.

, • ··AtUBI~KtI
Information U date

Emotional Intelligence
Recognizing and Regulating Emotions
by Amy Reeves, DSN, APRN

H
istorically, cognitive intelligence has been pro- levels since the early 1900s. The group of individuals en-
moted as an important factor in academic and ca- tering today's work force is more cognitively intelligent,
reer success. The majority of colleges have used but less emotionally intelligent (Achenbach & Howell,
grade point averages and college entrance test scores as 1993). According to a survey of employers, skills most
admission criteria and predictors of academic success sought after in workers are the non-academic skills: com-
with intelligence quotient (IQ) being the primary measure munication, creative problem solving, personal and inter-
of cognitive intelligence. However, research in the past personal skills, collaboration, and leadership (Carnevale,
decade has shown that cognitive intelligence is only half Gainer, Meltzer, & Holland, 1988). These skills promote
of the equation necessary for success in the workplace. A interdependence and teamwork. These effective assets
study of Harvard business, law, and medicine graduates can improve organizational performance in an era of nar-
found that IQ was not highly correlated with future career row profit margins and an unstable economy (Dearborn,
success (Akers & Porter, 2003). Ability to perform the 2002; Lam & Kirby, 2002).
job for which an individual is hired is a given. How the
job is performed is cruciaL The "how" is called emotional THE BRAIN AND EMOTIONS
intelligence (Humphrey, 2002). This is the other part of Through neuroanatomy and neurobiological and
the success equation, and it is the piece that may mat- neurophysiological processes, the role of emotions and
ter most in an individual's career trajectory. Emotionally behavior can be better understood. Emotions and behav-
intelligent individuals are those who are likely to be hired iors are the result of the complex interplay of the individ-
for a position, be promoted, and become a major asset to ual's response to the environment. From an anatomical
the company (Goleman, 1998). viewpoint, the brain's amygdala is where the emotions
Research has shown that since World War I, the aver- related to a particular experience are stored. Human be-
age IQ of individuals has risen 24 points, while emotion- ings attach emotions to experiences and these continue
al intelligence has fallen (Neisser, 1997). The rise of IQ to influence future decision-making abilities. If strong
scores has been attributed to improved nutrition, increased emotions, such as anxiety or fear, are experienced with a
numbers of children who finish school, fewer children in particular activity, these emotions will be recalled when
families, and the availability of computers in homes and it is time to repeat that particular activity. Basic decisions
schools (Goleman, 1998). Emotional intelligence, though such as, "Where is the best location to give this injec-
not identified until 1990, was measured in these studies tion?" are made based on prior experience. If the last ex-
by the psychological parameters of loneliness, depres- perience giving an injection was anxiety provoking, these
sion, anger, anxiety, impulsivity, and aggression. Each of same feelings are likely to reoccur.
these parameters has worsened across all socioeconomic Situational stress can undermine decision-making,
concentration, and recall, which can lead to an increase in
ABOUT THE AUTHOR errors. Stress and related emotions can cause the amygda-
Dr. Reeves is Family Nurse Practitioner, East Tennessee State University, la to override the prefrontal (executive decision making)
Johnson City, Tennessee. area and signal it to act, as in the classic "fight or flight"

