The United States health care system is under great pressure for change. According to a study of 13 high income countries, the United States is the highest spender on health care which is 17.1% of gross domestic product or $9,086 per person. Despite the high spending on health care, the United States has the lowest life expectancy and highest infant mortality rate of those countries included in that study (Squires & Anderson, 2015). Therefore, the industry seems to face divergent goals of reduction of costs while improving the quality of patient care within an environment of constantly changing technology.
Hospitals attempt to decrease costs by reducing the number of nurses to patients. Recent studies point to the relationship between nurse staffing and safe patient care (Nursing Shortage, n.d.). According to Aiken, Clarke, Sloane, Sochalski, and Silber (2002), nurses reported greater job dissatisfaction and emotional exhaustion when they were responsible for more patients than they felt they could safely care for. Cost reduction efforts through higher patient loads for nurses may result in nurses having a negative perception of their work environment. These negative perceptions of the work environment may also result in nurses having negative organizational commitment.
Research on organizational commitment suggests that work environment, organizational climate, and culture are factors associated with the development and orientation of employee organizational commitment (Jernigan, Beggs & Kohut, 2002; Erdogan, Bauer, Truxillo & Mansfield, 2012; Meyer, Stanley, Herscovitch & Topolnytsky, 2002; Pfeffer &Veiga, 1999; Dessler, 1999). Understanding how antecedents such as work environment relate to organizational commitment is important for researchers and practicing managers. Such knowledge may provide a framework for understanding how attitudes evolve and could form a basis for developing strategies to support organizational commitment, employee motivation, and other managerial decision making. Van Rooy, Whitman, Hart, and Caleo (2011) contend that understanding how employee attitudes either directly or indirectly impact firm performance is critical. Understanding the dynamics of employee attitudes adds to our understanding of organizational performance.
Two major factors driving changes in the health care industry are the Affordable Health Care Act and the aging Baby Boomer population. The amount and complexity of changes and of regulations in the health care industry make it an important industry to study. Nurses are on the front line in health care and are viewed as the linking pin between the health care establishment and individual patients. Therefore, nurses also seemed to be important subjects to study. Knowledge of nurses' perceptions of their work environment and their organizational commitment could provide meaningful data to aid in the formulation of effective and efficient strategic plans. Perhaps, this research study might contribute to the accomplishment of the goals of decreasing costs and increasing the effectiveness of the health care industry.
The purpose of this paper is to examine the relationship between nurses' perceptions of their work environment and their organizational commitment.
In spite of occasional criticism (Baruch, 1998; Klein, Molloy & Brinsfield, 2012), organizational commitment remains a focus of research interest. Over the past twenty years, researchers have examined organizational commitment from many perspectives (e.g., Loke, 2001; Meyer, et al., 2002; Mathieu & Zajac, 1990). Topical research investigations have addressed the nature of the relationship of organizational commitment and job or work satisfaction (Bateman & Strasser, 1984; Vandenberg & Lance, 1992; Jernigan, et al., 2002), intention to leave the organization (Jaros, Jermier, Koehler & Sincich, 1993; Vandenberg & Nelson, 1999; Hatton, Emerson, Rivers, Mason, Mason, Swarbrick, Mason, Kiernan, Reeves & Alborz, 2001), the influence of personal characteristics on dimensions of organizational commitment (Abdulla & Shaw, 1999), intrinsic motivation and affective commitment (Eby, Freeman, Rush & Lance, 1999), bases and foci of commitment (Clugston, Howell & Dorfman, 2000; Morin, Vandenberghe, Turmel, Madore & Maiano, 2013), human resource practices (Herrbach, Migonac, Vandenberghe & Alessia, 2009; Whitner, 2001), the dimensionality of commitment (Penley & Gould, 1988; Allen & Meyer, 1990; Meyer, Allen & Smith, 1993; Jaros, et al., 1993; Meyer & Allen, 1997), satisfaction with the supervisor (Jernigan & Beggs, 2005), work-family conflict (Lambert, Pasupuleti, Cluse-Tolar, Jennings & Baker, 2006), and organizational culture and staff outcomes (Hatton, Rivers, Mason, Mason, Emerson, Kiernan, Reeves & Alborz, 1999a).
