Rethinking our Biases about Professional Motivation

By Rose O. Sherman, EdD, RN, FAAN

Long ago, I was a nurse recruiter at a large VA Medical Center. We had advertised a vacancy for a surgical intensive care unit nurse manager. I was interviewing an excellent candidate with a strong ICU leadership background. She had recently moved to a community that almost 50 miles from our medical center. I was perplexed as to why she would not seek work closer to home. It would be a long commute in heavy traffic. She had no prior VA experience. So I shared this concern and asked her why she was applying for the position. Her eyes welled up with tears. She told me that she was going to take a chance and just be very honest with me. She had an 8 year old son who needed a heart transplant. Her husband had taken a new job and his health insurance would not cover her son’s pre-existing condition. She had done her homework about medical insurance and learned that the federal government was one of the few employers who would cover the family immediately. There would also be no concerns about pre-existing medical conditions.

This nurse was an excellent candidate for a nursing management role and interviewed well. I sat down with the surgical director and Chief Nursing Officer to talk about her selection and shared the conversation we had about her son. The surgical director’s immediate reaction was that we should not hire her because her professional motivations for employment were very concerning. Our CNO listened quietly and weighed in with her opinion. I will never forget what she said. She told the surgical director that she completely disagreed with her assessment. Her opinion was that she could think of no better motivation for doing a great job than knowing the life and health of her son was at stake. This nurse was hired for the position. Sadly, her son died before he was able to receive his heart transplant. His mom continued to work for the VA for the rest of her career.

I was reminded of this story when I attended a presentation the other day where the nurse executive was discussing coaching new staff. A few of the nurses in the audience were very vocal in their observations that many new nurses coming into the profession today are in it for the money, and not a love of nursing. The nurse executive took a step back and said that she was one of those nurses who entered the profession because of job stability and earning potential. “I was a struggling, divorced, single mom and nursing was my ticket to a better future. I did not enter nursing with a high degree of passion about what I was doing. Over time, I grew to love it and 25 years later I am still practicing.”

There were important points in both of these stories. As leaders, we often let our own value system drive our biases about the professional motivations of others. Some nurses knew that they wanted to be nurses from the time they were five years old, but this is not everyone’s life story nor should it be. Some of our most successful nurses today entered the profession as second degree students who developed their interest later in life but are no less passionate about the profession. One of Stephen Covey’s 8 habits for highly effective people is to “seek first to understand then to be understood.” This is good advice for all of us to exercise before we question the professional motivations of others.