Building emotional intelligence: a strategy for emerging nurse leaders to reduce workplace bullying

Conflicting Working Relationships Among Nurses: The Intersection of Should Nursing, Double Domination, and the Big Picture

Background

Research conducted on conflict between Registered Nurses (RNs) has established that it happens regularly within the hospital setting, that it adversely affects the health and well-being of RNs, impacts the effective functioning of the health care organization, and compromises quality patient care. In this article, the phrase conflicting working relationships (CWRs) is used to represent working relationships between RN peers that are non-collegial, uncaring, and non- supportive, and inclusive of the behaviours associated with incivility, horizontal violence, and bullying, among others.

Purpose

To examine how nursing, including nursing knowledge and practice, is socially organized within the hospital setting and how this organization is linked to CWRs between RN peers.

Methods

Interviews were conducted with 17 RNs, followed by text analysis and mapping guided by institutional ethnography (IE) as the research methodology.

Results

The intersections between should nursing, double domination, and the big picture threads shows work environments where RNs struggle to provide appropriate care and conflict has become institutionalized. The intersection between threads can be used as caution areas for RNs and individuals in leadership positions to reflect on nursing practice when conflict is being experienced.

Conclusions

The contextual variables surrounding professional nursing practice are very influential with respect to how RNs relate to each other. A new type of dialogue about the organization of nursing practice in the hospital setting is needed to support more relational practices between RNs.

Nurse leaders' experiences of upwards violence in the workplace: a qualitative systematic review

OBJECTIVE

The objective of this review was to synthesize the qualitative literature on the experience of upwards violence in nursing workplaces directed towards nurse leaders who have authority over those who direct the violence towards them.

INTRODUCTION

Workplace violence has impacted nursing work life for decades. It has been studied mostly from a downwards and lateral perspective and less often from an upwards direction towards individuals in leadership positions. Little is known about the experiences of nurse leaders or the potential consequences of workplace violence, including what impact upwards violence has on leadership ability and sustainability.

INCLUSION CRITERIA

This review considered qualitative studies that included nurse leaders who experienced upwards violence in nursing workplaces from nurses they supervise. Nurse leaders were registered nurses or advanced practice nurses employed in a position where they supervised other nursing personnel (eg, registered nurses, licensed practical nurses, nurse practitioners, student nurses). The positions held by nurse leaders included all roles (eg, nurse manager, clinical nurse specialist, nurse practitioner, nursing professor) where the position included supervising other nursing personnel.

METHODS

The search strategy aimed to find both published and unpublished studies in English from 2000. The search was first conducted in January 2019 and rerun in June 2020. The databases searched included CINAHL, MEDLINE, PsycINFO, and Embase. To ensure full coverage, databases not specific to the nursing profession, but with potential content on upwards violence, were also searched for examples of upwards violence against nurse leaders. These databases were ABI/INFORM, Sociological Abstracts, LexisNexis Academic, Scopus, and Web of Science. The search for unpublished studies included ProQuest Dissertations and Theses, Google Scholar, OpenGrey Repository, Health Business Elite, and Factiva. Papers meeting the inclusion criteria were appraised by two independent reviewers for methodological quality using the JBI critical appraisal checklist for qualitative research. Data extraction was conducted according to the standardized data extraction tool from JBI. The qualitative research findings were pooled using the JBI method of meta-aggregation.

RESULTS

Six papers were included in the review yielding a total of 50 findings and nine categories. The categories were aggregated to form three synthesized findings: i) Physical, psychological, financial, and quality-of-work toll of upwards bullying: paying a high price; ii) Coping with violence alone; and iii) What happened to me? My take on the violence. The ConQual scores were low to moderate.

CONCLUSION

The synthesized findings reveal that nurse leaders' experiences of upwards workplace violence is a troublesome problem that leads to a negative impact on physical and psychological health, and creates a cost in terms of time, money, and efficacy of the workplace.

