Delegation and Its Relation to Job Involvement as Perceived by Staff Nurses in selected Hospital in Minia Governorate

Asmaa Awwad korany¹, Sanaa Mohamed Araf², Rasha Mohamed Nagib Ali³

1. B.Sc. Nursing, Minia University, Egypt.

2. Assist. Professor of Nursing Administration, Faculty of Nursing, Minia University, Egypt.

3. Lecturer of Nursing Administration Department, Faculty of Nursing, Minia University, Egypt.

Discussion

Organizations are turning their focus to their human, intellectual, knowledge management and information system resources in recognition of their vital role as a driving force behind their success and the sustain ability of their competitive advantage (15). Furthermore, having a motivated, involved, and participative work force is considered an important aspect to an organization’s success as keeping employee motivation, participation and job involvement up leads to improved productivity and lower turnover rates (16).

The present study confirms that about fifty percent of staff nurses who worked at Samalot and El fekria Hospital aged from 20 – 30 years old, this may be attributed to that most nurses in these hospitals were recent employed,  the majority of them were females in the both hospitals, This results might be attributed to the fact that the majority of nurses who graduated from secondary diploma school, technical institute and faculty of nursing were females and society's view about nursing profession considered it appropriate to females more than males. As regards to qualification, more than half of them from both hospitals had technical institutes qualification degree this may be due to nurses with diploma of secondary nursing school were retired and replaced by technical institutes qualification. And about half of them have years of experience from 11 to 20 years.

The current study results presented that the majority of the staff nurses had low level about their total score of the delegation score and its dimensions in both hospitals (Samalot &Elfkrea). This might be as a result of many reason such as; increasing workload on nurses, nurses fear of taking responsibility of the task that has been delegated to them, nurses feel low confidence in themselves to do the work, as well as job stress and short time to do delegation. Thus, there is a need to provide head nurses and staff program about delegation practice which in turn improve staff stratification, skills, and patient outcomes.

This was consistent with White et al. (2011) ⁽²⁰⁾ who indicated in their study that rehabilitation nurses had low delegation skills; and there is an urgent need to educate rehabilitation nurses about delegation standards and discuss delegation practice among nurses. This increased knowledge can lead to better patient outcomes and more efficient use of staff while promoting better teamwork between nurses.

Also, this result was in line with Magnusson et al. (2017) ⁽²¹⁾ who mentioned in their study that the newly qualified nurses in the study reported that they had limited opportunities to practice delegation and to develop the confidence and authority necessary to supervise and organize care during their pre-registration education. Thus, there is a need for increased focus on learning in these areas.

Moreover, Curtis and Nicholl (2004) ⁽²²⁾ added that it is important for nurses to improve their delegation skills because ‘one of the most complex nursing skills is that of delegation. Thus with the increasing significance of delegation for the nursing role, there is a need for delegation and supervision to be included in the nursing pre-registration curriculum and preceptor ship program.

Also based on current study result, it is important to provide nursing student enough practice of delegation process during their academic training because they haven’t enough training and preparation to do their role. Weydt (2010) ⁽²³⁾ mentioned that delegation is crucial skill among nurses because it requires sophisticated clinical judgment and final accountability for patient care’. Also, Hasson et al (2013) ⁽²⁴⁾ suggested that current pre-registration nurse education does not prepare nursing students to carry out this role; thus they need more training programs.

In addition delegation score may be low due to head nurse poor skills in delegation or they try to choose competent nurses to delegate. These results go in the same line with study done by Sayani, (2016) ⁽²⁵⁾ as the study revealed that to delegate tasks to staff nurses head nurses must select competent employee able to perform task accurately to avoid blame from others.

The current study results revealed that the majority of the staff nurses had low level about their total score of job involvement in both hospitals (Samalot &Elfkrea); this might be as a result of many factors as increasing workload, negative attitudes of manager or peers, poor or no motivated environment, no participation in decision making, job stress, poor justice, poor delegation skills, poor supervision for staff, and leadership style among manager; which lead nurses to feel demotivated, dissatisfaction in their jobs, and poor relations with managers; which in turn decrease the staff nurses level of job involvement. Thus there is a need for more training and supervision of staff nurses to increase their job involvement.

In the similar spirit the result of Dajani (2015) ⁽²⁶⁾ indicated that leadership and organizational justice were the most significant drivers of employee engagement. Employee engagement had significant impact on job involvement.  Also, Lambert et al. (2015) ⁽²⁷⁾ results indicate that variety of training and supervision had positive associations with job involvement, and employee satisfaction

Also, Rizwan et al. (2011) ⁽²⁸⁾ agreed that the employees can easily be involved in their work if managers design the job according to the attitude of the employees. This means that the employee should consider the job challenging and enjoyable. If the nature of the job matches with the attitude of the employee, these employees will be more productive and helpful for the organization for achieving their objectives and goals.

However, Sellar and Andrew (2017) ⁽²⁹⁾ mentioned in their study among Auto Mechanic Employees that they have moderate level of job involvement. Also, they observed that quality of work life is related to employees’ job involvement. This shows that employers need to develop working conditions and greater organizational efficiency to enhance high Job involvement among the employees.

Also, Singh and Gupta (2015) ⁽³⁰⁾in their study about job involvement, organizational commitment, professional commitment, and team commitment among employee from different organization, revealed that participants had high level of job involvement.

