LEADERSHIP
Employee Engagement: How to Motivate
Your Team?
Karen Macauley, DHA, MEd, BSN, RN, CEN
E
mployee engagement. Without question, a corpo-
rate buzz word. But, what does engaging employ-
ees mean? How can you do it? Does it matter to
your bottom line? Why does it matter if you have
engaged employees on your team?
Nursing leaders play an integral role in employee sat-
isfaction, patient satisfaction, and employee productivity.
Satisfied and engaged nurses provide safer and higher
quality patient care. Engaged nurses strive for higher pa-
tient satisfaction. Engaged employees have more motiva-
tion and interest in participating in department activities
and in improving patient safety and patient care initia-
tives. Employee engagement often starts with a nursing
leader. Nursing leaders have significant impact on the
way an employee feels about their career, their patients,
and their organization.
Carnegie1 describes employee engagement as an emo-
tional and functional commitment to the employees organ-
ization. Leiter and Maslach2 note that engagement requires
energy, involvement, and efficacy. Kahn3 adds 3 conditions
of work associated with employee engagement: meaning-
fulness, safety, and availability. Engaged employees are
committed to their organization. They are high perform-
ers who are enthusiastic, empowered, inspired, and confi-
dent.1 Engaged employees are emotionally and cognitively
immersed in their job allowing a sense of meaningfulness
and value in the work leading to higher sensitivity to the
organizations mission and to organizational change.4
Engaged employees care about the future of their or-
ganization, have a strong emotional bond to their organi-
zation, are vested to ensure the success of their organiza-
tion, and have both their hearts and heads engaged in
their work.5 This commitment and bond with their or-
ganization leads to higher productivity, increased profits,
improved safety, and lower absenteeism.5 In addition, or-
ganizations that have higher employee engagement have
significantly less turnover. Carnegie1 notes that turnover
Author Affiliation: All Childrens Hospital Johns Hopkins Medicine, St.
Petersburg, Florida.
The author declares no conflicts of interest.
Correspondence: Karen Macauley, DHA, MEd, BSN, RN, CEN, All
Childrens Hospital, 501 Sixth Ave S, St. Petersburg, FL 33701 (karen.
macauley@jhmi.edu).
DOI: 10.1097/JTN.0000000000000161
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JTN-D-15-00042.indd 298
alone costs organizations $11 billion annually and can
be significantly lessened with an engaged and committed
employee environment.
Disengaged employees, on the other hand, often do
only as they are told, miss more work, and are more
likely to leave an organization.5 Those who are actively
disengaged are physically present but emotionally absent;
they are unhappy and vocal in their unhappiness, speak
poorly of their organization, and actually quit but physi-
cally stay in the environment causing significant morale
issues for the others within the environment. These dis-
engaged employees are extremely detrimental to the or-
ganization; yet these employees make up a majority of
the corporate workforce. Carnegie1 notes that 71% of all
employees are not fully engaged.
Why is employee engagement important? Carnegie1
notes that engaged employees are up to 202% more pro-
ductive than unengaged employees. Higher employee
engagement can lead to higher quality of individual and
team work, which then can lead to higher growth, pro-
ductivity, and revenue for an organization.4,6 Organiza-
tions with highly engaged employees have a 26% higher
revenue per employee and these organizations are more
likely to exceed the industry average for 1 year revenue
growth. Finally, organizations with highly engaged em-
ployees and team members have safer organizations and
have a 49% safer environment.6
FOUNDATIONS OF EMPLOYEE
ENGAGEMENT
Organizational commitment is allegiance to ones organi-
zation2 and is different than employee engagement and
job satisfaction. Engagement refers, instead, to the em-
ployees relationship with the work itself while job sat-
isfaction is the degree to which the job itself is fulfilling.
Engaged employees have organizational commitment
and this commitment contributes to both the morale of
the organization and to the loyalty the employee feels to
their organization.
The Social Exchange Theory (SET) is one of the foun-
dational theories for workplace behaviors.7 Review of the
SET gives a theoretical foundation to understanding em-
ployee engagement. The SET states that relationships of
trust develop over time and that these relationships are
based on trust, loyalty, and mutual commitment.7 There
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 are guidelines identified in the exchange and one of the
most recognized exchange is reciprocity or repayment.
Reciprocity exchange develops better work relationships
than other forms of exchange.7
Social exchange relationships (interpersonal connec-
tions) can produce positive work behaviors and employ-
ee attitudes.7 Blau8 notes that most human pleasures de-
rive from human interactions and that people will often
get specific benefits from these social interactions and, in
general, 1 good deed deserves another. This reciprocity
theory lends itself to employee engagement in that the
relationships across an organization build trust, loyalty,
and enthusiasm for an employees work within an or-
ganization. When an employee is happy and loyal, they
will be more engaged and positive about their workplace
and team.
ARE EMPLOYEE ENGAGEMENT AND
MOTIVATION THE SAME THING?
According to Osmundson,9 motivation is defined as ones
ability/energy to get excited or exert effort to complete a
task. Motivation encompasses effort, persistence, direc-
tion, and goals. Effort refers to the amount of effort put
forth in the attainment of a goal and persistence relates to
the ability to stay the course until the task is completed.
