Relationship Between Emotional Intelligence and Occupation Stress Level Among - PowerPoint Presentation

1. Relationship Between Emotional Intelligence and Occupation Stress Level Among Certified Registered Nurse Anesthetists Andrea C. Bittinger, DNP, CRNACopyright 2019. Andrea Bittinger. All Rights Reserved.

2. Disclosure StatementI have no financial relationship or any commercial interest related to the content of this activity.I will not discuss off-label use during my presentation.

3. Learner OutcomesUnderstand definition of Emotional Intelligence (EI)Relate how Emotional Intelligence affects stress and burnoutDescribe common sources of stress for Certified Registered Nurse Anesthetists (CRNAs)Identify the relationship between Emotional Intelligence and stress in CRNAsRecognize how Emotional Intelligence can be used to decrease stress and burnout for CRNAs and Student Anesthetists

4. AcknowledgementsKaren Dunn, PhD, RN, FGSAAnne Hranchook, DNP, CRNAEstelle Codier, PhD, RN ** All pictures are from Google images **

5. BackgroundFirst heard about Emotional Intelligence (EI) in February 2015Took EI course in August 2015 (Thank you Dr. Kannoy)Started DNP in September 2015EI in students EI in CRNAsEI in NursesStress and burnoutEmotional Intelligence and stress in CRNAs

6. Background and SignificanceCertified Registered Nurse Anesthetists (CRNAs) are an advanced clinical nursing specialty, administering approximately 43 million anesthetics to patients in the United States each year in collaboration with surgeons, anesthesiologists, dentists, podiatrists, and other qualified healthcare professionals.

7. Background and SignificanceCRNAs are exposed to a wide range of stressors and therefore experience high levels of occupational stress and job burnout. Within healthcare systems, burnout from job related stress can ultimately have harmful effects on patients’ care and safety.

8. Background and SignificanceBurnout in healthcare providers is heading to national epidemic levels50% of clinicians have issues with burnoutBurnout is more common in the younger providerIt is an occupational syndrome

9. Background and SignificanceResearch evidence suggests that nurses who showed higher levels of Emotional Intelligence (EI) had significantly more positive outcomes that included: improved quality of care increased patient safety lower work-related stressless job burnout

10. Literature ReviewHong and Lee (2016) Studied the mediating effect of EI on emotional labor, job stress, burnout and nurses’ turnover intention in 211 nurses. Found job stress had the biggest direct effect on nurses turnover intention and an indirect effect through burnout.EI was found to have significant indirect and total effect on turnover intention through job stress and burnout.Authors concluded nurses who score higher in EI report lower turnover intentions because EI reduced the effects of stress and burnout.

11. Literature ReviewLanda, Lopez-Zafra, Martos & Aguilar-Luzon (2008)Examined the relationship between 3 emotional intelligence components in 180 nurses. Found nurses who scored higher in emotional clarity and emotional repair reported less stress than nurses who scored lower in these components. Nurses who scored high in emotional attention reported higher levels of stress.

12. Literature ReviewGorgens-Ekermans & Brand (2012) Examined the relationship between occupational stress, burnout and EI in 220 nurses. Nurses who reported higher levels of emotional control and emotional management reported lower levels of stress and burnout than nurses who reported lower levels of emotional control and emotional management.Ability to effectively manage negative and positive emotions in oneself and others is a protective aspect of EI.

13. Literature ReviewCodier, Kooker & Schoulz (2008) Studied 27 nurses to look at EI and their organization variable, clinical performance and career path.Nurses who were on the clinical ladder had higher EI scores than those not on the clinical ladder.Nurses who had higher EI also scored higher on their clinical performance.

