).
Knowledge of healthcare professionals’ perceptions and attitudes toward low workplace morale may help identify methods to improve this ongoing phenomenon.

4. Study Objectives
Graduate students from an MHST/NURS course participated in a two-phase mixed methods research project to examine healthcare professionals’ perceptions and attitudes toward workplace morale.
Common themes were identified using qualitative research methods and this information was used to develop a survey, which enabled quantitative analysis and findings that provide insight into the impact of workplace morale on healthcare professionals.

5. Lab 1: Focus Group and Qualitative Analysis
Methodology Limitations Data Analysis Results Discussion

6. Lab 1: Methodology
Focus group questions gathered information regarding participant’s views on the evidence and consequences of low morale, the impact of management, and practices that might improve morale.
Three members of Group C participated by answering four questions posed by the Principal Investigator.
The focus group took place over 1 hour and 30 minutes via Adobe Connect.

7. Lab 1: Limitations
The major limitation was the small sample size of three participants.
Technical difficulties and the lack of physical presence over Adobe Connect during the focus group may have limited ease of conversation impacting the results.
Participants may have been biased as all took part in the development of the questions and had pre-planned discussion points for the session.

8. Lab 1: Data Analysis
Field notes were collected by the principal investigator and reviewed by all members of Group C.
Data was reviewed, placed into a data collection table, coded, and broken down to identify themes.
These themes were further examined in order to determine what aspects of morale in the workplace warranted further investigation.

9. Lab 1: Results Themes of low morale in the workplace were found to be:
Negative behaviours/outcomes: gossip, complaints, and conflict.
Atmosphere/emotions: unhappiness, frustration, and loneliness.
Workplace values: lack of teamwork, ineffective communication.
Management/leadership beliefs: lack of direction or interaction with staff, ineffective disciplinary action.  

10. Lab 1: Discussion
Consistent low morale can reduce individual and team performance resulting in negative effects on the quality of health care and service provided (Day, Minichiello & Madison, 2007).
Low morale as a result of poor management and leadership can mirror employee lack of commitment, loyalty, and organizational value (Chen et al, 2015).

11. Lab 1: Discussion continued
Low morale can have a devastating impact on individuals, teams, quality of care, and the workplace atmosphere (Berrios et al., 2015).
Effective management and leadership can be key in mitigating morale in the workplace.
A ten-question survey was developed to further investigate the effects of workplace morale in a healthcare setting.

12. Lab 2: Survey and Quantitative Data Analysis
Methodology Limitations Data Analysis Results Discussion

13. Lab 2: Methodology
Data from the focus group contributed to the development of a 10-item survey which was sent to 13 fellow classmates.
The survey was sent via course as an attachment to a consent form.
Clicking on the link implied consent to participate in the study.
100% of respondents replied

14. Lab 2: Limitations
The major limitation was the small sample size of thirteen participants.
Purposeful sampling was not feasible due to time constraints.
The homogeneous group of participants were all female healthcare professionals.
Generalizability of the findings are restricted due to these limitations.

15. Lab 2: Data Analysis
Results from the survey were analyzed using quantitative statistical analysis.
Each question was examined individually and the percentage of responses were calculated and compared to the group.
The data was analyzed to determine which factors were most significant with respect to working in an environment with low morale.

16. Lab 2: Results
All respondents had experience with low morale in the workplace (100%, n=13).
The majority of participants agreed that low morale causes a disconnect between employees, peers, jobs, managers and the company (84.6%, n=11).
Responses were varied as to how the healthcare professionals surveyed handled working at a job with low morale.

17. Lab 2: Results continued
The most significant evidence of low morale in the workplace was found to be a negative mood/unhappy people (53.8%, n=7).
53.8% (n=7) felt the largest contributor to low morale to be increased workload/Inadequate staffing.
Another varied response was the most significant consequence of low morale with 30.8% (n=4) agreeing it results in increased stress.

