https://doi.org/10.15218/ejnm.2020.10 Erbil j. nurs. midwifery, Vol. 3, No.

(1), May, 2020

Original Article

Consequences of Emotional Intelligence in Nursing: A Concept Analysis

Abdulaziz Mohsen Alsufyani; Comprehensive Rehabilitation Center, ministry of labour and social development, Taif,
Saudia Arabia )Correspondence: [email protected] )
Omar Ghazi Baker; Department of Community and psychiatric nursing, College of Nursing, King Saud University, Ry-
iadh, Saudi Arabia
Yasir Mohsen Alsufyani; Department of Nursing, College of Nursing, King Khalid University, Abha, Saudi Arabia

ABSTRACT
Background and Objectives: Emotional intelligence refers to a social skill, which enables individu-
al to better regulate emotions and cope up with the different demands and environmental pres-
sures. This assists in enhancing professional competence enabling better delivery of services. This
paper aimed to examine the consequences of emotional intelligence in the nursing profession by
presenting its concepts, definitions, models, and implications.
Methods: A literature review study was made and articles were searched from various databases
including Scopus, EMBASE, ProQuest, PsychINFO, and CINAHL, using key terms “emotional intelli-
gence,” “nursing,” and “concept analysis” from 2000 to 2019. Twenty articles were included fol-
lowing their compliance with the inclusion and exclusion criteria and removing of the duplica-
tions.
Results: Social and personal attributes affect emotional intelligence. Self-awareness, relation-
ships, self-management, and social awareness are other important components of emotional in-
telligence. The nursing professional explains a social and personal aspect that emotional intelli-
gence entails and further portrays a meaningful role of emotional intelligence in both the sensi-
tivity and moral dimension of clinical practice.
Conclusion: The nursing professionals who possess increased emotional intelligence experience
few emotional psychosomatic symptoms and emotional exhaustion, greater workshop collabora-
tion and teamwork, more satisfaction with their jobs, fewer unidentified patient care needs, and
better emotional health.
Keywords: Concept analysis; Emotional intelligence; Nurses; Nursing; Psychology

Received: 29/12/2019 Accepted: 30/3/2020 Published: 30/5/2020

INTRODUCTION
Emotional Intelligence (EI) refers to the Emotionality is a skill for showing empathy,
competence to manage and regulate the being concerned about the insights of oth-
emotions of oneself and others. It is ob- ers in a situation, and communicating feel-
served across several nursing domains, giv- ings [4]. The social competence of individu-
en its nurses’ wellbeing, which successively als, their competence to explain strong so-
influences patients and their families cial skills and to influence others is con-
[1].There is a general lack of understanding cerned within the sociability component.
of EI and its overall significance and scope Wellbeing includes a person having the
with various competing definitions and attributes of feeling happy and satisfied
models [2]. When integrated in practice, with a positive outlook on life and a good
unclear concepts can lead to a significant level of self-esteem [5]. Lastly, self-control
amount of misapprehension and confusion, shows the competence of a person to con-
since EI is a concept already emerged with trol and regulate his emotional responses
confusion. EI is identified through four and skills for handling stress. Landa et al.
major aspects, including emotionality, [6] showed that emotional intelligence was
sociability, wellbeing, and self-control [3]. initially mentioned in the nursing field

