JONA

Volume 32, Number 4, pp 203-210

2002, Lippincott Williams & Wilkins, Inc.

Exploring Emotional Intelligence

Implications for Nursing Leaders

Joan M. Vitello-Cicciu, PhD, RN, FAHA, FAAN

Emotional intelligence is being touted in the popular
literature as an important characteristic for successful leaders. However, caution needs to be exercised
regarding the connection between emotional intelligence and workplace success.The author contrasts 2
current models of emotional intelligence, the measurements being used, and the ability of emotional
intelligence to predict success. Implications for the
workplace are discussed.
Healthcare is changing so rapidly that healthcare
leaders can no longer use outmoded ways of leading
our organizations. Consumers are demanding that
the healthcare system become more relationshipcentered and service-oriented.1 Patients who participated in the Picker-Commonwealth Study1 articulated the need for healthcare clinicians to provide
effective emotional support to them and their loved
ones.
Demands of patients place additional burdens
on nursing leaders who are often managing and coordinating the environment in which healthcare
providers deliver care. At the same time, healthcare
leaders are charged with the responsibility of becoming more democratic and humanistic. Their accountabilities include meeting the needs of staff and
helping themselves and staff develop better interpersonal and communication skills.Yet, according to
Bellack,2 some of the new practitioners in nursing
seem to lack the social and emotional competencies
needed for successful and effective performance in
the current chaotic and demanding environment.

Author affiliation: Patient Care Services, St. Annes Hospital,

Fall River, Mass.
Corresponding author: Joan M. Vitello, PhD, RN, FAHA, FAAN,
182 Wayside Inn Road, Sudbury, MA 01776 (jvitello19@cs.com).

JONA Vol. 32, No. 4 April 2002

Kerfoot3 contends that successful healthcare

leaders are those who lead with heart and possess
what has come to be known as the soft skills.These
are being empathetic to their employees, enhancing
individual and group relationships, and recognizing
the individual contributions of each member of the
healthcare team. Successful leaders are also adept at
analyzing the emotional side of issues, anticipating
how people will react, and creating programs that
will assist their staff with the emotional side of workrelated issues. Kerfoot3 states, aggressive, totalitarian, tough leaders usually fail because of their inability to handle the emotional side of leadership.(p59)
The emotional side of leadership requires
unique abilities. It requires that people in a leadership role possess the ability to identify emotions in
themselves and others, use emotions in their
thought process, understand and reason with emotion, and manage emotions in ones self and others.
People who behave in these ways are referred to as
emotionally intelligent individuals by Mayer and Salovey.4

What is Emotional Intelligence?

Salovey and Mayer5 originally defined EI as the ability to monitor ones own and others feelings and
emotions, to discriminate among them and to use
this information to guide ones thinking and actions.(p189) In their seminal article, Salovey and Mayer5
proposed a conceptual model of EI that included 3
processes: (1) appraisal and expression of emotion,
(2) regulation of emotion, and (3) utilization of emotion. Salovey and Mayer5 initially defined EI as these
3 abilities. In 1997, Mayer and Salovey4 made revisions to their original definition of EI and added another ability,EI involves the ability to perceive emotions; the ability to access and/or generate feeling so
as to assist thought, to understand emotions and
emotional knowledge, and to reflectively regulate

203

emotions so as to promote emotional and intellectual growth.(p5)

Mayer and Salovey4 have depicted these abilities
in a conceptual framework that is hierarchical in nature from the basic psychological process of perceiving and expressing emotions to the higher, more
psychologically integrated process of the reflective
regulation of emotions (Figure 1). People with high
EI are expected to progress through these abilities
and to master them.4 (p10)

The predominant assumption regarding EI is

that emotions and intelligence are connected. Moreover, this connection seems to link an individuals
ability to feel, think, and thus behave in an intelligent
manner. Researchers on intelligence caution that in
order for a construct to be determined as an intelligence, it must reflect mental performance rather
than personality traits, preferred ways of behaving,
or a persons self-esteem.6-8 Scarr8 notes that there
are human virtues such as extroversion, self-confi-