The Relationship Between Emotional Intelligence and Nurse-Nurse Collaboration

PURPOSE

The purpose of this study was to examine the relationship between emotional intelligence and nurse-nurse collaboration among registered nurses in Jordan.

DESIGN

This study used a cross-sectional, quantitative survey design to query 342 nurses who worked in two hospitals in Jordan.

METHODS

We used Arabic versions of valid, reliable instruments to measure emotional intelligence and nurse-nurse communication.

FINDINGS

A total of 311 questionnaires were returned (91% response rate). Nurses' emotional intelligence was positively and significantly correlated with the nurse-nurse collaboration subscales. The results also indicated a statistically significant mean difference in communication subscale scores by gender and nursing unit.

CONCLUSIONS

The present study demonstrated that nurse-nurse collaboration is linked to benefits for nurses in terms of improved job satisfaction, better nurse retention, improved quality of patient care, and enhanced healthcare efficiency and productivity. This suggests that improving nurse-nurse collaboration may have spillover effects of benefits, not only for nurses but for patients, organizations, and the overall healthcare system.

CLINICAL RELEVANCE

Building an environment that encourages collaboration among nurses can greatly impact the performance of nurses and its benefit to nurses. Encouraging employees to participate in activities and to collaborate in making this an integral part of their evaluation will contribute to improving the teamwork in patient care.

The relationship between leadership behaviours of ward nurse managers and teamwork competency of nursing staff: A cross-sectional study in Japanese hospitals

AIMS

The aim of this study was to clarify what kind of leadership behaviours of ward nursing managers are related to the teamwork competency of nursing staff.

BACKGROUND

There are two types of leadership behaviours: administrative and emotional intelligence leadership. While emotional intelligence leadership is important for teamwork, it is not clear how it relates to individual teamwork competency.

METHODS

This was a cross-sectional study. A questionnaire survey was distributed among 13 hospitals in Japan between May and August 2019.

RESULTS

We analysed 960 questionnaires. Multiple regression analyses revealed that two emotional intelligence leadership behaviours (staff nurturing and support, and care for patients) were positively associated with all three teamwork competencies (skill, knowledge and attitude, β = 0.141-0.318). Regarding administrative leadership behaviours, only human resource management was related to teamwork competency knowledge (β = 0.182).

CONCLUSION

Nurses' teamwork competencies were primarily related to emotional intelligence leadership. Furthermore, their teamwork competency was related more to nurse managers' behaviour towards patients and other staff members rather than towards themselves.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers need to be role models for nursing staff, recognizing that the way they relate to others influences the teamwork competency of their nursing staff.

Examining 'sticky' storytelling and moral claims as the essence of workplace bullying

BACKGROUND

Fisher (1985) argued that "there is no genre…that is not an episode in the story of life" (p. 347). As they incorporate moral claims, stories become 'sticky,' even when they are not accurate of fact, shifting listener beliefs, values, and sense of self.

PURPOSE

This study examined 'sticky' storytelling and moral claims inherent in workplace bullying.

METHOD

Critical hermeneutic method nested within an integrative review served as the research approach, extending findings reported in published research reports and gray literature.

FINDINGS

Through polished use of rhetorical style and resource control strategies within tacitly or explicitly supportive workplace contexts, bullies construct convincing but morally disengaged narratives-sticky stories-that violate ethical principles and yield moral ambiguity for their victims as they impede workplace productivity.

DISCUSSION

Largely ineffective, policies aimed to stem bullying have done little to date to mitigate bullying's impact. Recognizing the moral storytelling characterizing workplace bullying might strengthen policy for constraining workplace bullying.