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after 2000.Ever since then, studies have methods are adopted for providing clarity
shown its integration with various nursing on concepts, its strengths, and limitations
competencies, improved practices, educa- so that it can provide an improved contri-
tional achievements, compliance with the bution to its application and knowledge.
discipline, enhanced professional behav- Several methods have been proposed for
iour, and patients’ satisfaction [7,8]. How- concept analysis. However, this paper uses
ever, Smith, Profetto-McGrath, & Cum- an evolutionary method for concept analy-
mings [9] have described it as an ambigu- sis proposed by Rodger in 1989 due to its
ous term in nursing, given its relatively new strong viewpoints in evaluating subject to
development [10]. Various studies confirm change. Rodgers [15] assumes that con-
that the adequate use of the concept and cepts are revealed by a cluster of situa-
its clear understanding assists nurses tions, phenomena, or attributes that are
across different disciplines, including edu- experienced concerning similarities. This
cation, research and practice [11-13]. method refers to the concepts that are
Thereby, this research aims to investigate constantly enriched and approves that
the emotional intelligence concept for clar- conceptual variations and innovations
ifying the definition and its implementation might be defined over time because con-
in the healthcare setting, primarily by the cepts are discussed and transferred
nurses. A strong and positive link of emo- through social interactions and education.
tional intelligence with staff wellbeing and Therefore, attributes and consequences
performance [8-15], further necessitates its related to EI were searched and presented
assessment. A vivid comprehension of EI in this paper. Lastly, related concepts were
and its consequences is incremental in acknowledged, and an exemplifying model
nursing practice, which assists in under- case of the concept was developed to pro-
standing the association of emotions with vide conceptual clarity. Data source The
cognition. EI allows nurses to make better concept of EI was explored using a com-
decisions, improve relationships, positively prehensive literature review, considering
affect care quality and their families, and the Rodgers evolutionary method concept
effectively manage their patients. Identify- analysis. This approach provides the best
ing the consequences of EI might enhance way of examining EI in nursing practice.
its adoption within the nursing profession, One of the strengths of using this approach
especially due to the EI impact on nursing is its viewpoint toward changes that hap-
actions. Certainly, this paper aims to exam- pen over time, rather than defining an ulti-
ine the consequences of EI in the nursing mate truth, which can be used later for
profession by presenting its concepts, defi- developing a general understanding of EI.
nitions, models, and implications. No particular range or limitations were
identified for supporting the dates of publi-
METHODS cations to support this approach. The arti-
It is important to clarify concepts such as EI cles were searched from databases such as
throughout nursing practice, as concepts Scopus, EMBASE, ProQuest, PsychINFO,
majorly contribute to the development of and CINAHL for the key terms “emotional
awareness. Unclear attributes and defini- intelligence,” “nursing,” and “concept anal-
tions of concepts significantly prevent the ysis” from 2000 to 2019.To narrow the re-
fundamental use of the concept because sults, the Boolean approach was used,
there might be doubt concerning related or such as “Emotional Intelligence” AND
similar concepts. The concept analysis “Nursing.” The objective of the literature

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review was to obtain published peer- RESULTS

reviewed articles that were presented in Definitions
the English language. Articles presented in In the area of psychology, several different
abstracts were also considered in the inclu- types of EI are identified, such as the de-
sion criteria. No restrictions were applied velopment of cultural intelligence and its
in terms of geographical setting to obtain a association with social intelligence [17].
broader view of definitions, concepts, and Emotional intelligence is interlinked within
consequences of EI in nursing. Articles fo- the theory of multiple intelligences, where
cusing on the behaviours of adolescence the role of emotions and relationships was
and EI and other specific subjects were ex- first considered within the concept of intel-
cluded from the search process. These ligence [9,18]. EI is originally defined as
were excluded as these are too specific, based on a set of interlinked competen-
whereas the focus of the present paper is cies. Currently, it is defined as a heteroge-
to provide a general EI understanding. Psy- neous combination of attributes as com-
chology, business and management, edu- pared to ability [19]. Goleman [20] defined
cation, and healthcare were several disci- one of the innovative definitions of EI,
plines in which we were restricted to ex- which is widespread in the discipline of
tract the articles related to EI. The articles nursing. According to the definition, EI is
that had an emotional intelligence word in defined as competence to identify the feel-
their title or abstract were selected. The ings of a person and emotions interlinked
quality assessment was conducted to en- with other relationships. It is essential to
sure that the selected article meets the focus on the general implications of this EI
points laid out for the study selection. The definition and the contributions of
studies’ methodological quality was ranked Goleman [20], Mayer and Salovey [21], and
using the hierarchy of evidence: nursing Bar-On [22] as they contributed to this
resources [16]. 20 articles were included in realm by developing their models. Attrib-
this concept analysis paper after com- utes Attributes of emotional intelligence
pleting the inclusion and exclusion process are classified into two major categories,
and removing the duplications. Figure 1 including social and personal attributes.
presents the selection procedure of the Firstly, social attributes are based on social
number of articles included in this re- awareness and relationship management.
search. Social awareness refers to the observa-
tions and understanding of emotions, con-
cerns, and needs of others, the ability to
explore things with other people’s insights,
and picking up emotional cues [23-25]. Re-
lationship management is a competence
for managing better relationships, inspiring
and influencing others, and communi-
cating clearly for managing relationships
with others [24, 26, 27]. Self-awareness, in
personal attributes, entails understanding
and identifying emotions and motivations
of a person along with his strengths, weak-
nesses, and needs. Self-management is a
Figure 1: Study Procedure
competence of controlling or redirecting

