44 January 2014 • Nursing Management
www.nursingmanagement.com
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Making the case for
emotionally intelligent leaders T By Estelle Codier, PhD, MSN, RN
here’s ample research evidence that nurse leaderhe ship, sh organizational change, and burnout impact operational outcomes and fiscal performance. o op Regardless of the specific healthcare reforms R Re implemented in the months and years ahead, im there’s little doubt that at its center will be nurse t th leaders implementing unprecedented systems lee innovation and organizational change. It’s essential that nurse leaders actively develop the skills needed not only to navigate this decade effectively, but also to thrive and grow. Retention of nurse leaders with such skills is critical to prevent high levels of middle management turnover and the resultant drain of wisdom, experience, and stability that are a preventable and costly burden to the healthcare industry.
Understanding the concept Several models of emotional intelligence (EI) exist. One model defines EI as a set of skills, another as a personality trait, and a third a combination of both. The Ability Model, frequently used in nurse research, operationalizes EI as a set of the following skills: the ability to identify emotions correctly in self and in others, the ability to use emotions in the reasoning process, the ability to understand emotions, and the ability to manage emotions in one’s self and in emotional situations.1 These abilities may be used as a guide for both assessing EI skills and for developing plans for performance www.nursingmanagement.com
Nursing Management • January 2014 45
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Making the case for emotionally intelligent leaders
improvement for employees who need psychosocial skill improvement. The earliest research studies on measured EI focused on leadership and organizational behavior. In large, global organizations, early EI research demonstrated evidence of a relationship between high levels of performance and high EI scores. Subsequent empirical EI workforce studies have been carried out across many professions, cultures, and work settings. A wide range of EI research examines the relationship between EI ability and leader efficacy; employee
both psychological and physiological measures of wellness, reduced burnout, and positive adaptation skills.1-6 Data from a meta-analysis published in 2009, which reviewed 141 research studies investigating EI and leadership effectiveness, demonstrated a moderately strong relationship between measured EI and indicators of leadership effectiveness.4 In a meta-analysis the following year, data from 62 independent samples identified a validity estimate of 0.59 for the relationship between leadership
Nurses with high EI abilities demonstrate positive conflict styles, work better in teams, and have higher job satisfaction.
performance and retention; and organizational commitment, positive conflict styles, and prosocial organizational behavior. Comparing the literature on empirical EI research is complicated by the wide range of models, definitions, and instruments used for measuring EI. However, hundreds of studies in psychology, education, and organizational development literature provided evidence for a relationship between EI scores and positive organizational outcomes. Such outcomes include high levels of performance, employee retention, teamwork, effective communication, collaboration, and organizational commitment, as well as
effectiveness and emotional intelligence measures.7 Research in the U.S. military and in the public sector has provided similar findings.8-11 The relationship between EI and transformational leadership has been explored and some correlations between them identified.7
Needed in nursing Research findings in nursing make a clear case for the importance of EI ability in nurse leaders. Some of the earliest nursing research on EI were studies exploring EI in nurse leadership.12,13 A meta-analysis of 18 nursing research studies concluded that, “emotionally intelligent
46 January 2014 • Nursing Management
nurse leadership is characterized by self-awareness and supervisory skills that highlight positive empowerment processes, creating a favorable work climate characterized by resilience, innovation, and change.”14 By 2010, small surveys of research studies on EI and leadership outcomes revealed conflicting findings and a consensus was reached: further study was required.15,16 Positive organizational outcomes such as employee satisfaction and effective organizational change were associated with nurse leaders’ emotional intelligence.17 Another study, which explored the impact of peer coaching on measured EI scores, provided evidence for a positive impact of peer coaching on EI ability. The study also identified a significant inverse correlation between measured EI and variables that reflected burnout risk.18 Research findings provide evidence that measured nurse EI correlates positively with important organizational outcomes such as positive conflict styles, patient perceptions of nurses’ caring, degree of collaboration, team effectiveness and cohesion, clinical nurse retention, performance, and measures of both physiological and general wellness. Nurses with high EI abilities demonstrate positive conflict styles, work better in teams, and have higher job satisfaction. The business case for emotionally intelligent nurses is made when these findings translate into lower employee turnover, thus resulting in reduced costs of recruitment and new employee orientation. Additionally, the invisible costs of lateral violence in the workplace and its impact on both turnover and performance effectiveness may also contribute to cost www.nursingmanagement.com
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
savings.5,19-26 Finally, both the direct and indirect costs associated with customer dissatisfaction and poor team communication can’t be underestimated. Both direct fiscal outcomes (length of stay, complication rates, and litigation) and safety outcomes (error and near misses) can result from poor communication, as studies such as the Institute of Medicine’s To Err is Human: Building a Safer Health System, which focuses on patient safety, have repeatedly reiterated.
