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The Role of Emotional Intelligence in HealthCare: Bridging the Gaps of Communication

by Melanie Frizzell
August 2017 Melanie Frizzell

An Emotionally Intelligent based system to defend the value of social-emotional life learning as it may benefit individuals, the medical companies they work for, and the clients they serve. 

Conflicts in healthcare work environments is not a new issue. However, today’s competitive marketing for hospitals and outpatient medical facilities is on the rise. The more options are available to the consumer, the more competitive the market.  As this relates to communication skills, some may call that “bedside manners.” Word of mouth is often the best or the worst advertisement for medical providers and medical facilities.  The interactions or conversations between a patient or their family/friends with any employee of a medical care facility are expected to focus on giving excellent customer service. Additionally, accusations of inappropriate behaviors or less than desirable conversation validate the need for employers and their employees to be aware of their emotions and their ability to recognize opportunities in social-emotional life learning as it may assist them to bridge their gaps in communication and to meet or exceed customer service expectations.

Key Points for Emotional Intelligence in Healthcare settings:

-        Conflicts in intimate interactions in healthcare facilities are accidental, occasional, and unique, yet they may also be systemic, repetitive, and alike.

-        Healthcare providers and patients/family/caregiver relationships are sensitive, highly complex emotional relationships that require reliable and accountable system design methodologies that bridge the gap in communications that are profoundly informed by our emotional intellect.

-        It is possible to create an emotionally intelligent system design approach for medical professionals and facilities in conflicts for reduction of reported grievances or aid in service recovery.

Keywords: Conflict Resolution System Design; Patients; Families; Facilities; Medical Professionals; life learning, Reconciliation; Emotional Intelligence; Service Recovery.

“It takes something more than intelligence to act intelligently.” (Fyodor Dostoyevsky)

INTRODUCTION

Nurses, Doctors, and other medical care professionals have enjoyed enormous success in de-escalating intense moments, settling and resolving even the most complicated internal department disputes or dissatisfied patient complaints. But we have yet to become aware the benefits of social-emotional intelligence skills.  The proper use of mental tools to preventatively and proactively respond to conflict in healthcare settings not merely to individual differences may show beneficial for the employee, employers, and clients. Identification of an underlying driver of ineffective or inappropriate communication conflicts in healthcare settings necessitates life learning as it relates to our efforts to be continuous, spontaneous emotional learners. Increased awareness of the emotional triggers that set us up to fail to communicate effectively with our patients and co-workers may prevent unwanted behaviors and improve employee retention and patient satisfaction. Employing conflict management strategies within the intimate relationships in medical facilities may open our minds to what could be done creatively to avert natural friction. Organizations can not prevent all undesirable behaviors, but developing social-emotional skills may bridge the gaps of communications in conflicts and lead to closure through service recovery.

We have not fully appreciated the beneficial role that recurrent, unresolved disputes play in customer service transformation or acknowledged our emotionally intellectual ability to pinpoint precisely the places where bridging the gap of communication is useful. This system design may bring awareness of social-emotional intelligence and defend the value of life learning as it may benefit individuals, the medical companies they work for, and the clients they serve. The goal is to provide mental tools to be used by employees and employers in health care businesses that may be helpful at work and home to make employers and staff speak and act more emotionally intelligent. It is possible for the healthcare facilities to experience benefits such as employee retention because of a reduction of the frequency of nurse or other medical professional employee burnout or compassion fatigue. Also, stress management with the use of life learning may increase patient satisfaction scores, public relations and contribute to a respectable reputation of the healthcare facility.

These systemic issues of under-developed social-emotional intelligence are often challenging to address because they lie at the center of what holds the relationships between patients, medical care providers, and a healthcare facility reputations together. When letting alone, the negotiations of settlements for medical negligence, misconduct accusations, or discussions to resolve minor grievances, contains the possibility of even greater divergence in the experience of healing, fear, grief, loss, or pain.  Prioritizing emotional and physical significance of conflicts that arise in stressful moments lead to healthy and productive communications.

