Like it or not your emotions are central to how you perform at work and function in life.

Our emotional states are all linked decision making, interpersonal skills, and ways we manage our energy and focus throughout a day.

We all have a choice to make: Do we learn to lean in and harness our own emotions and those of others? Or do we ignore, suppress and avoid them?

In this article, I’ll be outlining how emotional awareness forms one part of Emotional Intelligence (EI). We’ll then look at why EI is important in healthcare and how you can begin to develop an aspect of EI.

Emotional Intelligence

Emotional Intelligence (EI) is our ability to be aware of our own and others’ emotions and use this to guide our own behaviour. In theory, this then helps us successfully navigate interpersonal interactions.

According to Daniel Goleman, the American psychologist who is at the forefront of this area of research, EI is comprised of a number of interrelated components. These include: self-awareness, self-regulation, empathy, motivation, and social skills.

Each of these components has a range of constituent skills.

For example, self-awareness involves an ability to understand one’s own emotions, strengths and weaknesses; empathy involves a range of different skills to understand and appreciate other people’s thoughts and emotional states.

All of us possess some degree of skill in each of these areas, but these competencies vary considerably between people.

Traditionally, standard intelligence, or IQ, was assumed to be the most important predictor of success.

It’s true that IQ is a good predictor of what kind of job you go into, however, your Emotional Quotient (EQ) is thought to be even more important for job performance when you’re actually in that job.

That’s because when you finally get to be a nurse, you’re then competing with other people who have similar IQs.

EI is what really sets you apart as after technical ability is accounted for, it’s your skills in interacting with people that matter.

If you want to be more effective in your role and enjoy a less stressful life, then working on your EI might be something you want to focus on.

Don’t take my word for it – look at some of the benefits found from the literature in healthcare:

• Higher EI is related to lower burnout in physicians (Swami et al., 2013) and nurses (Szczygiel & Mikolajczak, 2018).

• EI is a predictor of resident well-being during training programs (Lin et al, 2016).

• Deficits in EI are proposed as an explanatory model to account for negative patient safety outcomes (see Codier & Codier, 2015) and thus, improved EI is related to higher quality care.

• Higher EI is related to improved conflict resolution ability in nurses (Jordan & Troth, 2002)

• Higher EI is correlated with objectively measured nursing performance (Beauvais et al., 2011).

• When EI training is formally embedded within medical institutions, it promotes leadership development that has positive effects on organisations such as improved care delivery (see review by Mintz & Stoller, 2014).

Emotional awareness as a core skill in healthcare.

One of the fundamentals of Emotional Intelligence is being able to accurately identify, name and understand your own emotions.

In the rest of this article, I’m going to explain why this is important for day-to-day work and outline two methods you can use to develop this skill.

Why is it helpful to be aware of your own emotions?

1) Emotions act as messengers.

Emotions are a clever design of evolution to help guide you to act in certain ways. Historically, these were of survival value for you and your tribe.

Emotions, along with other feelings and sensations, often help reveal something important about the external world.

For example, feelings of discontent, frustration, humiliation and sadness would be quite normal after a senior colleague berates you or shames you in front of your peers.

These emotions would be telling you something important and to deny them, ignore them or suppress them is likely to have an adverse effect on your overall well-being.

If we’re not aware of what the emotional messengers are, we have little control over our behaviour.

Ignoring and suppressing feelings may work in the short term but as you may be experiencing right now, it’s not an effective long-term strategy.

2) Emotions can be tamed through language.

Once you use words to describe your own emotions, this helps to regulate how you are feeling.

For example, it has been shown in a number of studies that labelling emotional states helps to downregulate negative emotion (see Torre & Lieberman, 2018, for a review).

Moreover, having a greater ability to differentiate negative emotions is related to improved well-being (e.g. Erbas et al., 2018).

This basically means that when you are able to tell yourself  “I’m feeling disappointed, upset, defeated and also angry”, you’re likely to move on from that experience much quicker than if you have or do not use language to deconstruct your internal experience.

Take a moment to think about your role in healthcare: I would take a guess that being able to regulate negative emotions like stress and anxiety is likely to be beneficial for you, your team and your patients.

3) Effective decision making is dependent on good emotional awareness.

Think back to your ancient ancestors; decision making was tied to one of the various motivational drives that we evolved as a species.

Emotions developed as a way to guide this process and make it more successful.

