Alfred Health

Whitney Johnson is the Clinical Supervisor, and Group Reflective Practice Facilitator at Alfred Health, based in Melbourne, Victoria, Australia. With over 11 years of dedicated service at Alfred Health, Whitney has played a crucial role in leading and overseeing mental health and addiction services within the organization. Her leadership reflects a deep commitment to improving patient outcomes and advancing nursing practices in mental health care.

Through this article, Whitney emphasizes the importance of emotional intelligence (EI) in healthcare leadership, particularly in the context of high turnover rates and staff dissatisfaction.

Healthcare leaders are navigating a global sector landscape marked by high turnover rates, workplace stress, and substantial demands on nursing staff, resulting in alarming adverse impacts for patient care and overall healthcare delivery. Increasingly, we are also experiencing compounding concerns for staff wellbeing, and the potentially detrimental long-term impacts they experience because of these caring roles. As the Deputy Director of Nursing in Mental and Addiction Health at the Alfred Hospital, I have been forced to reflect and consider how we as healthcare leaders can foster a desire for staff to remain in our sector under increasing demand, further projected shortages, inadequate resourcing, poor working conditions, and likely at a cost to their own health.

High turnover intention has been reported as fuelled by burnout, lack of support, emotional exhaustion, and increased rates of anxiety, depression, and psychological distress amongst healthcare staff. Poor staff experience and wellbeing, and the subsequent impacts of staff turnover, continue to present as a significant threat to the sustainability of an already strained system. Our role as leaders requires us to address this seemingly unyielding issue of turnover and dissatisfaction amongst staff, but the question remains – How? Can leadership really make a difference to the dire state of our workforce?

Emotional intelligence (EI) stands out as a transformative force that can enhance leadership effectiveness and foster stronger, more resilient teams, as well as increasing the successful outcomes of other retention strategies. Research spanning the last four decades shows that emotionally intelligent leadership is linked to reduced turnover intentions, psychological empowerment, and increased work engagement. Studies indicate that nurses under supportive, emotionally intelligent leadership experience lower emotional exhaustion and greater job satisfaction compared to those under less supportive leaders. In the context of the ongoing nurse shortages, developing EI leadership skills is crucial, and while numerous leaders may excel in intellect and technical abilities, outstanding leaders demonstrate mastery in personal and social competencies.

Why is this important now:

The 2021 McKinsey Future of Work in Nursing Survey found that one-fifth of Australia’s registered nurses intended to leave their current role within the next 12 months. According to a survey conducted by NSI (a national nurse recruitment firm), the average turnover rate for registered nurses in Australia in 2021 was 27.1%, up from 15.1% in 2016. An increase in turnover rate brings with it significant financial costs, impacts for staff and teams, and disruptions to care, all of which negatively affect patient outcomes. Nurse turnover not only destabilises teams but also elevates workloads, changes clinical practices, and contributes to heightened stress, burnout and job dissatisfaction. Job dissatisfaction, as well as lack of recognition and poor organisational support, all contribute to turnover. Poor leadership is frequently cited as a key cause of high turnover intention.

“As a leader, take the time to assess your EI capabilities; consider how your emotional responses influence team dynamics and morale”

Investing in the support and development of our leaders is crucial for addressing these challenges. Effective leaders can foster a culture and working environment that is conducive to staff satisfaction and retention. This improvement can mitigate broader organisational issues like workload and remuneration, and ultimately improve patient care outcomes by ensuring a more successful workforce better equipped to meet the demands of their roles.

Understanding and Developing Emotional Intelligence:

Research into EI in nursing leadership and the impacts on staff experience has been examined for decades. Emotional intelligence—the ability to understand and manage one’s emotions and those of others—is essential for effective leadership. Leaders with high EI can regulate their emotions, positively influencing those around them. Key components of Daniel Goleman’s model of EI include self-awareness, emotional regulation, motivation, empathy, and effective communication.

As a leader, take the time to assess your EI capabilities; consider how your emotional responses influence team dynamics and morale. Engaging in self-assessment tools or seeking training opportunities can help identify areas for improvement, allowing you to grow as an emotionally intelligent leader.

Creating an Emotionally Intelligent Organisational Culture:

Here are a few strategies to consider:

• Model EI Behaviour: Demonstrate empathy, active listening, and effective communication in your interactions. Set the tone for the kind of emotional climate you want to cultivate.

• Curiosity and Self-Reflection: Constantly examine, take responsibility for, and challenge your own experiences and reactions. Consider how your emotions and perspectives are impacting on interactions and situations. Hold yourself to account, reflect on what your staff may be experiencing, and what they need from you as their leader.

• Training and Development: Implement EI training programs at all staff levels, focusing on essential skills that enhance communication, self-reflection, conflict resolution, and teamwork.

• Invest in EI Leadership and Mentorship programs: Enable experienced leaders to nurture other leaders, bolstering EI development and better preparing them for their roles. Ensure leaders receive comprehensive training and ongoing support to help them thrive. Provide resources such as workshops, coaching, and peer support groups that reinforce emotional intelligence skills.

• Feedback Mechanisms: Establish open feedback channels (for example: surveys, yearly performance plan meetings, staff forums, online Q&A platforms) that encourage staff members to express their emotions and concerns in a psychologically safe way. Validate these feelings and address them constructively to create a safe, supportive culture.

• Addressing Systemic Challenges: Advocate for systemic changes that address workplace challenges such as workload demands, occupational violence, and remuneration issues that can undermine nursing satisfaction. Align organisational objectives with staff wellbeing, reward and recognition programs, and workforce development opportunities.

• Evaluation: Utilise turnover intention tools, leadership self-assessment tools, and a variety of staff feedback mechanisms to ensure you are not missing opportunities for understanding the impacts of EI leadership, and identifying areas for growth, or mislabelling turnover intention as due to other factors.

In modern healthcare, never have we seen such pressure and demand on nurses, and our already fragile staffing levels are under significant threat. By cultivating EI within themselves and their teams, leaders can create supportive work environments that enhance employee wellbeing and retention rates.

As you reflect on your leadership style, consider how developing EI can serve as a strategic initiative to address the critical challenges facing healthcare. And whilst the inclusion of an EI model of leadership will not solve all the problems, it will provide an important and significant step towards improving organisational culture and staff wellbeing, and to provide a Band-Aid over the alarming haemorrhaging of our workforce.