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Vol. 39, No. 2, pp. 172–180
c 2015 Wolters Kluwer Health, Inc. All rights reserved.
Copyright Emotional Intelligence (EI) and
Nursing Leadership Styles
Among Nurse Managers
Brenda Tyczkowski, DNP, RN;
Christine Vandenhouten, PhD, RN, APHN-BC;
Janet Reilly, DNP, APRN-BC; Gaurav Bansal, PhD;
Sylvia M. Kubsch, PhD, RN; Raelynn Jakkola, BSN
Less than 12.5% of nurses aspire to leadership roles, noting lack of support and stress as major
factors in their decision not to pursue this area of practice. Psychological resiliency, described
as the ability to properly adapt to stress and adversity, is key to successful nurse managers.
Emotional intelligence (EI) is a related concept to resiliency and is another noteworthy predictor
of leadership and management success. This study was undertaken to determine the level of
and relationship between EI and leadership style of nurse managers employed in Wisconsin
and Illinois facilities. A descriptive, exploratory study design was utilized, with a convenience
sample of nurse managers working in 6 large Midwestern health systems. Nurse managers were
invited to participate in the study by their employer, completing the online consent form and the
demographic, Multifactor Leadership Questionnaire (MLQ) Form 5X and the Emotional Quotient
Inventory (EQ-i 2.0) surveys. Statistically significant positive relationships were noted between
EI and transformational leadership and the outcomes of leadership (extra effort, effectiveness,
and satisfaction). No statistically significant relationships were noted between EI and transactional
or laissez-faire leadership styles. Key words: emotional intelligence, leadership style, nurse
managers, resiliency, transactional leadership, transformational leadership
T
HE SCOPE of responsibility and the
depth of knowledge, skills, and attitudes
needed to be an effective nurse manager (NM)
continue to expand. This expanding role leads
to stress among NMs. Emotional intelligence
(EI) is a useful tool to enhance psychological resiliency to this stress. High levels of EI
can enhance transformational leadership style
Author Affiliations: University of Wisconsin Green
Bay (Drs Tyczkowski, Vandenhouten, Reilly, Bansal,
and Kubsch); and St. Vincent Hospital, Hospital
Sisters Health System, Green Bay, Wisconsin (Ms
Jakkola).
Funding obtained through University of Wisconsin
Green Bay dean and graduate studies grant.
The authors declare no conflict of interest.
Correspondence: Brenda Tyczkowski, DNP, RN, University of Wisconsin Green Bay, 2420 Nicolet Dr, Green
Bay, WI 54311 (tyczkowb@uwgb.edu).
DOI: 10.1097/NAQ.0000000000000094
required to create and maintain a positive
working environment.1 By understanding the
relationship between EI and NMs’ leadership
style, efforts may be taken to enhance EI behaviors and subsequently, resiliency.
The literature was reviewed to see what
has been written on EI and leadership styles.
Nurses are involved in countless interactions
each day requiring the display of leadership behavior, including EI.2 Emotional intelligence was correlated with positive processes
in health care environments and positive institutional outcomes.3 Emotional intelligence
scores of NMs were positively correlated with
patient outcomes, MD and patient satisfaction, reduced staff turnover, and increased
staff resilience.4,5
Nurses who consistently dealt with emotional interpersonal relationships reported
higher than average levels of EI using the
172
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Emotional Intelligence and Nursing Leadership Styles
Bar-on EQ-i survey tool to test EI. This reinforces the importance of having a high level of
EI to help manage interpersonal relationships
as part of nursing leadership. Authors of the
study recommended incorporating EI training
in nursing education. Improved training in EI
will lead to better interpersonal communication and better patient outcomes.6 Emotional
intelligence is a skill that can be learned by
means of counseling, training, and keeping a
reflective emotional journal.7
Emotional intelligence requires selfawareness and can be further enhanced
through practice and feedback. The correlation between EI and successful nurse
leaders is well documented.5 According
to these authors, EI refers to the ability to
discriminate and monitor emotions and use
the evidence to guide action and thought.