Optimizing performance The importance of the art and craft of relationship management to leadership effectiveness isn’t new. The relationship between leadership effectiveness and interpersonal proficiency is well documented. What EI theory lends to this discussion is a way to measure and identify specific ability sets. Nurse leaders can both be held accountable for EI skills and assist in developing them. The four EI abilities could be of use to nurse managers across the wide range of management responsibilities. Leveraging these abilities makes professional sense for improving organizational performance and patient outcomes; it also makes business sense from a potential savings standpoint, resulting from turnover reduction, improvement in patient outcomes, and reduction in possible litigation. There’s also evidence that measured EI ability correlates with performance in clinical nurses. Although no research has been done on the EI of nurse teams, research in other professions has identified a correlation between measured EI and team performance.20 For this reason, using EI criteria in the hiring process may be important for nurse www.nursingmanagement.com
leaders to consider. No evidence currently exists that EI testing at the time of hiring improves new hire outcomes; however, gearing interview questions toward hypothetical situations that showcase EI ability may be a useful method for identifying EI ability in prospective employees.
Psychosocial care Improvement in performance expectations for nurses’ psychosocial care is necessary across all aspects of nurses’ professional relationships— with patients, nursing staff members, and team relationships with physicians and other disciplines in the hospital setting, which are notoriously problem prone. Because relationship problems create communication
the need for clearer expectations for psychosocial care of patients. Nurses’ relationships with each other are also important because of their impact on patient outcomes and safety. Accountability for psychosocial performance within the nursing team may prevent lateral violence, cited by 60% of new graduates as the reason for departure from their first job. Because of the high cost of recruitment, hiring, and orientation, these relationship failures not only result in a high professional cost, but also excessive expense to a facility’s bottom line.
Enter patient safety Medical errors not only represent care failure, but also financial risk. In 2008, medical errors cost the U.S.
A generation of emotionally intelligent nurse leaders who are stable, thriving, and resilient can greatly enhance and transform the healthcare industry.