172 AAOHN JOURNAL

response. This survival response is not always the most and integrity. Self-regulation also includes the ability to
helpful or appropriate response, because emotions, rather remain flexible in an ambiguous work environment. The
than intellect, take control. However, the prefrontal area occupational health nurse stays focused and remains on
can resume control and override the emotional impulses if task. Nurses adept at self-regulation will demonstrate mo-
individuals are aware of the emotions they are experienc- tivation by being achievement-oriented, taking initiative,
ing. The limbic system, of which the amygdala is a part, and remaining optimistic. Although no one is at his or her
is an open loop system, which allows for outside influ- best all the time, the emotionally intelligent nurse is able
ence. Interactions with others can alter neurophysiology, to display these behaviors on a more consistent basis than
emotions, hormone levels, ability to sleep, response to the nurse who lacks emotional intelligence. After nurses
illness, and cardiovascular function (Goleman, Boyatzis, recognize and regulate their own emotions, they can be-
& McKee, 2002). Employees, coworkers, or supervisors gin to recognize the emotions of others.
may "push our buttons," and nurses may behave in a man- The third component of emotional intelligence is em-
ner they regret when they have had time to calm down. pathy-the awareness of others' feelings, both overt and
covert. This skill is enhanced by the ability to listen care-
WHAT,IS EMOTIONAL INTElLIGENCE? fully and observe others. Studies have shown that women
Emotional intelligence is the ability to recognize and are better able than men to accurately identify the feelings
regulate emotions in self and others (Abraham, 1999; of others (Hall, Rosenthal, Archer, DiMatteo, & Rogers,
Goleman, 1998; Schutte et al., 2001). There are four ma- 1977). This skill has been linked to increased success in
jor components of emotional intelligence: awareness of work environments (Hall et aI., 1977). Through empathy,
self and others and management of self and others (Gole- relationships and support among employees are strength-
man et aI., 2002). ened (Abraham, 1999; George, 2000). For example, the
Occupational health nurses who are self-aware accu- nursing supervisor for an occupational health clinic will
rately perceive the emotions they are feeling at any given be more effective with staff, administration, and clients
time. Emotional intelligence is the ability to recognize through the use of empathic listening.
and identify one's own feelings. Awareness of emotions Listening is an important skill in nursing. Often,
allows nurses to function optimally without being con- listening occurs while multi-tasking (e.g., while taking
trolled by their emotions. Emotional intelligence also in- a blood pressure reading and asking history questions).
cludes being able to accurately identify personal strengths This is not empathic listening. Empathic listening is
and weaknesses. This accurate assessment leads to an at- the ability to "be with" the individual while listening.
titude of self-confidence as occupational health nurses It is giving one's full attention to the individual, not
capitalize on their strengths, while remaining committed "listening with one ear" while planning a response at
to improving areas of weakness. the same time. This type of listening requires the full
After nurses recognize their own emotions and level attention of the listener. By being able to empathize
of capabilities, the second component of self-regulation with coworkers, occupational health nurses can assess
or self-management can begin. For example, the occu- the climate of the organization and recognize the un-
pational health nurse may react with hostility toward spoken rules of the workplace (Humphrey, 2002). Em-
or ignore the complaint of an employee who overuses pathy also enables occupational health nurses to read
the health service. Emotionally intelligent occupational employees and respond to their needs in a productive
health nurses will recognize their own feelings toward manner (Abraham, 1999). After occupational health
the employee, set those negative feelings aside, seek to nurses master an awareness of others, they can better
understand the reasons behind the frequent visits to the manage relationships with others-the final compo-
clinic, and provide appropriate health counseling to the nent of emotional intelligence.
employee. Later, nurses can reflectively examine why Through understanding others, the emotionally intel-
they experience negative feelings toward some employ- ligent occupational health nurse influences and mentors
ees' visits. This reflection enables nurses to improve their others, creating a more effective workplace. The occu-
self-awareness, experience personal growth, and become pational health nurse mentor provides development op-
more effective nurses. portunities for less experienced nurses. The mentoring
Self-regulation is the ability to handle difficult and process includes the professional and practical aspects
powerful emotions and redirect them in a positive man- of being an occupational health nurse and the effective
ner. It allows the nurse to work in a non-disruptive, calm, aspects of listening and empathy-both emotional intel-
professional manner regardless of the emotions occurring ligence skills (George, 2000; Simpson & Keegan, 2002).
inside, especially in times of crisis. This lends a sense of By responding to the emotions and needs of others, the
stability and reliability to the work environment. The oc- emotionally intelligent occupational health nurse is able
cupational health nurse's coworkers and subordinates are to manage conflict productively by uncovering hidden
not worried that the nurse will "fly off the handle" during agendas and root causes through the accurate appraisal
stressful situations. of others' feelings and emotions (George, 2000). Occupa-
Another aspect of self-regulation is the ability to admit tional health nurses promote team building and collabo-
fault and to confront inappropriate behavior in the work ration, both of which are important leadership abilities
setting. These behaviors are indicative of trustworthiness (Druskat & Wolff, 2001; Garrett, 2005; Wachs, 2005).

APRIL 2005, VOL. 53,NO.4 173

 Emotional Intelligence Checklist
1. Are you able to read other individuals' feelings, behaviors?
2. Are you able to look beyond the behavior to recognize hidden motivations or agendas?
3. Are you able to receive criticism from others without taking it personally?
4. Are you able to give criticism without making it personal?
5. When you experience strong emotions (fear oranger):
a. Do you behave and speak appropriately?
b. Are you able to stay on task?
c.Are you able to "have a good rest of the day"?
d. Are you able to separate the cause of the emotion (another person) from the emotion?
e. Do you later reflect on the situation that lead to the emotion?
f. Are you able to grow and learn from the experience?
If you answer yes to a question, you demonstrate some of the characteristics of emotional intelligence. No one is able to do
these things all of the time. Self-recognition is the firststep to becoming emotionally intelligent.