Figure 1. The 4 Ability Model

of Mayer and Salovey.4

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JONA Vol. 32, No. 4 April 2002

dence, and social perceptiveness that are important

for humans interacting with others and that these
virtues are related to,but are not a part of,intelligence.
Mayer and Salovey4 agree that everything connecting
cognition and emotion is not EI.They state,Emotion
is known to alter thinking in many ways...but not necessarily in ways that would make a person smarter.(p5)
Two models of EI have been proposed (ie, the
ability and the mixed model).9 The ability model has
been conceptualized by Mayer and colleagues9 as involving a set of mental abilities of perceiving, assimilating, understanding, and managing emotions. However, others such as Goleman and Bar-On, define EI as
a mixture of abilities and other personality dispositions and traits known as the mixed model. Mayer et
al.9 postulate that the motivation to label personality
traits, attitudes, and dispositions into a single entity as
EI is to be able to predict success in ones personal or
professional life.

Golemans Popular Version of EI

Shortly after Salovey and Mayers5 first paper on EI was
published in the academic literature, Golemans10 popular best-seller book, Emotional Intelligence: Why it
Can Matter More than IQ brought the construct of EI
to the publics view. Goleman10 defined EI as the ability to motivate oneself and persist in the face of frustration; to control impulses and delay gratification; to
regulate ones moods and keep distress from swamping the ability to think; to empathize and to hope.(p34)
EI was also depicted to represent a body of skills referred to as ones character.(p285) This definition is more
aligned with a definition of a motivational intelligence
rather than EI.
This mixed model of EI was further characterized
into 5 broad components:
1. self-awareness
2. self-regulation
3. motivation
4. empathy, and
5. social skills
These capacities were highlighted and expanded
upon to include 25 competencies under each dimension in Golemans11 second book entitled, Working
With Emotional Intelligence.These hierarchical competencies include: emotional awareness, accurate selfassessment, self-confidence, self-control, trustworthiness, conscientiousness, adaptability, innovation,
achievement drive, commitment, initiative, optimism,
understanding others, developing others, service ori-

JONA Vol. 32, No. 4 April 2002

entation, leveraging diversity, political awareness, influence, communication, conflict management, leadership,change catalyst,building bonds,collaboration and
cooperation, and team capabilities.
Golemans identification of these 25 competencies resembles the personality traits (trustworthiness,
conscientiousness, adaptability), motivational skills
(achievement drive,commitment,initiative),and social
attributes (influence, communication, and leadership)
characteristics of the mixed model.Interestingly,these
competencies all seem to correlate with success but
not necessarily with one another or EI as noted in the
ability model that Salovey and Mayer4 originally proposed.
Goleman11 argues that no one has perfected all 25
of these competencies. He contends that the ingredients for outstanding work performance require only
that we have strengths in a given number of these
competencies, typically at least 6 or so, and that the
strengths be dispersed across all 5 areas of EI.(p25)
Goleman11 categorizes EI competencies as:
1. Independentin that each one contributes
uniquely to job performance.
2. Interdependentin that each draws to some
extent on certain others with many strong interactions.
3. Hierarchicalin that each capacity builds upon
one another. For example, self-awareness precedes self-regulation and empathy.
4. Necessary but not sufficientin that having an
underlying EI ability does not guarantee people
will develop or display the associated competencies such as collaboration or leadership. Factors such as the context of the work place, or a
persons interest in his or her job will also determine whether the competence manifests itself; and
5. Genericin that this general typology is to
some extent applicable to all jobs, however different jobs may require different competencies
to be more pronounced.(p25-28)
Interestingly, Gardner13 criticizes Goleman for departing from the scholarly sense of EI to entering the
realm of values and social policy when Goleman
speaks about EI as if it encompasses a certain set of
recommended behaviors such as empathy, considerateness, or working toward a more smoothly functioning family or community or for socially desired
ends. Mayer states in an article by Tony Schwartz14 that
Goleman has broadened the definition of EI to such
an extent that it no longer has any scientific meaning

