Overview of the Chapter
This chapter will present an extensive review of existing relevant literature. The choice of the literature was guided by the study aim, objectives, and the empirical structure outlined in the preceding chapter. To this effect, the following subsections will be addressed: theoretical framework, nurses’ emotional intelligence, customer satisfaction, how nurses can instill in themselves emotional intelligence, training them to do this as well as similar patient satisfaction situations.
Theoretical Framework: Emotion Intelligence Theory
In a normal hospital scenario, a nurse is engaged by the principal to serve the interests of the patients. For this noble goal to be fully achieved, there must be mechanisms to align the interests of both the patients and nurses (Cooper, 1998). For instance, matters to do with understanding the patient’s mood and overall management of emotions should be carried out in a manner that does not infringe on the interests of either party (Carrothers, Gregory, & Gallagher, 2000). As expected, problems always occur at some point. The emotion intelligence theory was coined to address these inevitable problems. Basically, the theory posits that the principals have got the right to be informed while on the other hand, nurses and patients are obligated to provide timely and accurate information (Cronin and Harrison, 1988). The principal agrees with the nurses, where the principal pays the nurses to perform specific duties, for instance, treating, taking care of the patients, injecting, etc.
The rationale behind the selection of this theory was based on its ability to provide a clear picture of what transpires between nurses working in the hospitals and their principals’ patients (Damasio, 1994). Ideally, the theory provides the basis on which arguments will be made in establishing the rolesnursesurses’ play in the general well-being of the patients in terms of services.
This theoretical framework holds that the agreement between the patients and the nurses is governed by two salient determinants. The first determinant is based on the notion that nurses are autonomous and are prone to maximizing their own interests at the expense of patients with no particular interests being taken in these patients regarding their emotions. This determinant seems to hint that at any given time, disagreement between the patients and nurses should be expected. Secondly, the patient-nurses relationship is bogged by information asymmetry (Brink, 1998). This second determinant seems to suggest that at any given time, either the patient or the nurse will be having crucial information but are unwilling to pass that information to the other party. For example, in the hospital, the nurse may be having superior personal problems about himself/herself or to the hospital but may decide not to pass all the information to the nurse for fear that the nurse may fail to take it kindly (Duberstein et al., 2006).
Emotional intelligence difficulties which are experienced in most hospitals usually lead to serious patient care in the world (Elam, 2000). Efforts to formulate sound measures for invoking this emotional intelligence have given rise to the unending debate on what roles does prudent emotional intelligence plays? This debate revolves around the notion that lack of emotional intelligence among health practitioners leads to uncertainty and as witnessed in most hospitals, a major relationship barrier exists between the patients and the nurses (Gillis & Jackson, 2002). Most relationships in hospitals between the nurses and the patients’ especially financial institutions collapse because of poor emotional intelligence. Moreover, and from an emotional intelligence theory perspective, it is imperative to note that prudent emotional intelligence measures play an important role in mitigating the soaring of relationships between the patients and the nurses (Epstein & Hundert, 2002). This is because when the nurse engages in unethical practices such as unethical behaviors to hoodwink the patients or even not disclosing the correct status on the ground for the patients in the hospitals in a timely manner, chances are that at some point the hospital may experience a serious nurse to patient relationship problem that proved too hard to solve (Gesell & Wolosin, 2004).
Emotional intelligence is usually seen as a static instrument of building an effective relationship between the patient and the nurses. Emotional intelligence provides information about the emotional state and the problems present in a patient without necessarily providing solutions for them (Goleman, 1998). However, it is relatively important to appreciate that the first step of solving a problem is to identify it first. This can be achieved by conducting an endive research on the issue so as to gather enough information about it (Graugaard et al., 2005). In respect to this, prudent emotional intelligence skills achieved through proper planning, scrutiny, carefulness, observation, and implementation of decisions made thereof provide useful information about the root of the problem. With such “insider” information, most nurses can easily embark on the most appropriate ways of understanding their patients (Hall et al., 2002).
