Emotions: Not Obsolete In the Workplace
Emotions: Not Obsolete In the Workplace
A product of the industrial era, traditional leadership styles still reign dominant within healthcare systems answering to systemic pressures, rather than ensuring best patient health outcomes (Weberg, 2012). A consistent finding in current nursing literature is the importance of emotional competency of nurse leaders, as it reduces the burden of workplace stress and improves nurses’ self perception of job performance (Boamah, 2018; Lawal & Idemudia, 2017; Oh & Lim, 2019). Managers and leaders utilizing emotional competency with a transformational leadership style have higher nurse retention rates (Jambawo, 2018; Sheard, 2014; Velmurugan, 2017). This suggests the myth that emotions should be removed from the workplace is not only wrong, it is counterintuitive within the nursing profession and the healthcare system. In this paper, current nursing literature is used to negate the myth “emotions should be left at home,” while practical application and development of emotional competence of nurse leaders will be supported. Additionally, the concept of transformational leadership is used to support nursing leaders in affecting change in their workplace culture.
Stress and Emotions in the Workplace
Workplace stress is a large contributing factor of burnout in new nurses and is the leading cause of nurses leaving their jobs (Dyess, Sherman, Pratt & Chiang-Hanisko, 2016). Largely related to management and workplace culture, the nursing practice environment has long been a prominent topic in the nursing profession due to its correlation with job satisfaction (Roche, Laschinger, & Duffield, 2014). Understaffing caused by poor nurse retention compromises patient health outcomes and exacerbates workplace stress felt by remaining nurses and other allied clinical care providers (Elliott, 2017; Jambawo, 2018). If emotional labour becomes better understood and valued, more supportive strategies can be implemented to assist nurses in avoiding and recovering from compassion fatigue and burnout, effectively reducing the number of nurses leaving the profession (Elliott, 2017).
Nurses offer their clients “the unconditional gift of emotional support;” a type of emotional labour where they evoke emotional responses from their clients by showing an outward expression of empathy, regardless of their inward feelings (Elliot, 2017, p. 1071). Emotional labour has long been an intrinsic commodity of the nursing profession and remains undervalued within Canada’s healthcare system, despite it being a large contributor to compassion fatigue and burnout (Elliot, 2017). The expectation of nurses to suppress their emotions in order to satisfy others can be detrimental to nurses’ well-being, particularly in the absence of mutual support within the workplace (Elliot, 2017). This emotional labour is a key factor in workplace stress, which is difficult for new nurses to cope with due to healthcare organizations focusing on bureaucratic principles of productivity while undermining human dignity and respect for life (Honkavuo, Eriksson & Naden, 2018).
At a Systems Level Emotions Are Not Properly Addressed
Workplace cultures allowing nurses to off-load emotional labour is correlated with reduced rates of burnout and an increase in nurse retention, yet modern-day healthcare systems continue to host workplace cultures where emotions are not supported (Elliot, 2017). Staff development programs aimed at increasing the competency of nurses’ emotional intelligence (EI) have been linked with better ease of navigating workplace stress, consequently leading to improved job satisfaction (Geun & Park, 2019; Roche et al., 2014). EI is also linked with improved communication skills and increased nursing productivity (Geun & Park, 2019).
The systemic disconnect between emotions and workplace stress needs to be addressed, starting with the inability of traditional leadership styles to deal with the complexity of healthcare (Weberg, 2012). Although many new nurses leave their first job, they often leave the employer rather than the profession, which suggests that they leave due to workplace culture (Dyess et al., 2016). With the prominence of emotional labour in nursing and its many repercussions, the workplace culture should reflect these realities––something traditional leadership cannot support (Clarke & Marks-Maran, 2014).
Lack of effective leadership in nurse managers negatively impacts workplace culture, contributing to high attrition rates of new nurses (McCabe & Sambrook, 2014). Managers using traditional leadership styles implement known solutions to problems without using a collaborative approach, resulting in ineffective change processes and leaving nursing staff feeling unsupported (Dyess et al., 2016; Lachman, 2016; Jambawo, 2018). Described as influencing and inspiring others towards a common goal, leadership is important for management to demonstrate, yet is not a requisite for being a manager (British Columbia College of Nursing Professionals [BCCNP], 2018; McCabe & Sambrook, 2013).