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emotions constructively. It enables a per- potential for facilitating and strengthening

son to deny evaluation until sufficient in- their capacity to provide palliative care
formation is collected and to assume be- that Mr. M might be experiencing substan-
fore acting [24].Development of Cas- tial negative feelings. This evidence might
esModel cases and examples The model inform the next actions for the APN in sup-
case presented here is based on clinical port and planning care that is individual-
experience for representing the concept of ized to Mr. M, as she will be able to effec-
emotional support. The patient called Mr. tively work through their emotional state
M (names are altered within this section to and interpret that into supportive strate-
protect confidentiality and anonymity) was gies towards Mr. M. Contrary outcomes
referred by an advanced practice nurse In a contrary case, an example of the lack
(APN). See the below case: “The nurse was of emotional support is presented, which
shocked that Mrs. M did not start CPR on helps in exploring the ways that differenti-
her husband. The idea that Mr. M may ate it from the model case. “David is ad-
have had a better consequence regardless mitted to the local palliative care unit.
of any shortages led to feelings of frustra- Over the last few days, his condition has
tion for the nurse. She might not be cogni- deteriorated, and he cannot move from his
zant of her behaviours if the nurse did not bed. The senior nurse evaluates that David
identify her emotions. Inadequate reac- will require a bed bath the next morning.
tions can result in negative implications for So, two nurses have been asked to attend
family care. To be precise, emotional intel- to the personal care of David during their
ligence allows persons to be aware of their shift. The nurses enter the room of David
reactions and emotions and reflects the and inform him that they will be aiding him
way they respond to others. The feelings to wash. Both nurses start communicating
of frustration and disappointment can in- with each other discussing their daily rou-
terpret into formulating evaluations of the tine while carrying out personal care, and
nurse. In particular, the needs and con- communicate with David whenever he
cerns of Mrs. M may not be appropriately needs help”. The feelings of frustration
communicated and addressed if a thera- and dismay of a nursing professional can
peutic relationship is not developed. be translated into formulating evaluations.
Awareness of her emotions might either A negative evaluation may have the possi-
help the nurse to understand Mrs. M or bility to inhibit the development of a ther-
may enable her emotions to lead how she apeutic relationship if the nursing profes-
delivers care”. APN is allowed by being in sional shows this reaction to the patient.
charge of the emotions of Mr. M in emo- Consequently, the needs and issues of a
tional prediction. Affective prediction fore- patient might not be appropriately ad-
casts how people will feel in response to a dressed and communicated, if a therapeu-
future event. The APN observed the condi- tic relationship is not established. The
tions of Mr. M, considering that his unan- nursing professional will also be troubled
ticipated medical emergency and his prog- by the responses and feelings of a frustrat-
nosis was deprived under different situa- ed patient. Identifying the emotions of a
tions. An emotionally intelligent person is patient can either help the nursing profes-
capable of identifying and managing his sional to understand him/her or may ena-
emotions in a way that would positively ble the nursing professional to interfere
affect her relationship with Mr. M. Conse- with how she delivers care. Related case
quently, the competence of APN has the In a related case, the concept is associated

