Leading nurses: emotional intelligence and leadership development effectiveness

Leadership in Health Services
Leading nurses: emotional intelligence and leadership development effectiveness
Kerri Anne Crowne, Thomas M. Young, Beryl Goldman, Barbara Patterson, Anne M. Krouse, Jose Proenca,
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To cite this document:
Kerri Anne Crowne, Thomas M. Young, Beryl Goldman, Barbara Patterson, Anne M. Krouse, Jose Proenca, (2017) "Leading
nurses: emotional intelligence and leadership development effectiveness", Leadership in Health Services, Vol. 30 Issue: 3,
doi: 10.1108/LHS-12-2015-0055
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http://dx.doi.org/10.1108/LHS-12-2015-0055
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Leading nurses: emotional intelligence and leadership
development effectiveness
INTRODUCTION
Long-term care providers include adult day service centers, home health agencies,
hospices, nursing homes, and residential care communities which provide a variety of care
services for older individuals. Nursing home facilities comprise an important sector of the long-
term care field. In 2012 there were 15,700 nursing homes in the United States that served almost
1.4 million residents (Harris-Kojetin, Sengupta, Park-Lee and Valverde, 2013). These facilities
are staffed by a variety of employees, such as social workers and nursing assistants, but one
particular category of employees that play an important role in resident care is nurses. In nursing
homes, the Directors of Nursing (DONs) are mandated by federal law to be Registered Nurses
(RNs) (Fleming and Kayser-Jones, 2008) and RNs represent 11.7% of nursing home nursing
staff (Harris-Kojetin et al., 2013). The DONs have the ultimate responsibility for staffing the
nursing department in sufficient numbers to provide quality care. These tasks are critical and
many DONs report that they are ill prepared to meet them, even though some state that the
DONs hold the most crucial organizational positions in nursing homes when it comes to quality
of care (Fleming and Kayser-Jones, 2008; Rowles, 1995). One DON noted that nurses move
from strictly clinical positions to administrative positions with minimal management knowledge
or skill, which makes it difficult for them to be managers, let alone true leaders (Wunderlich,
Sloan and Davis, 1996),. Others also note that many nurses become formal leaders without
leadership training (Kerfoot, 2008; Swearingen, 2009). Therefore, it is widely acknowledge that
nursing managers are inadequately prepared for their roles (Newman, Patterson and Clark,
2015). Yet, while many skills are needed for nurses to be successful, scholars note thatDownloaded by University of Windsor At 08:35 01 June 2017 (PT)

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leadership development and training is critical for nurses (Dunne, Lunn, Kirwan, Matthews and
Condell, 2015), especially since leadership development is thought to be critical for optimal
success in managerial roles (Wong, Spence Laschinger, MacDonald‐Rencz, Burkoski,
Cummings, D'Amour, Grinspun, Gurnham, Huckstep, Leiter, Perkin, MacPhee, Matthews,
O'Brien‐Pallas, Ritchie, Ruffolo, Vincent, Wilk, Almost, Purdy, Daniels and Grau, 2013).
Moreover, nurse managers are thought to be highly influential to workplace cultures (Newman et
al., 2015) and scholars state that nurse leaders should look for development programs that focus
on both their emotional intelligence and the transformational leadership skills (O'Neill, 2013).
The Leading Nurses Program was designed and implemented to provide such development. This
paper will evaluate the effectiveness of some of the aspects of the program, which addresses a
recent call by scholars to evaluate specific leadership development programs (Dunne et al.,
2015).
The Leading Nurses Program Purpose
Nursing homes require strong leadership by DONs and other RN leaders in order to
improve the quality of care provided to residents in their facilities. The three-year Leading
Nurses project was developed and implemented to achieve Purpose P3 of the Nursing Education,
Practice, and Retention (NEPR) program. Leading Nurses provided leadership development for
DONs and other RN leaders working in nursing homes in the United States, specifically homes
in southeastern Pennsylvania, southern New Jersey, and Delaware. Content for the Leading
Nurses project was based on the results of a focus group conducted by the researchers in 2003 as
well as their follow-up demonstration project called Management Skill Development for Nursing
Leaders: Improving the Work Environment for Direct Care Workers.Downloaded by University of Windsor At 08:35 01 June 2017 (PT)