Unsatisfied employees may not attribute their emotions to lack of emotionally healthy connections with their families, peers, team leaders, managers, or administrators. Personal reflections on their role in a conflict may lead to forwarding thinking and a more satisfying interaction with peers. At any level, the communications breakdown can result in misunderstandings that can lead to serious medical complications. These complications can be for both patient and medical staff and qualify as acute or chronic either physical or emotional.

“John Medina, a developmental molecular biologist and research consultant and author of “brain rules,” offers readers 12 principles for surviving and thriving at work or home. Medina argues that “depression hobbles the brain’s natural improvisatory instincts the way arthritis hobbles a dancer. Fluid intelligence, problem-solving abilities (including quantitative reasoning), and memory formation are deeply affected by depression.”  “Stress is behind more than half of the 550 million working days lost each year because of absenteeism. Stressed employees tend to avoid coming to work at the slightest excuse, and they often show up late.” Medina added the “Centers for Disease Control and Prevention asserts that a full 80 percent of our medical expenditures are now stress-related. In a workforce where 77 percent report a lot of trips to the doctor. That’s not all. Prolonged stress can cause depression, which alters the ability to think—a direct assault on a corporation’s intellectual capital. This injury to business productivity is threefold.”

“Depression in some circumstances may be attributed to the added stress either employees or patients experience in personal or professional life and makes for less than desirable environments to begin their healing and recovery processes.”

“Those same people who have lost their creativity incur more health care expenses. Thus, not only does stress reduce the contributions valuable employees can make, but those same employees begin to cannibalize their company’s internal resources. And it’s not just mental health expenditures. Depressed individuals are at increased risk for other diseases.”

“People who burn out are often fired if they don’t leave on their own. Turnover further disrupts productivity, plus sets off a costly recruiting and training effort.”

Medina suggests “three things matter in determining whether a workplace is stressful.”

1.     Type of stress

2.     Balance between occupational stimulation and boredom

3.     The condition of the employee’s home life.

Additionally, “the perfect storm of occupational stress appears to be a combination of two malignant facts: a) high expectations of you and b) you have no control over whether you will perform well.” Helplessness? As Medina suggest, productivity and monitoring need a balance between controllability and uncontrollability to deploy problem-solving strategies.

Emotional Intelligence History 

·      A brief history of organizational management approaches date back to 1800’s and 1900’s by Frederick Winslow Taylor and H.L. Gantt, mid-1800’s to early 1900’s.

·      The classical approach for specific functions of the executive (Max Weber and Chester Bernard) and behavioral approach related to the economic man v. administrative man, managers who make a rational decision but constrained by human resources (Herbert Simon).

·      Beliefs people want to make greater use of their talents. Integrative approach in 1920’s general system theory was a closed vs. open system.

·      Neoclassical approach recognized executive functions and needed for cooperation between management and subordinates (Mary Parker Follet 1868-1933).

·      Quantitative method post-WWII was the management science use of modeling and simulation to assist in planning and forecasting.

·      In the 1960s mechanistic as highly structured and traditional. Organic viewed as employee-centric. Contingency matching structure to organization’s environment as central management approaches.

·      IQ was the only recognized evaluation of intellect.

·       In the 1990s Peter Salovey and John Mayer defined “Emotional Intelligence as a form of social intelligence that involves the ability to monitor one’s feelings.”

A transition from industrial age to informational age equaled changes in management strategy and employer/employee relationships. Trends shaping management globalization, technology advances including the decentralization of the workforce and demographics with baby boomers retiring and intergenerational workforces demanding flexibility.

IQ vs. EQ

Daniel Goleman, a psychologist, and science journalist define the human IQ as an entry level functioning or threshold ability, and EQ is an individual’s ability to monitor feelings and emotions, and actions. Goleman suggests three domains in qualities that help us stand out as individuals.

