Learning Activity week 4

123

11 Emotional Intelligence, Nurse Leadership, and Organizational Change

INTRODUCTION

Emotional intelligence (EI) is defined as the “ability to recognize the meanings of emotions . . . . and to reason and problem-solve on the basis of them” (Mayer et al., 1999, p. 267). In this chapter EI is operationalized with the following skills:

1. Accurate identification of emotions in self and others *2. Understanding emotions *3. Using emotions to reason (integrating thinking and feeling), and 4. Managing emotions. (Mayer et al., 1999).

For the purposes of this text, skills 2 and 3 are reversed from the pub- lished Mayer et al. order. This is done to better align the four abilities with the nursing process illustrated throughout this text.

This chapter examines nurse leader (EI) abilities specifically as they apply to organizational change. This chapter illustrates use of EI abilities as they enhance the following leader skills: managing clinical outcomes, change resistance, supervisory relationships, team conflict and consen- sus-building, and managing time.

NURSE LEADERSHIP AND EMOTIONAL INTELLIGENCE (EI)

More than twenty years of international research across dozens of dis- ciplines and hundreds of research studies has provided ample evidence

Copyright Springer Publishing Company. All Rights Reserved. From: Emotional Intelligence in Nursing DOI: 10.1891/9780826174543.0011

124 Emotional Intelligence in Nursing

that EI correlates with leader effectiveness, wellness, and career longev- ity. Nursing EI research has built on these findings and validated them, supporting the importance of EI for nurse leaders (see research summary, Chapter 15). Nurse leaders can and must utilize EI skills to face the un- precedented challenges confronting them daily within the context of a rapidly changing industry. These skills are among the most important for facilitating organizational change. For that reason, this chapter focuses on change skills including the following: management of clinical outcomes, change resistance, supervisory relationships, team conflict, consensus processes, and leader self-care.

APPLYING EI ABILITIES IN MANAGEMENT OF ORGANIZATIONAL OUTCOMES

Optimizing organizational outcomes invariably involves change processes. Continuous quality improvement, employee performance evaluation, and process changes necessitated by new clinical procedures all work together to create an environment where change is the status quo. Nurse leaders must develop abilities that support themselves, their staff, and the organi- zation in this constantly dynamic industry. An early meta-analysis of 141 EI leadership research studies across all disciplines provided evidence for a relationship between EI and positive leadership outcomes (Mills, 2009). In some of the earliest nurse EI research, EI significantly correlated with important organizational outcomes such as customer satisfaction, fiscal outcomes, and organizational resilience amid change (Cummings et al., 2005). Meta-analysis of nurse leader EI research concluded EI is a useful tool for nurse managers, particularly as it is related to effective leadership outcomes that support successful navigation of change (Aker- jordet & Severinsson, 2018; Prezerakos, 2018).

The skills necessary for leaders to navigate change successfully all correlate with EI ability. The EI abilities enable leaders to manage them- selves, their staff, and organizations through the challenging emotional topography of change processes that are required to improve organiza- tional outcomes. This is especially evident in one of a nurse manager’s most difficult challenges: managing resistance to change.

Using EI Abilities in Change Resistance

Change resistance is an intrinsic part of the change process. It is not a sign that the change process is ineffective. What is of concern is resistance that begins to obstruct change, or when change resistance interferes with performance, teamwork, or safety. Table 11.1 lists common manifestations of resistance to change, their symptoms, and common negative outcomes.

Chapter 11 Emotional Intelligence, Nurse Leadership, and Organizational Change 125

TABLE 11.1 Change Resistance: Symptoms and Negative Outcomes

RESISTANCE SYMPTOM SYMPTOMS NEGATIVE OUTCOMES

Emotions Negative emotions, self- centered orientation

Contagion of negativity, reduced interpersonal effectiveness, increased conflict, reduced customer satisfaction

Disengagement Avoidance, reduced communication, apathy, low morale

Poor performance, team dysfunction, reduced customer satisfaction

Performance Poor quality and quantity of work, noncompliance, increased medical errors, under- involvement in change process

Financial loss, reduced customer satisfaction, miscommunication, team dysfunction, noncompliance, compromised patient safety

Disruptive behavior Inappropriate behavior, bullying, conflict, undermining and passive/aggressive actions, increased involvement in change process but in a disruptive way

Miscommunication and team dysfunction, team/energy lost in personnel action

Negativity Intentional miscommunication (rumors, gossip), focusing on negative outcomes, celebrating failure, overt negativity about change process

