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Nurse leader
emotional intelligence
How does it affect clinical nurse job satisfaction?
By Angela R. Coladonato, DNP, RN, NEA-BC, and Mary Lou Manning, PhD, CRNP, CIC, FAAN, FNAP

Effective nurs-
ing leadership is criti-
cal to successful organizational
outcomes and employee job satisfaction.
Strong leaders are skillful in relating to oth-
ers and creating relationships that are essential
to achieving their goals.1 Emotional intelligence (EI)
has been recognized in the social psychology literature
and is now receiving attention in the nursing theoretical
and empirical literature as having a significant impact on
leadership success.2 The concept of EI is defined as the abil-
ity to accurately perceive, appraise, and express emotion.3
EI encompasses the ability to control impulses and delay
gratification, regulate ones mood, and continue to be
motivated and empathize with others when faced with
frustrating situations.4
Theres evidence that emotionally intelligent
nurse leaders can help their organizations
create a competitive advantage through
improved retention of top talent,
intraprofessional team-
work, use of time
and resources, and
increased motivation
and innovation of team
members, as well as estab-
lished trust among nurs-
ing and leadership.5 Nurse
leaders who possess high EI
understand the impact of oth-
ers on both their professional and
personal well-being, showing an
appreciation of their contributions
and fostering a healthy environment
that supports staff engagement, job sat-
isfaction, continuous learning, information
sharing, and decision making.6,7 High EI
results in the ability to motivate employees
to do their jobs more effectively and increases

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Nurse leader emotional intelligence

employee job satisfaction, in Methods (NDNQI) survey completed at


addition to leading to transfor- This descriptive, cross-sectional the same institution were
mational leadership practices study was conducted at a 245- included in this study.
that ultimately influence quality bed, not-for-profit community The EQ-i 2.0an assessment
patient outcomes.8,9 hospital in southeastern Pennsyl- tool based on the Bar-On Model
We demonstrate how clinical vania. Following Institutional of Emotional-Social Intelligence
nurse job satisfaction and nurse Review Board approval, a conve- (ESI)measured participant EI.18
manager ability, leadership, and nience sample of nurse leaders The EQ-i 2.0 is an electronic

Nurse leaders with high EI tend to develop positive


relationships with clinical nurses and are
better able to manage emotions in the workplace.
support of nurses are connected, (inpatient nurse directors and self-report instrument containing
as well as how a nurse manag- nurse managers) were invited via 133 items scored on a five-point
ers self-perceptionone of e-mail to participate in a confi- Likert scale: 1 = never/rarely,
five EI subscalesmay predict dential, anonymous EI question- 2 = occasionally, 3 = sometimes,
nursing job satisfaction. (See naire. In addition, existing data 4 = often, and 5 = always/almost
How do we define nursing from the National Database of always. The instrument includes
job satisfaction?) Nursing Quality Indicators five composite scales that reflect
various characteristics of EI and
How do we define nursing job satisfaction? are further divided into three
Job satisfaction for nurses encompasses a feeling of value, meaning, subscales each. (See Figure 1.)
and happiness in the workplace.10 When nurses experience high lev- The tool is internally consistent
els of job satisfaction, they have increased morale and organizational as measured by Cronbachs alpha
commitment, and are more inclined to stay at the organization and in at .97 for the total EI scale, from
the profession.11 Nursing job satisfaction is also important to patients, .88 to .93 for the composite
families, and healthcare practitioners because its been linked to positive
patient outcomes and quality care.12 Although theres no one definition scales, and at .77 or higher for
of nursing job satisfaction, for nurses working in acute care hospital the subscales.19
settings, contributing factors include the intrapersonal, such as age, the The instruments raw scores
interpersonal, such as autonomy, and the extrapersonal, such as pay.13 are converted into standard
Nurse managers can be instrumental in influencing nurse job satisfac- scores based on a mean of 100 and
tion by providing positive leadership, role-modeling, and understanding the
unit-based issues and challenges important to nurses.13 The more that a standard deviation (SD) of 15.
nurse managers appear transparent and self-aware, the more clinical nurses This facilitates comparison of the
show satisfaction with their work.14 And clinical nurses who perceive their respondents scores to the scores
nurse managers as transformational display overall higher job satisfaction.15 of the normative sample and,
However, nurse managers often take on a great deal of emotional theoretically, to the rest of the
burden due to staff demands.16 Managers handle personal, professional,
and emotional issues from staff members, as well as field queries and population. EQ-i 2.0 scores above
complaints from both internal and external constituents. Additionally, 110 are considered in the high
nurse managers are expected to utilize their expertise to ensure intrapro- range and indicate emotionally
fessional collaboration with other disciplines, healthcare policy makers, intelligent people. The midrange
and the community to improve care quality and transitions, and inspire scores fall between 90 and 110,
new leadership.17
whereas lower scores indicate a