1.       Cognitive: Basic Natural ability to understand complex concepts

2.       Technical Education: Advance to College, etc.

3.       Emotional Learning: Lifetime experience learning.

Goleman suggests that if we just embrace cognitive skills and technical school or scientific academia, we leave out emotional learning. Furthermore, adapting to change needs practice, sustained effort and is a process that will not be effective if viewed as a cookie cutter employee training. Social skills for becoming someone people want to work with is far more valuable, and EQ can improve over time versus our IQ numbers compare us to others, and that appears to not change significantly over time. To be productive life learners, Goleman believes you must want to be empathetic and look through a customer’s lens and defends empathy is crucial to building rapport. Create an environment of desired safety, warmth as a caring leader who chooses to lead an organization which supports surviving and thriving which may be compatible with an individual who seeks to be on a team that is empathetic and active listeners.

Emotional Tools for Your Toolbox

There may be natural friction or conflict in any relationship. The same is true in any team environment. Managers may benefit from looking at conflict as an opportunity to innovate and set higher productivity goals. Goleman’s Emotional Intelligence Theory suggest seven characteristics of emotionally intelligent people.

1.       They are change agents who focus on rapid changes that take place in work environments and expectations.

2.       They are self-aware and focus on how this relates to team relationships.

3.       They are empathetic and are open to see a conflict as if being in the other individual’s circumstances.

4.       They are not a perfectionist.

5.       They are balanced.

6.       They are curious.

7.       They are gracious.

Goleman recommends skills in “emotional intelligence is a practical skill that everyone can develop. During crises, conflicts, adversarial negotiations, and competition, people with little emotional intelligence quickly reach the limits of their capacity for self-control, self-awareness, self-management, empathy, and collaboration, leading to considerable losses for themselves, other employees, and the organization as a whole.”

T.E.A.M. (Lencioni)   

Patrick Lencioni is an author and founder of the Table Group. He is considered to be a leader in specialized management-consultant for organizational health and suggests dysfunctional organizations may suffer from the lack of trust, commitment, accountability, and management. 

·       Trust: The absence of trust prevents effective teamwork

·       Execution: Fear of conflict and lack of commitment

·       Accountability: Avoiding interpersonal discomfort prevents holding members from holding one another accountable for their behaviors and performance

·       Management:  Inattention to Results pursuit of individual goals erodes the focus on collective success Development Cycle

Stages by Tuckman

Bruce Tuckman, researcher, and theorist of group dynamics.  His theory on stages of group development, He suggests these stages occur when transitioning a team of strangers to an organized group with common goals.

·        Forming—factors include organizational goals, proximity, psychological considerations, structure

·       Storming-conflict regarding roles in group, establishing cohesiveness, ability to handle conflict

·       Norming- determining rules, accountability within the organization, ability to handle conflict

·       Performing -execution phase

·       Adjourning (if applicable                                 

Beyond Reason

Roger Fisher world-renowned negotiator and Daniel Shapiro, psychologist, and expert on the emotional dimension of negotiation authored their book “beyond reason.” They insist emotions matter and suggest that their writings can help the reader to use emotions to transition a disagreement-big or small, professional or personal. J. Kagan, with Harvard University, wrote that this tool “may offer clear account complex effects of human emotions in social exchange that should raise the level of civility and effectiveness in all our interactions.”

Managerial Perspective for handling employee complaints

From: Society for Human Resource Management HR Magazine “Giving Voice to Employee Concerns” by Carolyn Hirschman, August 1, 2008, In her article, Hirschman makes the following statements.

1.       Advocates appreciation for employees who bring up concerns or complaints

2.       Proper employer response can:

·        Build trust, loyalty among employee and employer

·       Allow business to become aware of problems

·       Avoid lawsuits

·       Generate ideas to improve company

3.       Complaint gathering tools such as hotlines and employee surveys can be used to identify trouble spots and trends that can lead to organizational changes.

