Abstract
Psychological contract describes the non-verbal understandings existing between employee and employer through an unwritten, implied agreement determining future obligations and commitments. This chapter throws light on the concept of psychological contract and facilitate the determination of the significant influence of socio-demographic factors on the psychological contract of doctors and nurses and its impact on their behavioral outcomes. There is a need to assess the mental pressures of professionals at the workplace due to poor working conditions, lack of safety and security, lack of trust and authority to take decisions regarding crucial surgeries, and doctors not being treated with dignity and respect. The data is collected from Senior HR managers and doctors from four major hospitals in the Indian IT hub, Bangalore. Data is analysed adopting qualitative research. The study emphasizes the importance of psychological contract in healthcare sector and significance of HR practices is building commitment and positive behavioral outcomes leading to quality healthcare services.
TopIntroduction
Businesses in the present digitized millennium considers the skilled and competent knowledge workers along with their complex bundle of values as the assets of an organization and the main key to innovation and growth. Commitment, engagement, involvement and integrity of the employees are the values that lead an organization towards sustainability and progress by creating long-lasting relationships with external and internal stakeholders (Robert, G. E. et al., 2012). It is beyond doubt that, high customer experience and business value is achieved through well-trained, committed and competent employees, who are the ones coordinating between customers and organizational goals. It is crucial for any organization to maintain positive interpersonal relationships with the employees in order to achieve its ultimate goals (Patrick & Priscilla, 2019). Psychological contract explains the root of existence of contemporary employment relationships in modern workplaces (Maria Tomprou, 2011) leading to values of commitment, engagement and empowerment among the employees irrespective of the nature of job and industry. The dynamism in the business environment, depreciating labor market and organizational transitions has made it challenging to retain talented and productive employees in the fast-booming Healthcare sector.
Globally, healthcare sector is projected to grow at an annual rate of 4.1% in the period between 2017-2021, up from simply 1.3% in 2012-2016 (Economic Survey report, 2017-18). Robust growth mandates committed employees and effective talent management programs. This is where Psychological contract becomes an inevitable key to enabling organisations balance the increased expectations of healthcare professionals (doctors, nurses etc.) and maintain commitment and contributions as per organisational goals. The concept of psychological contract has captured the attention of researchers as a framework for understanding the employment relationship (Coyle-Shapiro, Jacqueline A-M. & Parzefall, M., 2008), managing mutual expectations, needs, commitment and reciprocal contributions as per organisational standards contributing to talent management and growth (Taylor & Tekleab, 2004).
India is expected to rank amongst the top three healthcare markets worldwide in terms of incremental growth by 2020 as per the SEPC report. According to a study by National Healthcare Retention and Registered Nurse Staffing Report, the average hospital turnover rate in 2017 was 18.2%, which is the highest recorded turnover in the industry for almost a decade (Wells, M., 2015). The rising turnover rate of employees in healthcare industry is possibly due to lack of work engagement, lower job security and personal safety of healthcare professionals, lack of training and professional development, less adoption of newer technologies, challenging work-life balance and high stress levels in the hospitals (Warrier, 2017).
The high stress levels, challenges and accountability involved in the job roles mandates psychological contract to exist as a talent retention strategy. The healthcare professionals need to deal with patients who may be upset or scared, the doctors are often required to disclose tragic news to patients and their family members that leads to critical attacks on them. Safety, security and stress of the healthcare professionals is a major concern in an emerging country like India, raising constraints for doctors and nurses to perform their job better. Healthcare professionals do not often have a choice in their day-to-day lives and find it difficult to find social support from the hospital management. This impacts their psychological contract adversely leading to burnout, low commitment, poor behavioural outcomes and degrading healthcare services offered to the patients. Psychological contract describes the understandings, beliefs and commitments that exist between an employee and employer (Patrick, H., 2008). It is important to identify the determinants that affect the psychological contract of professionals in healthcare sector and to identify the reasons beyond it as well as consequences. The ultimate outcome is retention and undeterred employee performance.
Key Terms in this Chapter
Transactional Contract: Transactional contracts focus more on explicit elements in which employees are less career oriented, lack of trust in employer and greater resistance to change.
Psychological Contract Fulfilment: Psychological contract fulfilment is created when the employer keeps the promises of employees.
Relational Contract: Relational contract the contract that gets affected based on relationship of trust between both the parties (i.e., employer and employee).
Reciprocates: Reciprocates means both the parties’ employer and employee enter into agreements mutually, making the obligation of one party corresponding to the obligation of the other.
Psychological Contract: The psychological contract is the unwritten set of expectations of both employee and employer at the time of employment contract.
Organisational Citizenship Behaviour: Organizational citizenship behaviour deals with positive and desirable behaviour of employees that benefit the team and encourage greater organizational functioning and efficiency.