The past 24 years in health care have exposed me to many different styles of leadership. These styles incorporated the technical understandings of the leader coupled with their personalities and traits. Styles often gleamed their true colors during stressful situations where some leaders maintained their composure and others did not.
I entered healthcare in 1996 based on my passion to help others. I never knew the term emotional intelligence (EI) until later in my educational studies. EI is rarely discussed in the healthcare settings I have worked, yet I knew that I must be positive and persuasive in my approach to both patient’s and co-workers. I learned a phrase early in my career and use it frequently. The phrase reminds me that I am the independent variable in the equation that ultimately involves the outcome of my patients. This term is Q-TIP or “quit taking it personally”. I understood my role as a healthcare worker and leader. This role placed me directly in the path of others who needed help. People in the hospitals, nursing homes, and clinics are there because things are not going well in their lives. People are not always happy to see us healthcare workers. This is something I accepted early in my career.
The purpose of this paper is to understand how EI can make leaders better. EI brings both risks and benefit for leaders. Understanding the literature will provide science and intuition to help mold my future leadership skills.
High EI: Benefits and Risks
Emotional intelligence defines a person’s abilities beyond the measurement of Intelligence Quota (IQ) alone. Examining the components of EI allows leaders to understand their own strengths and weaknesses, while coaching others to do the same. Goleman (2004) identifies the five skills of EI as: self-awareness, self-regulation, motivation, empathy, and social skill. Improving inherited EI qualities and traits in well documented in the literature. Leaders must recognize the benefits and risks of high EI in practical settings.
The Benefits of High EI
High EI comes with multiple benefits in the workplace. Using any of the five categories, these benefits range from strong organizational skills, moving past obstacles and meeting deadlines, to professional and empathetic interactions with co-workers and customers. Goleman (2004) paints the picture of high EI as the employee who does not react to situations, rather moves their feelings aside and attempts to understand all angles before responding. Leaders who demonstrate high EI make every effort to understand where others are coming from and how emotions are impacting their current response. High EI is beneficial to the healthcare arena due to the constant onslaught of emotions. Health care workers deal with people experiencing personal struggles and strategies daily. They must be empathetic and productive in their efforts. Leaders take on additional emotions when their units or teams are short staffed, experience policy changes, and difference of opinions and priorities. High EI allows leaders to focus on priorities, overcome obstacles, and motivate others to push forward. High EI keeps you going, however does not dismiss your feelings. It is shown in the business sector that leaders who excel in EI improved their annual earning goals by 20% (Goleman, 2004). Leaders with strong EI are effective in their roles. A study involving 79 nurses and 113 patients looked for statistical significance between nurse understanding of EI and patient experience results. P-values were less than 0.05 for patient satisfaction scores and empathetic scores and emotional awareness (Celik, 2017). This shows strong probability and meets the gold standard for p-value showing a strong relationship between nurses with a good understanding of EI and improved patient satisfaction. The correlations in the study by Celik (2017) shows that when nurses have EI skills, they can relate to the patient’s emotions and are perceived as compassionate and warm.
The Risks of High EI
It is difficult to think of high EI in a negative or consequential light. Risks of high EI can include a lack of empathy that feels disingenuous to others. Staff may find it hard to accept their leader is truly working for their goals if no emotions are shown or articulated. Davis and Nichols (2016) share their findings and research on what is coined the “dark side” of emotional intelligence. One example suggests that managers with high emotional awareness EI exhibit poor psychological health and struggle with situations where emotions can be high (Davin & Nichols, 2016). Having too much awareness of one’s emotions may suppress creative thinking. High EI can come across as fake and be disruptive in building genuine relationships. When taken too far, this emotional suppression can lead to manipulation of others (Davis & Nichols, 2016). People must continue to feel and experience their feelings and acknowledge feelings of others. Leaders who only care about productivity, profits, or job tasks fail to recognize their teams in a genuine way. This can lead to turn-over and poor performance indicators. High EI must be used for good intentions, thus to importance of mitigation efforts.