Contagion of negativity, reduced interpersonal effectiveness, increased conflict, reduced customer satisfaction

Avoidance Reinforcing old behaviors, avoiding the change, working around the new requirements to revert to the old, refuse responsibility

Loss of accountability and informal leadership, parallel processes as new and old coexist, covert threat to change process

Creation of barriers Cadre of those opposed to change formed, participation solicited

Mistrust, secrecy, paranoia, splitting in team goals, recruitment to threaten change process

Controlling behavior Overt undermining of change process, advocating for return to the old way

Overt threat to success of change process

Source: Changing Minds. (n.d.). Signs of resistance. http://changingminds.org/disciplines/ change_management/resistance_change/sign_resistance.htm

126 Emotional Intelligence in Nursing

Any one of the resistance elements listed above has enough power to effectively derail a change process, particularly once a culture of resis- tance is established. When resistant staff recruit others, subsequent team splitting undermines change as well as staff morale, performance, and interpersonal relationships. This resistance manifests interpersonally with subtle pressure and overt bullying. All negative elements of change resistance can be effectively addressed with EI abilities. For example, a leader could (1) identify emotions such as anger or frustration from the change, (2) teach about change resistance to facilitate understanding of the emotions related to this process, (3) model “think/feel” management of bullying behavior, and (4) model emotionally problem-solving by mak- ing plans for emotional self-management and group management during stressful change. These actions can prevent resistance from progressing from a maladaptive response by individual staff members to a culture of resistance that effectively undermines the desired change.

Story: Unchanged

The hospital made a major commitment to improve patient safety. A con- sultant had been hired, meetings held, buy-in of senior leaders achieved, planning for long-range and short-range strategy completed, and educa- tion of the staff had begun. At every step of the process, the administration made significant effort to include clinical staff in revising procedures. The proposed change involved three major elements of nursing shift change report:

1. The shift change report would relocate to the patient’s bedside, so IVs and equipment could be checked by both shifts.

2. The format of shift change report would standardize all elements required for reporting, including safety concerns and risk factors.

3. Patients would be included in report, and goals for each shift which would be summarized on a whiteboard at each patient’s bedside.

This change was never presented as optional. Medical error data had been presented to the group that clearly indicated changes were neces- sary. In the beginning, resistance was subtle. Resistant staff grumbled, “The patient should not be able to hear what we say in report.” Because the change was under the banner of patient safety, the staff refrained from overt complaints, but “didn’t like” the shift change format. Comments such as, “I have my own way of keeping everything organized so I don’t forget anything” surfaced. Because bedside shift report was not recorded, the implementation team could not monitor either location compliance or shift report content compliance unless a member was physically present.

Chapter 11 Emotional Intelligence, Nurse Leadership, and Organizational Change 127

As the staff accommodated to the change, intensive monitoring took place for weeks.

The first overt resistance behaviors were verbal negativity, grudg- ing compliance, and splitting of the staff. The staff was forming into two camps: those who changed and those who did not. Although shift report had moved out of the old shift report lounge, it began moving further and further from patient bedsides. It started at corridors outside patients’ rooms, then onto corridor furniture, and finally to family rest areas at the end of hallways. In this manner, the location of the shift report, one of the important aspects of the change, was totally subverted. Other aspects of the change were undermined. The whiteboard plans of care for each patient were similarly undermined. At first, they were not kept up-to-date, and eventually not used all. Insidiously, the unit old-timers pressured newer staff to revert to the old ways. Eventually, unless a change process monitor was physically present, very little bedside shift reporting was done at all. The standardized shift report content was almost completely abandoned as staff reverted back to their own preferred means of giving report.

Applying EI

How could this story, typical of change resistance, have been different? Research evidence demonstrates that leader EI abilities result in nurses more effectively navigating organizational change (Cummings et al., 2005). These abilities can also address and mitigate change resistance. The intentional use of EI abilities could have changed the trajectory of the change process, as well as the degree to which resistance was successful. Change makes all of us uncomfortable, that is natural, but the only way to make our patients safer is to be willing to change.

