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Emotional Intelligence in Hospice and Palliative Care Elizabeth Freitas, MS, RN, OCN®, ACHPN® Clinical Nurse Specialist, Pain & Palliative Care The Queen’s Medical Center Honolulu, HI
Beth Freitas has no real or perceived conflicts of interest that relate to this presentation.
1. Define what are emotions 2. Describe the components of one Emotional Intelligence (EI) Framework 3. Identify three ways EI is important in hospice and palliative care nursing 4. Identify three methods to assist with difficult emotions: personal and systems
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What are emotions? • Source • Response • Expression
What is Emotional Intelligence? • Ability to identify emotions in self • Ability to identify emotions in others • Ability to manage emotions effectively
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Why is this important to me as a hospice or palliative care nurse? • Natural body tendency is fight or flight • Impact on personal health • Impact on care for patient and/or family
What are common emotional pairs? • Joy vs. Sadness • Trust vs. Disgust • Fear vs. Anger • Surprise vs. Anticipation
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What emotions in hospice and palliative care? • Patients and families • • • • • • • •
Denial Anger Bargaining Sadness Depression Frustration Guilt Acceptance
Emotional Intelligence Rounds • What is going on emotionally with your patients? • What is going on emotionally with you? • What is the most difficult emotion for you to deal with? What do yo do to deal with it?
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Most difficult emotion? • Anger • Sadness
Case Study Mrs. M is a 78 year old woman with end stage breast cancer. She is pleasantly confused. She thinks the staff are her sons and daughters. Her oldest biological son is very upset with the care she is receiving. He feels it takes too long for people to answer his phone calls/mother’s call light. He speaks disrespectfully to the female staff. He frequently asks the nurses’ aides questions that are more appropriate for the physicians.
What is anger? • Usually comes form a primary emotion.... • • • • • • •
Afraid Attacked Offended Disrespected Forced Trapped Pressured
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What to do with “others’ anger”? • Safety first • Ask opened ended questions • Try to determine the primary emotion...that’s where the work can begin
Ways to avoid feeling emotions • Excessive behaviors: eating, drinking, exercise • Ignoring • Always staying busy.....
Steps for anger management • Acknowledge emotion: “Yes, I’m angry.” • Take responsibility • Figure out why • Release the emotion constructively
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Case Study Mr. K is 32 years old. He and his girlfriend have lived together for the past 8 years. They have two young girls: 3 and 7 years old. Mr. K has metastatic colon cancer. He sought treatment at a major cancer center and has been away from his family for the past 8 months. He is actively dying but he does not want to give up hope for a cure. His girlfriend is unable to come visit him at the hospital.
Sadness: patients and families • Confirm emotion • Listen • Can action be taken? Who needs to act? • Avoid “fix it” statements
Positive management: personal • Acknowledge • Mediation • Guided imagery • Journal • Exercise • Sing • Play in garden • Prayer
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Positive management: systems • Professional resources: therapist and peer group • Environment
Culture and emotions • Male/female • Caucasian/Asian • Extravert/introvert • Manager/employee
Summary • Emotional Intelligence: what’s going on with you, your patients, and how are you managing? • How do you manage anger • How do you manage sadness • What are your emotional biases?
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Thank you!
References Akerjordet, K, & Severinsson, E. (2004). Emotional intelligence in mental health nurses talking about practice. International Journal of Mental Health Nursing,13(3), 164‐170. Codier, E, Freitas, B, & Muneno, L (2013) Developing emotional intelligence ability in oncology nurses: a clinical rounds approach. Oncology Nursing Forum. 40(1):22‐9. Codier E, Kamikawa C, & Kooker B. (2011) The impact of emotional intelligence development on nurse managers. Nursing Administration Quarterly, 35(3):270‐6. Codier, E, Kooker, B.M., & Shoultz, J. (2008). Measuring the emotional intelligence of clinical staff nurses: An approach for improving the clinical care environment. Nursing Administration Quarterly, 32(1), 8‐14. Codier E, & MacNaughton, N. (2012). Are male nurses emotionally intelligent? Nurse Manager, 43(4):1‐4. Deshpande, S.and Joseph, J. (2000). Impact of emotional intelligence, ethical climate, and behavior of peers on ethical behavior of nurses. Journal of Business Ethics, 85(3), 403‐410. Mayer, J.D., Salovey, P. & Caruso, D. (2008). Emotional intelligence new ability or eclectic traits? American Psychologist, 63(6), 503–517. Rooke, S. (2007) A meta‐analytic investigation of the relationship between emotional intelligence and health. Personality and Individual Differences, 42(6):921–933.
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