Emotional intelligence at admission in labour 

Ruth Deery

Professor of Maternal Health

Aims of session

• To provide an overview of emotional intelligence• To highlight research relating to emotional

intelligence /emotion work in midwifery• To analyse how misplaced emotional intelligence

can effect a woman's admission to hospital and thus negatively effect the labour process

• To devise our own positive coping strategies

Relationships, context and organisation

‘...it is not simply the woman or the setting, the attendant or the policies that influence the outcome. Rather, it is the complex interrelationships among these separate elements’

(Enkin, 2006, p.268)

‘The Organizational Flow’

• ‘The many moves to standardize services through guidelines, policies, procedures and pathways have made the organizational flow more powerful…the pressure to go with the flow of the organization had a divisive effect on relationships…controlling the flow enables organizations to run smoothly…the flow necessitates the development of a whole series of coping habits…’

(Kirkham, 2011, p.88)

Coping mechanisms

“…we used to spend hours with them in their homes and you know you were really their friend…you were their friend in the end…but you’re so busy now…that personal touch is lost…” (Frances)

Suppressing emotion

‘…it can be incredibly stressful, can be emotionally draining or the other way – an absolute high!’

Focus group 4 First year 3-year course student midwives. (Hunter, 2002).

•  ‘It’s very difficult…we are looking at people that have on-going emotional problems…but it goes with the job’

• Interview 2 (Deery, 2003)

Obedient technicians

• Large centralised units can mean becoming an obedient technician in order to cope (Deery & Hunter, 2010)

• Crafting efficient , ‘one size fits all’ organisations does not facilitate the development of meaningful relationships (Sennett, 2008)

‘Coping’ or ‘re-enacting’

I went home and I sat in the chair for about an hour and a half…just like zombified…thinking about what had gone on…and if I had done everything…

(Penny, community midwife in Deery, 2003, 2010)

Professional dissonance

• …trying to hold simultaneously two, often conflicting, sets of values; the professional values of midwifery in which the managers have been educated and practised, and the values of the target and star rating-driven New NHS.

(Deery, Hughes & Kirkham, 2010)

Emotion work and emotional intelligence

Given the evidence that midwifery is emotionally demanding work, midwives need to develop ways of working which acknowledge the significance of feelings.

• This would increase the visibility of emotion work AND facilitate debate about developing a more ‘emotionally intelligent’ type of practice (Hunter & Deery, 2005 ).

Emotional IntelligenceWhat is it….?

1. Knowing your emotions

2. Managing your own emotions

3. Motivating yourself

4. Recognising and understanding other people’s emotions

5. Managing relationships, i.e. managing the emotions of others

Emotional intelligence versus IQ

• EI key to success in midwifery (i.e. relationships)• EI is the ability to bring health care practitioners

together and motivate them• EI is the trust to build productive relationships• EI is the resilience to perform under pressure• EI is the courage to make decisions• EI is the strength to persevere through

adversity

Behaviours

AttitudesAttitudes

ValuesValues ThoughtsThoughts

FeelingsFeelings

CommitmentCommitment

BeliefsBeliefs

MotivesMotives

Safety/careSafety/careLife balanceLife balance

SELF – AWARENESS

SELF-MANAGEMENT

SOCIAL AWARENESS

RELATIONSHIPMANAGEMENT

PERSONAL COMPETENCIES

SOCIAL COMPETENCIES

Emotional IntelligenceEmotional Intelligence

What I seeWhat I see What I doWhat I do

Emotionally intelligent midwifery

Clinically it was just lovely. I enjoyed every moment

because I’m happy without doctors, and I’m happy making my own decisions, and I’m perfectly happy with women who are birthing physiologically, and clinically it was just my dream, it was my dream job. (Deery et al. 2010, Midwife 1)

It’s like going to heaven being with midwives that work the same way, who are enthusiastic. I felt this big cloud has lifted!(Caseload midwife, McCourt and Stevens, 2008)

Group work

• Five different scenarios requiring emotionally intelligent responses;– Telephone triage in latent phase (good and

bad scenario)– Arrival at labour ward but still in latent phase– First time to labour ward in established labour– High risk woman in established labour

Demands on midwives at point of admission

• Listening to the woman/positive language• Navigating the system• Developing empathy• Keying/writing information/summarise• Knowing about the issue in question• The environment• Summarising/repeating back

Successful ‘balancing’ and calibration

• ‘People who successfully balance engagement with detachment know what they can and cannot change or control. They are sensitive to their own emotional needs. They choose their level of engagement based on what they know they can handle at a particular time. People who successfully balance engagement and detachment understand the importance of self-care’ (Carmack, 1997, p.142)

Behaviour and values

• Organisations are successful when– strong values are held by all– strong guiding vision – the vision communicates what behaviour is

appropriate and what is not. – values are widely shared across the

organisation and are reflected in the everyday actions of employees at all levels

Final thoughts….

• “…in the day to day world no intelligence is more important than the interpersonal…”

• Gardner, H. & Hatch, T. (1989) Multiple intelligences go to school, Educational Researcher, 18 (8): 4-10

Final thoughts….

• “I like to listen. I have learned a great deal from listening carefully. Most people never listen”Ernest Hemmingway

Treat women and their partners as you would like to be treated