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Emotional Intelligence and Intent To Stay Among Nurses
Emotional Intelligence and Intent To Stay Among Nurses
DOI: 10.1111/jonm.12932
ORIGINAL ARTICLE
1
Faculty of Nursing, Jordan University of
Science and Technology, Irbid, Jordan Abstract
2
Faculty of Nursing, Jordan University of Aims: This study aimed to examine the relationship between Emotional intelligence
Science and Technology & RN King Hussein
(EI) and intent to stay and to identify their correlates among nurses.
cancer Center, Irbid, Jordan
3
School of Medicine, The University of
Background: EI plays a significant role in nurses’ practice, relationships, behaviours
Jordan, Amman, Jordan and decisions.
4
Psychiatric and Mental Health Nursing, Methods: A descriptive, cross-sectional study was conducted with a sample of 280
Zarqa University, Zarqa, Jordan
5 registered nurses working in a public, a private and a university hospital in Jordan. A
Faculty of Business, Amman Arab
University, Amman, Jordan self-administered questionnaire was used to collect data from the participants.
6
School of Nursing, The University of Results: EI was significantly correlated with nurses’ intent to stay (r = .427, p < .01).
Jordan, Amman, Jordan
Some of the nurses’ socio-demographic and work-related characteristics were found
Correspondence to predict EI and intent to stay.
Zaid M. Al-Hamdan, Faculty of Nursing,
Jordan University of Science and Conclusion: The findings of the study came with a supportive knowledge about the
Technology, P.O.Box 3030, Irbid 22110, positive impacts of EI on nurses’ intent to stay. Improving both EI and intent to stay
Jordan.
Emails: zaid_hamdan@hotmail.com, among nurses is important because it could have positive effects on organisations’ de-
zmhamdan@just.edu.jo cisions, policymaking process, quality of care, employee commitment and satisfaction.
Implications for Nursing Management: Nurse managers should pay attention to the
EI of nurses during recruitment considering various determinants of EI identified in
the current study. Additionally, nurse managers might want to strengthen factors as-
sociated with more stay intent among their staff.
KEYWORDS
1 | BAC KG RO U N D (Goleman, Boyatzis, & McKee, 2013). These dimensions have sig-
nificant effects on nurses’ practice, behaviours and outcomes.
Emotional Intelligence (EI) is defined as “the subset of social intel- Nurses with higher levels of EI can deliver higher quality care and
ligence that involves the ability to monitor one's own and others’ achieve organisational goals (Ezzatabadi et al., 2012). In addition,
feelings and emotions, to discriminate among them and to use this nurses with high EI usually report better job satisfaction (Clancy,
information to guide one's thinking and actions” (Salovey & Mayer, 2014). Furthermore, higher levels of EI are strongly associated with
1990) (p. 189). The EI has four dimensions or skills; Self-awareness, lower burnout and stress levels among nurses (Görgens-Ekermans &
Self-management, Social awareness and Relationship Management Brand, 2012).
J Nurs Manag. 2020;28:351–358. wileyonlinelibrary.com/journal/jonm© 2019 John Wiley & Sons Ltd 351 |
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352 AL-HAMDAN et al.
Nurses’ EI was found to be significantly and positively correlated on nurses’ job satisfaction (Al-Faouri, Al-Ali, & Al-Shorman, 2014).
with coping, nurses’ well-being, nurses’ self-efficacy and negatively However, no previous study examined the relationship between EI and
correlated with stress (El-Sayed, El-Zeiny, & Adeyemo, 2014; Karimi, intent to stay among Jordanian nurses. In addition, no previous study
Cheng, Bartram, Leggat, & Sarkeshik, 2015; Park, Ha, Lee, & Lee, identified the correlates of EI and intent to stay among nurses working
2014). Nurses who pose EI qualities experience less stress in their in Jordanian hospitals.