Using EI to Manage Change Resistance: Identifying Emotions What if the nurse leaders had done staff education on change resistance? Teaching staff about typical emotional responses to change, even posting the resistance chart on the unit, might have made identifying emotional resistance and the negative behaviors associated with it easier. “You might start hearing people say negative things about this change. Remember, the goal is to make patients safer!” Also, teaching staff to identify change resistance recruitment is very important. “You might feel pressure from people who don’t want to make the change. Pay attention if you start to feel pressured or bullied!” Identifying resistance emotions and resistance symptoms publicly and explicitly keeps resistance from taking root and progressing. Talking about them openly during performance reviews is also helpful.

128 Emotional Intelligence in Nursing

Using EI Abilities to Manage Change Resistance: Understanding Emotions After identifying resistance emotions and behaviors, understanding them is an important next step. For example, some of the emotional negativity stemmed from fear. Everyone knew many of the older staff, who had a lot of informal power, gave poor reports. Newer staff found confronting this problem awkward since it had been tolerated for years. Accountability had never been successfully addressed.

Using EI to Manage Change Resistance: Using Emotions to Reason and Managing Emotions Providing unit education ahead of time could have decreased resistance behaviors and given the staff language to talk about it when pressure and bullying surfaced. A unit party to celebrate the first few weeks of the change, where staff could socialize and emphasize positive progress, is one simple solution. Identifying emotions, understanding them, and using them to think about both the change process and resistance could have enabled the nurse manager to select interventions to address the emotional issues underlying the noncompliance instead of focusing on the noncompliance as the problem.

While dealing with resistance meant addressing fear (“Doing things differently can be scary. Let’s be patient with each other as we get used to the new shift report”), it also meant addressing the loss of social time in the breakroom before shift report. With bedside reports, the oncoming shift didn’t have a chance to relax together and check-in before the shift began. Understanding this emotional need could have improved compli- ance and reduced resistance behaviors.

APPLYING EI TO TEAM PROCESS MANAGEMENT

Effective leaders are masters at working with teams, and nurse leaders are especially so. Their management of nurse, administrative and inter- disciplinary teams are among their most important, challenging, and re- warding tasks. Consensus building and conflict management are among the most important team processes that nurse leaders must cultivate. For both, EI abilities play a crucial role.

Applying EI to Group Consensus

Using EI ability helps nurse leaders to manage groups and teams more effectively. Much of leaders’ work is in groups of all sizes, so the

Chapter 11 Emotional Intelligence, Nurse Leadership, and Organizational Change 129

development of team management skills enhances leader effectiveness. An example of this is the use of EI leader ability in guiding the consensus process. Across all the phases of consensus development, EI ability can be used to both guide and enhance the process.

For nursing and interdisciplinary teams to function effectively, lead- ers need skills in consensus building. Performance of this skill is rarely taught, evaluated, or developed in either nursing school or graduate-level nurse leader education. As illustrated in Exhibit 11.1, EI abilities contrib- ute specifically to the three main phases of the consensus process.

Using EI Abilities: Consensus Phase I In the first phase of group consensus, the group brainstorms ideas about issues and possible solutions. In a clinical setting, this could include any- thing from issues that impact a problem, such as interpersonal or group dynamics, organizational issues such as short staffing or miscommunica- tion, or even clinical issues such as interdisciplinary team conflict. The rule in this phase is “no editing, judging, or prioritizing” and the goal is to get as many issues/solutions on the table as possible.

Identifying emotions and understanding emotions in oneself and others is crucial during this phase. For example, if one staff member has a strong emotional reaction to someone else’s contribution (“I hate that idea, it will never work!”), identifying and recognizing the strength of that emotion enables the staff member to use what they understand about emotions and consensus (“Wait, sorry, this is only Phase I! No editing yet! I can raise my concerns later.”). Many items on the brainstorm list never get to Phase II. If staff spend emotional energy and interpersonal good- will on a disagreement during Phase I, both may have been wasted on an idea that wasn’t even going to make it to the next stage. Understanding

EXHIBIT 11.1 Using EI Abilities in Consensus

PHASES OF CONSENSUS PROCESS RELEVANT EMOTIONAL INTELLIGENCE ABILITIES

Phase 1: Brainstorming ideas for problem solution

Identifying emotions correctly in self and others, Understanding emotions

Phase 2: Identifying common themes Understanding emotions, Using emotions to reason

Phase 3: Formulating priorities among themes

Identifying emotions correctly in self and others, Understanding emotions, Using emotions to reason, Managing emotions in self and others

Source: Mayer, J. D., Caruso, D., & Salovey, P. (1999). Emotional intelligence meets traditional standards for an intelligence. Intelligence, 27, 267–298. https://doi.org/10.1016/S0160-2896( 99)00016-1

130 Emotional Intelligence in Nursing

emotions also helps maintain personal communication discipline at this stage. Brainstorming only works effectively under the “no editing, judg- ing, or prioritizing” rule.