When we’re not aware of how our emotions are influencing our decision making, our actions are being kidnapped by our own ignorance and it’s our future self who has to pay the consequences.

Most nurses will have had the experience of regretting a clinical decision they made. Whilst mistakes are inevitable in life, some of these can be avoided.

For example, hasty and hurried decisions can be driven by frustration, stress or anger.

When we’re more aware on a moment-to-moment basis of our internal state, we can have a negative emotional response without translating it into our behaviour.

Therefore, awareness of emotions affords a more deliberate deployment of your mental librarian who can help retrieve what you need for the occasion without getting hijacked by an internal sensation.

For a nice recent review of the evidence linking the importance of emotions to clinical decision making, see Kozlowski et al (2017).

A guide to enhanced self-awareness and emotional understanding

Hopefully, at this point, you’re more convinced that improving your emotional awareness may be of value.

Let’s walk through how you can improve this skill. I am going to present two methods below and I highly recommend trying both of them.

1) Enhance your emotional vocabulary.

As mentioned, differentiating between different emotional states is beneficial for well-being and regulating emotions.

Just as if we were trying to learn medical terminology or a new language, we would need to consult a dictionary or other helpful corpus of terms to expand our knowledge and vocabulary.

It’s the same with emotions.

There are numerous lists of emotion words that you can use to help build up this skill. For example, print out this emotions wheel, and do the following:

• Think back to a situation in the past 24 hours that led to you feeling moderate-intense negative emotion.

• Close your eyes and relive the experience as best you can. Allow yourself to re-experience the emotions that were present at the time and let these wash over you.

• Open your eyes, look at the list of emotion words, and start writing down what happened, how you felt/feel right now, and why you think the situation led to you feeling this way.

• Next, write down what you did to manage the emotion afterwards.

• Finally, pick whatever new emotion words you found that helped describe your experience and make a note of them somewhere you can come back to.

I personally like writing them on sticky notes or the whiteboard in our kitchen. Remind yourself of these and use them to describe a similar experience when it arises.

• Repeat this cycle once per week during some set journaling time. Keeping a regular slot of say, Friday morning, will help to process the week’s events and create some space for the weekend.

This whole process will help you understand the link between situations and how you feel, as well as give you additional language to describe your experience.

2) Regular emotional check-ins using a body scan.

Emotions are a visceral/somatic and cognitive experience.

Because you’ve been trained to sharpen and use that tool of your mind, it may feel unusual and even alien to go into your body, but it’s an essential component to understanding your emotions.

I recommend stopping, pausing and checking in with your body at least 5 times per day. It needn’t take long, just follow this process:

• Stop for a moment and say to yourself something like “what am I feeling at this moment?”

• Breathe in through your nose and out through your mouth.

• Allow your attention to scan through your body, starting in the head and working down through the neck, shoulders, chest, back, tummy, legs and feet.

• Repeat the question “what am I feeling in this moment?” a few times until something shows up for you as you do this.

Then, describe your inner experience with labels such as “I’m feeling anxious and tense in my stomach” or “I’m feeling anger and frustration in my face, arms and hands”.

• Use your breath, in through the nose and out through the mouth to bring some space into your body and let the sensations float freely through you.

The more you practice this, you will be surprised at just how quickly you can check in with yourself and become more aware of your emotions and physical state.

You’ll also be surprised at how much this helps to regulate those difficult emotions too.

Just in the same way you get more relaxed and fluent in doing a physical exam with a patient, as you internally examine yourself it will start to become second nature and can be done in a few seconds.

For me, I make an effort to do this before and/or after each session with a client.

I find it helps get me in the zone and process things after interactions. It’s amazing how the benefits of this short practice accumulate by the end of the day.

To download the above info for free as a pdf to store somewhere for easier access, click below.

Summing up

In this article, I’ve introduced to you the concept of Emotional Intelligence (EI) and how it has been shown to be beneficial for doctors and nurses in their roles.

Whilst EI is made up of a range of skills, I’ve focused on providing you with some practical tips on how to develop a core component of this: self-awareness.

This kind of self-awareness practice is best treated as an ongoing self-development task and can absolutely be done on your own.

It can also be helpful to have a guide to assist with this process.

If you’re keen to work on self-awareness and feel like you want support, at Nurse Wellbeing Mission we offer affordable group reflective practice sessions for nurses.

To find out more go to our Reflective Practice page.