The relationship between EI and effective
leadership has been validated by others.1,8-10
The most effective leaders were those with
high EI.11 A study conducted in Boston with
more than 20 000 executives found that EI
was twice as important as technical skills and
cognitive abilities in determining leadership
ability.11 High-level EI leaders bring out the
best in members of the organization, drive
emotions in a positive manner, connect with
others at an emotional level, and make work
more meaningful.11 It is important for leaders
to recognize their own emotions and to be
able to express those emotions to others.12 In
doing so, the leader uses his or her positive
emotions to motivate others and enable the
vision of the organization to be enacted
through job performance.
In a meta-analysis, leaders with high levels
of EI were shown to demonstrate transformational leadership styles. Subordinates consistently rated transformational leaders as more
effective than laissez-faire and transactional
leadership styles.13
There is considerable agreement that high
levels of EI are a necessary component of
transformational leadership.14-16 Transformational leaders develop constructive and positive relationships with followers and respond
to their emotional needs.17 Significant re-
173
lationships were found between subscales
of EI and components of transformational
leadership.14,15 Emotional intelligence is associated with 3 attributes of transformational
leadership (using the Multifactor Leadership
Questionnaire [MLQ] survey): idealized influence, individualized consideration, and inspirational motivation.1 These authors also found
that high levels of EI (using the Bar-on EQ-i)
can enhance transformational leadership style
required to create and maintain a positive
working environment.
One study found a strong correlation
between transformational factors and leader
effectiveness, satisfaction, and extra effort.18
Subordinates were more satisfied with
transformational leaders and perceived them
as more effective than laissez-faire leaders.
Another study examined the relationship
between leadership style and extra effort,
perceived leadership effectiveness, and satisfaction with the leader.19 It found a stronger
relationship between transformational and
outcomes factors than between these factors
and transactional and laissez-faire styles.
Another study found that charismatic leaders
were similar to transformational leaders in
that they did not influence followers on the
basis of authority.20 Rather, they were highly
self-confident and had a set of behaviors that
followers imitated. Transactional leaders used
a negotiation process, in which followers
exchanged efforts for rewards.20 Several
studies noted strong relationships between
EI and transformational leadership.21-23
Resiliency, EI, and leadership style have
been identified as traits in successful
NMs.2,14,18,24 Resiliency includes constructs
similar to EI: energy, passion, the ability to
bounce back from hardships, drive, “tanks
seems full”, grounded, adaptable, and a
healthy work/life balance.24(p138) To cope,
leaders need to be resilient and agile, able to
accept complex change, be emotionally intelligent, and able to help others move forward
and achieve success.25 Organizations need to
foster EI and resiliency into their culture and
leaders. Resilient leaders are positive, flexible,
focused, and are able to deal with reality and
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improvise. Furthermore, they are self-aware,
able to manage themselves, are aware of others, and can manage relationships. Resilient
leaders demonstrate EI.25
A descriptive exploratory study was conducted to explore the level of and relationship between EI and leadership styles of NMs
employed in Wisconsin and Illinois. A convenience sample of NMs working in 6 large
Midwestern health systems was used for this
study.
Emotional intelligence is operationally defined in this study as having “abilities such as
being able to motivate oneself and persist in
the face of frustrations; to control impulse and
delay gratification; to regulate one’s moods
and keep distress from swamping the ability
to think; to empathize and to hope.”11(p34) Resiliency is defined through similar constructs,
including perseverance (persistence), equanimity (self-control), and positive psychological capital (hope).26 Emotional management is
recognized as a protective factor in resiliency
along with the ability to bounce back and
move on in life after adversity is present.27
management by exception (passive) and
laissez-faire. The MLQ Form 5X also measures
3 outcomes of leadership—extra effort, effectiveness, and satisfaction. The MLQ Form 5X
has demonstrated reliability and validity.18
A gold standard measurement of resiliency
has not yet been identified26 ; therefore, the
related concept of EI was explored, using the
EQ-i 2.0 survey tool to measure the EI of NMs.
The EQ-i 2.0 tool uses a 5-point Likert-type
scale to measure emotional intelligence and
coping ability as components of personality
and disposition on the basis of responses to
133 survey questions.28 Results provided include a total EI score and 5 composite scale
scores (self-perception, self-expression, interpersonal, decision making, and stress management) based on the Bar-on Model of Emotional intelligence.28 The EQ-i 2.0 has been
used worldwide and has acceptable reliability
and validity.