Using EI Abilities: Consensus Phase II In the second phase of consensus, the group identifies themes among the brainstormed items from Phase I. All four of the EI abilities support this complex phase while the brainstormed items are categorized and prioritized. Identifying emotions correctly, both in oneself and others, can help clarify this process. Understanding emotions like defensiveness can prevent derailing the consensus. When a group is problem-solving, defensive feelings can arise if people feel judged or undervalued. Defen- siveness is a highly charged emotion that can hijack a discussion easily and distract from the group task. However, it often responds well to ac- knowledgment, especially public acknowledgment. For example, “Jack, everyone knows how hard you have worked on this, and no one is criti- cizing that. We are just all trying to find some new ways to get our budget under control.” By identifying and acknowledging Jack’s defensiveness, the consensus process is not derailed by it, and Jack can stay actively engaged.

Using EI Abilities: Consensus Phase III Identifying, understanding, using, and managing emotions can help a leader through the third consensus phase, which culminates in the se- lection of a few summary or action items. Disappointment, for example, may arise when brainstormed items are not included on the list. When the leader identifies this, they prevent disappointed group members from dropping out of the consensus process. “I am really disappointed that my idea didn’t make the list, but maybe we can come back to it another time. For now, I am ready to move on.” Modeling disappointment like this supports the group decision and models moving on. It also signals to the group that the idea may come up again in the future.

Applying EI to Conflict Management

As summarized in Chapter 15, there is ample evidence from multidisci- plinary research that EI ability is associated with positive conflict skills for individuals and within teams. Using EI ability in conflict interactions changes interpersonal power dynamics and can result in stronger rela- tionships and more collaboration within the change process. An illustra- tion from the martial art aikido makes this clear.

Chapter 11 Emotional Intelligence, Nurse Leadership, and Organizational Change 131

When two traditional martial artists are joined in an attack, one force meets another force and the stronger, faster, or more agile person “wins.” This is the traditional model of conflict resolution. For example, a nurse leader wants a change in the unit, they have the power, so they “make” the staff comply. One force (the leader) confronts another force (the staff). The leader has more power, so the staff is forced to comply with the will of the leader.

What is an alternative? In aikido, when faced with an attack, the per- son “attacked” quickly and smoothly moves out of the way, lining up with the attacker. The person attacked has literally physically lined up with their attacker. Instead of “my way versus your way,” it is as if the at- tacker says, “let me see from your perspective.” In EI terms, the person at- tacked is willing to get off their own position and idea long enough to see things from the other person’s perspective. From this position, they can more accurately identify the emotions of the other person. By getting off their own “position” for a moment, the “win/lose and who is stronger?” approach to the conflict has changed dramatically. Instead of “stronger versus weaker and winning versus losing,” the goal becomes shared un- derstanding. In a very physical way, emotional perspective is identified, understanding achieved, thinking about the situation has shifted, and a different solution other than simply overpowering the other person is achieved.

Story Reflection: Unchanged

In the story about shift report, if the nurse leader had used the traditional, “who has the most power,” approach to conflict resolution, she might have said, “You will do report at the bedside because I have the power to make you. If you keep doing it in the report room, I will use disciplinary ac- tion.” Using EI abilities and the aikido approach, the leader might instead say, “Oh! You miss having time with your shift peers before starting the shift. Let’s do a 5-minute shift overview in the report room with everyone present, then go to the bedside for detailed reports.” By abandoning the traditional power position for a moment, the leader can think/feel with new information and hypothesize that the resistance could have origi- nated from the emotional and social loss of a small group huddle at the beginning of a shift or from fear of failing to give an improved report. The leader can then manage the emotional situation differently and propose a new solution. Using the aikido model, the nurse manager in this scenario is willing to get off their own position long enough to “see” where the staff is coming from and suggest a solution that addresses the staff con- cerns within the context of the required change. In this case, by using EI abilities in the conflict, a very different outcome is possible.