18. Lab 2: Results continued
The majority of respondents (84.6%, n=11) felt that management influences workplace morale.
61.5 % (n=8) felt that open and effective communication is the biggest influence management can have on morale in the workplace.
38.5% (n=5) felt the most important thing to improve workplace morale is building a trusting relationship between team & management.

19. Lab 2: Discussion
The survey results reinforce our hypothesis that low morale impacts the majority of healthcare professionals.
The findings further support that low morale is caused by increased workload, inadequate staffing levels, and poor quality leadership/management.
The role of management in influencing and improving morale is also highlighted in the results.

20. Lab 2: Discussion continued
The results of this survey support the significance of management on staff morale.
Managers can help to improve staff morale by “ensuring a safe and cohesive work environment” (Duffield, Roche, O’Brien-Pallas, Catling-Paull, & King, 2009, p. 16).
Effective unit managers communicate with staff openly, effectively dealing with poor performers and offering guidance. (Duffield, et al, 2010).

21. Integration & Synthesis
The results of the study support the literature review’s findings that low morale has a significant negative impact on the attendance, retention, recruitment, wellness, productivity, quality, efficiency, and happiness of healthcare professionals (Anzai, Douglas, & Bonner, 2014; Bernstein, 2015; Capko, 2013; Hegney et al, 2005) resulting in increased stress and staff turnover.
The role of management was identified in both parts of the study as having a significant influence on morale in the workplace.

22. Conclusion
Low morale in the workplace is a primary concern for healthcare professionals.
This mixed-methods study identified a widespread continuum of contributing factors and consequences of low morale.
In the interest of quality patient care it is crucial that leaders in the workplace seek to engage staff in authentic meaningful ways to abolish factors that negatively impact the morale of healthcare professionals.
Further research is needed to develop a strategic action plan to improve morale.

23. References
Anzai, E., Douglas, C., & Bonner, A. (2014). Nursing practice environment, quality of care, and morale of hospital nurses in Japan. Nursing and Health Sciences, 16, doi: /nhs Bernstein, A. (2015). Ten ways to get the best out of your staff. Nursing and Residential Care Journal, 17(9), Retrieved from Berrios, C., Joffres, Y., & Wang, L. (2015). Workplace psychological health among Canadian nurses. UBC Medical Journal, 6(2), Retrieved from Capko, J. (2013). Improve morale and productivity with great staff meetings. Podiatry Management, Retrieved from

24. References
Chen, S.Y., Wu, W.C., Chang, C.S., & Lin, C.T. (2015). Job rotation and internal marketing for increased job satisfaction and organizational commitment in hospital nursing staff. Journal of Nursing Management, 23, doi: /jonm Day, G., Minichiello, V., & Madison, J. (2007). Nursing morale: Predictive variables among a sample of registered nurses in Australia. Journal of Nursing Management, 15(3), Duffield, C., Roche, M., O’Brien-Pallas, L., Catling-Paull, C., & King, M., (2009). Staff satisfaction and retention and the role of the nursing unit manager. Collegian, 16(1), pp Retrieved from Duffield, C., Roche, M., Blay, N., & Stasa, H. (2010). Nursing unit managers, staff retention and the work environment. Journal of Clinical Nursing, 20, pp doi: /j x

25. References
Hegney, D., Eley, R., Plank, A., Buikstra, E., & Parker, V. (2005). Workforce issues in nursing in Queensland: 2001 and Issues in Clinical Nursing, 15, doi: /j x Keogh, K. (2014). Majority of nurses say they would consider leaving the profession. Nursing Standard, 29(2), Keyko, K. (2014). Work engagement in nursing practice: A relational ethics perspective. Nursing Ethics, 21(8), Lowes, L., Carrick-Sen, D., Baillie, L., Deaton, C., McCabe, C., Norton, C., ... Robb, E. (2015). Valuing the workforce: Staff wellbeing and patient care. British Journal of Nursing, 24(15),

26. The End
Thank You !!