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with the concept being investigated but Peter has been contacted by the local
does not comprise all the defining charac- community nurse at home to arrange her
teristics. “Sarah is a 45-year old woman first visit to obtain a pre-chemotherapy
who comes to see her husband, Joseph, at blood sample. While obtaining his sample,
the local community hospital. Joseph was the nurse talks with Peter about his re-
diagnosed with a malignant brain cyst 19 cent scans. The nurse listens to Peter
months before and received proper treat- about the negative effect of the news and
ment, resulting in modifications to his mo- how he understands what is happening.
bility, personality, and cognitive function. He becomes quite upset when explaining
Diagnoses have indicated advanced dis- what the future may hold for him, and he
ease, and he has currently been complain- quickly attempts to regain his composure.
ing about rapid seizures. Sarah was in- The nurse portrays what a distressing
formed that Joseph is working with the time it must be for him and his family and
physiotherapist, so she has to wait for him reconfirms Peter that the primary health
to return. The nurse offers Sarah a cup of care team is there for helping and sup-
tea while using the chance to ask how Jo- porting him”. Being responsible for one’s
seph is. The nurse sits beside Sarah and emotions enables an individual to involve
asks her a few simple questions, which al- in emotional prediction. Affective predic-
low her to talk. She tells the nurse about tion forecasts how a person will feel in
the negative effect of Joseph’s illness on reaction to a future event. Consider an
their personal lives”. Motivation indicates example; if a patient had an unexpected
having a distinctive focus to gain, and em- medical emergency and the prognosis of a
pathy is the ability to understand emo- patient was adverse, the nursing profes-
tions, perspectives, and thoughts of anoth- sional should respect the feelings of that
er person. A person would have to be mo- patient under different conditions, and
tivated to understand emotions and be therefore, forecast future feelings. A nurs-
clear in accepting the emotions of other ing professional is emotionally intelligent
individuals. The related case presented who is competent enough for identifying
above shows an example of the concept of and managing her emotions in a way that
empathy, which refers to actively listening, positively impacts her working relation-
feelings with sensitivity and accuracy, and ship with the patient. Consequently, the
feeding back thoughts. The APN explains ability of nursing professionals can facili-
empathy by making efforts to understand tate and strengthen their competence to
what is happening from the perspective of provide supportive care to the patient, as
Jensen. The APN manages to convey her the nursing professional identifies his/her
understanding of Jensen’s situation by ac- own emotions. A nursing professional
knowledging her feelings using verbal and who possesses EI has competence in iden-
non-verbal behavior .Borderline example tifying and understanding that the patient
In a borderline case, an example is pre- might be facing substantial adverse feel-
sented comprising the defining characteris- ings or emotions. This information may
tics but varies significantly in one of them. assist in inspiring the nursing professional
A borderline case is presented below con- to plan her next actions in caring for and
cerning emotional intelligence. “Peter is a supporting the patient. Furthermore, a
58-year-old gentleman who has progres- nursing professional will be able to effec-
sive lung cancer, and he has to initiate a tively work through her emotional state
course of palliative chemotherapy. and transmit that into supportive actions

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towards the patient, which consequently as influence the practices of the staff
enriches the antecedents of empathy. An- nurses and more. Tyczkowski et al. [31]
tecedents of emotional intelligence Self- stated that emotional intelligence ena-
management and self-awareness are im- bles the individuals to become emotion-
portant factors to maintain the well-being ally sound, fostering transformational
of both the nurse and their patients. To be leadership within nursing practice. Given
precise, APNs who developed a sense of that the concept of EI is not generally
empathy are motivated to cope with their recognized in the nursing discipline, it is
own emotions, to experience less stress, integral for the nurses to further re-
burnout, and job dissatisfaction. These an- search this area to improve and develop
tecedents influence the care of patients, their understanding, which will promote
the overall well-being, and the families of better understanding, information syn-
nurses. In addition, emotional intelligence thesizing, as well as generating and as-
is also comprehending the influence of sisting in improved decision making [32,
emotions on other individuals and pacify- 33]. Sarrionandia and Garaigordobil [34]
ing emotions of an individual at times. also emphasized emotional intelligence
Consequences of emotional intelligence development among the nurses as it re-
Consequences are incidents or events that duces the emotional psychosomatic
can occur due to the occurrence of a con- symptoms and burnout, promoting satis-
cept. Determining consequences through- faction towards their job. Emotionally
out the context of a model case enhances intelligent nurses can employ research-
the transparency of EI in the nursing prac- based knowledge and knowledge-
tice. The consequences of EI throughout transfer techniques for delivering quality
the nursing practice are related to the -infused results. This understanding is
wellbeing of nurses as working experts. likely to refine the quality as well as de-
For instance, the evidence is present be- livery of nursing care.
tween nurses and job satisfaction, stress
DISCUSSION
levels, retention, and burnout [28]. A nurs-
ing professional possessing EI would be The preliminary focus of this concept
able to comprehend the process to predict analysis was to understand the conse-
future emotional reactions of an individu- quences of EI in the nursing practice,
al, in terms of patient and family care [29]. specifically on the nursing professional,
A nursing professional can help the devel- who can meet the needs of a person,
opment of positive relationships as they families, communities, and a population.
are aware of predicting their feelings, re- A nursing professional can address her
actions, and responsiveness to a future own emotions and feelings for under-
interaction or event [30]. Consider a case standing how they affect her ability and
where inadequate reactions of a nursing collaboration to explain leadership [11-
professional can result in adverse implica- 13]. Emotions are an important compo-
tions to the patient and family, which nent of critical decision-making and are
might be due to the feelings of frustra- a fundamental aspect of the quality of
tions. Precisely, EI enables people to be clinical care. A broad foundation of nurs-
aware of their reactions and emotions and ing expertise required in decision-
reflect the way they respond to others. making directly affects patients and fam-
This is particularly useful for the nurses in ily care. Particularly, decisions are more
leading positions as they affect as well patient and family-focused and