However, information that is provided through prudent emotion scrutiny through emotional intelligence in the enhancement of good relationships can be categorized into two core groups, that is, public information and private information. In respect to public information, it is normally intended for outside sources such as hospital managers, stakeholders, banks and other financial institutions, state bodies, public institutions, hospital partners among others. On the other hand, and as some researchers opine, private information is usually provided for internal use, especially for nurses to patient’s decision-making purposes (Kirk, 1995). From an emotional intelligence theory perspective, these two groups of information play a key role in building perfect relationships. This is because they are all bend towards creating a good rapport between the nurse and the patient (Kearley, Freeman, & Heath, 2001).
Though in each group the relationship is different (in the case of public information, the principal is the shareholders of the hospital and other key superior doctors in the hospital, the principal, is the patients within the hospital but the overarching idea is similar (Kerfoot,1996). As some researchers opine, prudent information sharing between the nurse and the patients regarding the emotional status and opinions of a hospital helps in monitoring the emotional relationship with third parties. This is because prudent emotion study determines whether patients are emotionally stable regarding the type of patent care they are receiving and most importantly, the kind of emotional relationship between such patients and their doctors. This is no doubt a relationship mechanism that ensures that satisfaction is maintained in the hospitals (LeBlang, Basanta, and Kane, 1996).
All hospitals that have been publicized to the general public are required by the general population, by the hundreds or thousands who visit them daily to portray the best pictures and caring to their patients in particular (Lopes, Salovey, & Straus, 2003). This emotion intelligence characters provides standardized procedures to various players who use this as their key asset to produce the perfect communication between themselves and the patients (Magee & D’Antonio, 1999). Therefore, it is important that the emotional intelligence to be reliable and relevant to help patients and other players in the health facilities and institutions to make sound decisions (Lindeman, 2007). This notion is supported by some researchers who postulates that the emotional intelligence, which is the best way to measure patients comfort ability and discomfort, is by all measures the best strategy to enhance perfect patient to nurse relationship and help them build on a good working ground (McQueen, 2004).
Moreover, it should be noted that emotional intelligence usage in the hospital is critical in hospital operations and general performance of the nurses (Pearson and Raeke, 2000). Emotional intelligence plays a central role since it is pro-cyclical – it is able to exacerbate its effects in the hospital system by causing either positive effects or negative implications which in turn leads to satisfaction or dissatisfaction to the patients. However, pro-cyclicality takes place as a result of booms and bursts which happen as a result of the relationship that presently exists (Salovey & Mayer, 1990).
It is argued that emotional intelligence allows health institutions to increase their leverage in booms, which later makes financial system increase more due to the satisfaction received by the patients, as a result of the good treatment that they are accorded in the hospitals where the nurses are proficient (Shenolikar, Balkrishnan, & Hall, 2004). Notably, emotional intelligence becomes a critical area that should be carefully managed when pursuing good relationships, since some times some patients’ attitudes and moods are unpredictable and may change on occasional basis. So, the nurses ought to be very careful and should read emotions with utmost intelligence (Stratton et al., 2005).
In addition, it is acknowledged that emotional intelligence helps to reduce patients’ boredom and fear of poor handling in the hospitals. The relationships can become worse if the nurses fail to play their emotional intelligence constructively. However, a research conducted recently proves that most nurses are recognizing their roles in orchestrating the perfect communication or relationships between them and the patients, and those who feel they have the skills are trying to use them to the perfection, with others finding their ways into institutions that could perfect them in these skills. This is because they are well aware that this type of relationship will greatly have positive impacts to them in their careers and also to the financial well being of their fellow employers (Thom, Hall, & Pawlson, 2004). This will be important to them also since a bulge in their pockets will seem forthcoming. However, in order to accomplish this noble emotional task, it is the nurses’ role to have accurate information about the true nature of their patients so that they can help to prevent mistakes that result to bad relationships (Vitello-Cicciu, 2003).
Nevertheless, emotional intelligence is also used to mitigate patient dissatisfaction by performing a forecasting role. It performs this by determining evolution trends of future relationship and patient satisfaction performance based on the information given by the patients in the one on one talks with them. However, a researcher postulates that in times of relationship crises between the nurses and the patients, it is usually difficult to forecast or even make estimates but at the same time it too important to do the forecast. The forecast helps to mitigate relationship crisis by developing better structural programs and intelligence levels that are geared towards counteracting the crisis effects (Wagner et al., 2002).
