Emotional intelligence during clinical placement: nursing students' experiences of affective events

Abstract

This study seeks to determine whether emotional distress during the first clinical placement is a cause of attrition from nursing programs. There is an impending shortage of nurses over the next decade as healthcare loses a generation of older nurses to retirement. The increasing demand of an unprecedented ageing population requiring health services has the potential to result in nursing shortages. Many nurses work in emotionally charged and stressful environments which can lead to burnout and a decision to leave nursing altogether. If nurses can regulate their emotions at work, such dire consequences may be avoided. Nursing students learn alongside a registered nurse and are subject to the same challenging situations. They may be exposed to levels of emotional distress for which they have not been prepared. On this point, previous research indicates that an inability to mediate the effects of emotional engagement during clinical placement contributes to attrition from nursing programs.Attrition from nursing programs is multifactorial. To become a nurse requires the attainment of knowledge, the ability for clinical reasoning and highly developed psychomotor and interpersonal skills. Effective interpersonal skills to engage with patients, their families and other health care workers are reliant on healthy levels of emotional intelligence. If emotional intelligence is lacking, then the ability to manage the demands of human relationships within the health care environment may cause emotional distress. This study will examine the influence of emotional intelligence on affective events experienced by nursing students undertaking their first clinical placement.Research DesignA mixed method design was employed to examine the influence of emotional intelligence on affective events experienced by nursing students. Three sub-studies were conducted. In Study One, the emotional intelligence of nursing students, as a positive coping strategy for emotional encounters, was measured with the Mayer Salovey Caruso Emotional Intelligence Test (MSCEIT) before clinical placement. Data analysis identified if there were relationships between the emotional intelligence scores and other characteristics of the students. In Study Two, nursing students were asked to complete a written reflection about an emotionally challenging situation that occurred during their clinical placement. This approach allowed the nursing students to both discuss and reflect on events in a manner that contributed to learning outcomes. The reflective data were used to inform the final findings through an examination of the students’ individual reflections on emotional engagement. In Study Three, the written reflections were transformed to numeric data to allow integration with emotional intelligence scores and demographic data.ResultsThe age of the participants (n = 84) ranged from 17 to 51 years (M = 21.01, SD = 7.36). Results for Study 1 identified positive relationships between total emotional intelligence, age and grade point average in this sample. This result was similar to findings from other studies. The model found no support for a connection between emotional intelligence scores and attrition or age and attrition. Thus, emotional intelligence does not predict attrition in this sample. In Study 2, qualitative analysis highlighted the diverse nature of clinical placement experiences and different recollections of experiences between participants. Broadly, students chose to reflect upon interactions with patients and family members and team members including nurses, medical and allied health professionals. Differing perceptions of emotional engagement were identified among the three groups. End-of-life care and poor support from buddy nurses were shown to be particularly distressing for some of the nursing students. In Study 3, results indicated that students complied with the reflective writing instructions, some did not write about an emotional event but instead described how they had been involved with caring for a patient. Results for Study 3, found no statistically significant differences between levels of emotional intelligence between positive and negative emotion or attrition. Together, results from Study 2 and 3 suggested that nursing students may be exposed to emotionally challenging situations during clinical placement for which they are ill-prepared.ConclusionThe results highlighted the diverse nature of clinical placements and different recollections of experiences between participants. It would appear there was a lack of preparation for the demands of emotional engagement and this was evident, particularly in relation to end-of-life care. In this regard, teaching ways of managing emotionally challenging situations continues to be a challenge for nursing education. The findings offer another perspective on emotional intelligence research by using a qualitative approach, thus meeting calls to broaden the existing knowledge surrounding emotions research.