While the possible pool of NMs was not determined, a total of 142 NMs completed the
demographic items, 128 completed the MLQ
Form 5X, and 110 NMs completed the EQ-i
2.0 instruments. Matched responses to the demographic, MLQ Form 5X and EQ-i 2.0 items
were available for 77 NMs.
DATA COLLECTION
FINDINGS
Demographic survey questions were
derived from the literature review and with
input from participating health care institutions. The MLQ Form 5X was used to measure
the leadership style of NMs.18 This survey
instrument includes 45 items designed to measure the frequency of leadership behaviors
using a 5-point Likert-type scale. Leadership
styles include transformational, transactional,
and passive/avoidant.18 Transformational
leadership consists of 5 subscales (idealized
attributes, idealized behaviors, inspirational
motivation, intellectual stimulation, and
individualized consideration). Transactional
leadership style includes 2 subscales, namely,
contingent reward and management by exception (active). Passive/avoidant leadership
style is made up of 2 subscales including
Data were analyzed using SPSS, Version 21
(IBM Corp., Armonk, NY) and Partial Least
Square (PLS) software (SmartPLS 3, Hamburg,
Germany).28 Descriptive statistics were calculated for demographic variables and mean total MLQ-5X scale and subscale scores. EQ-i 2.0
scores were reported collated and analyzed
by Multi-Health Systems Inc.29
As presented in Table 1, participants in
this study were primarily female (92%), white
(97%), and 61 years of age or older (35%).
The highest level of education reported by
participants was BSN (56%), with the majority of subjects reporting less than 5 years’ experience as a manager (34%). When asked
about previous training in EI, 62% reported
having no previous EI training. This points
out the opportunity to provide training on the
METHODS
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Table 1. Demographic Characteristics of
the Sample (n = 142, Respondents Who
Completed Entire Demographics Section
of Survey)
Variable (n = Respondents
for Question)
n (%)
Sex (n = 146)
Male
13 (9)
Female
133 (91)
Race/ethnicity (n = 146)
White/Caucasian
138 (95)
Asian
3 (2)
Black/African American
2 (1)
Hispanic/Latino
2 (1)
Pacific Islander
1 (1)
Level of education (n = 141)
BSN
78 (55)
MSN
21 (15)
MS-other
20 (14)
ADN
14 (10)
Other
8 (6)
Experience as NM (n = 146)
<5 y
48 (33)
5-10 y
40 (27)
11-15 y
23 (16)
16-20 y
13 (9)
20+ y
22 (15)
Time spent on NM duties (n = 141)
>75%
105 (74)
51%-75%
22 (16)
<50%
14 (10)
Employment setting (n = 146)
Inpatient
64 (45)
Outpatient
30 (20)
Other
52 (35)
Title (n = 146)
Nurse manager
63 (43)
Director
12 (8)
Other
71 (49)
Previous training in EI (n = 146)
Yes
57 (39)
No
89 (61)
Previous training in leadership styles
(n = 146)
Yes
114 (78)
No
32 (22)
Appropriate training to deal with conflict
(n = 146)
Yes
116 (79)
No
30 (21)
(continues)
175
Table 1. Demographic Characteristics of
the Sample (n = 142, Respondents Who
Completed Entire Demographics Section
of Survey) (Continued)
Variable (n = Respondents
for Question)
n (%)
Confidence in resolving conflict on the unit
(1- to 10-point scale, 10 = high confidence)
(n = 146)
Mean
7.9
Standard deviation
1.5
Level of interdisciplinary teamwork on the
unit (1- to 10-point scale, 10 = high level of
collaboration (n = 146)
Mean
7.8
SD
1.7
Abbreviation: NM, nurse manager.
concepts of EI and leadership styles to a
young, up-and-coming generation of NM.
Participants who completed the MLQ Form
5X described their leadership on each of 45
items using a Likert-type scale, with 0 = not
at all to 4 = frequently, if not always. Scale
and subscales of the MLQ Form 5X including range of scores, measures of central tendency, and reliability results were calculated
using SPSS and are reported in Table 2. Results indicate the majority of NMs’ leadership
style aligned with that of transformational, followed by transactional and passive avoidant.