Moreover, it should be understood that in the relationship crises period between the nurses and the patients, nurses who are pros in the emotional intelligence become key aspects in the mitigation efforts. This is the most important mediator of information that shows important aspect of communication activity of a hospital entity in addition to showing aspects of the national friendship and relationship. Therefore, it is held that emotional intelligence information provides both the internal and external information to the decision makers which facilitates designing sound strategies in mitigating the occurrence of bad or sore relationships between the nurses and the patients (Yamashita, Forchuk, and Mound, 2005).
Furthermore, it should be recognized that emotional intelligence is a powerful institution which helps to reduce information asymmetry and improve the quality of management capabilities. It also helps in human resource building to the relevant decision makers that facilitate better services in line with better communications and relationship within the health services fraternity. However, despite the crucial role that emotional intelligence plays in the health industry, nurses have at times made mistakes due to misunderstanding between them and the patients which have resulted into adverse relationship crises and sore gelling between one another. This sometimes results in influxes in these types of centers due to merely a simple misunderstanding between the two parties so caution of the highest order ought to be taken (Lindeman, 2007).
Role of Nurses in controlling nurses to patient relationship
Nurses and the general nursing practisioner’s fraternity play critical roles in the nurses to patient relationships. These greatly important persons have the noble role of controlling the type of relationships between them and the patients in order to guard the health industry from negative effects that results from the adverse effects of sore relationship crises. According to some researchers, Nurses play an important role both within and on the general platform in the health sector as its leverage is confined to making sure that the relationship with the patients is always at its best, and hence the importance of emotional intelligence in nurses is pivotal as it helps in understanding the patients, their expectations and the emotional intelligence. Also, it acts as the future determinant of the success within the hospital. Nurses have been tasked to come up with good regulatory frameworks that are used to regulate health services and communication procedures in the health institutions that are in line with the customers’ expectations (Rosenberger & Lachin, 2002). By doing so, it promotes sound policies that are geared toward mitigating relationship crisis. Moreover, some researchers affirm that nurses do not only use the regulatory and supervisory roles but also employs cyclical and other close considerations together with increased patient concentration, and linkages of different parts of the global health system.
In addition, it is affirmed that the nurses put more focus on the general risks in regards to the current stability, including financial risks and inflation together with other general variables in order to effectively mitigate the relationship risks that may occur because of the effects of these variables if not properly mitigated on time. Moreover, it is opined that Nurses mitigate relationship crises through its mandate of immediate relationship crisis management particularly through this emotional intelligence. This would have a long term positive effect, and would help in effectively building on the perfect relationship with the patients, through reading their minds and getting the way into their interests, and hence creating maximum customer relationship. Additionally, it has been affirmed that relationship crises have created opportunity for the nurses to reinvent themselves and play a more creative role in mitigating effects of this relationship downturns.
Nonetheless, improved emotional intelligence is the best way of mitigating relationship crises. Relationship crises between the nurses and the patients’ are always blamed on poor emotional intelligence which entails poor relation management by health institutions (Downs, 1999). Therefore, nurses as players must have proactive structural measures that can withstand major shock of relationships downturns. In addition, it is held that these structural measures need to be reviewed regularly to remain relevant in ever changing social environment to be able to withstand the storm released by these patient-nurses relationship downturns.
The Nurses roles from a patient relationship downturn Standpoint
According to some researchers, the nursing sector is one of the most challenging and with the greatest emotional task in the world due to the persistent pressure that the nurses undergo in trying to perfect their relationship with the patients. On one side, it is challenging because even with the underlying pressures and expectations in this age, social crises continue to bog the society. On the other hand, it is tasking because the industry has continued to fall under the same pressures that has been facing it since its inception. Nevertheless, there have been considerable gains made in the realms of perfection, where a lot of relationship perfection has been achieved through this emotional intelligence. Again and courtesy of technological developments which have culminated in new services in the human resource sector, the industry has strived to perfect the law of emotional intelligence that have greatly helped to merge the relationship between patients and nurses.