Military Surgical Team Communication: Implications for Safety

Introduction

Medical error is the third leading cause of death in the United States, contributing to suboptimal care, serious patient injury, and mortality among beneficiaries in the Military Health System. Recent media reports have scrutinized the safety and quality of military healthcare, including surgical complications, infection rates, clinician competence, and a reluctance of leaders to investigate operational processes. Military leaders have aggressively committed to a continuous cycle of process improvement and a culture of safety with the goal to transform the Military Health System into a high-reliability organization. The cornerstone of patient safety is effective clinician communication. Military surgical teams are particularly susceptible to communication error because of potential barriers created by military rank, clinical specialty, and military culture. With an operations tempo requiring the military to continually deploy small, agile surgical teams, effective interpersonal communication among these team members is vital to providing life-saving care on the battlefield.

Methods

The purpose of our exploratory, prospective, cross-sectional study was to examine the association between social distance and interpersonal communication in a military surgical setting. Using social network analysis to map the relationships and structure of interpersonal relations, we developed six networks (interaction frequency, close working relationship, socialization, advice-seeking, advice-giving, and speaking-up/voice) and two models that represented communication effectiveness ratings for each participant. We used the geodesic or network distance as a predictor of team member network position and assessed the relationship of distance to pairwise communication effectiveness with permutation-based quadratic assignment procedures. We hypothesized that the shorter the network geodesic distance between two individuals, the smaller the difference between their communication effectiveness.

Results

We administered a network survey to 50 surgical teams comprised of 45 multidisciplinary clinicians with 522 dyadic relationships. There were significant and positive correlations between differences in communication effectiveness and geodesic distances across all five networks for both general (r = 0.819–0.894, P < 0.001 for all correlations) and task-specific (r = 0.729–0.834, P < 0.001 for all correlations) communication. This suggests that a closer network ties between individuals is associated with smaller differences in communication effectiveness. In the quadratic assignment procedures regression model, geodesic distance predicted task-specific communication (β = 0.056–0.163, P < 0.001 for all networks). Interaction frequency, socialization, and advice-giving had the largest effect on task-specific communication difference. We did not uncover authority gradients that affect speaking-up patterns among surgical clinicians.

Conclusions

The findings have important implications for safety and quality. Stronger connections in the interaction frequency, close working relationship, socialization, and advice networks were associated with smaller differences in communication effectiveness. The ability of team members to communicate clinical information effectively is essential to building a culture of safety and is vital to progress towards high-reliability. The military faces distinct communication challenges because of policies to rotate personnel, the presence of a clear rank structure, and antifraternization regulations. Despite these challenges, overall communication effectiveness in military teams will likely improve by maintaining team consistency, fostering team cohesion, and allowing for frequent interaction both inside and outside of the work environment.

The impact of workplace bullying on flourishing: The moderating role of emotional intelligence

Orientation: Workplace bullying has detrimental effects on employee well-being. Emotional intelligence may moderate the relationship between workplace bullying and flourishing.Research purpose: The purpose of this study was to examine the nature of the relationship between workplace bullying and flourishing and to investigate the moderating role of emotional intelligence in the workplace bullying–flourishing relationship.Motivation for the study: There is a paucity of studies exploring the moderating role of personal resources such as emotional intelligence in the relationship between workplace bullying and flourishing.Research approach/design and method: The study used a cross-sectional design, quantitative approach and a convenience sampling method. Employees from a higher education institution (N = 1102) participated in this research. Descriptive, correlation and moderation analysis was used to analyse the data.Main findings: The results showed that there was a significant negative relationship between workplace bullying and flourishing. Emotional intelligence significantly moderated the relationship between workplace bullying and flourishing.Practical/managerial implications: Organisations should develop and/or strengthen the level of emotional intelligence in employees in order to reduce the negative effect of workplace bullying on well-being.Contribution/value-add: The findings of this research contribute to the limited body of research investigating personal resources such as emotional intelligence as a moderator in the bullying-well-being relationship.