Participants indicated higher satisfaction with
leadership behavior (3.35), followed by effectiveness (3.26), and finally their ability to motivate (2.97).
Results from participants who completed
the EQ-I 2.0 survey provide total EI scores
and five composite scale scores (see Table 3).
The mean total EQ score for participants was
107.76. As noted in Figure 1, 8.2% (n = 9) of
the participants scored below average for the
total EQ, 42.7% had an average EQ score (n
= 47), while 49.1% (n = 54) showed a higher
than average EQ score.
The 5-component scale scores included on
the EQ-i 2.0 tool are stress management, decision making, interpersonal, self-expression,
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Table 2. Multifactorial Leadership Questionnaire (MLQ Form 5X) Results (n = 128)
Scale and Subscale
Item #’s
Total MLQ 5X
Transformative
Idealized Attributes
Idealized Behaviors
Inspirational Motivation
Intellectual Stimulation
Individual Consideration
Transactional
Contingent Reward
Management by Exception-Active
Passive Avoidant
Management by Exception-Passive
Laissez-Faire
Outcomes of Leadership
Extra Effort
Effectiveness
Satisfaction
Range
Mean
SD
2.25-4.0
1.75-4.0
1.25-4.0
2.0-4.0
1.5-4.0
2.25-4.0
1.25-4.0
2.0-4.0
0.0-4.0
0.0-4.0
0.0-4.0
0.0-4.0
1.86-4.0
1.0-4.0
2.0-4.0
1.0-4.0
3.28
3.04
3.25
3.38
3.29
3.44
2.36
3.22
1.54
.65
.76
.53
3.19
2.97
3.26
3.35
0.385
0.532
0.545
0.499
0.510
0.452
0.493
0.509
0.744
0.497
0.604
0.536
0.468
0.627
0.488
0.543
1-45
10,18,21,25
6,14,23,34
9,13,26,36
2,8,30,32
15,19,29,31
1,11,16,35
4,22,24,27
3,12,17,20
5,7,28,33
39,42,44
37,40,43,45
38,41
and self-perception. A sixth area was explored, on the basis of data analysis, entitled
“happiness.” High EQ-i 2.0 scores (above 100)
indicate emotionally intelligent people, while
lower scores indicate a need to improve EI in
specific areas (Table 3).
Figure 2 describes the relationship between EI and NM’s leadership style. Results
demonstrate that EI explains 18% of variance
in transactional leadership style, 20% of the
variance in passive/avoidant leadership style,
41% of the variance in outcomes of leadership, and 44% of the variance (R2 ) in transformational leadership style. In addition, selfTable 3. EQ-i 2.0 Total and Composite Scale
(Standard) Scores
Cronbach α
0.848
0.853
0.448
0.569
0.742
0.663
0.645
0.560
0.416
0.658
0.735
0.702
0.507
0.821
0.848
0.853
expression is found to be positively related
to transformational leadership style and outcomes of leadership (EES; it is the “Outcomes
of Leadership” scale, which comprises “extra effort,” “effectiveness,” and “satisfaction”).
Stress management skills are negatively associated with passive avoidant leadership styles
(P < .05) and positively associated with outcomes of leadership. Finally, while the relationship between self-perception and transactional leadership style was not significant (P <
.10), it was positively associated. In this study,
there was no significant association between
EI areas of decision making, interpersonal, or
happiness and leadership styles.
DISCUSSION
Scale and
Subscale
Range
Mean
SD
Total EQ-i 2.0
Stress Management
Decision Making
Interpersonal
Self-Expression
Self-Perception
Happiness
74-132
64-130
76-131
81-125
72-132
67-126
40-124
107.76
107.18
107.4
108.02
105.98
104.83
107.64
11.29
11.59
11.18
10.19
12.18
11.80
15.09
The majority of NMs in this study had high
EI scores and the predominant leadership
style identified by respondents in this study
was transformational, followed closely by
average EI scores and outcomes of leadership
(extra effort, effectiveness, and satisfaction). Sixty-two percent of the respondents
acknowledged previous EI training and education, while over three-fourths of respondents
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60
50
Number (of parcipants)
LWW/NAQ
40
30
20
10
0
Below Average
Average
Above Average
Figure 1. Mean total (standard) EQ-i 2.0 score of NMs. Note: Below average scores = <90; average scores
= 90 to 109; above average = >109.
reported having previous leadership training,
which may have affected the results of this
study. The literature noted many nursing
studies indicating that EI and transformational
leadership were teachable skills.14 Offering
course content, continuing education or
professional development opportunities to
develop EI, and transformational leadership
could have significant implications for nursing
educational institutions, health care systems,
and the quality of management skills in their
nursing students and current and future NMs.