problems, there’s new interest in accountability for improvement in this area. Healthcare outcomes and reimbursement criteria now include patient satisfaction with nursing care, which includes psychosocial care. Recent research highlights the differences, clearly articulated by patients, between instrumental caring (performance of activities and procedures) and experiential caring (the patient’s experience of being cared about). This further highlights
healthcare industry over 19 million dollars.27 Root cause analysis of sentinel events, medical errors, and patient injury events often identify dysfunctional or inadequate communication as a causative or contributing factor. For this reason, the IOM study outlining goals for improving patient safety included improvement in healthcare provider communication. It’s therefore possible that improving EI skills, by creating more effective communication, may create
Nursing Management • January 2014 47
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Making the case for emotionally intelligent leaders
a safer patient care environment.28 Using the skills of EI to identify gaps in psychosocial skill sets may be a first step for addressing communication errors that endanger patients and increase financial risk. Once specific psychosocial parameters for performance are specifically identified, there can be greater clarity for both what’s expected and what’s achieved in emotional interactions between patients, caregivers, and caregiver teams. Objective criteria give leaders at all levels of an organization the means to identify both excellent and underachieving staff behaviors, and are a powerful tool for performance improvement planning. The business case for the importance of EI ability in nurse leaders isn’t difficult to make. Decades of organizational research demonstrates that those with heightened EI abilities exhibit higher levels of performance, better organizational outcomes, and both employee health and professional resilience. So, what’s the bottom line? A generation of emotionally intelligent nurse leaders who are stable, thriving, and resilient can greatly enhance and transform the healthcare industry. NM REFERENCES 1. Mayer JD, Salovey P, Caruso DR. Emotional intelligence: new ability or eclectic traits? Am Psychol. 2008;63(6):503-517. 2. Abraham R. Emotional intelligence in the workplace: a review and synthesis. In: Schulze R, Roberts RD, eds. Emotional Intelligence: An International Handbook. Cambridge, MA: Hogrefe & Huber Publishers; 2005:255-270. 3. Martin CM. A meta-analytic investigation of the relationship between emotional intelligence and leadership effectiveness. http:// gradworks.umi.com/33/03/3303343.html. 4. Mills LB. A meta-analysis of the relationship between emotional intelligence and effective leadership. JoCI. 2009;3(2):22-38.
5. Rego A, Godinho L, McQueen A, Cunha MP. Emotional intelligence and caring behaviour in nursing. Serv Ind J. 2010;30(9): 1419-1437. 6. Schutte N, Malouf J, Tornsteinsson E, Bhullar N, Rooke S. A meta-analytic investigation of the relationship between emotional intelligence and health. Pers Indiv Differ. 2007;42(6):921-933. 7. Harms PD, Credé M. Emotional intelligence and transformational and transactional leadership: a meta-analysis. JLOS. 2010; 17(1):5-17. 8. Kotzé M, Venter I. Differences in emotional intelligence between effective and ineffective leaders in the public sector: an empirical study. Int Rev Adm Sci. 2011;77(2): 397-427. 9. Thomas DE. Examining the relationship between emotional intelligence and leadership effectiveness of navy human resource officers. http://library.ncu.edu/ncu_diss/display_abstract.aspx?dissertation_id=1356. 10. Joseph DL, Newman DA. Emotional intelligence: an integrative meta-analysis and cascading model. J Appl Psychol. 2010; 95(1):54-78. 11. Zhang HH, Wang H. A meta-analysis of the relationship between individual emotional intelligence and workplace performance. Acta Psychol Sin. 2011;43(2):188-202. 12. Molter N. Emotion and Emotional Intelligence in Nursing Leadership. Santa Barbara, CA: Fielding Graduate Institute; 2001. 13. Vitello-Cicciu JM. Exploring emotional intelligence. Implications for nursing leaders. J Nurs Adm. 2002;32(4):203-210. 14. Akerjordet K, Severinsson E. Emotionally intelligent nurse leadership: a literature review study. J Nurs Manag. 2008;16(5): 565-577. 15. Akerjordet K, Severinsson E. The state of the science of emotional intelligence related to nursing leadership: an integrative review. J Nurs Manag. 2010;18(4): 363–382. 16. Feather R. Emotional intelligence in relation to nursing leadership: does it matter? J Nurs Manag. 2009;17(3): 376-382. 17. Cummings G, Hayduk L, Estabrooks C. Mitigating the impact of hospital restructuring on nurses: the responsibility of emotionally intelligent leadership. Nurs Res. 2005; 54(1):2-12. 18. Codier E, Kamikawa C, Kooker BM. The impact of emotional intelligence development on nurse managers. Nurs Adm Q. 2011;35(3):270-276.
