A Study on Whether Payment is a Motivating Factor towards an Increase in Number of Nursing Students

AStudy on Whether Payment is a Motivating Factor towards an Increasein Number of Nursing Students

Nameof Student

Tableof Contents

Abstract 4



1.1 Background Information 5

1.2 Statement of Problem 5

1.3 Justification 5

1.4 Research Questions 6

1.5 Objectives 6



2.1The Population of Nursing Students 7

2.2 Motivations for Health Workers 8

2.3 The Relationship between Nursing and Payment Rates 9

2.4 Why Students Choose Nursing 10



3.1 Study Site 12

3.2 Study Design 12

3.3 Study Population 13

3.4 Sample Determination 13

3.5 Data Collection Method 14

3.6 Data Analysis and Management 14

3.7 Ethical Considerations 14

References 16

Work Plan 18

Study Budget 19


Appendix I: Informed Consent Form used in the research were as follows 20


AACN– American Association of Nurses.

RN– Registered Nurse

LPNs – Licensed Practical Nurses

AStudy on Whether Payment is a Motivating Factor towards an Increasein Number of Nursing Students


Nursingis a critical field in the healthcare sector, which nurses highlydepend on for better health of a state, nation, and the whole world.It is the profession that deals with the promotion, protection, andoptimization of health and abilities. It is also essential for thediagnosis, treatment, and prevention of illnesses and injury. For anindividual to qualify as a nurse, they must undergo an academictraining and attain a diploma, degree or other advanced certificates,then get registered by a nursing body. The responsibilities andchallenges in the field call for proper motivation for one to decideon taking a course in nursing. At most, the motivation is usuallyintrinsic. Most nursing students are driven into doing the course bythe determination to offer care, or by the willingness to alleviatesuffering and pain. In other instances, however, the students aremotivated by extrinsic factors. Some of these include the workingcondition, allowances, job security, and salary. The research willfocus on finding out whether payment is the motivating factor towardsan increased number of students in the nursing field. Qualitativeresearch on the stated topic will be conducted in three nursingschools. A simple random sampling technique will be employed for thesample selection, and interviews carried out on consented studentsfor the collection of data.

CHAPTERONE1.0INTRODUCTION1.1Background Information

Therehas been a steady increase in the number of students enrolling innursing schools in the recent years. According to the AmericanAssociation of Colleges of Nursing, there has been a significantincrease in the number of students enrolling in colleges, and othertertiary education institutions for a course in nursing. Apreliminary survey by the AACN indicates a 3.5 percent increase inthe number of nursing students between the 2008 and 2009. There hasalso been a steady growth in salary and allowances for qualifiednurses. These two phenomena, therefore, form the basis of theresearch to establish if the amount of wages and benefits for a nurseare a motivating factor towards the increase in some nursingstudents.

1.2Statement of Problem

Evenwith an increment in the population of students enrolling in nursingcourses in tertiary institutions, there is an ever-expanding need forhealth care delivery. Most nurses are also retiring, and therefore,calling for an immediate replacement (Yedida, 2014). Thisconsequently calls for more registered nurses in the industry, andsuch can only be attained through the determination of a motivatingfactor for the increasing student population enrolling for a nursingcourse. With the determination of whether payment is one of thefactors that lead to an increase in the number of students enrollingfor nursing, it would be easy to develop strategies for attractingmore students to register for the course.


Theproject will be beneficial for the establishment of a motivatingfactor that leads to an increase in the number of students enrollingfor nursing. The results will be useful as they will indicate whetherthere is a relationship between payment and the number of studentsenrolling for nursing. It will also indicate how satisfying, orattractive is the salary received by nurses in the country.

1.4Research Questions

  1. Is salary a motivating factor for the increased number of nursing students?

  2. Are there other factors that motivate students to do nursing as a course of choice?


  1. To determine whether payment is a motivating factor for an increase in the number of nursing students.

  2. To determine whether there are other factors other than income that attracts student to pursue nursing as a course of choice.

CHAPTERTWO2.0LITERATURE REVIEW2.1 ThePopulation of Nursing Students

Accordingto AACN’s annual survey, there is a gradual increase in the numberof students enrolling for the baccalaureate and degree programs innursing. A previous study indicated that there was a 3.5 percentincrease from the year 2008 to 2009. Such, therefore, calls forapplause since it is a significant step towards achieving themuch-needed increment in the population of health workers, and moreespecially the nurses. According to the same site, there was also anincrease in the number of students graduating from entry-levelbaccalaureate programs (Rossester, 2010). Between 2008 and 2009, thepopulation of graduates in the entry-level baccalaureate hadincreased by 3.2 percent more than the previous year.

