THE INFLUENCE OF JOB DEMANDS ON THE RELATIONSHIP BETWEEN EMPLOYEE REWARDS AND JOB PERFORMANCE OF NURSES IN KENYAN NATIONAL REFERRAL HOSPITALS

Abstract

Job demands are sets of psychological pressures in the working environments that include working faster than normal, conflicting job assignments, intensive workload and pressures related to inadequate time. The Kenya health sector has experienced myriad of challenges. From the nurse’s perspective reports indicate severe shortage of nurses, increase workload, rising out- migration, inadequate facilities and persistent industrial action undermining nurses’ ability to provide dignified and competent healthcare. Hospitals therefore are losing highly competent nurses who are replaced mostly by new graduates, thus it is important to establish the effects of rewards and competences on service delivery of the existing nurses. The extension of role boundaries and role blurring is likely to undermine job performance in respect to competences and job demands. The national referral hospitals are relatively large facilities that often operate beyond capacity and have critical patients that overstretched both human and physical resources. This study sought to examine the mediating effect of employee engagement on the relationship between employee rewards and job performance of nurses in Kenyan national referral hospitals. The study adopted a descriptive cross-sectional survey research design. The study was carried out in all the four National Referral Hospital in Kenya namely Kenyatta National Hospital, Moi Teaching and referral Hospital Mathare Teaching and Referral Hospitals and National Spinal Injury. The target population for this study was 2,757 nurses in all the four national hospitals obtained through data query by the Human Resource department at the Ministry of Health and preliminary visit to HR departments of respective hospitals for data verification. A sample of 296 respondents was selected using Cochran formula (1963). Primary data was collected through semi structure questionnaires that were administered to the nurses. During data analysis, the study utilized both descriptive and inferential statistics. Descriptive statistics provided percentages, mean, standard deviation and coefficient of variation of the demographic characteristics and inferential statistics illustrated the regression analysis. The results for the moderating effect of job demands on the relationship between employee rewards and job performance was statistically significant.  The study therefore,  concludes that excessive job demands in terms of very complex tasks, heavy workload, inadequate time and emotionally draining duties hinders realization of organizational goals. Excess job demands also contribute to violations of patients’ rights to quality healthcare services. The study provides clear empirical evidence that heavy job demands undermine efficient and effective job performance. For organizations to benefits from employee efforts there should be appropriate workload, non-ambiguous roles and absence of conflicting assignments among other dimensions of job performance. This will promote healthy and efficient workforce. The management of the referral hospitals to ensure nurses are not engaged for long hours even those doing locums.  Work life balance programs be put in place to minimize negative impacts of excess job demands and improve employee well-being. Other appropriate interventions strategies to mitigate against job demands include training on time management, stress management and team based working. Development of clear policies, guidelines and procedures to promote role clarity, reduce conflicting assignments and provision of adequate time to accomplish tasks and meet deadlines. Redesign jobs and leveraging on technology to mitigate excess workload.

Keywords: Job Demands, Employee Rewards, Job Performance, Nurses & National Referral Hospitals.