48 January 2014 • Nursing Management
19. Bulmer Smith K, Profetto-McGrath J, Cummings GG. Emotional intelligence and nursing: an integrative literature review. Int J Nurs Stud. 2009;46(12): 1624-1636. 20. Chang JW, Sy T, Choi JN. Team emotional intelligence and performance: interactive dynamics between leaders and members. Small Gr Res. 2012;43(1):75-104. 21. Codier E, Kamikawa C, Kooker BM, Shoulz J. Emotional intelligence, performance, and retention in clinical staff nurses. Nurs Adm Q. 2009;33(4):310-316. 22. Codier E, Kooker BM, Shoultz J. Measuring the emotional intelligence of clinical staff nurses: an approach for improving the clinical care environment. Nurs Adm Q. 2008;32(1):8-14. 23. Güleryüz G, Güney S, Aydin EM, As¸an O. The mediating effect of job satisfaction between emotional intelligence and organisational commitment of nurses: a questionnaire survey. Int J Nurs Stud. 2008;45(11):1625-1635. 24. Jones TL, Argentino D. Nurse-to-nurse hostility, confrontational anxiety, and emotional intelligence: an integral, descriptive pilot study. J Perianesth Nurs. 2010;25(4):233-241. 25. Morrison J. The relationship between emotional intelligence competencies and preferred conflict-handling styles. J Nurs Manag. 2008;16(8):974-983. 26. Quoidbach J, Hansenne M. The impact of trait emotional intelligence on nursing team performance and cohesiveness. J Prof Nurs. 2009;25(1):23-29. 27. Van Den Bos J, Rustagi K, Gray T, Halford M, Ziemkiewicz E, Shreve J. The $17.1 billion problem: the annual cost of measurable medical errors. Health Aff (Millwood). 2011;30(4):596-603. 28. Kohn LT, Corrigan JM, Donaldson MS. To Err is Human: Building a Safer Health System. Washington, DC: National Academies Press; 2000.
Estelle Codier is an associate professor at the School of Nursing and Dental Hygiene at the University of Hawaii, Manoa.
The author has disclosed that she has no financial relationships related to this article.
DOI-10.1097/01.NUMA.0000440634.64013.11
www.nursingmanagement.com
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
www.nursingmanagement.com
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Making the case for
emotionally intelligent leaders T By Estelle Codier, PhD, MSN, RN
here’s ample research evidence that nurse leaderhe ship, sh organizational change, and burnout impact operational outcomes and fiscal performance. o op Regardless of the specific healthcare reforms R Re implemented in the months and years ahead, im there’s little doubt that at its center will be nurse t th leaders implementing unprecedented systems lee innovation and organizational change. It’s essential that nurse leaders actively develop the skills needed not only to navigate this decade effectively, but also to thrive and grow. Retention of nurse leaders with such skills is critical to prevent high levels of middle management turnover and the resultant drain of wisdom, experience, and stability that are a preventable and costly burden to the healthcare industry.
Understanding the concept Several models of emotional intelligence (EI) exist. One model defines EI as a set of skills, another as a personality trait, and a third a combination of both. The Ability Model, frequently used in nurse research, operationalizes EI as a set of the following skills: the ability to identify emotions correctly in self and in others, the ability to use emotions in the reasoning process, the ability to understand emotions, and the ability to manage emotions in one’s self and in emotional situations.1 These abilities may be used as a guide for both assessing EI skills and for developing plans for performance www.nursingmanagement.com
Nursing Management • January 2014 45
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Making the case for emotionally intelligent leaders
improvement for employees who need psychosocial skill improvement. The earliest research studies on measured EI focused on leadership and organizational behavior. In large, global organizations, early EI research demonstrated evidence of a relationship between high levels of performance and high EI scores. Subsequent empirical EI workforce studies have been carried out across many professions, cultures, and work settings. A wide range of EI research examines the relationship between EI ability and leader efficacy; employee
both psychological and physiological measures of wellness, reduced burnout, and positive adaptation skills.1-6 Data from a meta-analysis published in 2009, which reviewed 141 research studies investigating EI and leadership effectiveness, demonstrated a moderately strong relationship between measured EI and indicators of leadership effectiveness.4 In a meta-analysis the following year, data from 62 independent samples identified a validity estimate of 0.59 for the relationship between leadership
Nurses with high EI abilities demonstrate positive conflict styles, work better in teams, and have higher job satisfaction.