Mitigating the Risks of High EI
Healthcare leaders have accountability to practice emotional intelligence to guide their leadership effectiveness within their teams. Leaders must increase their level of awareness around the risks associated with high EI and include these risks in their own coaching strategies and personal awareness. A study was conducted to look at the impact peer coaching had on their EI abilities and understanding. During the research correlations were look ed at involving multiple factors. A p-value of <0.05 was found between EI scores and work-life balance (Codier, Kamikawa, & Kooker, 2011). Leaders with high EI who are constantly trying to improve their areas and teams must be willing to take breaks. Work life balance can help mitigate leaders from constantly striving to improve their abilities. Peer coaching and feedback was viewed as having a positive impact on nurse managers and their EI abilities (Codier, Kamikawa, & Kooker, 2011). In conclusion, organizations need guard rails for effective EI programs to reap the benefits associated with education and peer coaching and EI, while encouraging mechanisms for work-life balance. Feedback mechanisms can mitigate if overly confident leaders come across as arrogant.
How Leaders Can Enhance Their Emotional Intelligence
Many assessment tools exist that provide baseline understandings of a person’s emotional intelligence. A systematic review of 46 articles examined correlations between a person’s EI and the effect EI interventions have. Tools such as the Mayer-Salovey-Caruso emotional intelligence test (MSCEIT) or Trait Emotional Intelligence Questionnaire (TEIQue) provide baseline scores (Kotsou, Mikolajczak, Gregoire, & Leys, 2019). The articles used in the study show strong correlations in improved EI post-tests following EI training courses. A research study in Turkey involving 184 diabetic patients examined if structured EI courses improved post-test EI scores. The curriculum consisted of 90-minute sessions once a week for twelve weeks. Examples of these sessions include: to improve the perception of individuals about their feelings, how to differentiate emotions, understanding how emotions are expressed, how to become self-motivated, and using emotions in daily life (Yalcin, Karahan, Ozcelik, & Igde, 2008). Posttest scores were higher in those patients attending the curriculum than those who did not with a p-value of <0.05 and the control group posttest p value was >0.05 (Yalcin, Karahan, Ozcelik, & Idge, 2008). This data shows that interventions are directly related to improving a person’s EI while no intervention leads to no EI growth.
Nurse leaders can look for structured courses on EI, read articles, and books to help improve their EI. The challenges leaders face is finding work life balance. Awareness and practice can be separate issues as the challenges lie with, he daily problems leaders face. Changing one’s true emotions can be difficult and require the support of mentors and coaches to assist. I had a coach who monitored me on the units as a nurse leader. I was provided literature and EI exercises, however relied on feedback from my mentor and coach. Living and breathing EI requires practice. Goleman (2004) recommends practice and feedback as a mechanism to improve your emotional intelligence. Leaders must be honest in their quest and set aside time to breathe, focus, and eat. Emotions are harder to control when basic needs are not met. In my experience it is hard to get buy-in from nursing leaders. These leaders wish to remain in the trenches more than what is healthy, risking their emotions.
EI: Personal Mastery, Assumptions, and Biases
My personal mastery in Emotional intelligence is a constant tug-of-war match. My daily goal includes reminding myself that I must be mindful of how I respond and come across to my hospital colleagues. I can honestly reflect that I have done this consistently for many years in my nursing leadership career. I have an ability to redirect negativity, frustration, and other emotions from my team and others to keep the patient at the center. An example is to remind the emergency room nurses that people entering the department in psychological distress need our help the same as a person having a heart attack.
Goleman (2004) defines self-awareness as knowing your own strengths, weaknesses, emotions, values, goals and how they impact others. I have made many assumptions that this I practice self-awareness and understand the impact that my self-confidence has on others. My goal is to use my personal strengths towards confidence to help others. Feedback from mentors and peers have shown my own bias to how I think I come across to others. My self-confidence can be misconstrued and interpreted not as intended. I tend to share my accomplishments to motivate others, yet it can come across as bragging. I have learned to become a better listen and inject empathy to let others tell their story and provide guidance. This method has allowed me to help others without coming across as vein.
The 24 years of my nursing career has placed me in the direct line of people facing extreme situations. My strongest skill is my ability to sit, listen, validate feelings, and provide comfort. The challenge is to block the other tasks needed to be completed and provide focused attention on others. This requires the ability to form strong relationships with my team to delegate tasks so I can be in this capacity. Communication with my team to avoid assumptions is critical as I play the role of active listener.