Regarding the relation between the personal data and delegation; the current study revealed that there were no statistical significance differences between the nurses' personal data (ages, gender and qualification) with delegation except in area of years of experience that there was a statistical significance difference in Samalot staff nurses hospital. This may be due to the most of staff nurses in Samalot hospital had more years of experience which can be an important factor because it enhance the employees’ job satisfaction, ease the updating of skills, increase the sense of belonging, benefit and well-being, maximize commitment towards the organization and build the organization’s competitiveness.

It was consisting with Yoon, et al. (2016) ⁽³¹⁾as their study examined confidence in delegation of RNs in long-term-care hospitals, and investigated correlations between RNs’ confidence in delegation and leadership style. The results of their study displayed that the confidence in delegation was statistically significantly affected by current-unit clinical experience, total clinical nursing experience, training or educational programs, experience in delegation, legal understanding and leadership style. Participants with more than5 years of current-unit clinical nursing experience had more confidence to delegate than others (P = 0.018). The confidence in delegation of participants who had worked <5 years was significantly less than those with more than 5 years (P = 0.001).

Also, the results go in the same line with study done by Rahati et al (2015) ⁽³²⁾, they find that among all demographic variables, only the work experience of the employees showed a significant relationship with their job involvement.While, this result wasin consist with Abu-Aleinein (2016) ⁽³⁾who revealed that there are statistically significant differences between the responses about the impact of job involvement on job performance due to “age and educational level". Moreover, Doobree (2009) ⁽³⁵⁾ mentioned in his study on job involvement among bank mangers in Mauritius, that the previous experience of relative job have no direct effect on present job involvement.

Moreover, the current studydisplayed that there was no statically significant difference between delegation, job involvement and staff nurses personal data (ages, gender, years of experience and qualification) at Elfkrea hospital. This may be due to that, whole staff nurses regardless of their ages, gender, years of experience and qualification have over workload, stress and have low training programs about delegation. Also this might be due to the head nurse who give complete instruction don’t supervise and follow up subordinate's work, or due to head nurse delegates work before becoming sure from workers readiness to complete delegated task, readiness mean ability, willingness, and confidence to perform delegated task.

This finding was consistent with Potter, et.al, (2010) ⁽³⁶⁾ who argued that head nurses get upset when delegatee fail to follow their exact instructions and the job is not done right. This finding was also consistent with Baddar, et.al, (2016) ⁽³⁷⁾ who found that the majority of head nurses agreed to rank statements of “When I give clear instructions and the job isn’t done right, I get upset".   This finding result  may emphasizes that the head nurses  not cooperative with staff nurses and the organization not motivate the nurses as  decreasing in their  salary, no rewarding, increase workload and poor work climate. Whereas the working climate affects the staff nurses productivity, and when there is positive climate and reinforcement they can make better patient care.

This study finding consisted with Sethi et al (2016) ⁽⁷⁾ on their study about job involvement among senior secondary school teachers they found that there was no significant gender difference in the job involvement of teachers. In addition the study conducted with Doobree (2009) ⁽³⁵⁾ that there was no significant relationship between the (gender, age, educational qualifications and the length of service) of bank managers and their job involvement.

The results of the current study presented that there was a highly statically significant difference between Samalot and Elfkrea Hospitals regarding to delegation of authority and job involvement in favor to Samalot hospital. This results was not congruent with Sayed (2018) ⁽³⁸⁾ who assess the delegation attitudes and delegation of authority; and found the highest percent score of Head nurses working at El-Rajhi hospital, and the lowest percent score at Main Hospital, and there is no statistically significant difference between hospitals as regard to nurse’s delegation. Also, this is not consistent with the study of Ollo-Lopez, et al (2016) ⁽³⁹⁾ who found that employees had high levels of job participation and involvement which lead to higher levels of job satisfaction.

Adding to the above mentioned results the current study showed that, there were a positive correlation between delegation of authority and its dimensions “efficiency, effectiveness, empowerment and delegation process of head nurse and total delegation as well as between total delegation and job involvement. This might be attributed to most of head nurses who don't use delegation frequently in their work and there is no training program about how to use delegation strategies effectively.

This finding was consistent with Verghese (2016) ⁽⁴⁰⁾who mentioned that head nurses improve delegation attitudes through experience and following appropriate delegation strategies and building trust and teamwork with delegate. Also, the study findings was consistent with Kaernested and Bragaottir (2012) ⁽⁴¹⁾who mentioned that the majority of the head nurses have a potential for improvement of delegation attitudes.

Moreover, Wadi (2009) ⁽⁴²⁾ conducted study on the impact of authority delegation on managerial performance. The study aimed at identifying the impact of authority delegation on workers performance of Sudan University of Science &Technology (SUST). The study have reached for following results: delegation of authority strengthens human relations among members of the organization, enhance self-confidence among workers and increase the level of achievement in tasks and work assigned for workers and speed of implementation.

Conclusion

• It concluded from this study that the majority of staff nurses had low level regarding to delegation dimensions which include “efficiency, effectiveness, empowerment and delegation process" and job involvement in El-Fekria and Samalot hospital.
• There were a positive correlation between delegation of authority and its dimensions “efficiency, effectiveness, empowerment and delegation process of head nurse and job involvement.

Based on the findings of the current study, the following recommendations are suggested.

• Periodical training programs should be conducted to all head nurses and their staff nurses to increase their knowledge and competencies regarding to delegation skills and job involvement.
• Clear written policies should be present at all hospitals to help head nurses to discriminate between tasks that can or can't be delegated.