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empathetic and support and improve the CONCLUSION

role of the nursing professionals. In this Emotional intelligence is an essential as-
situation, the nursing professional explains pect of nursing practice as emotions and
a social and personal aspect that EI entails sensitivity to mood are prime compo-
and further portrays a meaningful role of nents of care and cannot be ignored from
EI in both the sensitivity and moral dimen- how we assume and act like experts.
sion in clinical practice [23-25]. Self- Much work remains to be done, especial-
awareness enables nurses to connect ly for the inconsistency of attributes,
thoughts, actions, and emotions in an in- whereas a great deal of work is attempt-
fluential manner [24], and therefore, is a ed for understanding and exposing EI as a
vital competency in decision-making and concept. EI facilitates emotional well-
creative procedures that might be based being among the nursing professionals
on intuitions and feelings. EI supports and helps in improving the competence
nurses in using empathy as a resource to to practice abilities that will benefit pa-
understand situations that are based on tients, colleagues, and families as working
moral evaluations and professional reflec- professionals and as individuals. Emotion-
tion associated with decision-making [4]. It al competence and effectiveness are used
also enables nurses to ensure the safety of interchangeably with emotional intelli-
the patients. EI has been associated with gence and are regarded as surrogate
stress, emotional wellbeing, and mental terms. Reflexivity and reflection are
health throughout the context of nursing. terms that are associated with emotional
Patients who are not able to adequately intelligence insofar as they are words that
manage their emotions do not seek help have something common with emotional
or encouragement. The competence of a intelligence but do not have the same
nursing professional to encourage emo- attributes. Consequently, EI encourages
tional management among patients and more than just awareness of emotions; it
their families might assist in facilitating enables nurses to provide quality care
therapeutic associations between nurses and support to their patients. The ability
and patients if nurses exemplify an emo- to identify and understand EI will remain
tionally intelligent practice. The nursing an essential aspect of nursing practice
professionals with high emotional intelli- moving forward, despite the misappre-
gence explain less emotional psychoso- hension and confusion about EI as a con-
matic symptoms and emotional exhaus- cept.
tion, greater workshop collaboration and
teamwork, more satisfaction with their ACKNOWLEDGEMENT
jobs, fewer unidentified patient care The author is very thankful to all the as-
needs, and better emotional health [8, 7, sociated personnel in any reference that
28]. However, for improving the out- contributed to this research.
comes, the clinical instructions, and the
regulatory system should be established CONFLICT OF INTEREST
for devising effective decisions. Guidelines The author reports no conflicts of inter-
can be set for training the employee which est.
not only improves the emotional intelli-
gence competence but also helps in in- FUNDING
creasing the satisfaction of nurses as well The study is self-funded.
as patients.

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