132 Emotional Intelligence in Nursing

APPLYING EI TO LEADER RELATIONSHIPS

Story: The Ghost of Colleen

Sally had been a staff nurse on the unit for nearly her whole nursing ca- reer and now was a few years from retirement. She was a lovely person, supportive of her colleagues, and well-liked by her coworkers and the new nurse manager on her unit. However, her performance was always borderline. Her personnel file reflected many unsuccessful performance improvement interventions and sick leave overuse from migraine head- aches. The new unit nurse manager quickly realized Sally’s consistent clinical performance problems meant it would not be long before Sally’s performance would need to be addressed again. Sure enough, Sally made a medication error and an appointment was scheduled to discuss it.

When Sally came to the manager’s office the day of the appointment, she sat down and looked at her manager with a “deer in the headlights” look on her face. The nurse manager was experienced and had done plenty of disciplinary counseling. She was good at it, but Sally’s emotional affect struck her as unusual. It was out of proportion considering the issue and not consistent with the good relationship the two had forged in the pre- ceding months.

Applying EI Abilities

Using EI: Identifying Emotions The nurse manager began to speak about the medication error. It was pretty cut and dry, a variation in protocol. There wasn’t much interpre- tation involved. The nurse’s frozen demeanor didn’t change, and she didn’t speak. Even the manager’s deliberately warm and nonjudgmental approach was not getting through. A bit frustrated, the nurse manager asked, “Has this kind of mistake happened before?”

Sally was suddenly energized and animated. Just about in tears, she said, “Oh, yes, I have been in this horrible little room many, many times.”

The nurse manager was taken aback at her intense and highly emo- tional response. Following “a hunch,” she changed the subject and asked about Sally’s relationship with her prior supervisor, Colleen.

Then tears spilled over. Sally described being terrified by her super- visor, by the threats of firing. She talked about how afraid she had been. She reported being constantly fearful that she would lose her job. She was afraid of being in charge on a night shift or orienting new employees because additional responsibilities meant bigger mistakes that would end her career. In her office, in “that horrible little room,” the nurse manager had a terrified employee in a flashback. The positive rapport with her new

Chapter 11 Emotional Intelligence, Nurse Leadership, and Organizational Change 133

manager didn’t help. Sally couldn’t hear her new manager’s words; they were drowned out by the toxic relationship with her previous manager.

Using EI: Understanding Emotions When levels of fear are high, physiology takes over. Fight/flight results in an adrenalin dump that widens and then narrows the visual field, cre- ating tunnel vision. Emotional thresholds change, resulting in irritability, hyper-responsiveness, and a decreased ability to process emotions. Touch is often perceived as threatening. It is difficult to take in new information or communicate due to amygdalar hijacking. Understanding all this, the manager knew her relationship with Sally, and indeed Sally’s future as a nurse, could ride on what she did next. The manager could not change Sally’s past. Nor could she avoid dealing with Sally’s very real perfor- mance problems. But she could address Sally’s fear that was blocking ev- erything else and creating a vicious cycle of poor performance.

Using EI: Using Emotions to Reason (Think/Feel) When we use emotions to reason, we “think/feel.” We combine the data from our emotional experience with data from our cognitive experience.

Sally was paralyzed by fear. The new manager knew she could not forge a new, more constructive relationship with Sally unless she helped Sally break the fearful pattern of the past. When the nurse manager used her understanding of emotions she identified, and used this to think dif- ferently about her employee, it made her interventions better.

Using EI: Managing Emotions The manager told Sally the conferences with her old boss sounded awful and asked how Sally had dealt with them. Despite her tears, Sally met her manager’s eye squarely and said, “I get migraines.”

With that answer, the manager knew if she looked through the per- sonnel records, she would see every conference between Sally and her supervisor was followed by a sick call. The polarized and emotionally charged relationship with her previous supervisor never addressed the performance problems, and Sally’s fear gave her migraine headaches.

The nurse manager needed to get through Sally’s fear. She said, “Sounds to me like we got the ghost of Colleen in this room.”

Unbelievably, Sally laughed. “You got that right.” The manager got up and held the door for Sally, saying, “Let’s get out

of here!” Once they were in a quiet lounge area on the unit, they sat down and

finally began to talk. It was productive, it was clear, and they were on the

134 Emotional Intelligence in Nursing

same page. They talked through the error. The conversation ended on a positive note. Sally did not call in sick the next day.

