Emotional Intelligence And Nurses’ Occupational Stress

Abstract


INTRODUCTION
Work-related to hospitals or health has a high tendency to be exposed to stress or depression resulting in disrupted services (Aiska, 2014). The complex work of nurses makes nurses work extra in providing services to patients. Nurses who are unable to meet work demands will find it difficult to escape from the pressure. Nurses will promote decreased morale, and work performance, and increase the risk of intervention errors that can be harmful to patients or the nurses themselves (Prasetyo, 2017). Nurses are a profession that has a high risk of stress because nurses have a very high duty and responsibility for the safety of human life. Occupational stress creates an imbalance between the physical and psychological which affects one's emotions, thought processes, and condition. Basically, every individual as a human being always receives various kinds of stimuli from the surrounding environment. Each person has a certain threshold for receiving these stimuli. Nurses experience occupational stress and often feel dizzy, tired, unfriendly, and lack of rest due to too high a workload and inadequate income.
The prevalence of occupational stress varies greatly in Indonesia among health workers, especially nurses. Research by (Martyastuti, 2019) revealed that nurses at the Medika Pemalang General Hospital experienced mild stress of 53,3% and moderate stress of 46,7%. Furthermore, research by (Haryanti, 2019) mentioned that 82.8% nurses experienced moderate stress at Semarang District Hospital. In general, based on research conducted by (Putri, 2019) regarding occupational stress in nurses, it showed that there were 40 people (76,9%) experiencing occupational stress. (Siringoringo's, 2018) research also showed that 17 (56,7%) nurses had severe stress. Factors affecting occupational stress include self-efficacy, emotional intelligence, and personality (Willy, 2019). Occupational stress occurs not only because of conflict but other influencing factors such as role conflict, work overload, responsibility for others, career development, lack of group cohesion, inadequate group support, task characteristics, and related leadership influences with job demands (Niken, 2015). If this stress is not resolved, it will lead to negative impacts including subjective, behavioral, cognitive, physiological, and organizational impacts (Gregson, 2012).
Emotional intelligence can influence nurses in fostering good relationships with others because good relationships can motivate themselves to work even better, so their performance increases. Nurses who are valuable assets for hospitals are sometimes faced with a dilemma. Therefore, it is important to understand and meet the needs of nurses and create comfortable work (Wahyuni, 2012). The ability to understand and manage emotions helps the process of self-development which enables a person to deal with a stressful work environment, as well as adapt to achieve goals. Emotional intelligence forms employees to be resilient so that it can lead to better motivation to achieve work performance (Avey, 2012). Suggests five basic skills in emotional intelligence including self-awareness, self-regulation, motivation, empathy, and social skills. Emotional intelligence is very important to control and reduce work pressure in addition to the ability to control emotions. Besides being able to control emotions, a nurse must also be able to act professionally at work and be intuitive with patients (Goleman, 2015).
The higher the emotional intelligence possessed by the nurse, the lower the stress experienced by the nurse. In other words, the lower the emotional intelligence possessed by the nurse, the higher the stress experienced by the nurse in providing nursing care because with high emotional intelligence nurses will be able to control stress while at work. If nurses have high emotional intelligence, occupational stress will be low then nursing care services will be of high quality. Additionally, friendly service will be established between nurses and patients (Ridhyalla, 2019). Nurses must be able to control their emotions in carrying out actions or work as emotional intelligence greatly influences a person's occupational stress level. In light of this explanation, researchers conducted this research entitled "The Relationship between Emotional Intelligence and Nurses' Occupational stress Levels".