performance and retention; and organizational commitment, positive conflict styles, and prosocial organizational behavior. Comparing the literature on empirical EI research is complicated by the wide range of models, definitions, and instruments used for measuring EI. However, hundreds of studies in psychology, education, and organizational development literature provided evidence for a relationship between EI scores and positive organizational outcomes. Such outcomes include high levels of performance, employee retention, teamwork, effective communication, collaboration, and organizational commitment, as well as
effectiveness and emotional intelligence measures.7 Research in the U.S. military and in the public sector has provided similar findings.8-11 The relationship between EI and transformational leadership has been explored and some correlations between them identified.7
Needed in nursing Research findings in nursing make a clear case for the importance of EI ability in nurse leaders. Some of the earliest nursing research on EI were studies exploring EI in nurse leadership.12,13 A meta-analysis of 18 nursing research studies concluded that, “emotionally intelligent
46 January 2014 • Nursing Management
nurse leadership is characterized by self-awareness and supervisory skills that highlight positive empowerment processes, creating a favorable work climate characterized by resilience, innovation, and change.”14 By 2010, small surveys of research studies on EI and leadership outcomes revealed conflicting findings and a consensus was reached: further study was required.15,16 Positive organizational outcomes such as employee satisfaction and effective organizational change were associated with nurse leaders’ emotional intelligence.17 Another study, which explored the impact of peer coaching on measured EI scores, provided evidence for a positive impact of peer coaching on EI ability. The study also identified a significant inverse correlation between measured EI and variables that reflected burnout risk.18 Research findings provide evidence that measured nurse EI correlates positively with important organizational outcomes such as positive conflict styles, patient perceptions of nurses’ caring, degree of collaboration, team effectiveness and cohesion, clinical nurse retention, performance, and measures of both physiological and general wellness. Nurses with high EI abilities demonstrate positive conflict styles, work better in teams, and have higher job satisfaction. The business case for emotionally intelligent nurses is made when these findings translate into lower employee turnover, thus resulting in reduced costs of recruitment and new employee orientation. Additionally, the invisible costs of lateral violence in the workplace and its impact on both turnover and performance effectiveness may also contribute to cost www.nursingmanagement.com
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
savings.5,19-26 Finally, both the direct and indirect costs associated with customer dissatisfaction and poor team communication can’t be underestimated. Both direct fiscal outcomes (length of stay, complication rates, and litigation) and safety outcomes (error and near misses) can result from poor communication, as studies such as the Institute of Medicine’s To Err is Human: Building a Safer Health System, which focuses on patient safety, have repeatedly reiterated.
Optimizing performance The importance of the art and craft of relationship management to leadership effectiveness isn’t new. The relationship between leadership effectiveness and interpersonal proficiency is well documented. What EI theory lends to this discussion is a way to measure and identify specific ability sets. Nurse leaders can both be held accountable for EI skills and assist in developing them. The four EI abilities could be of use to nurse managers across the wide range of management responsibilities. Leveraging these abilities makes professional sense for improving organizational performance and patient outcomes; it also makes business sense from a potential savings standpoint, resulting from turnover reduction, improvement in patient outcomes, and reduction in possible litigation. There’s also evidence that measured EI ability correlates with performance in clinical nurses. Although no research has been done on the EI of nurse teams, research in other professions has identified a correlation between measured EI and team performance.20 For this reason, using EI criteria in the hiring process may be important for nurse www.nursingmanagement.com
leaders to consider. No evidence currently exists that EI testing at the time of hiring improves new hire outcomes; however, gearing interview questions toward hypothetical situations that showcase EI ability may be a useful method for identifying EI ability in prospective employees.