205

or utility and is no longer a clear predictor of outcome.(P307) Bennis15 also debates Golemans premise
that emotional competencies are hierarchical, stating
that if emotional competencies are hierarchical, how
could President Clinton skip self-regulation (including
impulse control and trustworthiness) without hampering his fabled empathy and social skills?(P10) Moreover, Bennis15 struggles with Golemans contention
that all 25 competencies are of equal value.
In both of his books, Goleman10,11 proposes that EI
will account for success at home, school, and work;
that it will assist people in working as cooperative and
effective members on a team, and that EI has proven
to be twice as important as technical skills and IQ for
jobs at all levels. Goleman11,12 contends that EI is a
learnable construct and improves with age. Mayer et
al.9 agree that EI develops with age but differ with
Golemans predictive claims of the value of EI.These
scholars argue that Golemans statements that EI
should predict success at higher than an r .45 level
is contributing to the overwhelming popularity of EI
in the lay press.9
Since Golemans 2 books have been published,
the media and organizational development literature
have continued to disseminate strong claims about the
power of EI. EI is being touted as more important than
IQ for predicting success in ones life and in the workplace.16-18 Mayer et al.9 caution us that there is little to
no evidence to validate the assumptions that EI accounts for a large part of a persons success at work or
in life and suggest that some of the enthusiasm is certainly misplaced and misleading. (p411) These originators
of EI state more emphatically,The first way it is misleading is with respect to how strong a prediction can
be made.According to popular writing, if intelligence
predicts 20% of the variance of some success, EI can
help fill in the gap. To the unsophisticated reader,
bringing up the 80% unaccounted-for variance figure
suggests that there may indeed be a heretofore overlooked variable that truly can predict huge portions of
life success.Although that is desirable,no variable studied in a century of psychology has made such huge
contributions.9(p412) The popular literature continues to
inundated us with books and articles on EI.17-22 What is
disturbing is that many continue to make claims about
the significance of EI despite the cautions of the
founders of EI.

Measurements of EI
A preponderance of measurement tools based on selfreports or self-evaluations are used to measure EI.The
interest to measure EI has become heightened using

206

the mixed model. Daniel Goleman and Richard Boyatzis developed a test entitled the Emotional Competency Inventory (ECI) a 360 measurement commercially available by the Hay Consulting Group.This tool
allows a person to self-evaluate as well as obtain a 360
assessment from family members, peers, direct reports, clients or customers, supervisors or other individuals as to the persons 25 aforementioned competencies.
Reuven Bar-On23, an Israeli psychologist, has also
developed an instrument entitled the Emotional Quotient Inventory (EQ-i) which is self-administered.This
instrument has 133 questions that evaluates 15 qualities including empathy, self-control, self-awareness, assertiveness, independence, social responsibility, and
even happiness.Again one should note that these factors relate to personality traits and even mood states
and not necessarily to the ability to perceive, use, understand, and manage emotions as Mayer and Salovey
envisioned.
Tony Schwartz4 relates that he personally took
both the Goleman and Bar-On measurement tools for
EI. He scored above the target level in every single category on the ECI but according to the EQ-i,he is sorely
lacking in EI. How is it that his scores could differ so
widely? He offers the following explanation,One possible cue is that Bar-Ons EQ-i is a self-assessment test
whereas my scores on the ECI reflect not only my responses, but also the aggregate opinions of 9 others
who rated me...one potential explanation is that I am
harder on myself than others are on me. However,
with a couple of notable exceptions, I gave myself almost the same ratings that others gave me on the
ECI...Another possible explanation for my contrasting
scores is that the 2 tests are based on different definitions of EI.(p310) Thus, which of these 2 tests should a
potential employer believe,if they were to use such an
instrument to screen potential applicants?
A growing number of assessment tests can also be
found on the Internet as well. For example, quizzes
posted on goodhousekeeping.com allow you to rate
your EI.Assessment tests from the Utne Reader (Goleman24 devised this one for the Utne Reader) and USA
Weekend are also posted on Web sites. However, according to Trochim25 neither of these self-reported
tests provides any evidence of results that are valid or
reliable.
Self-report measures tend to be unreliable as
performance or ability measures because they are filtered through a persons self-concept and people
may feel the need to impress others.9 Some individuals taking a test on EI may also want to give answers that are more socially acceptable and this ten-