Lawal and Idemudia found many studies substantiating the need for managers to take accountability for mitigating work-related stress felt by their nursing staff (2017). Traditional leadership styles currently in use are not conducive to this finding as they cannot support the application nor development of EI skills, inadvertently contributing to a reduced capacity for resilience of new graduate Registered Nurses (Jambawo, 2018). The consequence of these outdated leadership styles avoiding emotions in the workplace are evident in the ever-climbing first-year attrition rate of novice nurses (Dyess et al., 2016; Elliott, 2017; Lachman, 2016).
Mitigating workplace stress through emotional intelligence. Organizational support from management in the workplace is crucial for nurses in coping with workplace stress (Lawal & Idemudia, 2017). In the absence of this support, individual nurses have a responsibility to develop resilience in order to persevere through the emotional labour experienced in the workplace and to reduce the burnout that results from the complexities of the nursing profession (Lachman, 2016; Melnyk, Gallagher-Ford, Long & Fineout-Overholt, 2014). As part of the Professional Responsibility and Accountability standards for Registered Nurses in British Columbia, maintaining emotional and psychological fitness to practice is listed within each of the standards’ domains (BCCNP, 2018). Nurses can accomplish this fitness to practice through EI, which increases their resilience through the ability to acknowledge and understand the emotions of both one’s self and those of others; the ability to use emotions constructively, and the ability to regulate one’s own emotions (Lawal & Idemudia, 2017).
Leadership Styles Can Promote or Discourage Emotions
Healthcare organizations utilize traditional leadership styles focusing on arbitrary ideas of efficiency and productivity based on systemic pressures (Lacey et al., 2017). These monetary constraints contribute to organizations losing sight of healthcare’s most basic values and its “employees’ existential foundation to serve, alleviate suffering and protect life” (Honkavuo et al., 2018, p. 1965). In contrast, the use of transformational leadership in healthcare is correlated with better patient outcomes as evidenced by a reduction in medication errors, patient falls, nosocomial infections, and patient mortality (Boamah, 2017; Oh & Lim, 2019). Unlike traditional leadership styles, transformational leadership is relational, encourages trust between team members, is motivational with clearly articulated visions, is collaborative, and attends to individual needs (Boamah, 2017; Cortez de Faria et al., 2017). By building relationships with followers, nurses using transformational leadership styles increase their influence over culture in the workplace and contribute to readiness for change (Weberg, 2012).
The Role of Nurse Leaders in Honoring Emotions in the Workplace
Any nurse can embody leadership through collaborating intra or interprofessionally with the intent of initiating change to improve healthcare systems or practice environments (Dyess at al., 2016; Lorber, Treven, & Mumel, 2016). Change is not something only those in formal positions of power can initiate, it can be effectively driven by nursing leaders at any level of the organization (Logrippo, Kelly, Sardinas, & Naft, 2018; Eads & Maruzzella, 2016; Boamah, 2018). Nurse leaders can advocate for change by challenging the “fundamental beliefs, assumptions, and common practices” that is workplace culture and by being present in policy development (Lui & Johnston, 2019, p. 2; Weberg, 2012). Strong nurse leaders motivate their followers to assume tasks and make decisions based on mutually identified goals, initiating the change process (Lorber, Treven, & Mumel, 2016).
Appreciative inquiry (AI) assists nurse leaders in identifying the might, should, and will be of the workplace culture (Melnyk et al., 2014; Van Wyk, 2015). Through AI, nurse leaders can encourage change by disseminating knowledge of EI and its positive correlation of nurse retention rates; advocating for policies that support EI, and role modeling their own EI in order to positively influence the resilience of others (Lachman, 2016; Van Wyk, 2015). Consequently, these changes can exemplify the necessity of nurse-centered staff development programs focusing on EI by the demonstrated increase in retention rates (Geun & Park, 2019).
Summary
The myth that emotions have no place in the workplace is absolutely false in relation to nursing. Despite extensive knowledge negating the use of traditional leadership styles within healthcare systems, these leadership styles continue to be used. This lack of transformative leadership leaves nurses to cope with their own emotional labour– an expected yet unsupported commodity of the nursing profession. Emotions need to be addressed from a systems level down to front-line staff. Nurses have a professional responsibility to strive for emotional intelligence in order to maintain fitness to practice, and to ensure best patient outcomes. All nurses have the capability to be leaders and can affect change in the culture of their workplace through role modeling emotional intelligence and advocating for policy change.
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