Psychosocial care Improvement in performance expectations for nurses’ psychosocial care is necessary across all aspects of nurses’ professional relationships— with patients, nursing staff members, and team relationships with physicians and other disciplines in the hospital setting, which are notoriously problem prone. Because relationship problems create communication
the need for clearer expectations for psychosocial care of patients. Nurses’ relationships with each other are also important because of their impact on patient outcomes and safety. Accountability for psychosocial performance within the nursing team may prevent lateral violence, cited by 60% of new graduates as the reason for departure from their first job. Because of the high cost of recruitment, hiring, and orientation, these relationship failures not only result in a high professional cost, but also excessive expense to a facility’s bottom line.
Enter patient safety Medical errors not only represent care failure, but also financial risk. In 2008, medical errors cost the U.S.
A generation of emotionally intelligent nurse leaders who are stable, thriving, and resilient can greatly enhance and transform the healthcare industry.
problems, there’s new interest in accountability for improvement in this area. Healthcare outcomes and reimbursement criteria now include patient satisfaction with nursing care, which includes psychosocial care. Recent research highlights the differences, clearly articulated by patients, between instrumental caring (performance of activities and procedures) and experiential caring (the patient’s experience of being cared about). This further highlights
healthcare industry over 19 million dollars.27 Root cause analysis of sentinel events, medical errors, and patient injury events often identify dysfunctional or inadequate communication as a causative or contributing factor. For this reason, the IOM study outlining goals for improving patient safety included improvement in healthcare provider communication. It’s therefore possible that improving EI skills, by creating more effective communication, may create
Nursing Management • January 2014 47
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Making the case for emotionally intelligent leaders
a safer patient care environment.28 Using the skills of EI to identify gaps in psychosocial skill sets may be a first step for addressing communication errors that endanger patients and increase financial risk. Once specific psychosocial parameters for performance are specifically identified, there can be greater clarity for both what’s expected and what’s achieved in emotional interactions between patients, caregivers, and caregiver teams. Objective criteria give leaders at all levels of an organization the means to identify both excellent and underachieving staff behaviors, and are a powerful tool for performance improvement planning. The business case for the importance of EI ability in nurse leaders isn’t difficult to make. Decades of organizational research demonstrates that those with heightened EI abilities exhibit higher levels of performance, better organizational outcomes, and both employee health and professional resilience. So, what’s the bottom line? A generation of emotionally intelligent nurse leaders who are stable, thriving, and resilient can greatly enhance and transform the healthcare industry. NM REFERENCES 1. Mayer JD, Salovey P, Caruso DR. Emotional intelligence: new ability or eclectic traits? Am Psychol. 2008;63(6):503-517. 2. Abraham R. Emotional intelligence in the workplace: a review and synthesis. In: Schulze R, Roberts RD, eds. Emotional Intelligence: An International Handbook. Cambridge, MA: Hogrefe & Huber Publishers; 2005:255-270. 3. Martin CM. A meta-analytic investigation of the relationship between emotional intelligence and leadership effectiveness. http:// gradworks.umi.com/33/03/3303343.html. 4. Mills LB. A meta-analysis of the relationship between emotional intelligence and effective leadership. JoCI. 2009;3(2):22-38.
