The relationship between the perceptions of implicit rationing of nursing care and emotionally intelligent leadership style among direct-care nurses
Implicit rationing of nursing care and emotionally intelligent leadership style of nurse managers have been found to contribute to patient outcomes. No studies had been done prior to this study to examine possible links between implicit rationing of nursing care and emotionally intelligent leadership style of nurse leaders on a hospital unit. The purpose of this cross-sectional survey design study was to examine relationships between amounts of perceived implicit rationing of nursing care and perceptions of emotionally intelligent leadership style of nurse leaders on the acute-care hospital unit. The sample for this study consisted of 248 direct-care nurses licensed in Oregon and working in acute-care hospitals. The nurses were recruited using an electronic list of licensed RNs in the state of Oregon from the Oregon Board of Nursing. Data were retrieved using an online platform. The conceptual framework, Implicit Rationing of Nursing Care (Schubert et al., 2007) guided the study, providing a basis for relationships between nursing management, direct-care nurses, and implicit rationing of nursing care. Two instruments were used to survey direct-care nurses about implicit rationing of nursing care and characteristics of their professional work environment on their unit. The first was the Perceived Implicit Rationing of Nursing Care (PIRNCA), a unidimensional scale containing 31 items. The second instrument that was used was Revised Nursing Work Index (NWI-R), a unidimensional scale containing 57 items. Free-text items included comments by the direct-care nurses about their ability to complete care for their patients, quality of care ratings of care for their patients on their unit and estimates of the percent of care that goes undelivered on their unit. Findings of this study support an association between direct-care nurse perceptions of a more resonant, emotionally intelligent leadership style of nurse leaders on their unit and lower amounts of implicit rationing of nursing care (r = -.358, p < .01). A professional nursing work environment, supported by emotionally intelligent resonant leadership style has an association with perceptions of less implicit rationing of nursing care by the direct-care nurses, and might be an intervention that would produce better patient outcomes in acute-care hospitals.