14. Literature ReviewPerry (2005) examined CRNAs to assess occupational responsibilities, perceived stressors, coping strategies and work relationships.Most common stressor was related to patient care (complications, death).Also indicated staffing issues, production pressure, interpersonal relationships.Coping – remain calm, pray, internalizeHobbies at home

15. Literature ReviewChipas and McKenna (2011) Surveyed 7,537 CRNAs and student anesthetists to determine their current level of stress and its manifestations.Average stress score on a 10 point Likert scale4.7 in CRNAs7.2 in studentsMany symptoms of stress: agitation, vertigo, gastrointestinal illnesses, psychiatric illnesses

16. Literature ReviewChipas and colleagues (2012) Looked at student anesthetists for their level of stress while enrolled in a programStress level of 7.2 on a 10 point Likert scaleReported many forms of chronic illness, including obesity, hypertension, chronic back pain, gastroesophageal reflux and substance abuseAlmost half had depression; 21% had suicidal ideations

17. Outcome of Literature ReviewHaving higher levels of EI may be a key coping mechanism in CRNAs to decrease and/or ameliorate occupational stress.

18. Emotional Intelligence

19. Emotional IntelligenceEmotions begin in the limbic area but MUST BE processed in the frontal lobe and other “higher” areas of the brain for maximum effectiveness FLEE, FIGHT or FREEZEIntelligence involves a capacity or abilityEI can be learnedIt is the HOW you do your job, not the WHAT you do in the jobIt’s not your personality, it’s what you do with your personality

20. Emotional IntelligenceThe ability to perceive emotion, integrate emotion to facilitate thought, understand emotions and regulate emotions to promote personal growth (Mayer & Salovey, 1997).“The capacity for recognizing our own feelings and those of others, for motivating ourselves, and for managing emotions well in ourselves and in our relationships” (Goleman, 1998, p.317).

21. Emotional IntelligenceVariety of interrelated emotional and social competencies, skills and behaviors that impact how effectively one understands self and others, relates with others and copes with daily stressors (Bar On, 2006).“A set of emotional and social skills that influence the way we perceive and express ourselves, develop and maintain social relationships, cope with challenges, and use emotional information in an effective and meaningful way” (Stein, Book & Kannoy, 2013, p 4).

22. Operational Definition of Emotional IntelligenceThe ability to perceive, understand, integrate, and regulate emotions to allow one to successfully cope and adapt to others and the surroundings.

23. Purpose of StudyAssess the levels of Emotional Intelligence (EI) among CRNAsAssess the levels of workplace stress in CRNAsDetermine if significant relationships exist between levels of EI, levels of stress, and demographic variables (age, gender, practice setting and years of experience)

24. Conceptual Model Transactional Model of Stress, Appraisal and Coping (Lazarus & Folkman, 1984)Two primary classifications for coping:Problem focused – behavioral actions are used by the person to improve the situationEmotion focused – utilizes strategies to alter the way one attends to or interprets the situationEI conceptualized as an emotion-focused coping strategy used by CRNAs to deal with occupational stress.

25. MethodologyConvenience sample of CRNAs who are active members on a list-serv of a Michigan Association of Nurse Anesthetists (MANA)Qualtrics survey emailed to 2,070 CRNAsInclusion criteria:Able to read and write in EnglishCurrently employed as a CRNAPracticing for at least 1 year

26. InstrumentationSeveral different models of EIAbility Model Trait Model Mixed Model The tool that was utilized to test for EI in this study was developed based upon the Mayer and Salovey Adaptive Ability Model.

27. Instrumentation Emotional Intelligence Scale (Schutte et al., 1998)33 item scale categorized EI into 4 subscalesPerception of emotionsManagement of own emotionsManagement of others emotionsUtilization of emotionsUses a 5 point Likert scale 1 = strongly disagree; 5 = strongly agreeCronbach’s alpha 0.78

28.

29. InstrumentationWorkplace Stress Survey (The American Institute of Stress, n.d.)10 question survey, using a sliding 10 point Likert scale1 – 4 = strongly disagree5 – 7 = agree somewhat 8- 10 = strongly agreeNo data on reliability and validity but confirmed as reliable by past reviewers

30.

