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Emotional Intelligence in Neonatal Intensive Care Unit Nurses

Decreasing Moral Distress in End-of-Life Care and Laying a Foundation for Improved Outcomes

An Integrative Review

Lewis, Stephanie Lacefield PhD, RN, CNE

Journal of Hospice & Palliative Nursing: August 2019 - Volume 21 - Issue 4 - p 250–256
doi: 10.1097/NJH.0000000000000561
Ethics Series

End-of-life care in the neonatal intensive care unit (NICU) is one of the most challenging practices for nurses. Negative emotions associated with moral distress often cause care to be incomplete or nurse disengagement. Emotional intelligence in nurses holds potential to address this issue, while improving patient outcomes. The purpose of this study was to critically appraise the evidence about emotional intelligence in nursing and to explore the relationship between emotional intelligence, moral distress in NICU nurses, end-of-life care, and other priority nurse and patient outcomes. A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses)–structured integrative review was conducted, and CINAHL, Ovid, PubMed, and other databases were searched. Twelve studies were identified as relevant to this review after exclusion criteria were applied. Evidence supports the efficacy of emotional intelligence in bedside nurses as a method of improving key nurse and patient outcomes. Additionally, research suggests that emotional intelligence can be improved by training interventions. Clinical educators should integrate emotional intelligence concepts and strategies into staff training. Further research is recommended to validate previous findings in the NICU setting. Exploration of the relationship between emotional intelligence and moral distress in NICU nurses would provide a foundation for experimental designs to evaluate the effectiveness of emotional intelligence training interventions.

Stephanie Lacefield Lewis, PhD, RN, CNE, is associate professor of nursing, Troy University School of Nursing, Phenix City, Alabama.

Address correspondence to Stephanie Lacefield Lewis, PhD, RN, CNE, Troy University School of Nursing, Troy University, 1510 Whitewater Ave, 317A, Phenix City, AL 36867 (

There was no funding received in relationship to this study.

The author has no conflicts of interest to disclose.

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© 2019 by The Hospice and Palliative Nurses Association.