MN7181- The role of psychological contract on heath care worker

The Role of the Psychological Contract on health care workers

The psychological contract denotes an unwritten set of expectations operating at all times between every member of an organization and various managers and others in that organization according to Schein (1965). In other words it is about a belief between the employer and employee relationship based on expectations and commitment. The breach in the psychological contract would affect the  performance of the organization simply due to disruption of employer - employee bond with mutual trust ( Armstrong, 2006).

In health care scenarios where the high quality service is the expectation of the employer by a committed health care worker. However the continuing commitment of the health care worker would invariably necessitate making the promises on the employers part. However the health care services inherit the challenge of dynamic complexity of working environment, involvement of multiple professionals and caretakers on one platform and authentic value based influences. 

The Employee expectations and values in health care

1. Economic expectations - satisfactory remuneration and infrastructure of the work place (locker space, equipment, uniforms and safe work environment)
2. Expectations related to HRM practices - Training opportunity, Carrier development opportunity, Carrier appraisal and rewards
3. Socioemotional  expectations - Supportive social background to do a good job ( support from the managers, colleagues,  the supervision and leadership with perform a clear role,  Work-life balance and job security.)

 The unmet  transactional expectations and relational expectations mentioned above would have significant effect on performance. The elaborated results of this would be withdrawal of extra effort, working to rule, limiting work time to contracted time ( refusing to do Overtime).

The provision of training to increase the competency of the employment is positively related to increased confidence obviously. This also brings about the perception support delivered by the organization to do a good job, more than the knowledge gained from the training. When the employer has met the expectation of socioemotional factors like help and support to deliver the services they become motivated and innovative in the services rendered. This is of ample importance in the improvement of the quality of health care in holistic patient care (Hyde et al., 2009).

In addition to these influences of an employee’s psychological contract the public health care workers are compelled to perform by public service value. The public service value based expectations are more in clinicians than in non clinical staff. However the effect of unmet  public service value based expectations would be less on the performance. 

The public service values like patient waiting period to receive consultation and treatment  is considered as a moderator of the performance in the health care workers. This influences the employee in three different ways (Najuma et al.,2013).

1. Directly affecting the ability, motivation and opportunity regardless of expectations.
2. Indirectly affecting through met and unmet expectations and their effect on ability and opportunity. 
3. Moderating the direct and indirect effects on performance.

Therefore the psychological contract of the health care worker seems to closely related to the performance level in patient care while the public service value is an influential factor for the performance. It would be strategic to assure the transactional and relational expectations are met to obtain a committed and innovative service with a high standard of patient care.

References

1. Armstrong M (2006), A hand book of Human resource management practice, 10th edition, pp 235.
2. Hyde et al. (2009),Human relation management expectations and health care: A qualitative study, Human relations,  62(5), pp 701-725.
3. Najuma et al (2013),. The role of psychological contract on health care workers’ commitment in public sector in Uganda: a case study of medical doctors in MNRH, International journal of science and research 6, pp 2253 -2267.