Inteligência emocional em enfermeiros: a escala Trait Meta-Mood Scale

Resumo Objetivo Nesse contexto, o objetivo desse estudo é duplo. Primeiro, almeja-se explorar as propriedades psicométricas da TMMS-24 em uma amostra de enfermeiros espanhóis e em segundo lugar fornecer alguns percentis para interpretar os níveis de IE em enfermeiros espanhóis. Métodos Um desenho de estudo descritivo correlacional foi utilizado para avaliar as propriedades psicométricas da TMMS-24. Este estudo foi realizado com uma amostra de 530 enfermeiros de 11 hospitais espanhóis da Comunidade Valenciana. Os critérios de inclusão foram enfermeiros ativos (temporário, interino ou permanente) nos centros selecionados que haviam previamente consentido em participar. A idade dos participantes variou de 22 a 64 anos (X= 44,13; DP = 11,58). 75,6% eram mulheres (401), 53,8% (285) eram funcionários permanentes, 28,4% (151) eram substitutos e 17,8% (94) tinham contrato temporário. A análise estatística foi realizada através do programa SPSS (Statistical Package for the Social Sciences, Versão 22), além dos programas EQS (Structural Equation Modeling Software, Versão 6.2) e FACTOR. Resultados Os resultados indicam que as propriedades psicométricas da TMMS-24 são adequadas e seu uso parece ser justificado. Por último, são apresentados percentis para interpretar os níveis de inteligência emocional em enfermeiros espanhóis. Conclusão O instrumento tem várias aplicações potenciais para gerentes de enfermagem preocupados com o ambiente de trabalho de saúde e com enfermagem. Primeiro, o estudo apoia o uso da TMMS-24 no contexto de enfermagem na Espanha. Em segundo lugar, o estudo também apoia o uso da TMMS-24 para avaliar a IE em enfermeiros. Terceiro, a avaliação da prática de enfermagem atual, a partir de uma perspectiva de autoavaliação, pode determinar as necessidades de treinamento e avaliar a eficácia da formação e das intervenções para melhorar a IE. Em quarto lugar, a existência do instrumento e dos percentis facilita a interpretação das pontuações obtidas e permite uma rápida comparação com outras amostras de enfermeiros.

How to Prevent Workplace Incivility?: Nurses' Perspective

Background:

Many articles have studied workplace incivility and its influence on outcomes, but very few have been conducted to assess how to prevent this issue. In this study, we aimed to determine how to prevent workplace incivility from the nurses' perspective.

Materials and Methods:

This was a qualitative study which was based on a conventional content analysis approach. Thirty four nurses (25 to 52 years old) from seven training hospitals in Tabriz, Iran were selected through purposive sampling. Thirty six semi-structured interviews and eight field notes were analyzed.

Results:

The data analysis revealed 417 codes, ten categories, three subthemes and one theme, that is, A Need for a Comprehensive Attempt. Attempt of organization, nurses, and public as subthemes are needed to prevent workplace incivility.

Conclusions:

The findings of the study indicated that a comprehensive and systematic attempt was needed to prevent incivility. Nurses should try to improve their skills; officials should try to show the real image and position of nurses and hospitals to the community.

Mobbing among care workers in nursing homes: A cross-sectional secondary analysis of the Swiss Nursing Homes Human Resources Project

BACKGROUND

As a category of bullying, mobbing is a form of violence in the workplace that damages the employing organization as well as the targeted employee. In Europe, the overall prevalence of mobbing in healthcare is estimated at 4%. However, few studies have explored mobbing among long-term care workers.

OBJECTIVES

This study aims to examine the frequency of mobbing in Swiss nursing homes and its relationships with care workers' (i.e. registered nurse, licensed practical nurse, assistant nurse, nurse aide) health status, job satisfaction, and intention to leave, and to explore the work environment as a contributing factor to mobbing.

DESIGN

A cross-sectional, multi-center sub-study of the Swiss Nursing Homes Human Resource Project (SHURP).

SETTING

Nursing homes in Switzerland's three language regions.

PARTICIPANTS

A total of 162 randomly selected nursing homes with 20 or more beds, including 5311 care workers with various educational levels.

METHOD

Controlling for facility and care worker characteristics, generalized estimation equations were used to assess the relationships between mobbing and care workers' health status, job satisfaction, and intention to leave as well as the association of work environment factors with mobbing.