The Nursing sector boasts as the world leader in terms of intelligence and everything in the sector, is mandated with performing their tasks with the utmost intelligence to the utmost perfectness. Perhaps, this emotional intelligence is its huge driving force courtesy of the prudent emotional intelligence regulations that continue to be implemented over the years (Nunnaly & Bernstein, 1994). Even with the inflow of patients in the hospitals surpassing that of the nurses within, the emotional intelligence must always be at its highest levels to counter the pressure that can at times seem deafening. This has been evidenced by hospitals where the hospitality seems to be at its greatest levels and these particular hospitals tend to experience the highest number of patients, and the preference by patients is always directed towards these types of hospitals. This is because the patients feel that the staffs understand their dire needs and are ready to help them at all costs.
The hospitals ought to set standards high where every nurse in the hospitals’ staff ought to be impacted with this particular type of emotional intelligence. Staff should be shown how to read and predict the expectations of their customers, so as to be in a good position to enhance harmony with their patients and be able to keep and maintain their daily positive image that will be greatly determined by how they give services to their patients and on how they are able to deal with their patients in terms of their problems and in respecting their modalities and needs.
Constant relationship crisis, alongside other social crises has occasioned significant paradigmatic shift in the way the relationship between the patients and nurses is taken. As a matter of fact, the nursing sector has been a subject of significant regulation especially by the principles that are deeply rooted in the patent care of the patients, since they must take up all the necessary measures that must incorporate emotional intelligence in their daily life with the patients (Burns & Grove, 2004).
All the nurses are mandated to affiliate themselves to the needs of the patients in some way so that they can be assured of long term relationships with their patients. The economic intelligence plays a huge role in this affiliation since a nurse would not make the best out of his/her affiliation if he/she is not impacted with the correct skills to understand the expectations of the patients and his/her already acquired mood towards the hospital. This is essential to better assist nurses in promoting greater regulatory social management and perfection for mitigating, if not, eliminating the likelihood of any form of bad relation with the patient if there occurs any form of dissatisfaction.
One of the many requirements of an ideal social management system is rational behavior by the patients and the nurses. However, another unstated requirement concerns moral behavior. The health sectors are sometimes faced by irritating behaviors which are brought by patients with some sort of ill behaviors and the possibility of impacting the emotional intelligence on such patients becomes impossible and so the nurses are faced with the herald task of trying to build an efficient relationship with their patients which becomes a daunting task. Therefore, the need to have a daily to daily close encounter with the patients is paramount if the emotional intelligence is become successful in having a long term relationship with such kind of patients (Hulley, 2006).
There is a great need for the hospitals to come up with a certain centralized unit that will be mandated with the task of teaching the basics that will add knowledge to the nurses to help them get the best emotional intelligence. This would help them create the best relationships with their patients and would set up measures that would categorize the different types of patients and the way to deal with such kind of different people. This is because some of the patient would be very difficult to understand so units would be pivotal to come up with measures that would help impact the emotional intelligence on this particular type of patients perfectly.
Criticism self control
Nurses who elicit emotional intelligence in themselves have abilities to respond to various different situations through their interactions without being overwhelmed by those situations being big or small. This can be an important competency when, for instance, a patient raises a complaint with a nurse or is threatening towards him/her in some way. A nurse whose self control is low against criticisms is more likely to take some comments or questions as personal attacks on him/her, and become less available to listen to and care for such a patient. He/she could become angry and create a sour relationship between herself/himself and the patient.
Self encouragement within nurses
The possession of emotional Intelligence invokes self encouragement within the nurses and they tend to become more and more persevering when facing all type of difficult situations with the patients no matter the character of their patients and they tend to give emotional support to their patients even in the middle of crises which tends to inspire them at every single occurrence, thus disseminating their competencies, strengths and positive emotions to patients. There is also likelihood that such nurses would view adverse situations in a more positive way and would be willing to try new approaches and solutions without the fear of failing and would take every step with sheer optimism. In a basic perspective, provided that nursing is mostly relational in nature, it is likely that more self-encouraged nurses adopt more expressive compassionate behaviors in dealing with patients.
