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Putting the “care” in health care

Ever had a late-night visit to the emergency room or a nerve-wracking doctor’s visit become a much less stressful experience, all thanks to a few kind words and support from the nurse who provided care? You might know the feeling — and while at the time, the nurse may have seemed to be reading your mind, this is actually a powerful skill that doesn’t take any supernatural ability. Monitoring emotions in social situations is what experts call “emotional intelligence” (EI) and its role in nursing is one that has the potential to change how health care happens.

headshot of a woman with her hair up in a bun, looking at cameraDr. Estelle Codier

For Dr. Estelle Codier, who began her career in one of the first dedicated trauma units in the United States, this was a clear phenomenon that she and others recognized. Some nurses had the ability to cope with stressful situations, even in fast-paced trauma scenarios, while keeping their cool and managing their patients’ sometimes difficult feelings. While she knew it when she saw it, Codier didn’t have a name for what it was. That sense is what initially drew her to her research into emotional intelligence in nursing. The concept wasn’t new — emotional intelligence was something that people talked about across other professions and disciplines — but her focus on hospitals was. 

“I said, ‘I am convinced it is the thing’” says Codier. The studies on EI’s positive effects had already been done across other fields around the world, and Codier believed nursing would be no different. “We could get data that it affects performance and that it affects longevity, and retention, and sick leave, and all sorts of fiscal outcomes and patient outcomes and patient safety,” she says.  


The effect of emotional intelligence

Nurse talking and doing a emotional support to a female senior patient at hospitalThinking back to your positive patient experience, there are probably a few things that stand out. Maybe the nurse asked how you were and responded thoughtfully to your worries. They might’ve helped you better understand your treatment by relating to you with a personal story. Perhaps they even intuited your feelings, whether you were anxious, upset, or in pain, and gave you the support you needed at that moment. Those are the tenets of emotional intelligence: identifying emotions, understanding emotions, using emotions to reason, and managing emotions. Each is contrary to outdated ideas that you should “leave your feelings at home” or that emotion can muddy objectivity. Codier’s experiences had already suggested that was false — and her research backed it up. 

Emotionally intelligent teams outperform others, even if leadership is poor. Individuals provide better care to patients. Patients, in turn, are safer and left the hospital sooner. In addition, nurses with high EI are more resistant to job stress, make decisions more quickly, and show increased willingness to learn and grow in their roles. Emotionally intelligent people are also better managers and can help train individuals. 

“You can learn it, you can improve it, you can require it of other people, you can observe it in situations,” says Codier. “I say it’s like CPR. It doesn’t take a doctor to learn about it and to practice it. You have to do it.” 


Using emotional intelligence to drive change 

COVID-19 put a spotlight on nurses everywhere. “The ability to think on your feet, change systems, do things innovatively, and make it all work has been really obvious in the pandemic, and the nurses’ role,” says Codier. Beyond their immense workload as cases surged, nurses played an enormous role at bedsides, helping grieving families say goodbye to loved ones over phone calls, or sometimes being the only person in the room as patients passed away. Doing that well required high emotional intelligence — and dealing with the aftermath will, too. 

portrait of a young nurse in a blue uniform and a protective shield to protect against a new dangerous virus covid19

We may never know the full effect the past year had on nurses. For many, it could take a long time to recover from the strain, and Codier warns many more could leave than there are nurses to replace them. “We could lose a generation of nurses because of the cost,” says Codier. Excessive burnout, even in normal times, is an issue the health care system needs to address — and using the language of emotional intelligence can help. 

Similarly, emotional intelligence has the potential to help with the next major challenge of the pandemic: vaccine hesitancy. “Nursing is one of the most trusted professions here year after year according to Gallup polls,” says Codier. 

Resisters may be reluctant to get vaccinated for myriad reasons. “People are going to have to use every emotional intelligence skill to reach them,” says Codier. “If we can figure out a way to do this, we could change the course of the epidemic, which is not a small thing at this point.” 

COVID-19 could be a watershed moment for health care across the country, but only if people step back to address the gaps that contributed to the crisis. The key could be nurses who, using EI, have the potential to be “change agents” across the system. Work that needs to be done will require healing and advocacy, transforming ethical standards to keep patients and hospital staff safer. Emotional intelligence is the key to getting it done. 

“It’s not a soft skill,” says Codier. “It’s a shovel.” 



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