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Soft Skills and Emotional Intelligence Are Important for Newborn Care Nurses

A nurse takes care of a newborn baby at Lodwar Referral Hospital in Turkana, Kenya. Photo by Patrick Meinhardt for IntraHealth International.

A nurse takes care of a newborn baby at Lodwar Referral Hospital in Turkana, Kenya. Photo by Patrick Meinhardt for IntraHealth International.

"I usually start feeling stressed the moment I step inside the hospital,” says Sharrold, a newborn unit nurse in Kenya. "Imagine coming to the ward in the morning and seeing 20 babies who need care and five of them are critical, mothers who are distressed, shortage of gloves, and stock outs of essential drugs and saline. Moreover, there are only two of us to handle all this. This is our everyday life.”

Nurses like Sharrold working in newborn units are primary caregivers to newborns, and nursing practice can deeply influence newborn health outcomes. Newborn care units are emotionally charged units with high levels of uncertainty and anxiety for the health workers. In addition, newborn care nurses are put in a unique position of handling emotions of parents and caregivers.

Patient safety and quality of care are at risk when nurses face emotional distress and burnout.

Poor communication and disrespectful behavior of nurses can lead to mismanagement of babies and add to the existing stressful environment. In many low-resource settings, the work environment characterized by heavy workloads, insufficient staffing, infrastructural challenges, and medical emergencies add to the nurses’ physical and psychological stressors. Studies from both high and low-middle income countries have shown newborn care nurses to be stressed due to high workload and emotionally taxing situations.

Patient safety, quality of care, respectful care, as well as personal and professional relationships are at risk when nurses face emotional distress and burnout. Researchers believe burnout leads to a sense of helplessness and hopelessness and can be described as a “syndrome of emotional exhaustion, depersonalization (a disconnection from coworkers), and a reduced sense of personal accomplishment.”

Systemic and policy challenges such as staff shortages require health systems changes and long-term commitments. Meanwhile the nurses should not be left to deal with all this alone and should be equipped with key soft skills enhancing their emotional intelligence which can help them cope better in stressful situations, prevent burnout, focus on their well-being, and provide improved care.

Soft skills can help nurses navigate the difficult terrain of providing health care in resource-limited settings.

Soft skills are non-technical skills that relate to how you work—how you manage work, how you solve problems, and how you interact with others at work. Soft skill attributes like interpersonal skills, communication, teamwork, integrity, positive attitude, flexibility, and responsibility can help nurses and other health workers navigate the difficult terrain of providing health care in resource-limited settings. Emotional intelligence is defined as “the ability to perceive, interpret, demonstrate, control, evaluate, and use emotions to communicate with and relate to others effectively and constructively.” Emotional intelligence can help nurses develop more flexible range of emotional responses to deal with stressful situations. It also facilitates problem solving, decision making, and development of relationships with peers and parents, thereby improving nurse performance and quality of care provided.

Evidence supports the efficacy of emotional intelligence in improving key nurse and patient outcomes in newborn units. Research also suggests that emotional intelligence can be improved by training interventions. One such intervention is the iCARE-Haaland Model, which refers to intelligent Communication, Awareness and Action, Reflection, Emotions and aims to build health professionals’ capacity to provide patient-centred care, communicate, relate well with colleagues, build emotional competence, and take better care of their own health and wellbeing. The model has been developed over a period of 14 years and has been implemented in various settings like Lithuana, Kenya, United Kingdom, and Namibia. In recent years, the model has been adapted for training newborn nursing managers in Kenyan public hospitals.

While the impact of these trainings on nurses’ well-being and quality of care in the long run is yet to be seen, initial results seem promising as the participants reported increased confidence and self-awareness resulting in a stronger sense of professional identity as well as better understating of their colleagues and patients emotional triggers. Further research should be conducted to consolidate learnings from similar interventions in other contexts aiming at equipping the nursing cadre with better soft skills.

Soft-skills training should be integrated into nursing education early on.

Globally 2.4 million newborns died in 2020 and 47% of all under 5-mortality in that year was in the newborn period (the first 28 days of life). To improve survival and well-being of newborns, the World Health Organization suggests strengthening neonatal nursing to expand quality services. While clinical competence is essential for providing standard care, soft skills are also critical for success. To achieve this, it is important for governments and professional bodies to take an active role in supporting the nursing cadre and invest in training initiatives which can help address stress and burnout amongst them.

Soft-skills training and emotional intelligence concepts and strategies should be integrated into nursing education early on and be a regular part of their continuous medical education. These soft skills will not only help in creating a resilient nursing workforce and valuable team members, but also create a conducive environment to provide best possible care for newborns across the world.

Dyuti Sen is a Frontline Health Worker Coalition Regional Advisor. She just graduated from the University of Oxford with distinction, earning a Masters of Science in International Health and Tropical Medicine. Recently Sen worked with the Health Systems Collaborative team at Oxford to evaluate soft skills training programs for newborn care nurses in Kenya. She interviewed Nurse Sharrold in Kenya for another project to understand her experience working as a public sector nurse.