Adapted from Druskat & Wolff (2001).

Emotional intelligence is a complex phenomenon hearing protection among plant workers. The production
that can be learned and mastered through a lifetime of ex- supervisor talks at length about his interest in safety, and
periences (Freshman & Rubino, 2002). Emotions affect hardly lets Mary present her program proposal. Mary
cognition and cognition affects emotions, thus influenc- knows from working with the production supervisor that
ing behavior and decision-making (George, 2000; Lam he is more interested in the bottom line and looking good
& Kirby, 2002). The ability to empathize, be self-aware, to his boss than with the safety of the workers. When
motivate others, have successful relationships, and main- Mary arrives in Health Service, the new nurse is waiting
tain self-control is an important aspect of professional for orientation. Mary sets aside her anger and spends the
nursing (Cadman & Brewer, 2001). next few hours explaining the general duties and the pa-
perwork expected ofthe occupational health nurse.
CASE STUDY In this scenario, Mary understands the hidden agenda
Mary is an occupational health nurse with 10 years driving the production supervisor's behavior. Even though
experience. She has worked in her present position as a his inappropriate behavior has angered her, Mary under-
supervisor at a large plant for the past 7 years. Today, she stands that his behavior is his issue, not hers. For now
has a meeting with middle management personnel and she has to set aside her anger and work with a new nurse.
then she has orientation for a nurse who is new to oc- Although it might be tempting to vent, Mary understands
cupational health. this would be inappropriate and refrains from doing so.
Mary is angry when she leaves the meeting with the
production supervisor. Mary spent several hours prepar- EMOTIONAL INTELLIGENCE AND NURSING
ing a proposal to improve employee compliance with the Nursing is a complex profession requiring profes-
use of hearing protection and the production supervisor sional nurses to interact with a variety of individuals in-
ignored her presentation. Mary is angry that she has to cluding professional colleagues, clients, and families in a
cope with a person who does not value her work. When high-stress environment. Emotional intelligence matters
Mary arrives in the Health Service, the new nurse is wait- more as the complexity of the work increases (Goleman,
ing. Mary, red-faced from the meeting, says. "As an occu- 1998). Emotional intelligence allows nurses to develop
pational health nurse, you will have to get used to dealing therapeutic relationships, care for clients and their fami-
with middle-management jerks like I just did! They don't lies, and manage stress (Cadman & Brewer, 2001; Simp-
understand anything about safety and they think all we do son & Keegan, 2002). There has been little emphasis on
is give flu shots!" emotional intelligence in health care. This may be due
In the above scenario, Mary has allowed her emotions to to the belief that interpersonal skills and empathy are
take charge, rather than the rational part of her brain. This already strong among health care employees. However,
lack of self-control causes Mary to act in an unprofessional research has shown that nurses do not always have suf-
and unappealing manner. However, if Mary has developed ficient skills in these areas (Bailie, 1996).
emotionalintelligence, the scenariomight transpireas follows: Studies with nurses and other professionals have
Mary has just come from the meeting with the pro- shown that moods tend to synchronize with cowork-
duction supervisor. She is angry because she spent several ers over time (Totterdell, Kellet, Teuchmann, & Briner,
hours preparing a proposal to improve compliance with 1998). Moods also can be transmitted to clients and influ-

174 MOHN JOURNAL

 How To Improve Emotional Intelligence at Work

1.Get to know the people you work with.

2. Have "member checks" atbeginning of meetings.
3. Recognize inappropriate behaviors occur for a reason. Ask questions and listen.
4.Tell coworkers what you are thinking and feeling.
5. When making a group decision, check for consensus.
6. Ask coworkers who did not share an opinion for their opinion.
7. Be concerned that all voices may not have been heard in quick decisions.
8. Play the devil's advocate.
9. Set ground rules for teams and use them to redirect inappropriate behavior.
10. Be supportive of coworkers and be willing to help out.
11. Let coworkers know they are valuable.
12. Respect coworkers.