Sally and her unit leader were not done with the ghost of Colleen. Sally continued to have performance issues, and sometimes during dif- ficult conversations she looked tense. Her manager would raise eyebrows and ask, “Colleen?” Sally would laugh and say, “No, I’m good.” Their relationship stayed strong during the required process to improve Sal- ly’s performance. Slowly, the ghost of Colleen faded. Sally was never the strongest nurse on the unit, but her positive and encouraging personality remained valuable to the unit.

Story Reflection

Only a few simple EI abilities made the difference between a traumatized employee stuck in a vicious cycle and a unit no longer disrupted by sick calls and an underperforming nurse. The relationship with Sally’s unit leader stayed strong. The manager had helped Sally recover from an emo- tional trauma and improve her attendance and performance. The team was saved the loss of a valued member, and the quality of team care im- proved along with Sally’s performance. This story illustrates the power of EI ability to increase the effectiveness and impact of leader relationships, whether they be relationships with employees, peers, or line relationships within an organization.

APPLYING EI TO LEADER TIME MANAGEMENT

Most nurse managers would agree with the phrase, “My time is driven not by what I can do but what I must do.” Most times, management systems reflect the same, seemingly common-sense approach to time manage- ment; start with the leadership goals, then prioritize according to the most time-sensitive or those with the highest financial or safety risk. However, using EI ability to manage time starts with the opposite assumption: “My time is driven by what I can do more than what I must do.” This consti- tutes a fundamental stress and energy management strategy in the short run and contributes to long-term thriving and burnout prevention across the trajectory of a nurse leader’s career.

Story: Monday Morning

It was barely 8 a.m. on Monday morning, and the ICU nurse manager was already exhausted. She was fighting a cold and the third cup of coffee was

Chapter 11 Emotional Intelligence, Nurse Leadership, and Organizational Change 135

not helping get her going. Her eye was on her earliest possible departure to home and early to bed. The schedule for her week was overbooked, the unit was very busy and there had been last-minute sick calls. What she had to do for even the next few hours seemed overwhelming. What if she worked this situation with EI, beginning with herself and what she could do? Using a simple EI tool offers an entirely different approach to “Just do it.”

Applying EI Abilities

Using EI: Identifying Emotions One important way to use EI in time management is illustrated using Figure 11.1. On this chart, the vertical axis is labeled “Energy,” and the horizontal axis is labeled “Mood.” This Mood/Energy chart is a fast way to assess resources at the beginning of a day, meeting, or at the beginning of work on a project. This practical example shows how to use EI to im- prove leadership effectiveness.

The manager started by identifying her own emotions. She had very low energy, but actually, she was in a pretty good mood. Upon reflection, she realized that she was excited about greeting a new leader who had recently joined the organization. Today was the new manager’s first day.

Using EI: Understanding Emotions The human body and human emotions are inextricably connected. The nurse manager understood the connection between her physical and emotional energy. Her moods, her emotional baseline, were connected to

En er gy

Mood

FIGURE 11.1 EI assessment: mood and energy. Source: Original to author

136 Emotional Intelligence in Nursing

her physical well-being. Both needed to be addressed, as each supported the other. She felt physically very low from the cold and mentally over- whelmed by the work, but her excitement about a new colleague was the fuel to plan the next hour of her day.

Using EI: Using Emotions to Reason After using the Mood/Energy chart to identify where she was, the nurse manager used her understanding of mood and energy to pick her next actions. Instead of starting on the biggest or most pressing problem, she chose to increase both her energy and her mood by welcoming the new manager and making a date for coffee later in the day.

Using EI: Managing Emotions Using the Mood/Energy EI Assessment This simple use of EI ability to jumpstart and fuel a typical Monday slump shows how to use EI in time management. Identifying where in the four quadrant Mood/Energy chart the leader is at a given moment and under- standing the physical/emotional phenomena of each quadrant can help the leader think/feel their way to efficient and effective self-management. For example, the leader in the previous example had low energy but higher mood (compared to the level of energy). This places the manager in Energy/Mood quadrant two.

Self-Management in Quadrant Two In quadrant one, low energy is challenging. If energy-demanding activi- ties cannot be avoided, they should be approached carefully, conserving energy if possible. One goal is to choose energy conserving or energy- generating activities. High mood of quadrant two is an asset, a resource to draw on. If activities can be selected that use this, it can boost the low energy. For managers energized by interpersonal relationships, schedul- ing some relationship time could add energy. For a manager energized by a certain project, making time for it, even if it is not the highest priority, can help boost the low energy state.