In this study, a significant positive relationship between EI factors and transformational leadership style was noted. These
results are consistent with those of other studies that found an association between EI and
transformational leadership suggested in the
Figure 2. Relationship between emotional intelligence and leadership styles.
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literature.10,14,15 It can be proposed that leadership style and EI in NMs impact health care
systems, in their parts and as a whole, since EI
and leadership style are known to influence
not only individual NM success but also the
overall nursing unit or environment.10,15,30
While there is some evidence that selfperception is associated with transactional
leadership styles, the relationship is weak. Future research is needed to explore the relationship. The lowest mean leadership style of
NM respondents in this survey was passiveavoidant. This leadership style provided respondents the least ability to manage stress,
therefore reducing their resiliency. Previous
literature has supported the hypothesized
relationship between low EI and burnout.5
The literature notes the need for EI and the
ability to rebound from stress in effective
leadership.31 To create resilient and effective
NMs, health care systems must assist NMs to
build EI skills and transformational leadership
qualities/skills including stress management,
decision-making and happiness.
Almost one-third of respondents in this survey were 61 years of age or older. This speaks
to the aging nursing workforce and its aging
NMs while adding urgency to prepare future
NMs who will be knowledgeable in EI.32 More
than half of the NM participants were prepared at the BSN level, confirming the suggestion that EI education should be included in
the bachelor’s-level nursing curriculum2 and
encouraging the Institute of Medicine report
Initiative on the Future of Nursing recommendation 7 to “prepare and enable nurses to
lead change and advance health.”33
Some factors limited the results of this
study. The demographic and MLQ 5X questions were combined into 1 instrument. The
EQ-i 2.0 survey was hosted on a separate,
proprietary Web site, which added complexity for participants. Participants in this study
needed to enter the name of their institution
on both the combined demographic and MLQ
5X instruments and on the EQ-i 2.0 instrument to allow manual, de-identified matching of data. Some participants did not identify their institution on both surveys, reducing
the number of surveys available for comparison. The result was a loss of 33 unmatched
response sets.
An additional factor related to the small
sample size available for data analysis could
be the inherent level of respondent survey fatigue or lack of time at work to complete the
3 surveys because of the number of instrument questions. While both the EQ-i 2.0 and
the MLQ 5X had psychometric data indicating reliability and validity, the data were selfreported and from a sample with the majority
being white, female NMs. Additional studies
with 360◦ approaches to assess NM leadership styles, resiliency, and EI in larger, more
diverse samples of NMs are needed.
IMPLICATIONS
So what do these results mean to (nurse)
managers and administrators? The results
of this study are important to health care
systems as they experience an increased need
to educate, recruit, and retain top-performing
nursing leadership and managers.10,15,30 As
a related factor to resiliency, EI is not static
and can be taught and enhanced.14 Emotional
intelligence and predominant leadership style
assessment could be considered by health
systems in pre-employment screening as a
way to recruit the strongest applicants to
nursing management and administration.
These assessments could also be included
in performance reviews for existing NM employees or in succession planning to groom
future NMs. The ideal candidate for leadership development programs are nurses who
are in the early stages of their career, who
hold a BSN or higher.34 In response to health
care reform and improvement, the Institute
for Healthcare Improvement, in collaboration
with the Robert Wood Johnson Foundation,
created a how-to-guide for health systems
to create NMs who will lead innovation and
improvement.35 This guide includes a 4pronged approach to improve NMs’ ability to
support transformational change that includes
talent management, formalized nursing leadership development programs, development
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of leaders’ EI, and effective succession
planning. The concepts and results found in
this study most certainly support such efforts
179
for the development of strong and resilient
nurse leaders in tomorrow’s health care
systems.
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