work, less burnout experience and high level of organisational com- Nel, Jonker, and Rabies (2013) suggest that poor EI is associated
mitment and intention to stay (Hong & Lee, 2016). Furthermore, EI with difficulty in responding to job demands, burnout and reduced
was found to have a strong relationship with self-leadership (van Zyl, commitment. Also, Trivellas, Gerogiannis, and Svarna (2013) found
Mokuoane, & Nel, 2017). Research has shown that nurse managers that only self-emotion appraisal (SEA) and one's use of personal emo-
with EI capabilities have the precedence to discover and manage neg- tions (UOE) have a direct impact on nurses’ intention to stay in their
ative attitudes and behaviours such as bullying which ensures a safer jobs. However, in a more recent study by Lee and Woo (2015), all EI
and better workplace environment (Bennett & Sawatzky, 2013). dimensions, UOE, SEA, AEA and UOE, were positively correlated with
The American Nurses Association (2016) reported that the larg- registered nurses' intention to stay in their career (Lee and Woo, 2015).
est proportion of clinical care providers are nurses. The nursing However, male nurses who have higher EI scores were more likely to
shortage and nurses’ turnover are problems facing health care sys- leave their jobs. Hong and Lee (2016) found that EI had a minimal not
tems around the world (Flinkman, Leino-Kilpi, & Salanterä, 2010). significant effect of EI on nursing stay intention but in a positive direc-
As nurses act as a monitoring system for the patients, assessing, tion. It was also found that EI of registered nurses and their intention
intervening and detecting adverse events or complications, it is im- to stay in their jobs are positively correlated; once nurses have a high EI
portant to have well-trained and highly educated nurses who are score, their intention to stay in their jobs is highly expected (Suneyna &
able to deliver high-quality care to the patients and reduce mortal- Sasikala, 2014). This gap in knowledge is clear as the literature review
ity rates (Kuo, Lin, & Li, 2014; Kutney-Lee & Aiken, 2008). According revealed no consensus on these relationships. The aim of this study
to Mariani (2012), a nurse's intent to stay is defined as “the nurse's was to examine the relationship between EI and intent to stay and
plan in projected number of years to remain active in the nursing to identify their correlates among Jordanian nurses. The outcomes of
profession in practice, education, administration, or research” (p. 3). the current study would help health care sectors to put strategies to
A nurse's intention to leave is defined as nurse's decision to likely increase stay intention rates among nurses. Increasing stay intention
leave the current job in the nursing field and looking for another ca- rates would enhance the quality of care, cost, and nurses’ and clients’
reer opportunity (El-Jardali, Dimassi, Dumit, Jamal, & Mouro, 2009). satisfaction. In addition, the outcomes of this study could help nurse
Nursing stay intention and turnover have been found associated managers in the recruitment process by hiring nurses who are able to
with many factors; such as length of working hours (Dall'Ora, Griffiths, meet the organisational goals.
Ball, Simon, & Aiken, 2016), demographic variables; gender, having a
childbearing responsibilities, job satisfaction levels, workload and or-
ganisational attitudes (Flinkman et al., 2010), work environment, staff 2 | M E TH O DS
empowerment and support (Karimi et al., 2015), nurse-physician rela-
tionship, age, nurses’ participation in hospitals activities and tasks, and 2.1 | Study design
burnout (Heinen et al., 2013). EI is recognized as a factor that could
contribute to collaboration and increases staff well-being and intent A quantitative, descriptive, cross-sectional and correlational study
to stay, and this is because individuals who own strong social aware- design was used.
ness are able to act properly in different social situations (Karimi et al.,
2015).
Nursing turnover has significant negative economic impacts on 2.2 | Settings
health care organisations. Several studies have been conducted to es-
timate the cost of nurses’ turnover (Li & Jones, 2013; Roche, Duffield, Data were collected from a university, a governmental and a private
Homer, Buchan, & Dimitrelis, 2015). According to Nursing Solution tertiary hospital in Jordan. Hospitals were selected randomly from
Incorporated (NSI) survey (2016), the estimated cost of nursing turnover Jordanian hospitals that have at least 300 registered nurses and a
in 2015 was $38,000–$59,000 for each registered nurse, with average bed census of 200 or more.
hospital loss of 5 Million Dollar- 8 Million Dollar. Jordanian health care
sectors face challenges in terms of the continuous nursing shortage and
attrition of nurses. Between 2003 and 2007, the turnover (moving out- 2.3 | Sampling technique
side Jordan) rate among Jordanian nurses was 32.1% (n = 5,737).