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The goal of Leading Nurses was to improve the care of approximately 3,750 residents in
30 nursing homes through new skill sets and evidence-based protocols that were learned and
implemented by nurse leaders in these facilities. Other program objectives included:
1. To determine if there is a difference in emotional intelligence scores prior to an
educational intervention and at the end of 3 years for directors of nursing/nurse
managers
2. To determine the effectiveness of an emotional intelligence and leadership
educational intervention on leadership skills among directors of nursing/nurse
managers
3. To determine the perceptions of the long-term care work environment by staff
reporting to directors of nursing/nurse managers in the program and start and
completion of the program
4. To determine the impact of an emotional intelligence and leadership educational
intervention on nurse retention and core clinical indicators
This paper examines a portion of the data gathered during the three-year program.
Specifically, it provides an analysis of the data on the emotional intelligence and
transformational leadership that was conducted as part of the project; thus the first two purposes
above are most relevant to this article. Examination of objective 3 and 4 are beyond the scope of
this paper, since the goal here is to assess the effectiveness of the training program.
EMOTIONAL INTELLIGENCE DEVELOPMENT AND NURSING
Emotional Intelligence (EI) is an ability which focuses on the accurate perception and
expression of emotion; the understanding of emotional knowledge; the use of feelings to
facilitate thought; and to regulate emotions in oneself and others (Salovey, Mayer, Caruso,Downloaded by University of Windsor At 08:35 01 June 2017 (PT)

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Lopes, Lopez and Snyder, 2003). It has also been defined as a non-cognitive capability that
influences one’s aptitude to cope in various situations (Bar-On, Tranel, Denburg and Bechara,
2003). It has been linked to multiple positive outcomes including performance (Carmeli and
Josman, 2006; Slaski and Cartwright, 2002; Wong and Law, 2002) and leadership (Akerjordet
and Severinsson, 2008; Alon and Higgins, 2005; Prati, Douglas, Ferris, Ammeter and Buckley,
2003).
The study of EI in nurses has been acknowledged as important (Akerjordet and
Severinsson, 2008; Eason, 2009). EI has been found to be related to positive empowerment
processes and positive organizational outcomes in nurse leadership (Akerjordet and
Severinsson, 2008). Some authors advocate using EI as a part of the criteria for hiring of
nurses (Cadman and Brewer, 2001). Other areas that have been addressed include EI and
conflict management styles (Morrison, 2008), retention (Feather, 2009; Wallis and
Kennedy, 2013), and teams (Wallis and Kennedy, 2013) in nursing. Furthermore, EI has
been found to be positively related to well-being and negatively related to job stress
(Karimi, Leggat, Donohue, Farrell and Couper, 2014) and correlated with better overall
health, greater work satisfaction, and decreased risk of job burnout (Powell, Mabry and
Mixer, 2015). Others have identified EI as one important factor in clinical leadership
(Leggat and Balding, 2013). Additionally, emotional intelligence of team members was one
of the variables that had a positive impact on team dynamics, although the authors noted
that the team’s effectiveness may have built the social competency (Wallis and Kennedy,
2013). One scholar stated that more research on EI and nurse leaders is needed because of
the shortage and high turnover of nurse leaders (Feather, 2009).Downloaded by University of Windsor At 08:35 01 June 2017 (PT)

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Thus, the study of emotional intelligence in nurses is an important topic for
researchers and practitioners. It is critical to understand how EI can be improved because
of the previously noted positive outcomes associated with it, and because it is likely a skill
that would be helpful to directors of nurses in nursing homes and result in multiple
positive benefits.
Multiple authors have suggested educational training as a way to improve EI (Berman
and West, 2008; Gignac, Harmer, Jennings and Palmer, 2012; Laabs, 1999; Oginska-Bulik,
2005; Ornstein and Nelson, 2006; Pilkington, Hart and Bundy, 2012; Slaski and Cartwright,
2003; Zijlmans, Embregts, Gerits, Bosman and Derksen, 2011) and empirical data suggest that
training can effectively increase EI (Gignac et al., 2012; Herpertz, Schütz and Nezlek, 2016;
Khodayarifard, Cheshmenooshi, Nejad and Farahani, 2012; Slaski and Cartwright, 2003;
Zijlmans et al., 2011). One study found evidence to support increases in emotional identification
and emotion management abilities among individuals who were trained in emotional intelligence
(Nelis, Quoidbach, Mikolajczak and Hansenne, 2009). Another study of nurses found that EI
was advanced through a combination of training, experience, reflection, and reinforcement in
district nurses (Davies, Jenkins and Mabbett, 2010). However, at least one scholar believed that
EI training is not really of value (Clarke, 2006), and as EI development programs may vary
evaluating the effectiveness of an EI development program is important. Therefore this research
poses the question:
Research Question 1: Did the emotional intelligence development program have a
positive effect on emotional intelligence of nurses in nursing homes?Downloaded by University of Windsor At 08:35 01 June 2017 (PT)