RESULTS

In Swiss nursing homes, 4.6% of surveyed care workers (n=242) reported mobbing experiences in the last 6 months. Compared to untargeted persons, those directly affected by mobbing had higher odds of health complaints (Odds Ratios (OR): 7.81, 95% CI 5.56-10.96) and intention to leave (OR: 5.12, 95% CI 3.81-6.88), and lower odds of high job satisfaction (OR: 0.19, 95% CI 0.14-0.26). Odds of mobbing occurrences increased with declining teamwork and safety climate (OR: 0.41, 95% CI 0.30-0.58), less supportive leadership (OR: 0.42, 95% CI 0.30-0.58), and higher perceived inadequacy of staffing resources (OR: 0.66, 95% CI 0.48-0.92).

CONCLUSIONS

Mobbing experiences in Swiss nursing homes are relatively rare. Alongside teamwork and safety climate, risk factors are strongly associated with superiors' leadership skills. Targeted training is necessary to sensitize managers to mobbing's indicators, effects and potential influencing factors.

Addressing the Elephant in the Room: Nurse Manager Recognition of and Response to Nurse-to-Nurse Bullying

Health care bullying is a pervasive, underestimated, and underreported problem that results in poor outcomes for staff, patients, and health care organizations. The most common form of health care bullying occurs between nurses. Nurse managers hold an important role in the prevention and elimination of frontline nurse-to-nurse bullying. An anonymous Web-based survey was conducted to uncover what behaviors nurse managers perceive as bullying and how they respond to bullying acts. Respondents who had witnessed or been victimized by bullying were more apt to identify bullying and those who had been victimized or supervised nurses for more than 20 years were more prone to act upon bullying behaviors. There was only a moderate correlation between the identification of and response to bullying behaviors. Finally, overt bullying elicited a stronger response for intervention than covert bullying. Although nurse managers are well positioned to prevent and eliminate nurse-to-nurse bullying, they may not recognize it and often lack the skills and support necessary to address it. Decreases in nurse-to-nurse bullying reduce health care costs, improve nurse and patient satisfaction, and enhance patient outcomes. Therefore, nurse managers at all levels need education and support to ensure proper identification of bullying and, furthermore, to prevent and eliminate the behaviors.

Emotional intelligence education in pre-registration nursing programmes: an integrative review

OBJECTIVE

To investigate the state of knowledge on emotional intelligence (EI) education in pre-registration nursing programmes.

DESIGN

Integrative literature review.

DATA SOURCES

CINAHL, Medline, Scopus, ERIC, and Web of Knowledge electronic databases were searched for abstracts published in English between 1992-2014.

REVIEW METHODS

Data extraction and constant comparative analysis of 17 articles.

RESULTS

Three categories were identified: Constructs of emotional intelligence; emotional intelligence curricula components; and strategies for emotional intelligence education.

CONCLUSIONS

A wide range of emotional intelligence constructs were found, with a predominance of trait-based constructs. A variety of strategies to enhance students' emotional intelligence skills were identified, but limited curricula components and frameworks reported in the literature. An ability-based model for curricula and learning and teaching approaches is recommended.

Exploring workplace bullying in nursing

Bullying in the nursing workplace has been identified as a factor that affects patient outcomes and increases occupational stress and staff turnover. The purpose of this project was to assess registered nurses' perceived exposure to workplace bullying. A convenience sample of a Pacific Northwest state professional nurses' association membership was solicited for this descriptive study using the Negative Acts Questionnaire-Revised (NAQ-R). Forty-eight percent of respondents admitted to being bullied in the workplace during the previous 6 months, with respondents choosing "being ignored or excluded" as the most common negative experience in the workplace. The results of this study suggest that workplace bullying remains a problem for which reduction strategies must be devised as a means of retaining nurses and preventing adverse outcomes. One strategy shown to be effective in curbing bullying is assertiveness and aggression training for nurses.