JONA Vol. 32, No. 4 April 2002

dency may lead to response bias.26 People are notoriously inaccurate respondents in several areas of selfreports such as in self-reported intelligence and leadership performance.27-30 The problem with such easy
access to self-reported instruments such as those just
cited is that they could be used to assess an individuals
EI and other personality characteristics or to direct
major policy decisions.These may include: hiring practices in organizations, selection of candidates for leadership roles, and evaluation of work performance for
salary increases.

Ability Measurement of EI
The founders of EI, Mayer and Salovey, along with their
colleague David Caruso, have developed a tool to measure EI as a set of mental abilities that appears to be
content and structurally valid and reliable. Initially the
first instrument was called the Multifactor Emotional
Intelligence Scale (MEIS) which consisted of 12 ability
measures of EI divided into 4 classes or branches of
abilities, including (a) perceiving, (b) facilitating, (c) understanding, and (d) managing emotion.9,28 A revised research version of the MEIS was released in 2000 entitled the Mayer, Salovey, Caruso Emotional Intelligence
Test (MSCEIT) which is shorter and more professionally developed (J. Mayer, personal communication,
2/24/00).This instrument has been used with varied individuals in diverse settings and this author used it in
her dissertation. It became commercially available in
the fall of 2001 through Multi-Health Systems in
Toronto, Canada.
A mental ability test such as the MSCEIT proposed
by Mayer, Caruso, and Salovey28 appears to be the most
valid and reliable ability measurement tool to assess EI.
It is hoped that with the emergence of the commercially available version of the MSCEIT that such a tool
will used in multiple settings instead of relying solely
on self-report instruments.Such an ability measure may
help individuals who are thinking of pursuing a career
that demands a high degree of emotional labor be better matched to that career.According to Mayer et al.,9
ability-based emotional measures may be useful in identifying those individuals who may be mismatched in a
role or career because they lack the understanding to
listen empathetically or to behave in a sensitive manner
with others.(p413) Such mismatched individuals would be
able to then select the best environment to suit their
emotional abilities or make an earnest attempt to acquire those abilities.It is important for individuals to be
able to process their emotions in such a way as to understand them, and reflect on them to promote emotional and intellectual growth.

JONA Vol. 32, No. 4 April 2002

Developing EI
Recent neurobehavioral research on the limbic system
indicates that EI can be learned through motivation,extended practice,and feedback.12 Goleman12 contends to
enhance EI, one must break old behavioral habits and
establish new ones through an individualized approach. He also states that building ones EI will not
happen without a sincere desire or concerted effort on
the part of an individual.A brief seminar wont help or
a how-to manual. Learning to internally empathize as a
natural response to people is much harder to learn
than regression analysis.12(p97)
Using Mayer and Saloveys ability model, Caruso
and Wolfe31 suggest that identifying emotions (Ability 1)
can be improved upon by actively observing facial expressions and noting their congruency with the spoken words and tone of voice.They also suggest validating ones impression of anothers emotion with that
particular person.
In a study conducted by this author32,nursing leaders suggested that their caring for critically ill or terminally ill patients enhanced their ability to identify emotions in others.Perhaps a rotation in these clinical areas
could facilitate nursing studentsor new graduatesability to appraise emotions in others. I would also suggest
that such rotations incorporate patient care debriefings
to explore emotional reactions exhibited by either patients or their loved ones in these settings.
Self-reflection is another modality that may enhance the ability to identify emotions in oneself. Employing a mood journal to answer questions such as
What am I feeling now? What verbal or nonverbal
cues am I sending out to others? can be a useful catalyst in perceiving ones emotions.
Using emotions in thought (Ability 2) can be developed by trying to remain in the present and reflect
on upsetting situations after the fact to learn from
them. Emotional empathy is based on this ability. Developing empathetic skills through active listening and
using inquiry is needed to develop this second ability.
Understanding and analyzing emotions (Ability 3)
can be fostered by learning that emotions convey
meaning about relationships. It is also important to
learn about the transition of emotions from one state to
another. For example, annoyance and irritation can
lead to rage.A nurse leader can also learn about emotions, what causes them, and how they function. For
example, anger usually is a result of someones perception of being wronged or sustaining some injustice. Role playing of emotional situations and then
analyzing them afterwards may hone this third ability. Stories/narratives of difficult leadership situa-