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Figure 1: EQ-i 2.0
Total EI

Decision Stress
Self-perception Self-expression Interpersonal
making management

Emotional Interpersonal Problem


Self-regard Flexibility
expression relationships solving

Self- Stress
Assertiveness Empathy Reality testing
actualization tolerance

Emotional
Social
self- Independence Impulse control Optimism
responsibility
awareness

need to improve emotional skills qualities and the ways in which lated for demographic variables,
in specific areas (less than 90).19 the manager supports the nurse. total and composite EI scores; job
For the purposes of this study, Results are reported as mean enjoyment scores; and nurse
the researcher accessed only two scores. The higher the score, the manager ability, leadership, and
subscales within the NDNQI sur- more positive the rating.20 support of nurses scores. Twenty
vey: the job enjoyment scale and The EQ-i 2.0 instrument was nurse leaders participated in the
the nurse manager ability, leader- completed in approximately 20 to EQ-i 2.0 instrument. They were
ship, and support of nurses 30 minutes of uninterrupted time. homogenously female, between
scale.20 The job enjoyment scale Participation implied consent. ages 35 and 69, and worked full
consists of seven questions on a Demographic queries couldnt time. Educational levels ranged
six-point Likert scale, from be added to the EQ-i 2.0 tool from a diploma or associate
strongly agree to strongly dis- because the scores are computer degree through doctoral degrees.
agree. Results are reported as generated. Before EQ-i 2.0 data (See Table 1.) Existing data from
modified T-Scores, with 50 as the collection, the NDNQI survey the NDNQI survey included the
midpoint. Less than 40 indicates was completed by full or part- results of 79% (476/621) of eligi-
low satisfaction; 40 to 60, moder- time RNs who spend 50% of their ble direct care RNs.
ate satisfaction; and greater than time in direct patient care and The nurse leader total EI scores
60, high satisfaction.20 The nurse were employed at the hospital for ranged from 81 to 129, spanning
manager ability, leadership, and a minimum of 3 months. all three ranges, but the mean
support of nurses scale consists of total EI score was 104.76 (SD
five questions on a four-point Lik- Results 10.549) in the midrange (90 to
ert scale, from strongly agree to Data were analyzed through var- 110). The clinical nurse job enjoy-
strongly disagree. This scale mea- ious parametric tests using SPSS. ment scores ranged from 49.77
sures important nurse manager Descriptive statistics were calcu- to 75.20 (moderate satisfaction,

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Nurse leader emotional intelligence

40 to 60; high satisfaction, greater nurses; clinical nurse job enjoy- played average-to-high EI. Clinical
than 60), with a mean score of ment; and nurse leader total EI nurse job enjoyment scores
61.60 (SD 7.6962). was obtained. In this instance, showed variability between
The nurse manager ability, there was a strong correlation moderate and high satisfaction,
leadership, and support of nurses between job enjoyment and indicating that clinical nurses on
scores ranged from 2.46 to 3.62, nurse manager ability, leader- some units were less satisfied
with a mean score of 2.96 (SD ship, and support of nurses than staff on other units. Consis-
0.3144). A favorable rating is a (r = .82, P < .01). tent with this, there was no sta-
mean score that exceeds 2.5. A In addition to the total EI tistically significant relationship
one-way analysis of variance was score, the EQ-i 2.0 results are bro- between clinical nurses job
calculated on clinical nurse job ken down into five composite enjoyment and the EI of their
enjoyment related to nurse leader scores, which, in turn, are broken nurse leaders.
total EI. The analysis wasnt sig- down into a total of 15 subscale Most staff members reported a
nificant: F (3,30) = 31, P = .822 scores. All mean composite favorable rating of their nurse
(P > .05). Alternately, the Pear- scores fell into the midrange managers ability, leadership,
son correlation coefficient and (90 to 110) and included self- and support of nurses. Further,
P value of nurse manager ability, perception (101.41, SD 11.335), the more that nurses enjoyed
leadership, and support of self-expression (102.97, SD 12.511), their job, the more they believed
interpersonal (106.6, SD 9.7450), that their nurse managers pos-
Table 1: Sample characteristics decision making (104.41, SD sessed strong ability, leadership,
11.980), and stress management and support. Finally, nurse lead-
Variable n %
(105.15, SD 10.944). ers who were good at knowing
Age group The scores for the 15 subscales themselves well (self-perception)
20-29 0 0 were also in the midrange, with a were more likely to have staff
mean score of 103.56 (range 97.88 members who enjoyed their jobs
30-39 1 5
to 109.82). (See Table 2.) The sub- and believed that their nurse
40-49 4 20 scales of self-actualization (97.88, managers ability, leadership,
50-59 10 50 SD 11.7) and problem solving and support of nurses were
(98.41, SD 12.033) had the lowest strong.
60 5 25
scores, whereas the subscales of EI is considered to be an
Education empathy (109.82, SD 9.233), opti- important facet of effective lead-
Diploma/associate 2 10 mism (107.5, SD 12.755), and ership. Nurse leaders are faced
degree in nursing emotional self-awareness (107.15, with the daunting challenge of
SD 11.024) had the highest scores. not only managing unit clinical
Bachelors degree 11 55
A multiple linear regression and administrative activities,
Masters degree 6 30 was calculated to predict job but also playing a significant
Doctoral degree 1 5 enjoyment and nurse manager role in translating and achieving
ability, leadership, and support of organizational goals within their
Position
nurses based on all five composite defined areas of responsibility.7
Nurse manager 13 65 scales. Only the self-perception Nurse leaders with high EI tend
Nurse director 7 35 composite scale significantly pre- to develop positive relationships
dicted job enjoyment (beta = -.75, with clinical nurses and are
Gender
t = -2.373, P < .05) and nurse better able to manage emotions
Female 20 100 manager ability, leadership, and in the workplace.21 Clinical
Male 0 0 support of nurses (beta = -.72, nurses who feel that their nurse
t = -2.360, P < .05). leader demonstrates high EI
Employment status report significantly greater job
Full-time 20 100 Discussion satisfaction.22
Part-time 0 0 The overwhelming majority of Results of this study add to
nurse leaders in this study dis- the limited, but growing, body