4.       The company has a responsibility to set the tone that creates a “culture of candor” and responds to complaints, concerns by offering feedback to those identified areas. Provide summaries of the complaints and share those with employees.

5.       Training employees how to handle complaints.

Start with What You Know

Ken Cloke, Attorney, Arbitrator, author, mentor and Alternate Dispute Resolution Consultant along with and Dr. Joan Goldsmith who is also an author, my mentor and Alternate Dispute Resolution Consultant, offer some wisdom from being life learners. In their book, “The End of Management and the Rise of Organizational Democracy,” a quote was provided:

Out of all this has come the first clear recognition of an inescapable fact: we cannot successfully force people to work for management’s objectives. The ancient conception that people do the work of the world only if they are forced to do so by threats or intimidation, or by the camouflaged authoritarian methods of paternalism, has been suffering from a lingering fatal illness for a quarter of a century. I venture to guess that it will be dead in another decade.

Douglas McGregor

Cloke and Goldsmith acknowledged McGregor missed the rumors of the demise of such ancient concepts and own their failure to recognize the extent of the illness in management styles. They understand a combination of collaboration, self-management, and organizational democracy can take place.

A manager may have an authoritative management style that might say “It is my way or the highway.” Or perhaps one may think of adapting to change and the sustained efforts, as a process that needs time to develop and can’t be rushed or stamped out of a cookie cutter pattern. Cloke and Goldsmith, discuss “the need to end the era of overseers, surrogate parents, scolds, monitors, functionaries, disciplinarians, bureaucrats, and lone implementers is over, while the need for visionaries, leaders, coordinators, coaches, mentors, facilitators, and conflict resolvers is steadily increasing, pressing itself upon us.” An authoritative cookie cutter one size fits all mentality may cause communications to breakdown, diminish rapport and trustworthiness with the members of a team.   

Cloke and Goldsmith wrote, “These innovations are expanding the capacity of organizations to make rapid decisions, serve customers, communicate effectively, and implement change. Many of these modifications have grown out of rapid-fire innovations in information technology, transportation and communications, automated production, global internet access, neural net programming, robotics, ubiquitous computing, and nanotechnology, while others have developed out of team building, organizational psychology, communications, process mapping, collaborative negotiation, and conflict resolution.”  These visionaries continued to write, “Let’s start with what we know.” “The word management has many meanings, in one sense, it means simply to administer or handle, as one might manage a business, checkbook, or household. In other words, it means to cope or respond to situations, in “I’m managing well under the circumstances.” “In another, it means to control or direct others, causing them to submit to someone else’s will. It is the desirability of this last meaning that we question.”

Cloke in his book, The Dance of Opposites, wrote, “every workplace generates chronic conflicts, yet few organizations have rethought the way they work, or used conflict resolution skills and ideas to prevent and transform chronic conflicts at their sources, or examined their organizational communications and “conflict cultures” to discover how these conflicts are generated and reduce their reoccurrence.” He added, “fewer still have integrated conflict resolution and coaching, trained leaders as mediators, used conflict resolution principles to inform their change processes, conducted “conflict audits” to reveal where these streams of conflict originate, or designed complex multi-layered, self-correcting systems to improve their capacity for conflict prevention, resolution, and transformation.”

 Unmanageable Traits

Employee/Employers should reflect on the following traits and consider personal growth as a benefit personally and as an organization.