Up to the researcher's knowledge, there are only two studies in The sample size was calculated by using G*power statistical test pro-
Jordan highlighted EI among nurses. The first one investigated its gram (MS Windows version) (Faul, Erdfelder, Lang, & Buchner, 2007).
impact on nursing performance (Al-Hamdan, Nussera, & Masa'deh, Using a power of 0.95, α of .05, moderate effect size (Al-Hamdan, Al-
2016), while the another study investigated the impact of EI training Ta'amneh, Rayan, & Bawadi, 2019) and 8 predictors to be tested, the
AL-HAMDAN et al. |
353
minimum required sample size was 160. The sample size was increased Technology (IRB No. 2017/0068) and the Institutional Review Board
to 300 to avoid the risk of attrition and drop out during the study. (IRB) of the participating hospitals. Taking part in the study was vol-
untary; the participants had the right to withdraw from the study at
any time without accountability. Participants’ socio-demographic data
2.4 | Instruments and personal information were confidential; data were kept in a closed
cabinet in a closed office. Participants obtained the researcher's con-
2.4.1 | The Socio-demographic Questionnaire tact information for any question or explanation. Before starting filling
the questionnaire, participants were consented to be part of the study
In this questionnaire, participants were asked to identify their gen- by signing a written consent form. Approvals to use study instruments
der, age, marital status, educational level, experience in nursing and were obtained from instruments’ authors before collecting data.
the working area.
Note: Reference comparison groups: Sex: Female, Marital status: Single, Age: ≤30 years,
Experience: ≤11 years, Education: Master's degree, University type: Private, Hospital type:
Governmental hospital.
Note: Reference comparison groups: Sex: Female, Marital status: Single, Age: ≤30 years,
experience: ≤11 years, Education: Master's degree, University type: Private, Hospital type:
Governmental hospitals.
t = −1.274, p = .204), experience (β = .081, t = 1.204, p = .230) and their nursing career. The model showed that nurses working in uni-
nursing station (β = .030, t = 0.485, p = .628). versity hospital reported less stay intention in job (M = 2.9, SD = 1)
than those working in governmental hospital (M = 3.6, SD = 0.46),
p ≤ .001. Likewise, those nurses who work in private hospital
3.5 | Predictors of intent to stay reported significantly less intent to stay in their job (M = 3.6,
SD = 0.63) compared to those who are working in the governmen-
The multivariate linear regression model suggested that there was tal hospitals, p = .004. Conversely, the ever married nurses (mar-
a significant relationship between the collective set of variables ried and divorced) had significantly greater intent to stay in their
and the nurses’ intent to stay F (9,279) = 8.01, p < .001. The model job (M = 3.5, SD = 0.92) than their single peers (M = 3.1, SD = 0.92),
suggested that these variables collectively explained a total of p = .010. In the same manner, those nurses aged above 30 years
21.1% of the variations in the nurses’ perceived intent to stay in tended to report greater intent to stay (M = 3.8, SD = 0.58) than
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356 AL-HAMDAN et al.
their peers who were younger than 30 years (M = 3.2, SD = 0.97), nurses with higher levels of academic education had less stay intents
p = .01. However, sex (β = −.024, t = −0.406, p = .685), education and higher turnover rates. However, the study of Mrayyan (2005)
(β = −0.029, t = −0.504, p = .615), experience (β = .008, t = 0.139, was conducted since more than 10 years where nurses with higher
p = .889) and nursing station (β = −.064, t = −1.097, p = .274) did not education levels were highly dissatisfied and seeking higher job po-
converge significantly on intent to stay (Table 4). sitions and career development.
The outcomes of the current study should be interpreted con-
sidering some limitations. Including nurses in only three hospitals in
4 | D I S CU S S I O N Jordan may limit the generalization of study results and findings. In
addition, the bias and the possibility of subjectivity in responding
The purpose of this study was to examine the relationship be- to research instruments by the participants may negatively affect
tween EI and intent to stay and to identify their correlates among study findings.
