We have come to a time in our profession and industry when skills and knowledge are not enough to ensure sound clinical outcomes, a high level of patient satisfaction, and excellent staff engagement scores. This realization is difficult for me to write, and I am sure it is difficult for you to read.
Standardizing the academic preparation for nurses nationwide has been a constant goal put forth by the ANA during my forty-year career. Enabling nurses to practice to the level of their license and academic preparation was a major theme of the Future of Nursing 2010 Report to Congress. Encouraging clinical excellence through nationally accepted clinical certifications is a cause I have participated in and promoted to my students and colleagues. We have been validating clinical competency as outlined by the Joint Commission since the 1980s. Still, I am explaining to you that these actions are no longer enough.
When we review the indicators (metrics) for success such as the national survey indicators of patient satisfaction, staff satisfaction, and staff engagement, very few of the metrics address clinical knowledge and skill competency. Attaining desired scores seems to be a reflection on how well leaders connect with their staff and how well that team connects with patients and their families. It is the ability to access and use the interpersonal skills needed to build and sustain relationships that drive these survey outcomes. It follows then that anchored emotional intelligence skills are the new competency benchmark for success in the healthcare workplace.
The new equation for success is:
The healthcare industry has not embraced this equation as readily as other industries. I do not believe that this oversight was intentional. Since 1985 and the implementation of the prospective payment model, the healthcare industry has not had a sense of stability. We have virtually been trying to adapt or reinvent our models of care every few years in an attempt to survive. You can lose sight of the need to invest in the development of your staff when you are in survival-mode.
Emotional intelligence, as defined by Dr. Daniel Goleman (1998), is the ability to manage our emotions well in ourselves and our relationships. Emotional intelligence should be the new measuring stick used to assess a person’s ability to be a transformational leader and thereby, successfully lead in the 21st-century. Investing in emotional intelligence training for the staff can help them access their empathy and compassion easily. This ability to connect is essential if they are to engage the patient, their family, and each other.
If we are genuinely committed to creating patient-centered cultures where caring and service is at the heart of all we do, then we must insist that each leader and professional caregiver commit to growing his or her emotional intelligence. I believe that acknowledging the life skills of emotional intelligence as equally vital as professional knowledge and clinical skills in our leaders and staff is the long-term solution to effectively dealing with bullying and incivility in healthcare.
The Four Competencies of Emotional Intelligence
According to Daniel Goleman (1998), four competencies must be developed so that an individual can realize a proper level of emotional intelligence:
Self-awareness is the first element of emotional intelligence. It is also the gateway competency. You cannot progress any further along the path to achieving sound emotional intelligence if you do not spend the time and energy necessary to understand your emotional triggers.
Self-awareness is the ability to recognize and understand how your emotions act in your body to trigger you into action. It also helps you to realize the effect your conduct has in any given situation and on those around you. Becoming more self-aware is a process of stepping outside yourself and viewing your behavior and the consequences of your actions from a very different perspective. It affords you the opportunity to see how habitual behaviors that no longer serve you, produce undesired impressions and outcomes.
Acknowledging your character strengths but more importantly, recognizing the habitual behaviors you employ, that are short-circuiting your success, is not comfortable or pleasant. I often liken it to chewing on glass. No professional adult wants to engage in a process that reveals the etiology of their shortcomings and miscreations. However, this is the process. It takes a good deal of personal courage and fortitude to walk emotions back far enough to understand why you do what you do.
It also takes a lot of self-compassion to relive events that you wished you could undo. Nothing is gained through self-deprecation. The goal of the process is to gain insight and enlightenment, not beating yourself up to the point of shutting yourself down. The objective is to understand the energy behind your regrettable words and actions so that you can begin to forgive yourself and let go of the pain associated with that memory. You are then empowered to learn the lesson that allows you to move forward in a very different way.
It is hard work, and it takes time. However, the return on this investment is enormous. Self-awareness allows you to re-embrace your more authentic self. The person you were before life started to exact its toll on you. It enables you to take the next step along the path toward emotional intelligence development.
Self-management is the ability to act with intention. It is the life-skill that allows you to go through your day without being provoked to react in a manner that you did not actively and deliberately choose. Self-management requires that you do what it takes to have emotional self-control. Self-management provides you with that momentary pause between thought, emotion, and reaction that is so vital to acting with discernment.
When we pause, we become mindful in the moment. We can hear the intuitive guidance of our body better. You don’t ignore the feeling of tension in your neck. You realize that you are stiffing your mouth or getting a knot in your belly. These signals serve as messages that you are about to respond in a manner that is triggered, not chosen.
I cannot overstate the importance of self-management. How you respond is an essential component of your professional reputation. It is the life-skill that allows you to act consistently day in and day out. Regardless of your motivation or intent, people can only observe and respond to your behavior. Remember that people will always remember how you made them feel. Consistency gives people something to trust.
Role modeling is a transformational leadership tool for anchoring the behaviors expected by your organization. Consistency is what cements your actions and accurately demonstrates, to those you lead, how one should conduct oneself throughout the day regardless of what takes place. The ability to self-manage sends the positive message that each of us is personally responsible and accountable for our words and actions.
Social-awareness is a natural outgrowth of good self-awareness and self-management. Social-awareness is the ability to appreciate other people’s feelings, needs, and concerns. You are now capable of recognizing and appropriately responding to the emotions and needs of others. This attribute is an engagement essential. Social-awareness is the ability to step outside yourself and your immediate needs.
It is the life-skill that allows you to be available and empathetic to others. Social-awareness is the ability to make a very human and authentic connection. You have journeyed down the path of self-awareness and now know the effort that it takes to self-manage therefore, you have more compassion for the challenges of others.
When you can relate on that level, no one is a stranger. You create trust. You put people at ease, and you make them feel heard. Social-awareness makes you relatable on a very genuine level.
The skills of building relationship equity start to bubble up naturally. You become a better listener. You are capable of saying what you mean and meaning what you say in a manner that is free of harsh or inappropriate tones or sharp edges. There is a natural air of civility and fairness that emanates from within you. You are quick to acknowledge errors or shortfalls. This characteristic creates a reputation for transparency essential for transformational leaders.
The life-skill of relationship-management is the capstone of emotional intelligence development. This quality is the ability to acknowledge and understand that relationships are the currency of the workplace or your private life. People with sound relationship-management skills embrace that individual success and team/group success are one in the same.
Relationship-management is the life-skill that enables transformational leaders to create in others a desire to engage, participate, and do their personal best. These leaders are gifted with the ability to coordinate a group effort while remaining attuned to how individuals are thinking and feeling. They naturally stay curious and invite diverse thinking into any problem-solving task.
This ability to be inclusive of divergent thought is the foundation upon which they can build their conflict management skills. Mastery of conflict management is dependent upon one’s understanding and acceptance that there is never an absolute solution. They embrace negotiation and the win/win scenario rather than the energy of compromise that often leaves people feeling that they gave up something essential.
When your emotional intelligence is fully developed, it is easier to be consistent in an ever-changing environment. Emotional intelligence allows you to flow through the process of change. You are more capable of delivering a consistent product regardless of what challenges you on any given day.