It is a challenge for me to understand other’s when they are exhibiting emotions that block productivity. A bias I attempt to use as motivation in daily practice is when others around me are negative and complaining rather than looking for solutions. I feel my heart rate increase, breathing change, and become a bit angry. Initial responses include an elevated tone in my voice and making general comments to redirect. I assume others are more focused on putting up barriers than finding ways around. This bias prevents me from using my skills to help those on my team. I am beginning to inject humor to change the temperature when talking with other leaders and managers before looking for solutions.
Master Plan for EI Development
My master plan to develop my emotional intelligence involves ongoing learning, practice, and feedback. The literature frequently shows the impact on self-development in EI after seeking feedback from peers. Performance feedback provides real-time views on how your perceived. This feedback must include my ability to process negative perceptions and how I manage highly stressful situations (Sherman, 2020). The first step in my plan is to seek feedback from my peers on a routine basis and from my boss on a quarterly basis. Gebler, Nezlek, & Schutz (2019) discusses the strong pre-requisite of perceived emotions prior to EI development. Feedback leads to increased self-awareness and starting point.
Self-awareness and feedback provide me with an understanding of my strengths and weaknesses. Sherman (2020) states that leader performance improvement consists of leveraging strengths and minimizing weaknesses. Feedback from peers and my supervisors identifies my strengths in relationship building, helping others push forward using motivation, and keeping patients at the center of any situation. My weaknesses include passion perceived as anger and quick to respond or point out my perceptions of others.
I had a Studer coach six years ago as a new manager. Coaching provided me scripted responses for both patients and staff during stressful situations. Role playing exercises were helpful, however lacked the true emotions that come with the situations depicted. Data showed P<0.05 and P<0.01 in groups who received emotion regulation training showed improved ability to regulate emotions (Gebler, Nezlek, & Schutz, 2019). The more exercises or real-time emotional situations I can be involved in, the better I can regulate my emotions. I plan on involving myself more around the hospital in the psychological and medical codes moving forward.
I plan on assisting the education team in establishing an EI course for hospital staff. I currently teach the leadership academy at the hospital and plan to integrate EI discussions. I will remain consistent in my efforts to stay current with the literature and set a goal to read one to two articles per month on leadership and EI. The greater challenge I face in improving my EI is my personal work-life balance. I tend to work to the point of exhaustion.
I acknowledge my emotions are higher as does those around me. I must start taking time off from work and participating in life activities that energize me. I love to play guitar, work on my property, and plan trips. This balance is crucial in preventing amygdala hijacking due to sustained stressors.
Mastering my EI requires awareness, learning, practicing, feedback, and balance. I tend to go over conversations in my head or in front of a mirror when I know they will be tough. I am improving at hearing others first before I make conclusions to situations. Keeping EI at the forefront of my leadership journey will better prepare me to motivate, inspire, coach, triage, and understand others. Health care is in constant change, emotions are high, and I must help both myself and others deal with them.
Celik, G. O. (2017). The relationship between patient satisfaction and emotional intelligence skills of nurses working in surgical clinics. Patient Preference and Adherence, 11, 1363-1368.
Codier, E., Kamikawa, C., & Kooker, B. M. (2011). The impact of emotional intelligence development on nurse managers. Nursing Administration Quarterly, 35(3), 270-276. doi: 10.1097/NAQ.0b013e3182243ae3
Davis, S. K., & Nichols, R. (2016). Does emotional intelligence have a “dark side”? A review of the literature. Frontiers in Psychology, 7(1316). doi: 10.3389/fpsyg.2016.01316
Gebler, S., Nezlek, J. B., & Schutz, A. (2019). Training emotional intelligence: Does training in basic emotion abilities help people to improve higher emotional abilities? The Journal of Positive Psychology. doi: 10.1080/17439760.2020.1738537
Goleman, D. (2004). What makes a leader? Harvard Business Review. Retrieved from http://jbedwardsandassociates.com/wp-content/uploads/2015/12/HBR-What-makes-a-great-leader-D.-Goleman.pdf
Sherman, R. O. (2020). Learn to manage yourself. American Journal of Nursing, 120(2), 68-71. doi: 10.1097/01.NAJ.0000654348.26954.3a
Yalcin, B. M., Karahan, T. F., Ozcelik, M., & Idge, F. A. (2008). The effects of an emotional intelligence program on the quality of life and well-being of patients with type 2 diabetes mellitus. The Diabetes Educator, 34(6), 1013-1024. doi: 10.1177/0145721708327303