Adapted from Druskat & Wolff (2001).

ence their health outcomes. In a study of cardiac clients, strength and need for personal improvement. There are a
those cared for by nurses with a generalized depressed variety of methods to improve emotional intelligence (see
mood were four times more likely to die than those cared the Sidebar above).
for by nurses without depressed moods in similar units Bibliotherapy is the use of "self-help" books to im-
(Goleman, 1998). prove quality of life and individual characteristics. Biblio-
Occupational health nurses must not only meet the therapy, the reading of specific books about emotions, has
needs of well, injured, and ill workers, but also the work- been used with school-age children who lack the qualities
ers' employer. The ability to juggle the complex issues of of emotional intelligence and has helped children recog-
safety, wellness, injury, and illness along with the bureau- nize emotions and emotional situations through characters
cracy of multinational companies requires both cognitive in books (Borders & Paisley, 1992). Research has shown
and emotional intelligence. For example, the occupational these children improve their recognition of emotions in
health nurse for a major corporation has developed a com- other individuals and in themselves.
prehensive program to decrease the incidence of work-re- Adults also can develop emotional intelligence through
lated low-back pain and injury aggravated by obesity. This reading, though the research is sparse in these areas. Gole-
program has been developed using the cognitive skills of man (1998) suggests professional training programs should
epidemiology, research, and program development. How- be used to develop emotional intelligence in the workplace.
ever, for the program to be well received by management There are some practical guidelines to further develop what
and employees, the nurse will need to use the emotional in- has been known as "the art of nursing." Self-awareness can
telligence skills of empathic listening, awareness of others, develop through personal, quiet reflective time; joumal-
and influence. These skills are key to both the development ing; reading; or exercise such as walking, yoga, or t' ai chi.
and implementation of the program. Reading is a powerful way to improve self-reflection and
Occupational health nurses must focus on bottom-line self-awareness. In the current fast-paced world, it is impor-
financial outcomes to gain administrative endorsement for tant for individuals to schedule personal time.
their programs. However, employees are more likely to en- Another method for improving emotional intelli-
dorse programs that will lead to improvement in their per- gence is talking about what is occurring in one's life and
sonal health and well-being. The occupational health nurse workplace, including one's feelings, with others. When
must assess the workers holistically rather than focusing meeting with employees (especially angry ones), occu-
only on illnesses or injuries. The nurse must also be able pational health nurses must realize some of the emotions
to assess and intervene with sensitive issues of depression, belong to employees and some to staff. However, occu-
drug and alcohol use, and family problems. pational health nurses need not take on the emotions of
every person they encounter.
ASSESSING AND IMPROVING EMOTIONAL If an individual has difficulty coping with a particular
INTELLIGENCE emotion, therapy may be helpful. The occupational health
To determine one's own emotional intelligence, re- nurse may need to recommend employees see their pri-
view the inventory listed in the Sidebar on page 174. This mary care providers, visit local mental health clinics, or
is a brief skill checklist one can use to determine areas of see the company employee assistance provider. If an em-

APRIL 2005, VOL. 53, NO.4 175

 ,,"" IN SUMMARY
a ~ i!I~ ~ '~I

'.
'f< 11 " ¥ " I ""

ployee is extremely distressed, the local crisis response ---_._'_._, ..... _--~~~~---------~
team should be notified. The occupational health nurse
should be concerned for personal, individual employee, Emotionallnlelligence
and corporate safety. If an employee is in crisis, local
emergency services (e.g., police, emergency medical ser-
Recognizing and Regulating Emotions
vices) should be contacted. The occupational health nurse Reeves, A.L.
should maintain a current list of local health care, mental MOHN ]ournal2005,. 53(4), 172-176.
health, and crisis care providers.

