Maslow’s Hierarchy of Needs in Nursing Essay

Introduction

This text seeks to understand the nursing team and their job dissatisfactions. We propose the association with Abraham Maslow’s hierarchy of needs theory of human needs as a means of systematizing and understanding the recurring situations of the day-to-day and nursing practice. Needs are hierarchically structured in physiological, security, social, self-esteem, and self-realization, indicating the degree of satisfaction (from the disease to the fullness) of an individual or group. The advantage of this approach consists in being able to use the solidity, depth, and richness of Maslow’s theory in concrete and particular situations of the Nursing team.

Nursing has been pointing out, in scientific research, views, and considerations about the profession in a way that allows it to update and build a more consistent professional path. The care to build a history for Nursing with more scientific coherence allows nurses an intense and accurate growth, capable of reaching a more active and decisive future. In this context, this article aims to expose and reflect on a new proposal for a study applied to Nursing, which involves (dis)satisfaction in the work of the members of the nursing team, as a fundamental point in carrying out and developing their activities. The resumption of basic human needs is an essential instrument to understand the factors that motivate these activities, generating (dis)satisfaction and good performance by this team at work.

During our professional trajectories, we could see that the nursing team’s dissatisfaction at work was marked and visible. Since then, we began to question the reason for so many dissatisfactions and whether there was a compromise in patient care. It was clear to us that the care provided resides in each member of the nursing team is influenced through our desires, needs, and satisfaction. Everything that exists and lives needs to be taken care of in order to continue to exist and live. So, we understand that actions in Nursing were beyond appearances and rested on their essence. The values, fundamentals, feelings, and actions of team members were reflected in practice. Thus, the environment became a mirror of personal and social relationships.  The environment is like a biological, social, political, and economic system that organizes, disorganizes, and reorganizes itself.

In this environment, people create their own identity, ways of living, and caring, in which their (dis)satisfaction are fully implicit in the experience process, influencing the existing relationships in this space. Faced with these questions, the (dis)satisfaction of the members of the nursing team is related to the interaction necessary to provide care, which may compromise the assistance that will be provided.

Satisfaction is the action or effect of being fulfilled; pleasure, contentment; meeting expectations, meeting what is desired. In psychology, satisfaction is the result of a variety of attitudes of the person towards factors associated with their work, and attitude at work designates the feeling that the employee experiences regarding his/her job

Few proposals regarding the members of the nursing team and their influence on care are discussed in order to address their (dis)satisfaction and stress at work, except for the proposal that involves nursing know-how. Thus, the level of professional satisfaction has become an essential, determining, and debatable factor for a better understanding of care. Care must be understood as the performance of actions in nursing, considering it inevitable to satisfy a set of needs both of the clientele and of the members of the nursing team who perform this care, involving more interaction and autonomy. To this end, this reflection proposes a discussion about Abraham Maslow’s theory of human motivation or hierarchy of basic human needs ⁽⁵⁾correlating it with actions within Nursing. In this hierarchy, individuals are in a continuous process of development, tending to move between needs and in search of self-fulfillment.

Maslow’s Hierarchy of Needs in Nursing Concepts

Upon reaching physiological, safety, social, esteem, and self-fulfillment needs, human beings also achieve the necessary satisfaction to perform their activities better. Maslow is a psychologist and researcher of human behavior well known in Nursing. Maslow’s hierachy of basic human needs can also be applied in nursing to look at various things. In this approach of theory applied to the profession, the nurse is the responsible agent who carries out the planning process to take care of the client’s basic needs, establishing a direct and active nursing action in face of the problems presented by him. It is important to bring to Nursing observation, interaction, and intervention with the client to satisfy their basic human needs.

On the other hand, Maslow conceived the theory of human motivation based on the hierarchy of basic human needs. This theory assumes that all human beings have common needs that motivate their behavior in order to satisfy them, associating them to a hierarchy. The human being, as he is always looking for satisfaction, when he experiences some satisfaction at a given level, he soon moves to the next one, and so on. In his theory, Maslow hierarchically classifies needs into five levels, namely:

1- Basic or physiological needs: those directly related to the existence and survival of human beings, including food, water, clothing, sex, and sanitation needs. For Maslow, physiological needs are the starting point for the theory, as they are paramount. Physiological needs refer to the individual’s biological needs. They are the most pressing, dominating the direction of human behavior when it is dissatisfied. Thus, a person dominated by such a need tends to perceive only the stimuli that aim to satisfy them; his vision of the future is limited and determined by that need.

2- Security needs: in this group are the needs related to individual protection against dangers and threats, for example, the need for health, work, insurance, social security, and social order. Maslow emphasizes that the need for security allows the individual to prefer familiar things, tend to a religion or philosophy of life and daily routines. However, the need for security can only be considered an active and dominant motivator if it is found in times of urgency. As a result, security needs are of great importance.

3- Social needs: related to life in society, encompassing social needs, friendship, respect, love, leisure, and participation. These are the social interaction needs referring to the affection needs of the people we live with, such as; friends, bride, wife, and children. The human being will tend to build effective relationships in order to feel integrated, part of a group in society. Thus, when social needs are not sufficiently met, a person becomes resistant, antagonistic, and hostile towards those around them. The frustration of these needs often leads to social inability and loneliness. The need to give and receive affection is an important activator of human behavior when participatory management is used.