207

tions may also enhance a nurse leaders ability to recognize, interpret, forecast and then respond to diverse employee situations. Having coaches or mentors can also enhance this ability by being able to
talk with others regarding disturbing leadership
dilemmas and directly witnessing mentors handle
difficult situations.
Generating an emotion to help solve a problem,
energizing a group, or calming oneself prior to an
emotional event are learned skills to help one manage ones emotions as well as others (Ability 4). Employing such methods as relaxation techniques, intentional
breathing
exercises, meditation,
visualization techniques, self-help books can assist a
person to become more positive and manage emotions more effectively.
To acquire the ability to manage ones emotion
requires that nurse leaders recognize the emotion
and then use it to solve a problem. For example, at a
leadership meeting, one of your nursing colleagues
suggests that you take a nurse from his unit in a
transfer to your nursing unit to prevent this nurse
from being laid off. This evokes anxiety in you.
Rather than ignore this feeling, you reflect on it and
recall that in the past you had an unpleasant interaction with that nurse.You decide to speak with your
nursing colleague after the meeting and share your
concerns with him. Being aware of your emotions is
important in order to reflect on unpleasant emotions and to be able to ask, Why am I feeling that
way? Asking what if questions also allows oneself
to determine how different reactions to a problem
may work out and allows for problem solving and
strategizing to occur.

EI and Predicting Success

The degree to which EI is important to the overall
success in ones life and in ones work remains unanswered. This is in part because studying success,
whether personal or at ones workplace involves
first defining the success that is being evaluated, collecting data on the measures of interest, and using
the data to predict measurable outcomes.9 (p414) The
researchers11,23 who advocate the mixed model of EI
have begun such a quest. However, Mayer et al.9 advocate the sampling of variables from a broader and
more balanced fashion across the personality system
and measuring a broader variety of intelligences as
Gardner,33 in his multiple intelligence theory, has described. Given this methodology for studying success, it is apparent that one size will probably not fit
all sorts of success.9

208

EI in the Workplace
One important consideration for legitimizing EI is in
the workplace where emotions are regarded by
some as negative and needing to be controlled.The
rational view of organizations as mechanistic machines and people as cogs on the wheels of those
machines have contributed to a negative view of
emotions and the need to regulate emotions in the
workplace.34 It has been further argued that this overrationalized view of organizations has made it difficult
to recognize the pervasiveness and utility of emotions.
However,with the growth of a service-based economy
and more emphasis being placed on relationshipbuilding with customers, suppliers and even competitors in business, attention has shifted to the role of
emotions in the workplace and how emotions are expressed.Recent investigations in this area indicate that
the manner in which one demonstrates feelings has a
strong impact on the quality of service transactions
and that service providers are expected to feel and display certain emotions.35,36 Organizational researchers
are examining how workplace emotions are managed
by employees to improve work outcomes.37 For example, an employee may change how she feels or what
feeling she demonstrates in order to interact with customers in a more effective way.This type of effort on
the part of the employee to regulate ones feelings and
expressions of those feelings to display expected organizational behavior is known as emotional labor.38
The nursing profession is one service profession that requires a high degree of emotional labor.
As an example, nurses are expected to display emotions that convey caring, understanding, and empathy toward patients and their loved ones.The role of
the nursing leader is critical then in creating a supportive and positive work environment to help
nurses cope with the stress of managing their own
and others emotions, when the work demands that
certain expressions be displayed to patients and
their loved ones that may be contrary to the way
they actually feel (referred to as emotional labor).
The ability to understand and manage emotions in
an effective way is being reflected in patient satisfaction surveys. These surveys are also used by insurance providers to evaluate contracts with healthcare providers.
It will become even more important for nursing
leaders to create the climate for satisfied staff, patients, and their loved ones and diminish the degree
of emotional labor which may cause burnout of
nursing staff. Nursing leaders will be expected to
achieve desired organizational outcomes and ex-

