By Beth Boynton, RN, MS, CP

In Daniel Goleman’s model of emotional intelligence (EQ), there are two main competencies: Personal competency, which includes self-awareness, self-regulation, and motivation; and social competency, which includes social skills and empathy.

We can think of both competencies in terms of communication. Personal competency relates to our abilities to identify and value our needs, wants, limits, etc., and to express them respectfully, i.e., speaking up. Social competency refers to our ability to observe, interpret, understand, and respect others’ feelings, thoughts, and points of view, i.e., listening.

EQ and staffing

Safe nurse staffing is a complex, chronic, constantly changing, and expensive challenge with repercussions for all stakeholders. It’s a problem we’ve been trying to solve for as long as I’ve been an RN (over 30 years)! What’s missing in all of our efforts is a strategy that empowers us to express our needs in any given moment and have them respected. This is a moment-to-moment dynamic dance of communication among staff and with leaders that must include compromise, stretching, and limitations.

At any given moment, there must be enough staff with the right skills and experience to meet the diagnostic and related needs of patients. Nurse staffing ratios present a partial solution to safe staffing, as they provide a solid baseline of staff availability and patient needs.

However, nurses with EQ have access to vital skills that will help ensure a dynamic balance.

As individuals

Nurses with EQ can identify their needs and limits, feel worthy of having them, and express them respectfully and confidently. They will have developed an inner gauge to measure stress and recognize when overwhelm presents risks to themselves and patients. Not recognizing such limits shows up in work-related injuries, mistakes, burnout, and compassion fatigue. All of which have a counterproductive impact on staffing.

As team members

As nurses go about their work and interface with a variety of health care teams, not only will they be able to recognize and express their own limits, but they will also pick up on stress-related nonverbal cues expressed by colleagues and listen with respect when colleagues are asking for help. Offering feedback that includes concern, such as, “You look overwhelmed; do you need help?” is the opposite of blaming and bullying, which have been chronic problems alongside staffing issues.

As leaders

In addition to their individual and team influences, leaders with EQ also listen to and respect the needs and limits of staff. This means advocating for resources, considering limitations an organization should have on what care it can provide safely, and holding tough conversations with staff who have a pattern of limitations that are not aligned with job expectations. It may be tempting for leaders to pressure staff or ignore requests for additional help to accommodate organizational expectations, but in the long term, it is not healthy for anyone. Evidence for this is all around us these days with incidents of strikes, quiet quitting, sentinel events, toxic cultures, and more.

Developing EQ

Medical improv is an experiential teaching modality that is perfect for promoting EQ because it raises awareness of self and others, provides practice opportunities that build confidence, trust, empathy, flexibility, and more, and promotes positive relationships. All activities are based on the principle of “YES AND,” discussed in the KevinMD post, “‘YES AND’: a vital, versatile, and visionary leadership tool.”

Summary

While compromising and being available beyond expectations is necessary sometimes, constant stretching of staff is not a solution. This can only lead to burnout, quiet quitting, workarounds, mistakes, union strikes, poor patient experience, and other problematic outcomes. We need to be able to express our needs and be heard!

Ultimately, one nurse with EQ that faces chronic understaffing will probably find a way out. A team of nurses with leaders who have EQ will co-create systems where realistic expectations, safe care, respectful communication, and a healthy workforce are all emerging in a safe, affordable, and healthy balance. For everyone!