31. Sample295 participated in the surveyresponse rate of 14% Majority of participants were: (1) female (n= 186, 68.1%)(2) between the ages of 51 – 55 years of age (n =45, 16.4%)(3) practicing as a CRNA for over 25 years (n= 77, 28.1%)(4) working in Level I, II, and III trauma centers (n= 193, 71.2%)

32. SampleAge n (%)_26 – 30 y 8 (2.9)31 – 35 y 29 (10.5)36 – 40 y 30 (10.9)41 – 45 y 31 (11.3)46 – 50 y 36 (13.1)51 – 55 y 45 (16.4)56 - 60 y 42 (15.3)61 – 65 y 35 (12.7)> 66 y 19 (6.9) Current years as a practicing CRNAYears n (%)_1 – 3 23 (8.4)4 – 6 33 (12.0)7 – 10 35 (12.8)11 – 15 42 (15.3)16 – 20 28 (10.2)21 – 25 36 (13.1)> 25 77 (28.1)

33. SampleCurrent practice setting n (%)__Level 1 trauma center 94 (34.7) Level II trauma center 77 (28.4)Level III trauma center 22 (8.1)Rural practice 15 (5.5)Self-employed 24 (8.9)Agency work 6 (2.2) Community hospital 33 (12.2) Gender n (%)__ Male 87 (31.9) Female 186 (68.1)

34. ResultsStatistically significant inverse correlation between the total scores of the Emotional Intelligence Scale and the total scores of the Workplace Stress Survey (r = -.20, p < 0.01) Total EI M = 125.79 Range = 33 – 165SD = 11.55

35. ResultsHigher levels of EI associated withLess fatigueBetter task performanceLess depressionMore organizedGreater life satisfaction

36. ResultsStatistically significant inverse correlation Managing Own Emotions (r = -.29, p < 0.01)When I am faced with a challenge, I give up because I will fail (inverse scored)I seek out activities that make me happyI expect that I will do well on most things I tryConfidence in ability to solve problems = less workplace stress

37. ResultsStatistically significant inverse correlation Managing Others Emotions (r = -.18, p < 0.01) I compliment others when they have done something wellI know when to speak about my personal problems to othersI present myself in a way that makes a good impression on othersAbility to get along with others = less workplace stress

38. ResultsTotal Mean Score on Workplace Stress SurveyM = 42.48; (range = 10 – 100; SD = 13.07)Cronbach Alpha = 0.66Most stress for the CRNAs was related to:Lack of autonomy given the high levels of responsibility No recognition for positive outcomesNeed for more quality time to complete tasks

39. ResultsOf the demographic variables:Female CRNAs M = 127.55 (SD = 10.98)Male CRNAs M = 122.14 (SD= 12.16)t(254) = -3.52, p < .05No other significant correlations were found

40. LimitationsThis study had an overall 14% response rate A larger return sample, given the size of the list-serve group, would have strengthened the confidence in the results Variation in EI assessment tools is a limitation in studying EI as a concept in general No one tool that has been proven to be superiorSelf report assessment

41. ImplicationsAny study that addresses caregivers in healthcare should be done so to optimize patient safety. A higher EI score and less stress will lead to increased patient safetyAssessment of specific causes of workplace stress Develop programs aimed at decreasing workplace stress and burnout (with EI)Investigate the impact of EI programs and workplace stress awareness programs on patient outcomes and job satisfaction / attrition

42. ImplicationsAwareness of EI for employees as well as employers could provide a layer of employment screening Hire not only the most qualified CRNAs but those who will likely have optimal longevity in the workplace. Lower EI scores could be coached or educated on ways to improve EI so as to decrease the likelihood of job burnout.

43. ImplicationsEmotional intelligence is not a static factor One’s emotional intelligence can change over time and can evolve in targeted areas.EI programs can be developed and applied into practiceChange the emotional behaviors of health care providers leadership and team building coaching and workshops

44. ImplicationsEI screening could be useful for admission to nurse anesthesia programs to decrease attrition in programs and longevity in the profession Ideal for selecting the most qualified candidates, not only academically but also emotionally

45. ConclusionPrior research evidence and this study has shown nurses and CRNAs who have higher levels of EI cope better with workplace stress. CRNAs who managed their own emotions and others emotions had less workplace stress.Workplace stress can be harmful to the CRNA, the institution, and possibly the patient. Defining ways to better cope with stress is key to preventing the negative effects of stress on an individual and others.