SUMMARY
Occupational health nurses are in the unique posi-
1 Nursing is a complex profession that requires profes-
sional nurses to interact holistically with avariety of
individuals in a high-stress environment. This ability
tion to influence health in the work force. To maximize to interact with clients and employers is essential to
this positive health influence, occupational health nurses program development and implementation.
should develop the skills of emotional intelligence. Emo-
tional intelligence includes awareness of self and others
and empathy. These behaviors are congruent with the
mission of nursing because they improve health out-
2 and
Emotional intelligence includes awareness of self
others and empathy. Although it is thought many
health care employees already possess these skills,
comes. Occupational health nurses who are emotionally
research shows that this is not always the case.
intelligent have improved relationships with others, an
important aspect of the nursing role.
Emotional intelligence can be developed. The pro-
cess begins with self-awareness, enhanced through self- 3 Emotional intelligence can be increased through the
development of self-awareness, awareness of others,
and empathy. It is important for nurses to cultivate
care behaviors, such as exercise and journaling. Reading
popular self-help literature also can improve self-aware- these skills because the behaviors associated with
ness. After a nurse becomes self-aware, the next phase is emotional intelligence further nursing's mission by
improving health outcomes.
to develop an awareness of others. This can be learned
using the same type of techniques in the self-awareness
stage. The final step is the development of empathy. This
Freshman, B., & Rubino, L. (2002). Emotional intelligence: A core
is the active step using the knowledge developed in the competency for health care administrators. The Health Care Man-
prior two stages. Through discipline and effort, an indi- ager, 20(4), 1-10.
vidual can learn to actively listen to others. This type of Garrett, L.H. (2005). Interdisciplinary practice, education and research.
listening fosters empathy. MOHN Journal, 53(4), 159-165.
George, J.M. (2000). Emotions and leadership: The role of emotional
By working in a positive, caring environment, per- intelligence. Human Relations, 53(8), 1027-1055.
sonal growth in emotional intelligence can be enhanced Goleman, D. (1998). Working with emotional intelligence. New York:
(McMullen, 2003). Through the development of emo- Bantam Books.
tional intelligence, the nurse can improve personally and Goleman, D., Boyatzis, R, & McKee, A. (2002). Primal leadership:
professionally, a win-win situation for all involved. Realizing the power of emotional intelligence. Boston: Harvard
Business School Press.
Hall, J.A., Rosenthal, R, Archer, D., DiMatteo, M.R, & Rogers, P.L.
REFERENCES (1977). Profile" of nonverbal sensitivity. In P. McReynolds (Ed.),
Abraham, R. (1999). Emotional intelligence in organizations: A con- Advances in psychological assessment: Vol. 4 (pp. 179-221). San
ceptualization. Genetic, Social & General Psychology Monographs, Francisco: Jossey-Bass,
125(2), 209-224. Humphrey, RH. (2002). The many faces of emotional leadership. The
Achenbach, T., & Howell, C. (1993). Are America's children's prob- Leadership Quarterly, 13, 493-504.
lems getting worse? A 13-year comparison. Journal ofthe American Lam, L.T., & Kirby, S.L. (2002). Is emotional intelligence an advan-
Academy of Child and Adolescent Psychiatry, 32(6), 1145-1154. tage? An exploration of the impact of emotional and general intelli-
Akers, M.D., & Porter, G.L. (2003). Your EQ skills: Got what it takes? gence on individual performance. The Journal ofSocial Psychology,
Journal ofAccountancy, 195,65-69. 142(1), 133-143.
Bailie, L. (1996). A phenomenological study of the nature of empathy. McMullen, B. (2003). Emotional intelligence. Student British Medical
Journal ofAdvanced Nursing, 24, 1300-1308. Journal, 11(2), 18-19.
Borders, S., & Paisley, P.O. (1992). Children's literature as a resource Neisser, U. (Ed.). (1997). The rising curve. Washington, DC: American
for classroom guidance. Elementary School Guidance & Counsel- Psychological Press.
ing, 27(2), 131-140. Schutte, N.S., Malouff, J.M., Bobik, c., Coston, T.D., Greeson, c.,
Cadman, C., & Brewer, J. (2001). Emotional intelligence: A vital pre- Jedlicka, C., Rhodes, E., & Wendorf, G. (2001). Emotional intelli-
requisite for recruitment in nursing. Journal of Nursing Manage- gence and interpersonal relations. The Joumal ~fSocial Psychology,
ment, 9, 321-324. 141(4),523-536.
Carnevale, A.P., Gainer, LJ., Meltzer, A.S., & Holland, S.L. (1988). Simpson, RL., & Keegan, AJ. (2002). How connected are you? Em-
Work place basics: The skills employers want. Training & Develop- ploying emotional intelligence in a high-tech world. Nursing Ad-
ment, 42(10), 22-30. ministration Quarterly, 26(2), 80-86.
Dearborn, K. (2002). Studies in emotional intelligence redefine our ap- Totterdell, P., KeIlet, S., Teuchmann, K., & Briner, RB. (1998). Evi-
proach to leadership development. Public Personnel Management, dence of mood linkage in work groups. Journal of Personality &
31(4),523-530. Social Psychology, 74(6), 1504-1515.
Druskat, V.U., & Wolff, S.B. (2001). Building the emotional intelligence Wachs, 1. (2005). Building the occupational health team. MOHN Jour-
of groups. Harvard.Business Review, 79(3), 80-90. nal, 53(4), 166-171.

176 AAOHNJOURNAL