Theincrease in nursing student population has been recorded from 2002 todate. This was, however, preceded by declines in the population ofstudents graduating with a degree, or diploma in the same. Thedeclines were recorded within a six-year period of between 1996, and2001 (Rossester, 2010). Such changes in trends could be attributedto changes in various factors within the nursing field. Such factorsinclude changes in working conditions, better salaries, moreallowances, and an improved public image of the nursing field (CCUCAGS, 2012). Other factors include the motivation of high schoolleavers to take nursing as a course in their tertiary education, tomeet the nation’s goals of better health care delivery.

Thenational reforms for a healthcare call for more nurses with adoctoral, or a master’s degree. The enrollment of students for thedoctoral degree in nursing increased by 20.5 percent between 2008 and2009 (Rossester, 2010). The attainment of such advanced degrees is aguarantee for a salary increment, increased job security, andincreased chances of promotion at the current places of work. Suchbenefits motivate more nurses to upgrade their level of educationhence, the 20.5 percent increment in the nursing population seekingfor masters, and doctoral degrees.

2.2Motivations for Health Workers

Healthworkers are motivated by some intricate economic, social, andproficiency factors. There are numerous reasons to why health workersdo their job in a motivated manner. One most important factor, whichmotivates any health worker, is the knowledge that they are doingtheir jobs in an efficient manner and that they are performing wellin their duties. According to Culyer (2014), payment is also agreater motivating factor within the health sector. Health workersseem to retain their positions in institutions that pay well, haveroom for career development, have proper compensation deals, andprovide good grounds for career development. Good human resourcemechanism within a health system is critical to ensuring that theright motivating factors are adequately available for thesatisfaction of health workers, (Culyer, 2014) and attraction of newemployees.

Thebenefits enjoyed by the practicing nurses act as bait for attractingmore individuals to the profession. Despite the fact that nurses aredriven by the need to offer care, changes in the current world havemodified the situation making salaries, and other incentives are partof the things to consider before one registers for a nursing course.It has, therefore, been necessary for the government, and the privatesector to reform some issues within the health institution so as toattract more health workers, as a method of promoting health caredelivery. According to Culyer (2014), doubling the nurses’ salarywould increase their population by a double figure. This, hesuggests, is from results from a discrete choice study conducted inEthiopia, where increasing the wages indicated a possible increase inthe number of doctors willing to work in rural areas from 7 percentto more than fifty percent. The same phenomenon was likely to beexperienced within the nursing profession, where the number wouldrise from four percent to twenty-seven percent (Rossester, 2010).Other job attributes were also considered and studied, but theincrement of wages would seem to play a significant role inattracting nurses and doctors to work in the rural setting. From thestudy, it is, therefore, clear that wages play a vital role inmotivating nurses to work. According to Culyer (2014), financialincentives have a significant effect in the formulation of a decisionto work as a nurse, or to study nursing.

2.3 TheRelationship between Nursing and Payment Rates

Provisionof care is believed to be the fundamental goal and drive for nurses.The same has however, changed over time due to the shifts in theliving standards, and the way of life. Some people would willinglyaccept to work in the field for low wages due to the goodness oftheir hearts, and the drive to provide care. However, this group hasassumingly low financial responsibilities. In the past, most peoplewho enrolled for nursing were female gender (Wilkes et al., 2015).These were often young and childless, and if married, they woulddepend on their husbands for financial support. The pool of nurseswho are willing to work for low wages is however, shrinking due tochanges in the family structure, and the cost of living. Today,nursing education is relatively technical, and increasingly expensiveto the extent that very few people have the luxury of making adecision to choose the profession with less worry about the financialeffects (Mc Sherry et al., 2014).

