Maslow’s motivation theory suggests that individuals become motivated by a “hierarchy of human needs” (Yoder-Wise, p. 10). These needs begin with physiologic needs, and then progress according to safety, social needs, esteem needs and self-actualizing needs (Yoder-Wise, p. 10). Thus, when the need for basic safety needs including water, food and air are met, the human will reach out to the next level, which include social needs. These may include affiliation with others, promoting development of self-esteem and competence, along with achievement (Yoder-Wise, p. 10). The lower level hierarchical needs drive the behavior of higher-level needs. If lower level needs are not addressed, then higher level needs cannot be addressed. With regard to management, it is important for nurse leaders to understand that creativity and inventive cannot occur without having lower level needs met.

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In the Emergency Room, basic safety needs are constantly being met. These include needs such as safety needs, including the need for life-sustaining elements. This seems more elemental or appropriate for patients, as nurses and other staff members are constantly seeking for the safety of patients, including basic life-supporting measures. However, staff members are also seeking to fulfill basic safety needs, albeit they may come in another form. For example, staff members working the in the ER may be exposed to longer hours, and constant stress. Working long hours and tight shifts, nursing staff and other healthcare providers may find they lack basic life support systems needed to succeed in this high-intensity environment. Examples may include taking adequate rest breaks, getting food to eat while on their shift, and needs that include air, water and support for overly stressful situations.

A good manager will realize that appropriate staffing within the healthcare setting, and in particular in an emergent situations, can help reduce the stress and pressure that healthcare providers feel when working on critical cases. This is essential to the health and well-being of staff members, but also the patients that they treat.

The management style in the emergency room is often safety first, but also one of vision. In this regard, caring for the vision of the staff, and of the hospital is important. The hospital’s vision is to provide the best quality patient care, and to partner with communities in providing polished service through health innovation. The healthcare center operates through integrity and excellence. Given this, the management style is committed to operating in excellence, and caring not only for the basic needs of staff members but also for their self-esteem and continuing growth. Given Maslow’s model, this suggest that managers must move beyond basic needs, and work on bolstering staff members self-esteem and confidence on the job so that staff members have an opportunity to grow and contribute to the company. This is performed in many ways, including through routine performance reviews.

Armstrong (2006) finds that motivation and performance can be influenced by the perceived link between effort and performance, the link between performance and outcomes and the significance of the outcome of the person. Further, the motivation of a person may depend on the likelihood the person perceives that reward may follow effort and that a particular reward will be worth the effort. Rewards according to Armstrong (2006) must also be considered worthwhile; in this regard a staff member is charged with the task of working with key managers to establish goals, and acquire feedback during the performance management process.

Other factors that may influence Maslow’s theory and the corporate level of satisfaction among employees include the need to reward employment practices that are outstanding, and to acknowledge or outline role perceptions. These are best defined as what staff members want to do or thinks they must do; if they relate directly to what they should do, then the individual may succeed in their job role (Armstrong, 2006).

Competence and achievement needs are also met by the manager via the performance evaluation. This helps to boost creativity on the emergency room floor, with healthcare stare consistently working to create better ways to serve patients, and increase the efficiency of healthcare delivery. Working in the emergency room, there is also much in the way of stress. One way that management style can improve is to incorporate more stress management care, perhaps in the form of counseling or other supportive measures, or activities outside of the workplace to foster greater friendships and a sense of camaraderie. In Maslow’s hierarchy, this leads to a sense of love and belonging, which is actually in the middle of Maslow’s hierarchy of needs.

There is an EAP program, which is available to staff members. While it is important for staff members to feel they belong, it is also important for staff members to feel they have the support of friendships and family, and to have intimacy with their kin in order to adjust to the daily stress that is often apparent working in an emergency room. This can have dramatic effects over time on one’s psyche and wellness. Not managing this type of stress can impact an individuals’ ability to have or maintain adequate esteem, which is essential not only for achievement and gaining the respect of others, but also for maintaining one’s sense of self and self-esteem.

The highest level in the chart is the realization of self, spontaneity and acceptance of facts. This level can be achieved with ongoing support from management, and evidenced through many ways including through promotion or through quarterly rewards so that employees feel they are contributing to the greater good of the organization.