4- Ego needs (esteem): are related to self-satisfaction, characterized as needs for independence, appreciation, dignity, recognition, subjective equality, respect and opportunities. They express people’s needs or desires to achieve a stable self-evaluation as well as self-esteem firmly based on their personality. The satisfaction of these needs leads to feelings of self-confidence, value, strength, capacity, sufficiency, and usefulness to the world. In spite of the frustration of these needs, they produce feelings of inferiority, weakness or impotence, one can easily get a stimulus for severe traumatic neurosis

5- Self-fulfillment needs: they express the highest level of needs that are directly related to the individual’s full achievement. In this group are the needs for the full use of potential, capacity, and the existence of ideologies. They are growth needs revealing a tendency of every human being to fully realize their potential. This tendency can be expressed as a person’s desire to always become more than he is and to become all he can be. In this sense:  A musician has to make music, an artist has to paint, a poet has to write if he wants to be at peace with their respective personalities. A man has to be what he can be.

The need for self-fulfillment is not extinguished by the full act of satiating. The greater the satisfaction experienced the greater and more important the need will seem. The clear emergence of this need rests on the prior satisfaction of physiological, security, love, and esteem needs.

In addition to the five needs mentioned, the desire of every human being to know and know was added to the theory. Thus, there is a natural need for human beings to seek the meaning of things, in order to organize the world in which they live. These are the so-called cognitive needs, which include the desire to know, understand, systematize, organize, analyze and seek relationships and meanings. These needs would come before self-realization. The need to help others develop and fulfill their potential was termed transcendent and would come later to self-realization.

There are certain preconditions for basic needs to be satisfied and without these preconditions, it would be impossible to satisfy the needs. They are freedom of speech, freedom of expression, freedom to investigate and seek information, freedom to defend oneself and seek justice, equity, honesty, and guaranteed permanence within the group. If these freedoms are frustrated, the individual will react with an emergency threat response.

In this theory, the hierarchy between needs is linked to the characteristics of the human being, regardless of the production system. This system needs to satisfy them, under the penalty of creating/increasing the pressure on the part of the subjects involved. For Maslow, behavior is motivated by needs that he called fundamental needs.

The fundamental needs can be classified into superior needs and inferior needs that are guided under the principle of relative power. The basic needs are organized by themselves in a perfectly definitive hierarchy, on the basis of the principle of relative power. We can then describe that the inferior needs depend on the individual’s own internal conditions, that is why they are much more localized, they are instinctive, animal, perceptible, more numerous, easy to be measured (tangible), and more limited than the superior ones.

Superior needs require favorable external conditions that are more accessible to satisfaction. They are less numerous, therefore less noticeable, less controllable, develop important civic and social consequences and produce better subjective results, taking as an example the happiness, serenity, and richness of the internal life. When these needs are satisfied, it means that the individual has achieved greater biological efficiency, greater longevity, fewer illnesses. As such, they are more human and reflect self-actualization. The intention to satisfy basic needs is also associated with an ascending series of levels of psychological health. A man who gains respect and admiration from those around him, being able to develop his self-esteem, progressively favors his own psychological balance.

Thus, the following assumptions of the Basic Human Needs Theory were raised:

• The most important principle of motivational life is the organization of needs in a hierarchy of priority or potential;
• Human behavior is determined by basic needs and consequently motivated by them;
• There are pre-conditions for the needs to be satisfied;
• When a need is partially or satisfied, another of the superior type appears;
• Inferior needs are more internal, stimulated by the individual’s own issues; and the higher needs are more external, stimulated by matters outside the individual;
• When the individual partially meets his needs, he also reaches an ascending series of degrees of psychological health and satisfaction;
• A dissatisfied individual is a sick man (sick);
• Failure to meet basic needs may, over time, mean the emergence of serious pathologies;
• The dissatisfaction of needs leads the individual not to develop the maximum of their potential.

This theory is not the only one that explains human behavior, as not all behavior is determined by needs. The fundamental needs are largely unconscious and, on the other hand, sociocultural factors also influence the form of objects in which men seek to satisfy their needs.

Conclusion

In the light of these thoughts, we seek to unravel the consequences of the (dis)satisfaction of the members of the nursing team in the act of caring. These searches are very important for Hospital Nursing, but also for the health of the nursing worker and essential to understanding the care process, the implications for the members of the nursing team and for the clients under their care. Its contribution will be a deeper understanding of what moves the members of the nursing team, in their daily practice of nursing care, in the different scenarios of the hospital. This understanding brings in itself, a contribution to nursing care, teaching, and research. For nursing care and education, the contribution may come to mean a broad redirection to the resumption of Nursing principles and values, review, education, performance, and evaluation of this care and teaching, mainly focused on the performance of team members nursing, in hospital settings. For nursing research, the contribution implies new research possibilities. The objects of study may focus on something that has not been explored in other studies, that is, the influence of the (dis)satisfaction of the members of the nursing team at work on the care they offer. This vision leads to considering a new care proposal, focusing on the team member (employee), to develop excellent care, as a more integrated, autonomous, active, and satisfied team builds a healthier work environment, happy, able to rebuild a structured, planned and solid care on a day-to-day basis.