Direction is the effort related to the final goal and, finally,
goals are both individual and organizational and must be
aligned with the final product expected. These goals can
be performance or learning goals. Performance goals are
to gain favorable judgment from individuals with author-
ity or influence and can include peers and supervisors.
Learning goals, on the other hand, relate to an individual
using feedback to increase individual competence.
Maslow is an early pioneer in the theory of motivation.
He noted that individuals are motivated in a hierarchy of
need and every person is both capable and has a desire
to move up the hierarchy of need.10 Maslow identified 7
stages of motivation: biological and physiological, safety,
love and belongingness, esteem, cognitive, aesthetic, and
self-actualization and transcendence. Human motivation,
according to Maslow, is based on personal growth and
fulfillment. Growth along the continuum requires satis-
faction of each level before movement to the next level
and few people actually reach self-actualization and tran-
scendence.
The Pathgoal theory of leadership relies on 2 theo-
ries of work motivation: goal setting and expectancy
theory.11 Goal setting theory in effective methods to mo-
tivate teams is to set realistic but challenging goals and to
offer rewards. In contrast, the expectancy theory explains
why people would work hard for you and describes be-
haviors that lead to motivational goal attainment and in-
clude a personal belief that the attainment of the goal will
lead to something of value to the individual (pay, recog-
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JTN-D-15-00042.indd 299
nition, status). Engagement in the required or expected
behavior will lead to the accomplishment of the goal.11
Motivation is the ability and desire to get things done.
Employee engagement, on the other hand, is a fulfill-
ment of the heart and soul of the employee to be loyal to
their position and organization. One could be motivated
but not engaged although the terms are often used inter-
changeably. It is important to note that being motivated
alone is not the same as being engaged.
INFLUENCING EMPLOYEE ENGAGEMENT
A leader has a significant amount of influence on a team
members satisfaction, commitment, and engagement.
Kaye and Jordan-Evans12 identify the most important fac-
tors for keeping employees: meaningful and challenging
work, a chance to learn and grow, the sense of being
part of a team, and good bosses. Perceived organizational
support requires that an employee has the assurance that
there is support and assistance available to them when
needed to effectively do their job.4 In addition, psycho-
logical safety is a sense of self without consequence and
is necessary for high engagement.
Leiter and Maslach2 identify several areas of work life
that have an impact on an employees engagement. Work-
load has an impact on employee engagement. When a
persons workload exceeds their time and skill capability,
an employee is at great risk for burnout and dissatisfac-
tion. A sustainable workload, in contrast, allows oppor-
tunity for growth, which is an important component of
employee engagement.
Reward and recognition is another component impor-
tant to developing a high level of engagement. Consist-
ent, sincere, and timely feedback and interaction with
employees are a necessity within every team. Intrinsic
and extrinsic rewards are both important components of
rewards and recognition. Ram and Prabhaker2 note that
pay is an important consideration at the time of employ-
ment but extrinsic rewards become less important as an
employee settles into a position. At this point, the authors
note that intrinsic rewards are a much greater motivator.
Leaders need to take the time to find out what matters to
their employees. Not all employees are motivated by the
same reward and recognition of these differences is im-
perative for success and greater employee engagement.
A sense of community within the workplace will have
a positive influence on the team level of engagement.
Community includes social interaction, conflict resolu-
tion, support, and teamwork. According to Leiter and
Maslach2(p98) a lively, attentive, responsive community is
incompatible with burnout.
Employees require a sense of self-worth, which influ-
ences their perception of fairness within the work environ-
ment and the respect afforded to them throughout their
interactions at their job. Inequities in pay, responsibility,
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 and workload can have a profound negative impact on an
employees engagement within their organization. An em-
ployees values will also have influence on engagement.
Values are the ideals and motivations that attract employ-
ees to their job and organization; it is the alignment with
the organizational mission statement and the perception of
meaningful work.
WHAT A LEADER CAN DO TO IMPROVE
EMPLOYEE ENGAGEMENT?
Does it matter if employees are engaged? It absolutely
does. Can the nursing leader have a positive or negative
impact on employee engagement, productivity, and job
satisfaction? They absolutely can. Nursing leaders have a
profound and important influence on employee engage-
ment. Each leader must ensure that every employee clear-
ly understands the organizational mission. Employees
should work in an environment that supports their ideas
and have the support and supplies needed to be effective
within their position. In addition, the work environment
must be safe so that employees are empowered to be suc-
cessful without fear of retribution. It is imperative that em-
ployees are recognized and rewarded sincerely and that
they know that the leader also believes that their work
has meaning. Finally, and most importantly, employees
must feel valued by their direct supervisor and by their or-
ganization. Employees that are engaged state that the re-
lationship is what keeps them there, gives them courage,
gives them motivation, and makes them want to come in
and give their best every single day. This feeling of value
should come directly from the nursing leadership.
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Positive Intervention Strategies (Research in Occupational Stress
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3. Kahn W. Psychological conditions of personal engagement and
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4. Ram P, Prabhakar G. The role of employee engagement in
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com.au/media/92145/impact_of_employee_engagement_on_
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8. Blau P. Exchange and Power in Social Life. New York, NY: John
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9. Osmundson E. Leadership Through Motivation and
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10. McLeod SA. Maslows Hierarchy of Needs. 2014. www.
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11. Martin R. Pathgoal theory of leadership. In:Levine JM, Hogg MA,
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