Self-perception of performance

The nursing staff’s performance is basically the outcome of their own satisfaction, patient satisfaction, and the achievement of the hospital objectives. Performance is defined as “A quantitative measure characterizing a physical or functional attribute relating to the execution of a mission/operation or function”. Similarly, “performance is the accomplishment of work assignments or responsibilities and contributions to the organizational goals, including behaviour and professional demeanor (actions, attitude, and manner of performance) as demonstrated by the employee’s approach to completing work assignments”. Accordingly the performance is an employee's accomplishment of the assigned work as specified in the criteria and as measured against the standards of the employee's position. The key dimensions associated with the nursing staff performance are capacity to perform, willingness to perform and the opportunity to perform. The nursing staff’s capacity to perform depends on the nursing staff’s ability, age, health, skills, intelligence, level of education, endurance, stamina, energy level and motor skills. The willingness to perform depends on motivation, job satisfaction, job status, anxiety, legitimacy of participation, attitude, perceived task characteristics, job involvement, ego involvement, self-image, personality, norms, values, perceived role expectations, feelings of equity,. the opportunity to perform, equipment, material, and supplies; working conditions; action of coworkers; leader behaviour; mentorism; organisational policies, rules and procedures; information; time; and pay.

Performance measurement

Outcomes are often preferred for measuring system performance, but because many factors can influence outcomes besides nursing care, correctly interpreting outcome measures requires appropriate controls for these other factors, controls that can be difficult to implement. At the other end of the spectrum, structural measures are often viewed as too rigid and because many processes can affect how structure influences outcomes, making structure an imperfect substitute for how the system is performing. Process measures, like structural measures, are often easier to measure, but their connection to patient outcomes must be validated (Eddy 1998) and their strength is dependent on their association to clinically tested practice guidelines and

patient outcomes. This requires an evidence-based approach that is currently limited.

There are four components which can help to measure performance that include clinical utilization and outcomes, financial performance and condition, system integration and change, and patient satisfaction (McGillis Hall 2002). A wide range of factors have been proposed as key influencers in the performance of nursing. They fall into four broad categories: nurse training and competencies, physical plant and structure, nursing organization, and work environment and culture. Since all these factors have wide ranges and need evidence based outcome, it is decided to understand the nursing performance through self perception process. The key dimensions that are used to understand self perception of the nursing staff’s performance is knowledge, ability to handle the work load, ability to handle the patients, punctuality and attendance, interpersonal relationship, and future potential development of nurses. These details are presented in Table 3.12

Nearly 52 per cent of the nursing staff feel that their knowledge on their job is good, while 39 per cent of the staff feel that their knowledge on their job is very good. This indicates that the staff members are very positive about the knowledge they posses. The knowledge level would help better nursing care and safety for the patients. Nearly 44.2 per cent of the nursing staff feel good about their ability to handle the work load placed upon them, while 53 per cent of the staff feel very good about their ability to handle the work load placed on them. This shows that the nursing staff are confident of their ability to handle the work load which they are entrusted with from time to time. Since the majority of the nursing staff are experienced they have learnt to manage the workload effectively.

Table 3.12

Nursing staff’ perception on their performance

Variables Grading

Present designation

Total Staff Nurse _incharges Sister

Your knowledge about your

job Poor _{Average 20 (7.6)}1 (0.4) _{7 (13.2)} 0 (0.0) _{27 (8.5)}1 (0.3) Good 140 (53.0) 24 (45.3) 164 (51.7) Very good 103 (39.0) 22 (41.5) 125 (39.4) Your ability to handle the

work load placed upon you Average _{Good 120 (45.5)}8 (3.0) _{20 (37.7)} 2 (3.8) _{140 (44.2)}10 (3.2) Very good 136 (51.5) 31 (58.5) 167 (52.7) Your ability to handle the

patient Average _{Good 115 (43.6)}5 (1.9) _{21 (39.6)} 2 (3.8) _{136 (42.9)}7 (2.2) Very good 144 (54.5) 30 (56.6) 174 (54.9) Your view about your

punctuality and attendance at work Poor 1 (0.4) 0 (0.0) 1 (0.3) Average 12 (4.5) 6 (11.3) 18 (5.7) Good 111 (42.0) 14 (26.4) 125 (39.4) Very good 140 (53.0) 33 (62.3) 173 (54.6) Your inter-personal

relationship with colleagues and co-workers

Poor 0 (0.0) 2 (3.8) 2 (0.6) Average 6 (2.3) 0 (0.0) 6 (1.9) Good 108 (40.9) 19 (35.8) 127 (40.1) Very good 150 (56.8) 32 (60.4) 182 (57.4) Your estimate about your own

potential to develop further as professional Very poor 2 (0.8) 0 (0.0) 2 (0.6) Poor 2 (0.8) 0 (0.0) 2 (0.6) Average 28 (10.6) 4 (7.5) 32 (10.1) Good 126 (47.7) 24 (45.3) 150 (47.3) Very good 106 (40.2) 25 (47.2) 131 (41.3) Total 264 (100) 53 (100) 317 (100) (Figures in brackets indicate the percentage of nursing staff) N=317

Nearly 43 per cent of nursing staff feel that their ability to handle the patients is good while 55 per cent of the staff feel that their ability to handle the patient is very good. This shows that the staff members are highly competent to take care of the patients in their custody. Nearly 39 per cent of the nursing staff feel good about their punctuality and attendance at work, and 55 per cent of the staff feel very good for the same. This shows that the nursing staff are conscientious about their work, value time, and are able to do their work in time.

Nearly 40 per cent of the nursing staff feel that their interpersonal relationships with colleagues and co-workers is good, while 57 per cent of the staff feel that their inter-personal relationship with colleagues and co-workers is very good. This shows that the nursing staff are able to achieve team work and effect a better performance through coordinated efforts. Nearly 47 per cent of the nursing staff feel that their estimate about their own potential to develop further as a professional is good, while 41 per cent of the staff opine that their potential is very good. This shows that the nursing staff expect themselves to be better professionals and there is a high scope for them to develop their skills and abilities.