JONA Vol. 32, No. 4 April 2002

pressions such as a caring and a supportive environment.They will be expected to set the tone for their
nursing units and foster an esprit de corps that facilitates cooperation and positive teamwork. Minimizing or dealing with potential conflict among healthcare providers on a particular nursing unit will also
be crucial if the team is to be effective and avoid
burnout. This expectation requires these leaders to
possess a high degree of EI to recognize and use emotional information in social interactions with their
nursing staff and patients. It is just this type of emotional leadership as Kerfoot3 and Strickland39 contend
that is needed for effective performance in the current
chaotic and demanding work environment.

Nursing Leaders With EI

Nursing leaders who possess EI will demonstrate the
ability to perceive emotions, to express emotions accurately, and to differentiate authentic from false
emotional expressions. For example, they will be
able to detect when their nursing staff may be angry
at a management decision, yet they will be better
prepared to articulate a positive response to such a
decision. These nursing leaders will be able to use
emotions to redirect their nursing staff to important
patient care issues like prevention of medication errors.They will also be able to generate emotions that
facilitate decision making, to use mood swings as a
means of considering multiple perspectives among
their staff and to use varied range of emotions in different patient care situations.
These same nursing leaders will be able to understand complex emotions and how emotions may transition from one stage to another especially during the
death and dying phase for patients, their families, and
the nursing staff.They will also be perceptive in their
ability to recognize the cause of emotions and to understand relationships among emotions.
Lastly, according to Mayer and Saloveys conceptual framework (Figure 1), nursing leaders will be
able to manage their emotions. This will be evidenced by their ability to stay aware of their own as
well as others emotions, even those that are un-

pleasant. Moreover, these nursing leaders will use

this skill to solve emotionally laden problems without suppressing unpleasant emotions.40
The ability of nursing leaders to manage their
mood so as to display a positive mood may actually
enhance work performance.41 These leaders will
have achieved the ability to manage their emotions
as well as demonstrate for the most part their ability
to handle the stress of multiple tasks. Persistent
crises are not as likely to paralyze these leaders or
allow them to become emotionally overwrought.
Given the chaotic nature of healthcare, leaders who
possess this ability may become a more valuable resource in healthcare organizations. However, valid
and reliable measurements to assess such an ability
must be in place.

Conclusions
Emotional intelligence is a relatively new construct
that has many implications for leadership development, childhood development, and organizational
development. Its popularity is gaining momentum
but caution must be exercised regarding its worth
and how it is defined. Researchers and practitioners
should adopt the ability model so as to enrich our insights in understanding what makes an effective
nursing leader. If EI consists of mental abilities, then
it must be measured as an intelligence using ability
measures. Anecdotal stories suggest that healthcare
organizations stand to benefit from choosing leaders
with a high degree of EI. Nursing leaders who can
address the emotional side of their staff, patients, and
families may develop the highly energized and synergized teams necessary for the survival during this
ever-changing landscape of healthcare.
Acknowledgment
The author thanks Dr. David Caruso, Dr. Joyce Clifford, Maryellen Bowers Feldman, Dr. Nancy
Molter, Dr. Pat Pilette, Pat Prawlucki, Karen Kirby,
and Dr. Assaad Sayah for their careful review of
this article.

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JONA Vol. 32, No. 4 April 2002