46. ConclusionThe ability to effectively manage and cope with stress may indirectly allow the CRNA to provide better patient care and avoid job burnout. Knowledge of EI for an individual can be a powerful tool in decreasing workplace stress and increasing workplace satisfaction.This study provided a foundation that linked EI and workplace stress in CRNAs.More rigorous and in-depth research evidence is needed.

47. Final ThoughtRemember, most of your stress comes from how you respond, not the way life is. Adjust your attitude. Change how you see things. Look for the good in all situations. Take the lesson and find new opportunities to grow. Let all the extra stress, worrying and overthinking go.

48.

49. Andrea C. Bittinger, DNP, CRNAandrea.bittinger@beaumont.org

50. ReferencesAckley, D. (2016). Emotional intelligence: A practice review of models, measures, and applications. Consulting Psychology Journal: Practice and Research, 68, 269-286.Adams, K., & Iseler, J. (2014). The relationship of bedside nurses’ emotional intelligence with quality of care. Journal of Nursing Care Quality, 29, 174-181. American Association of Nurse Anesthetists. (2016, August 26). Certified Registered Nurse Anesthetists Fact Sheet. [Web log message]. Retrieved from https://www.aana.com/patients/certified-registered-nurse anesthetists-fact-sheetAugusto Landa, J. M., López-Zafra, E., Martos, M. P. B,.& del Carmen Aguilar-Luzón, M. (2008). The relationship between emotional intelligence, occupational stress and health in nurses: A questionnaire survey. International Journal of Nursing Studies, 45, 888-901. Bar-On, R. (2006). The Bar-On model of emotional-social intelligence (ESI). Psicothema, 18, 13-25.Chipas, A., Cordrey, D., Floyd, D., Grubbs, L., Miller, S., & Tyre, B. (2012). Stress: Perceptions, Manifestations and coping mechanisms of student registered nurse anesthetists. American Association of Nurse Anesthetists Journal, 80, 49 – 55.Chipas, A., & McKenna, D. (2011). Stress and burnout in nurse anesthesia. American Association of Nurse Anesthetists Journal, 79, 122-128. Codier, E., Kooker, B.M., & Shoulz, J. (2008). Measuring the emotional intelligence of clinical staff nurses: An approach for improving the clinical care environment. Nursing Administration Quarterly, 32, 8-14. 

51. ReferencesGoleman, D. (1998). Working with Emotional Intelligence. New York; Bantam Dell. Görgens-Ekermans, & G., Brand, T. (2012). Emotional intelligence as a moderator in the stress-burnout relationship: a questionnaire study on nurses. Journal of Clinical Nursing, 21, 2275-2285. Hong, E., & Lee, Y. (2016). The mediating effect of emotional intelligence between emotional labor, job stress, burnout and nurses’ turnover intention. International Journal of Nursing Practice, 22, 625-632. Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer Publishing Company. Mayer, J., & Salovey, P. (1997). What is emotional intelligence? New York: Basic Books.MultiHealth Systems https://tap.mhs.com/Portals/0/What%20is%20EI.pdfPerry, T.R. (2005). The certified registered nurse anesthetist occupational responsibilities, perceived stressors, coping strategies, and work relationships. American Association of Nurse Anesthetists Journal, 73, 351- 356.Schutte, N., Malouff, J. & Bhullar, N. (2009). The Assessing Emotions Scale. In C. Stough, D. Saklofske, J. Parker, J. (Eds.), The assessment of emotional intelligence (pp. 119-135). New York; Springer Publishing.Stein, S. J., Book, H. E., & Kanoy, K. (2013). The student EQ edge:Emotional intelligence and your academic and personal success. San Francisco; Jossey-Bass.The American Institute of Stress. (n.d.). Workplace Stress Survey. Retrieved at http://www.stress.org/wpcontent/uploads/2011/08/Workplace-StressSurvey.pdf