Self-Management in Quadrant Three The other quadrants have characteristics which, if identified and un- derstood, can support the manager in think/feeling (using emotions in reasoning), and self-managing in a way that makes their time manage- ment more effective. There is no “optimum” quadrant. It is easy to assume “high energy, high mood” is the ideal quadrant for leaders, but one man- ager noted that her staff avoided her when she was in that quadrant. The high energy/high mood made her come across as hyper and difficult to

Chapter 11 Emotional Intelligence, Nurse Leadership, and Organizational Change 137

deal with, and the high energy made her physically restless. So she began planning activities with physical activity, such as safety surveys of the hospital that gave her a chance to walk around so later she could work on projects that needed more focus.

Self-Management in Quadrant Four In high energy and low mood of quadrant four, how could avail- able energy boost mood enough to be more effective for high prior- ity activities? One manager used the example of working on the unit budget, a task she loathed. On the day this task had to be done, the manager used some of her available energy to move the project into a quiet corner of the cafeteria. Using available energy to “treat” herself to a change in location, her mood increased and she better tackled the budget project.

Self-Management in Quadrant One The low energy and low mood of quadrant one requires self-care! It might be a good time for activities that don’t require contact with other people. One nurse manager relegated hated tasks like filing or budget activities to quadrant one days, where she could lock herself in her office, listen to music she loved, and not focus on anything but those activities. She re- ferred to her quadrant one days as “time in the cave.”

Story Reflection

“Just do it” may be a short-term formula for success, but over a long pro- fessional career, it is a set up for burnout. Using EI abilities to plan and self-manage, even in something as basic as time management, is a force multiplier that can enhance leadership effectiveness. This contributes to both short-term and long-term effectiveness, thriving, and burnout pre- vention across the nurse leader’s career.

NURSE LEADERSHIP RESEARCH

Nursing leadership was among the first topics for nursing research (Vitello-Cicciuo, 2002), and has been well-explored in both individual studies on specific features of nurse leadership and meta-analysis (Akerjordet & Severinsson, 2010; Codier et al., 2011). Built on a solid foundation of research in other disciplines, this research is among the best substantiated among the whole body of nursing EI research.

138 Emotional Intelligence in Nursing

DEVELOPING EMOTIONAL INTELLIGENCE

SAMPLE EXERCISE #11: REWRITING HISTORY

Rewriting history can be a powerful way to review something that happened in the past, learn from it, and through the power of imag- ination, heal the parts that were painful. To do this, simply write down the story as objectively as possible. Stepping back from the story, reflect on how the four EI abilities worked for you, and in what ways you could have used them differently. Next, rewrite the story, including what could be done differently. Don’t change the actions and words of other people in the story, only your own.

REFERENCES

Akerjordet, K., & Severinsson, E. (2010). The state of the science of emotional intelligence related to nursing leadership: An integrative review. Journal of Nursing Management, 18(4), 363–382. https://doi.org/10.1111/j.1365-2834.2010 .01087.x

Changing Minds. (n.d.). Signs of resistance. http://changingminds.org/disciplines / change_management/resistance_change/sign_resistance.htm

Codier, E., Kamikawa, C., & Kooker, B. M. (2011) Developing the emotional intelligence of nurse managers. Nursing Administration Quarterly, 235(3), 1–7. https://doi.org/10.1097/NAQ.0b013e3182243ae3

Cummings, G., Hayduk, L., & Estabrooks, C. (2005). Mitigating the impact of hospital restructuring on nurses: The responsibility of emotionally intelligent leadership. Nursing Research, 54(1), 2–12. https://doi.org/10.1097 / 00006199-200501000-00002

Mayer, J. D., Caruso, D., & Salovey, P. (1999). Emotional intelligence meets traditional standards for an intelligence. Intelligence, 27, 267–298. https://doi .org/10.1016/S0160-2896(99)00016-1

Mills, L. B. (2009). A meta-analysis of the relationship between emotional intelligence and effective leadership. Journal of Curriculum and Instruction, 3(2). https://doi.org/10.3776/joci.2009.v3n2p22-38

Prezerakos, P. E. (2018). Nurse managers’ emotional intelligence and effective leadership: A review of the current evidence. Open Nursing Journal, 12(1), 86–92. https://doi.org/10.2174/1874434601812010086

Vitello, J. (2002). Exploring emotional intelligence: Implications for nurse leaders. Journal of Nursing Administration, 32(4), 203–210. https://doi .org10.1097/00005110-200204000-00009