Bettersalaries were indicated to be one of the motivating factors forbetter performance of nurses already in the field. This is mainlyattributed to the fact that in the modern economy, individuals needbetter payments to cater for their bills, and the rising livingstandards. Better payments have therefore, been considered as one ofthe factors that a nurse would consider before choosing a hospital,or a place of work. The nurses in the low-income pool also would beconvinced to change their places of work if they discoverbetter-paying hospitals, or other health institutions. Among thenurses in practice, salary has been indicated as a factor thatmotivates their working (Cowen &amp Moorhead, 2011). In thesituation where the nurses were promised of an increment in theirsalary, there was sufficient motivation to work hard. The nurses werealso satisfied with their working conditions, and expressed awillingness to go an extra mile in service delivery. On the otherhand, nurses who were paid poorly seemed to be demotivated in theirworking, and although they stuck to the principles of nursing, theyexpressed low enthusiasm to work (Nasrin et al., 2012). Decent wagesare necessary for the skilled, caring, and able nurses. Higher wageswould therefore, attract a greater proportion of genuinely caring,quality, and qualified medical personnel. The high wages would alsoenable the nurse to seek higher levels of education, to offerspecialized care.

2.4 WhyStudents Choose Nursing

Thereis an increasing number of students who choose to study nursing, andundertake a career in the same. Various factors have been attributedto the increase in the number of students wishing to take the course.One motivating factor is the availability of employment opportunitiesafter completion of the course, and during their study (Câmara etal, 2014). Other students decide to take the course due to anincreased readiness to offer care, or with the motivation of meetingthe patient’s needs.

Someof the factors that motivate students to pursue nursing as a courseare both intrinsic and extrinsic. In the present times, nursing hasbecome one of the better-paying careers in the United States, wherethe LPNs earn salaries ranging between $35,000 and $40,000 for oneyear, with no addition of overtime payments and allowances (Câmaraet al, 2014). The regular nurses, on the other hand, have the abilityto earn between $40,000 and $60,000 per year, after the completion oftheir graduate level. The payment rates have a higher possibility ofescalating due to the increasing demand for nurses for the provisionof health care services, and meeting the nation’s goals in healthcare delivery (Câmara et al, 2014). The generous payment istherefore, one of the factors that students consider when choosing todo nursing.

Accordingto Pruthi et al (2013), there is an increased demand for nurses inthe United States. Before students decide to undertake a particularcourse, most of them are always advised to consider the chances ofgetting employment upon completion of their course. Students willalways go for those courses that have a guarantee of getting employedwithin the shortest time possible. According to Pruthi (2013), thereis an increasing shortage of nurses in the United States. This isattributed to the high number of individuals seeking nursingservices, an increase in population, and the increase in retirementrates for the old nurses. It is estimated that there will be ashortage of about one million nurses in the United States by the year2020. The statistics are based on the health care needs of the peoplein the United States. The numbers therefore, indicate that there is ademand for nurses, and readily available employment opportunities forfresh graduates (Rossester, 2010). Due to such, most high schoolgraduates are motivated to take nursing with an assurance that theywill be employed immediately after school.


Thischapter covers the methods that will be used in the proposed study.It gives an account of where the study will be conducted, thedefinition of the study population, how the study population will beselected, the size of the study sample, methods that will be used indata collection, and how the data will be analyzed and presented.This section is fundamental, and it constitutes the practical part ofthe proposed study.

3.1Study Site

Thestudy will be conducted in the university’s school of nursing. Theschool has a suitable number of students from different financial,cultural, social, and religious backgrounds. The diversity of thestudents will also be an important factor in the study, as this mightbe one of the influences to for taking a course in nursing. Thenumber and diversity are essential factors for the choice of thestudy site. Such will reduce the costs of research, and still providethe appropriate data for the study. There is also a high chance ofgetting a satisfactory amount of data from the site.

3.2Study Design

Adescriptive survey design will be used for this particular study. Thedescriptive survey is particularly important for this study as itaims at demonstrating the relationship between the increasingenrollment of nursing students, and the current payment of practicingnurses. The study will also be conducted with no change, ormanipulation of the study environment.

3.3Study Population

Thestudy population will be made of students in the school of nursing.Inclusion and exclusion criteria will be considered in the choice ofparticipants. The study will however, not consider the year of study.

3.3.1The Inclusion Criteria

  • Nursing students in any year of study, and of any age will be considered for the survey. The students will have to consent as an ethical requirement for consideration in the study.

3.3.2The Exclusion Criteria

  • Those students who fail to consent will not be included in the survey.

