Monday, August 13, 2007

E-Journal Club #10

Cummings, Greta; Hayduk, Leslie; Estabrooks, Carole, “Mitigating the Impact of Hospital Restructuring on Nurses: The Responsibility of Emotionally Intelligent Leadership”, Nursing Research, January/February 2005, Vol 54(1), p 2-12.

Background: A decade of North American hospital restructuring in the 1990s resulted in the layoff of thousands of nurses, leading to documented negative consequences for both nurses and patients. Nurses who remained employed experienced significant negative physical and emotional health, decreased job satisfaction, and decreased opportunity to provide quality care.
Objective: To develop a theoretical model of the impact of hospital restructuring on nurses and determine the extent to which emotionally intelligent nursing leadership mitigated any of these impacts.
Methods: The sample was drawn from all registered nurses in acute care hospitals in Alberta, Canada, accessed through their professional licensing body (N = 6,526 nurses; 53% response rate). Thirteen leadership competencies (founded on emotional intelligence) were used to create 7 data sets reflecting different leadership styles: 4 resonant, 2 dissonant, and 1 mixed. The theoretical model was then estimated 7 times using structural equation modeling and the seven data sets.
Results: Nurses working for resonant leaders reported significantly less emotional exhaustion and psychosomatic symptoms, better emotional health, greater workgroup collaboration and teamwork with physicians, more satisfaction with supervision and their jobs, and fewer unmet patient care needs than did nurses working for dissonant leaders.
Discussion: Resonant leadership styles mitigated the impact of hospital restructuring on nurses, while dissonant leadership intensified this impact. These findings have implications for future hospital restructuring, accountabilities of hospital leaders, the achievement of positive patient outcomes, the development of practice environments, the emotional health and well-being of nurses, and ultimately patient care outcomes.

Judy's comments:
The objectives of this original research seem huge. First to develop a theoretical model seemed confusing and impossible to me. Then to take the subject of “emotional intelligence” and adapt it to this model seemed pretty daunting. But the author’s seem to pull it off with little effort and present some thoughtful introspection into some concepts that the bedside nurse doesn’t always dwell on. Specifically, how does her manager affect her working environment.

The subject of ‘emotional intelligence” caught my eye recently. I am still exploring the topic. I also haven’t found many articles that explore the history of the hospital restructuring of the 1990’s, of which I was a part of. Sometimes we don’t value our history enough.

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