Trust                                                                   Consensus

Caring                                                                 Craftsmanship

Creativity                                                             Values

Curiosity                                                              Perseverance

Insight                                                                Initiative

Synergy                                                              Flow

Integrity                                                             Collaboration

Love                                                                   Understanding

Dedication                                                           Wisdom

Leadership                                                          Passion

Honesty                                                              Forgiveness

Courage                                                              Unity

Empathy                                                             Trustworthiness

Compassion                                                         Follow-through

                 

Create Revolutionary Experience

Get feedback

I have surveyed medical staff ranging from patient representatives, medical assistance, nurse aides, LPN’s, RN’s, NP’s, and Doctors. I asked if they have ever heard of the term “Emotional Intelligence” or have ever felt as if patient feedback encouraged them to bridge the gaps of communication between patients, families, and the medical facilities. None of the subjects interviewed understood what defines emotional intelligence. Most all agree that ambiguities in assignments and lack of communication created the most conflict.  Additionally, all nurses reported compassion fatigue and work stress contributed to feelings of burnout, and difficulty with relationships at work. All subjects confirmed stressors in work and personal life. Doctors and nurses report compassion fatigue with heavy schedules over an extended period. All subjects agreed that bridging the gap of communication between patients, families, and the medical facilities is an idea they would like to include for professional development such as lunch and learns.

Cloke and Goldsmith discuss the lenses that distort feedback and suggest for anyone to receive accurate feedback, there must be an absence of fear of retaliation, yet hierarchies allow managers to use feedback as a means of punishment and control. Second, effective feedback requires that evaluators also correct themselves, yet authorities allow managers to avoid adjusting themselves based on feedback. Heinz von Foerster suggests “that heterarchical feedback by itself leads to a powerful mutation in the managerial injunction, “Thou Shalt,” transforming it into the self-managing declaration, “I shall.” When givers and receivers engage in open and honest feedback, they automatically become co-equal members of a team. And when team members give each other honest feedback, they cease being irresponsible employees and become self-managers, creating the collaborative declaration, “We shall.”

Distortion Feedback process: (Cloke and Goldsmith)

1.     Information

2.     Relative Power of Evaluator/Relationship to Evaluatee

3.     Organization Context, Culture, and History

4.     Standards, Models, Goals, Theories, and Expectation

5.     Self-image and Emotions

6.     Feedback Methods and Processes

7.     Results                                     

Substantive examples of group conflicts could be ambiguities in tasks/job roles and differences in goals. Three Types of Group Conflict.

1.     Substantive conflict is differences in ideas and courses of action.

2.     Relationship-interpersonal differences are among team members.

3.     Interpersonal versus Intrapersonal group conflict.

Consider Mediation

Organizations who put down the cookie cutter mold and allow emotional learning to be employed may benefit with employee retention and increase customer satisfaction. Conflict is not always bad and can open the door for creativity and problem-solving. One tool that may explain dividers and connectors and aid managers and staff members analyze the conflict is Christopher Moore, author of The Mediation Process. The triangle reveals process (procedural), emotion(psychology) and results (substantive).

Three Types of Conflict Conversations and Tips to Handle conflict by Conflict Research Consortium Staff

“What Happened” conversation tips:

1.     Don’t assume the other person’s intentions. Accusations create defensiveness.

2.     Disengage the intention from the impact. Don’t minimize the impact. We can’t know someone’s intent.

3.       Determine how you contributed to the situation and looked for ways to minimize the contribution in the future. Blame focuses on the past; forward thinking helps to future solutions.

“The Feelings” Conversation Tips:    Have your feelings, or they will have you!

1.     Unexpressed feelings will leak or burst into the conversation. Accept that you will have all kinds of feelings and these are natural.

2.     Unexpressed feelings make it difficult to listen. Recognize that right person will have bad feelings.

3.     Unexpressed feelings damage self-esteem and relationships. Learn that your attitude is as important as theirs. Negotiate with your feelings.

Use “I feel” statements. I feel ----------- when ------------------------------------------------?

Prepare for Difficult conversations “Core Identity” conversation tips:

1.     Let go of controlling how others will react.

2.     Prepare for their responses.

3.     Take a break get away to ponder the matter.

4.     Find the courage to ask for help.

                                                           

Prepare for Difficult Conversations

 Prepare for Difficult conversations by mapping it out.

·       What happened?

·       My Story?

·       His/her Story?

·       Impact/Intentions?

·       My Contributions?

·       His/her contribution?

·       Feelings?