3.4Sample Determination

UsingFisher’s Test to calculate sample size

n=t2x p (1-p)


Where:n=required sample size

t=confidenceinterval at 95 %( standard value of 1.96)

p=is the estimation of expected proportion with the variable of concernin the population&nbsp

m=marginof error at10%





Thereforen=81 participants.

3.5 DataCollection Method

Themethod of data collection will include semi-structured andinteractive interviews. The interview sessions will last betweenthirty to sixty minutes. The questions will first start with broadquestions as a way of motivating the participants to open up, andshare their views in a free manner. The interviews will be taperecorded for storage and analysis. The interviewer will also notedown specific points in each interview for later analysis.

3.6 DataAnalysis and Management

Theinterviews will be recorded through a digital sound recorder andtranscribed verbatim. The data derived from the interviews will bemanaged and sort-corded using an MAXQDA 2007 software (VERBI GmbH,Berlin, Germany). The data will then be analyzed through a constantcomparative technique. The processes of data collection, management,and analysis, will be conducted in a simultaneous manner.

3.7Ethical Considerations

Thestudy will be carried out following approval by the ethical committeeof the School of Nursing, and attaining permission to conduct thestudy from officials in the School of Nursing at the University.Participants for the study will be allowed to take part in theinterviews, or any part of the study following informed consent. Theinterviews will also be conducted only in the presence of theinterviewer and the interviewee as a way of respecting theconfidentiality, and privacy of the participants. The audio files andscripts from the interview will be coded so as to maintain privacy.The participants will also be informed of their ability to withdrawat any time during the study and take the tapes and manuscriptscontaining their information with no consequences.


Culyer,A. J. (2014). Encyclopediaof health economics.Amsterdam: Elsevier.

Câmara,A. G., Germano, R. M., Valença, C. N., Malveira, F. A. S., Pinto,D., &amp Cossi, M. S. (2014). Motivations of students to study fornursing: between empathy and the job market.&nbspJournalof Nursing UFPE online [JNUOL/DOI: 10.5205/01012007/Impact factor:RIC: 0, 9220],&nbsp8(2),346-350.

CCUCAGS. (2012). Benefits of a Career in Nursing: Intrinsic andExtrinsic. Retrieved June 12, 2016, fromhttp://www.ccu.edu/blogs/cags/2012/01/benefits-of-a-career-in-nursing-intrinsic-and-extrinsic/

Cowen,P. S., &amp Moorhead, S. (2011). Currentissues in nursing.St. Louis, MO: Mosby Elsevier.

McSherry,W., McSherry, R., &amp Watson, R. (2012). Carein nursing: Principles, values and skills.Oxford: Oxford University Press.

Nasrin,H., Soroor, P., &amp Soodabeh, J. (2012). Nursing Challenges inMotivating Nursing Students through Clinical Education: A GroundedTheory Study. NursingResearch and Practice,2012,1-7. doi:10.1155/2012/161359

Pruthi,S., Pandey, R., Singh, S., Aggarwal, A., Ramavat, A., &amp Goel, A.(2013). Why does an undergraduate student choose medicine as acareer? Natl Med J India, 26(3), 147-9.

RossesterR. (2010). Student Enrollment Expands at U.S. Nursing Colleges andUniversities for the 9th Year Despite Financial Challenges andCapacity Restraints. Journalof Professional Nursing,26(1),doi:10.1016/j.profnurs.2009.12.010

Wilkes,L., Cowin, L., &amp Johnson, M. (2015). The reasons students chooseto undertake a nursing degree. Collegian,22(3),259-265. doi:10.1016/j.colegn.2014.01.003

Yedidia,M. (2014). The effectiveness of Strategies Addressing the NurseFaculty Shortage. NursingEducation Perspectives,35(5),279-279. doi:10.5480/1536-5026-35.5.279






Problem formulation

Writing the Proposal

Data Collection

Data Analysis

Defense Presentation















3 Reams



Traveling Expenses

Several trips


Questionnaire Development




Binding the Final Project




Total Cost


APPENDICESAppendixI: InformedConsent Form used in the research were as follows

I(name)………………………………………………………………………. IDNO………………………………………………………herebysigns this Informed consent form with clear knowledge of what theresearch entails. I have been advised on the risks and benefits ofthis research, and have clearly understood that I have the right toaccept or fail to participate in the research. Having learnt all ofthe above I agree to take part in this research by offeringinformation that is fit for the research.