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of literature exploring nurse
leader EI. Although the majority
Table 2: Nurse leader EQ-i 2.0 subscale scores (n = 20)
of nurse leader total EI scores Subscale Mean Range SD
were in the midrange, findings Self-regard 100.53 63-123 15.375
demonstrated a strong correla-
Self-actualization 97.88 71-125 11.729
tion between clinical nurse job
enjoyment and nurse manager Emotional self-awareness 107.15 84-126 11.024
ability, leadership, and support
Emotional expression 102.32 68-121 9.975
of nurses. Midrange results,
which some would consider Assertiveness 103.15 67-127 11.032
average, arent always viewed in Independence 102.32 70-120 13.334
a positive light; however, aver-
Interpersonal relationships 103.35 81-125 13.282
age to above average EI scores
suggest that the respondent is Empathy 109.82 97-124 9.233
effective in emotional and social Social responsibility 101.53 80-124 10.607
functioning.23 This studys find-
ings are consistent with one Problem solving 98.41 70-123 12.033
sample of 206 ED nurses that Reality testing 107.91 86-130 11.36
found leadership played a criti-
Impulse control 104.85 62-125 13.725
cal role in creating work envi-
ronments that promote nurse Flexibility 102.53 94-122 7.325
retention.24 Stress tolerance 104.24 76-124 13.296
The EI subscales of empathy
and emotional self-awareness Optimism 107.5 77-124 12.755
are considered by many
researchers to be two of the A few factors may limit the iting passion to motivate their
most important components of results of this study. It was con- staff members to achieve goals
emotional-social intelligence.23 ducted at a single acute care insti- and aspirations that may not
Nurse leaders in this study tution and the sample size was have otherwise surfaced.
showed the highest mean sub- small, limiting the generalizability Acknowledging emotions can
scale score in empathy (109.82) of findings. Response bias may often be thought of as a soft
and an emotional self-awareness be of concern because the instru- side of leadership; however, its
mean score in the top third of all ments were self-administered one skill that nurse leaders must
15 subscale scores (107.15). and nurse leaders were direct possess to ensure that employee
Empathy and emotional self- reports of the author. Nurse guidance is based on a recogni-
awareness findings from this leaders werent homogenous, tion of both the emotional and
study are consistent with the including both nurse managers critical-thinking processes that
results of a research study in and directors. Because of the are part of every decision.
which 75 stories written by importance of participant confi- The literature supports the
nurses about nursing were ana- dentiality, comparisons between importance of nurse leader EI
lyzed to determine evidence of the groups couldnt be estab- skills to create a supportive envi-
EI attributes.24 The author con- lished. Finally, the NDNQI ronment and facilitate staff
cluded that empathy was the survey and the EQ-i 2.0 were empowerment, leading to staff
highest EI attribute occurring administered at different time job satisfaction. The ESI model is
most frequently in the stories, periods. both teachable and learnable.23
with emotional self-awareness in Theres emerging agreement
third place. Critical to nursing Practice implications that EI competencies can be
care, empathy is regarded as a Emotionally intelligent nurse improved, which may spark
vital component of any form of leaders inspire individuals by subsequent interest in EI devel-
caring relationship.25 challenging emotions and exhib- opment through leadership

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Nurse leader emotional intelligence

17. Ellis P, Abbott J. The emotionally resil-


Bonus content ient renal manager: understanding the
language of emotion. J Renal Nurs.
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Making the case for emotionally intelligent leaders? Springer Publishing; 2011.
http://journals.lww.com/nursingmanagement/Fulltext/2014/01000/ 19. Multi-Health Systems, Inc. The EQ-i 2.0
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complex healthcare arena, it Manag. 2007;15(4):386-391. Multi-Health Systems, Inc; 2011.
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