·       Identity issues?

It is Your Button

Cloke and Goldsmith, authors of Resolving Conflict at Work, offer sound advice for learning to successfully use techniques for responding to challenging behaviors as a lifelong process. “Remember: Even though someone pushes your button, it is your button, and you always have a choice in how to respond. Being skillful means choosing your response strategically from multiple alternatives. Reducing your feeling that the other person can control you, and allowing you to achieve a greater sense of power in the relationship.”

Below are only a few examples of relevant quotes from these very talented authors about attitudes, approaches, and techniques. I encourage you to place these recommendations in your mental tool box and use them to grow more Emotionally Intelligent and model these processes in your personal and professional life.

 “Accept other people and their ideas and feelings about the issues that divide you as legitimate from their perspective. Don’t question their character, personality, interests, or feelings.”

“Be willing to collaborate in defining what is wrong with your communication and relationship.”

“Do not start by indicating how they should change their behavior. Instead, start with yourself, describe the issue as an “it,” and use pronouns like “I,” or “we.”

“Work collaboratively to find solutions. Start by thinking of something you can do to improve the situation.”

“Strive for perfect integrity in your behavior.”

“If you want to create meaningful and lasting changes in the conflict culture of your organization, you will need to develop considerable clarity about what most needs to change and collaboratively create a sharp, compelling vision of what you want to bring into the new practicing honesty, empathy, and compassion as these changes are identified, agreed upon, shifted, and implemented.”

ENDNOTES 

1.       Parts of this article quoted from Kenneth Cloke, J.D., L.L.M., Ph.D., and Dr. Joan Goldsmith, Doctor of Humane Letters, authors of Resolving Conflicts at Work: Ten Strategies for Everyone on the Job (2011), The End of Management: And the Rise of Organizational Democracy (2002), http://hbr.org/1972/09/an-uneasy-look-at-performance appraisal

2.       Kenneth Cloke, The Dance of Opposites: Exploration in Mediation, Dialogue and Conflict Resolution Systems Design (2013).

3.       Parts of this article are excerpted from Warren Bennis and Joan Goldsmith, Learning to Lead: A Workbook on Becoming a LEADER (2010).

4.       Part of this section quoted from Daniel Goleman, Emotional Intelligence: Why it Can Matter More than IQ (2005), 978-553-38371-3

5.       Part of this article excerpted from Roger Fisher and Daniel Shapiro, Beyond Reason: Using Emotions as You Negotiate (2005), 978-0-14-303778-1

6.       Patrick Lencioni, The Five Dysfunctions of a Team: A Leadership Fabel (2002), 978-0-7879-6075-9

7.     From: Society for Human Resource Management HR Magazine

“Giving Voice to Employee Concerns” by Carolyn Hirschman, August 1, 2008, http://atteu.utah.ed

8.     John Medina, developmental molecular biologist and research consultant, author of Brain Rules: 12 Principles for Surviving and Thriving at work, home, and school (2008), 978-0-9797777-4-5

9.     Bruce Tuckman, Psychologist, Developmental Sequences in Small Groups, (1965) Vol 63(6), Jun 1965, 384-399, http://dx.doi.org/1037/h0022100

10.  Douglas Stone, Bruce Patton, And Sheila Heen, Difficult Conversations: How to Discuss What Matters Most, (New York: Viking Penguin, 1999)

11.  https://www..verywell.com/what-is-emotional-intelligence-2795423

 

Biography


Melanie Frizzell, LPN, M.A. is a listed Rule 31 General Civil Mediator trained in Family Mediation, Domestic Violence, and Congregational Conflict. She has a Master of Arts (M.A.) in Conflict Management from Lipscomb University, a Bachelor of Science in Psychology, Social Work, and Organizational Leadership from Lipscomb University. 

She is a License Practical Nurse with over 21 years experience, wife, and mother of three. She is passionate about teaching organizations and individuals how to develop social emotional intelligence strategies. 


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