Aggressive strategies used by organizations to adapt to more competitive environments led some researchers to question the value of organizational commitment as a theoretical construct. For example, Baruch (1998) argues that one of the costs of aggressive cost cutting to the organization can be decreased employee organizational commitment. The source of Baruch's position is a belief that the traditional employment relationship no longer exists. Because employees believe that their employer is no longer committed to them, they have no reason to be committed to the organization.
On an intuitive level, Baruch's argument is logical. However, we contend that changes in the traditional employment relationship may alter the nature of an employee's commitment rather than eliminate it. According to Mowday (1998), organizational commitment remains an important attitude that is worthy of study. Mowday contends that high commitment human resource practices produce high levels of affective commitment and subsequent organizational performance (p. 393). Mowday's position is supported by Whitner (2001) and by Herrbach et al. (2009) who report high commitment human resource practices affect the relationship between perceived organizational support and organizational commitment.
Most researchers have accepted that organizational commitment is multifaceted and that commitment represents both an attitude that describes an individual's linkage to the organization and a set of behaviors by which individuals manifest that link. Several studies have used the model of commitment developed by Meyer and Allen (1997) that identifies three components of commitment--affective, continuance, and normative.
The model of commitment developed by Penley and Gould (1988) takes a slightly different approach from the Meyer and Allen model. Based on Etzioni's (1961) multiform conceptualization of organizational involvement, Penley and Gould (1988) endorse that an individual's commitment to an organization exists in both affective and instrumental forms. One can be morally committed, calculatively committed, or alienatively committed to an organization.
Moral commitment is described by Penley and Gould (1988) as a highly positive affective form characterized by acceptance of and identification with organizational goals. As described by Penley and Gould (1988), calculative commitment is an instrumental form essentially focused on one's satisfaction with the exchange relationship. Given its instrumental nature, calculative commitment may be considered similar in nature to the "perceived sacrifice" dimension of Meyer and Allen's continuance commitment (Meyer & Allen, 1997). Calculative commitment may best be described as "supporting the organization to the extent that it supports you" (Hatton et al., 1999a). Alienative commitment is described by Penley and Gould (1988) as a highly negative affective form that is a consequence of a lack of control over the internal organizational environment and of a perceived absence of alternatives. Thus, alienative commitment can be seen as consistent with the "few alternatives" dimension of Meyer and Allen's continuance commitment (Vandenberghe & Panaccio, 2015). Employees who express alienative commitment continue to engage in work behaviors that indicate a desire to continue their membership in the organization. In essence, they ensure their work performance meets at least the minimal standards, and their interaction with managers and co-workers communicates that they do not want to leave (Penley & Gould, 1988).
Conceptually, Penley and Gould's (1988) moral and calculative commitment appear similar to affective and continuance commitment as defined by Meyer and Allen (1997). Etzioni (1961) as well as Penley and Gould (1988) define alienative commitment in terms of a lack of employee control. Penley and Gould contend that alienative commitment results from a perceived absence of alternatives and from a perceived lack of control over both internal and external environments. For example, the employee perceives rewards and punishments as random and unrelated to one's actual work performance (p. 47). This perception could reflect an external locus of control, a sense of powerlessness on the part of the employee, and possibly a lower level of engagement in the work role. Research by Vandenberghe and Panaccio (2015) would appear to support this interpretation. Meyer and Allen's continuance commitment comes closest to Etzioni's conception of alienative involvement (commitment). Meyer and Allen (1997) describe continuance commitment as representative of the individual who believes they have to stay because of the costs associated with leaving, a sunk cost argument. However, alienative involvement (commitment) reflects both one's sense of powerlessness, or lack of control, and a belief that one cannot leave because leaving is not an option.
Alienative organizational commitment could also be considered an outcome somewhat similar to work alienation. Kanungo (1992) defined work alienation as "a cognitive separation from one's job and other related...