Jordanian nurses. Worldwide, health care organisations struggle
to empower nurses and increase their productivity and retention
(Healy, El-Atroush, Abol-Enein, & El-Sayed, 2013). The findings of 4.1 | Limitation
the current study revealed that EI has a significant correlation with
nurses’ intent to stay in nursing and/or their current jobs. This out- There are some limitations in this study. The study used self-report
come is congruent with a study conducted in Greece which found questionnaires, which introduces bias and limits our ability to deter-
that EI is negatively associated with nurses’ intention to quit their mine actual relationships among concepts of interest. In addition, as
jobs (Trivellas et al., 2013). EI was negatively associated with leav- this is a cross-sectional study, it is not possible to make cause-and-
ing intention among nurses (Kang & Kim, 2016). The Regulation of effect statements.
Emotion (ROE) had the strongest positive relationship with inten-
tion to stay. This is congruent with the findings of some studies
(Güleryüz, Güney, Aydın, & Aşan, 2008; Ko & Kim, 2014), but in 4.2 | Implications for nursing management
contrary to the study of Trivellas et al., (2013) who found that only
Self-Emotion Appraisal (SEA) and Use of Emotion (UOE) had a sig- The findings of the current study have important implications
nificant positive impact on nurses’ job satisfaction and intention and recommendations for nurses and nursing managers. Nurses’
to stay. EI helps nurses to effectively handle their emotions and behav-
EI is a set of skills and abilities that the individual gains by learn- iours and respond to various situations smoothly and effectively.
ing from experiences and events (Goleman, 2006). However, many In addition, it improves nurses’ self-awareness and recognition of
studies looked for individual traits that may affect EI levels or capa- other emotions and promotes the relationships between nurses.
bilities. Our study found that level of education (Master's degree) This could also improve the workplace environment and achieve
and hospital type (a private one) were the most and significantly nursing goals and organisational aims. Nurse managers should pay
characteristics affecting Jordanian nurses EI scores, which was con- attention to EI of nurses during recruitment considering various de-
gruent with only one study (Kalyoncu, Güney, Arslan, & Ayranci, terminants of EI identified in the current study. Additionally, nurse
2012). However, the study of Kalyoncu et al. (2012) found that EI managers might want to strengthen factors associated with more
increases with ageing. Furthermore, previous studies revealed vari- stay intent among their staff. EI should be considered in nursing
ous factors associated with EI including years of experience, nurses’ courses, schools and academic settings. Nursing students should
gender and level of education (Humpel & Caputi, 2001; Nikolaou & be trained and educated about EI and its effectiveness in dealing
Tsaousis, 2002; Oginska-Bulik, 2005). However, none of these stud- with themselves and others during their early academic journey.
ies were conducted in the Arab world, indicating that cultural factors Continuous education, workshops and activities within educa-
might play a role in determining the factors associated with EI. tional facilities should be held to improve nurses' EI. Furthermore,
In this study, Jordanian nurses’ intent to stay in their jobs and understanding of EI and its impacts on nursing and organisational
careers was predicted by hospital type (governmental), marital sta- outcomes helps administrators to adopt action plans and strategies
tus (married), age (older than 30 years) and level of education (mas- to involve and promote EI practice in all nursing departments and
ter's degree). Many studies were congruent with these findings, sections.
while others were not. For example, a previous study revealed that
Jordanian nurses who work for the public sector in the governmen-
tal hospitals showed higher intent to stay rates than those work for 5 | CO N C LU S I O N
private or university hospitals which was congruent with our find-
ings (Al-Hamdan, Manojlovich, & Tanima, 2017). In addition, similar The findings of the study came with a supportive knowledge about
to our findings, Mrayyan (2005) revealed that married nurses and the positive impacts of EI on nurses’ intent to stay. Improving in-
those older than 30 years had higher rates of retention and stay in tent to stay could have positive effects on organisations’ decisions,
their jobs. In opposing to our findings, Mrayyan (2005) reported that policymaking processes, quality of care, employee commitment and
AL-HAMDAN et al. |
357
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