5. Rego A, Godinho L, McQueen A, Cunha MP. Emotional intelligence and caring behaviour in nursing. Serv Ind J. 2010;30(9): 1419-1437. 6. Schutte N, Malouf J, Tornsteinsson E, Bhullar N, Rooke S. A meta-analytic investigation of the relationship between emotional intelligence and health. Pers Indiv Differ. 2007;42(6):921-933. 7. Harms PD, Credé M. Emotional intelligence and transformational and transactional leadership: a meta-analysis. JLOS. 2010; 17(1):5-17. 8. Kotzé M, Venter I. Differences in emotional intelligence between effective and ineffective leaders in the public sector: an empirical study. Int Rev Adm Sci. 2011;77(2): 397-427. 9. Thomas DE. Examining the relationship between emotional intelligence and leadership effectiveness of navy human resource officers. http://library.ncu.edu/ncu_diss/display_abstract.aspx?dissertation_id=1356. 10. Joseph DL, Newman DA. Emotional intelligence: an integrative meta-analysis and cascading model. J Appl Psychol. 2010; 95(1):54-78. 11. Zhang HH, Wang H. A meta-analysis of the relationship between individual emotional intelligence and workplace performance. Acta Psychol Sin. 2011;43(2):188-202. 12. Molter N. Emotion and Emotional Intelligence in Nursing Leadership. Santa Barbara, CA: Fielding Graduate Institute; 2001. 13. Vitello-Cicciu JM. Exploring emotional intelligence. Implications for nursing leaders. J Nurs Adm. 2002;32(4):203-210. 14. Akerjordet K, Severinsson E. Emotionally intelligent nurse leadership: a literature review study. J Nurs Manag. 2008;16(5): 565-577. 15. Akerjordet K, Severinsson E. The state of the science of emotional intelligence related to nursing leadership: an integrative review. J Nurs Manag. 2010;18(4): 363–382. 16. Feather R. Emotional intelligence in relation to nursing leadership: does it matter? J Nurs Manag. 2009;17(3): 376-382. 17. Cummings G, Hayduk L, Estabrooks C. Mitigating the impact of hospital restructuring on nurses: the responsibility of emotionally intelligent leadership. Nurs Res. 2005; 54(1):2-12. 18. Codier E, Kamikawa C, Kooker BM. The impact of emotional intelligence development on nurse managers. Nurs Adm Q. 2011;35(3):270-276.
48 January 2014 • Nursing Management
19. Bulmer Smith K, Profetto-McGrath J, Cummings GG. Emotional intelligence and nursing: an integrative literature review. Int J Nurs Stud. 2009;46(12): 1624-1636. 20. Chang JW, Sy T, Choi JN. Team emotional intelligence and performance: interactive dynamics between leaders and members. Small Gr Res. 2012;43(1):75-104. 21. Codier E, Kamikawa C, Kooker BM, Shoulz J. Emotional intelligence, performance, and retention in clinical staff nurses. Nurs Adm Q. 2009;33(4):310-316. 22. Codier E, Kooker BM, Shoultz J. Measuring the emotional intelligence of clinical staff nurses: an approach for improving the clinical care environment. Nurs Adm Q. 2008;32(1):8-14. 23. Güleryüz G, Güney S, Aydin EM, As¸an O. The mediating effect of job satisfaction between emotional intelligence and organisational commitment of nurses: a questionnaire survey. Int J Nurs Stud. 2008;45(11):1625-1635. 24. Jones TL, Argentino D. Nurse-to-nurse hostility, confrontational anxiety, and emotional intelligence: an integral, descriptive pilot study. J Perianesth Nurs. 2010;25(4):233-241. 25. Morrison J. The relationship between emotional intelligence competencies and preferred conflict-handling styles. J Nurs Manag. 2008;16(8):974-983. 26. Quoidbach J, Hansenne M. The impact of trait emotional intelligence on nursing team performance and cohesiveness. J Prof Nurs. 2009;25(1):23-29. 27. Van Den Bos J, Rustagi K, Gray T, Halford M, Ziemkiewicz E, Shreve J. The $17.1 billion problem: the annual cost of measurable medical errors. Health Aff (Millwood). 2011;30(4):596-603. 28. Kohn LT, Corrigan JM, Donaldson MS. To Err is Human: Building a Safer Health System. Washington, DC: National Academies Press; 2000.
Estelle Codier is an associate professor at the School of Nursing and Dental Hygiene at the University of Hawaii, Manoa.
The author has disclosed that she has no financial relationships related to this article.
DOI-10.1097/01.NUMA.0000440634.64013.11
www.nursingmanagement.com
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