Controlling individual emotions
Everyone in the vast world Diaspora is faced with his/her own emotions which tend to change with every single occurrence of a situation and the nurses are no exception when being faced by this emotions so there is a dire need to have the utmost emotional intelligence that will guide them through the process of acquiring self control that will greatly guide them through controlling their self emotions. Nurses face extremes in emotion everyday. Patients exhibit unhappiness, confusion, anger, sadness and other aversion emotions. If nurses are not nimble-fingered in managing their own sensations, they may not be able to have calm attitude when faced by a crises. An emotional control loss can have negative effects for both nurse and patient. Caring requires emotional labor, that is, mental work to manage feelings. Emotional labor can be defined as the effort, planning and control needed to express organizationally desired emotions and smother undesirable ones during interpersonal operations. In nursing, desired emotions comprises of displaying an authentic caring character, articulating empathy for patients and illustrating an understanding for patients experiencing pain or disturbance, substantial and psychological vulnerability. Nurses are also anticipated to exhibit a non-judgmental comportment with patients, to promote trust and a intellect of protection. To make this achievable, nurses may necessitate smothering any distrustful emotions towards patients.
Understanding and emphasizing on other people’s emotions
By being considerate to the patients’ sentiments, and being more compassionate, nurses are more able to comprehend the values, uncertainties and qualms of patients. They are more pertinent to automatically have a bond with patients, understand the patients’ perspectives, understand the different roles of their dealings understand and gratify patients’ needs and retort to it in the most appropriate manner. Consequently, they can show privileged concern for their patients and come up with better emotional and psychosomatic reactions in them. Behaving with more empathy within them, nurses can be more sympathetic as well. Propose that consideration affects nurses’ conclusions and actions, contributing to brilliance in their roles of nursing. Researchers also claim that emotional participation by nurses may progress the eminence of care and is a key component of brilliance in the day to day practice of nurses.
Having recognized the general nature of the six emotional intelligence dimensions, it is recommended that they show a positive relationship with nurses’ caring behaviors. Nevertheless, the idiosyncrasies of nursing necessitate some multifaceted combinations of EI aspects so that nurses can be justly affirmative caregivers. For instance, a nurse with precise consideration of his/her own negative emotions, for instance, after seeing that the failure of the treatments monitored to a “particular” patient, may be very apprehensive about sharing it openly with the patient if he/she has inadequate self-encouragement to persist and exhibit suitable behaviors and sensitivities. Nurses who have a low self control over criticisms can lessen their compassionate behaviors towards patients who had un unanswered questions or aired complaints unless they compensate for this imprudent understanding with a stronger confidence in themselves that gives more motivation to them to continue with their persistence in acquiring behaviors that are more caring. We suppose that other relations between the dimensions of emotional intelligence can come up, although the investigative status of the field does not give clear outlook on this matter.
Factors that influence the application of Emotional Intelligence in nurses
There are some various contrasting issues that greatly influence and make the emotional intelligence a key component in the provision of the best health care by the nurses; this includes things like age, gender and even the condition of the health of the patients. Since the general hearing level of most old patients is low so the need for the nurses to understand this condition and have the perfect interaction with this kind of patients greatly requires the emotional intelligence of the highest level. The use of emotional intelligence will greatly require a wide-range of non-verbal interactions which may include things like smiling, touch, a direct eye-gaze to the patients, an affirmative nod of the head which are all part of the emotional intelligence which all the nurses are expected to exhibit.
The research was carried out within the required ethical standards. As a result, the researcher made sure that all the prominent processes were carried out in accordance with the espoused modern theoretical frame work. The researcher was conversant with the epic that study findings and conclusions are in most cases products of the researcher’s moral and political convictions. To this end, the researcher worked within the modern frame work of studying theories.Moreover, the researcher undertook a concrete study on the targeted study population and the existing literature.
This chapter has presented a comprehensive review of existing relevant literature about nurses, role and importance of emotional intelligence in enhancing the perfect relationship with the patients, and how this emotional intelligence will greatly impact positively in the face of the thousands of people who have ventured or are yet to venture in such hospitals. This will help in maintaining and attracting more and more patients to seek assistance in their hospitals due to the perfect services being delivered by these nurses. The review of these salient areas of the study topic was done in accordance with the espoused emotional intelligence theory basis.
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