METHODS
This research used analytic correlation with a cross-sectional approach. This type of research emphasizes the time of measurement or observation of the independent and dependent variables only once at a time when there was no follow-up. The population were all nurses at X Hospital in Lamongan. The samples were taken by cluster sampling technique and it was obtained 43 respondents. Data on Table 1 indicates that 24 (55.8%) of the respondents are female. In terms of educational background, 37 (86.0%) respondents are bachelor and professional nurse graduates. Additionally, the majority of the respondents (79.1%) has been working for 1-3 years. Data on Table 2 shows that most 23 (53.5%) nurses have high emotional intelligence, 20 nurses (46.5%) have moderate emotional intelligence, and no nurses with low emotional intelligence (0%). Besides, 23 nurses (53.5%) experience moderate occupational stress, 19 nurses (44.2%) experience low occupational stress, and 1 nurse (2.3%) experiences high occupational stress. Data on Table 3 shows that 23 out of 43 (53.48%) nurses have high emotional intelligence with a low level of occupational stress of 4 (9.30%) and 18 (41.86%) nurses have moderate occupational stress. On the other hand, 20 (46.51%) nurses have moderate emotional intelligence with 5 (11.62%) nurses experiencing moderate.

Emotional Intelligence of Nurses
The results indicated that 43 (53,3%) nurses had high emotional intelligence. In terms of social skills, most nurses are able to work well together and reconcile conflicts occurred between colleagues. Besides, the nurses can establish social relationships and act as good listeners for the patients and patients' families. In addition to high emotional intelligence, moderate emotional intelligence in nurses is shown in the indicators of self-regulation. Some nurses have not been able to control their emotions so that they cannot resolve conflicts properly. According to (Baron, 2015), someone who has high emotional intelligence has the ability to cope with environmental demands and pressures, various problems or challenges which arise in his life than someone with lower emotional intelligence.
According to (Rosalina, 2018), emotional intelligence in nurses will greatly determine the behavior of treating the patients because nurses who have good emotional intelligence can control their emotions when interacting directly with patients and their families. (Mubayidh, 2016) defines emotional intelligence as a social intelligence related to an individual's ability to monitor both his own emotions and the emotions of others, and also in differentiating his own emotions from the emotions of others, where this ability is used to direct his mindset and behavior. Based on the above opinion, it can be concluded that emotional intelligence is an individual's ability to be able to understand the emotions of oneself and others to be able to deal with problems, challenges, and pressures or stress faced in daily life and work.
Someone who wants to have high emotional intelligence must be able to understand and control their own and other people's emotions effectively, so that good interactions will occur and produce productive work results and can motivate themselves to work even better. It is very important for nurses to have emotional intelligence in addition to scientific knowledge and skills because quality care services are not only oriented towards administering drugs or other medical procedures, but also the behavior and treatment given by nurses during the healing process.

Occupational stress
Based on the research results, most nurses (53,5%) have moderate occupational stress. This means that it is at a level that is not dangerous for both the nurse and the workplace. Nurses have occupational stress which is being shown as an indicator of conflict with other nurses. Most nurses have difficulty working with nurses when moved to another room. In addition, nurses have high occupational stress as shown in the workload indicator. This is a small number of nurses who are unable to complete their work and find it difficult because the number of staff working in the room does not meet the needs. Nurses in the hospital can help the emotional needs of patients and the patient's family and nurses can provide satisfactory answers when patients ask questions.
Irham, (2017) revealed that stress does not just arise, but the causes of stress arise are generally followed by some event that affect a person's psyche, and the event occurs beyond his ability after these conditions have depressed his soul. Stress is usually defined by the internal and external conditions which create stressful situations, and the symptoms experienced by any person who is stressed. Nurses who experience occupational stress experience disturbances both physiologically and behaviorally towards moderate levels of occupational stress. Physiological disturbances are in the form of changes in metabolism, increased heart rate and respiration, increased blood pressure, and headaches. Psychological disorders are in the form of dissatisfaction, tension, anxiety, irritability, boredom, and procrastination. Behavioral disorders include changes in productivity, absenteeism, employee turnover rates, changes in eating habits, increased smoking and alcohol consumption, anxiety, and sleep disturbances (Robbins, 2013).
Nurses have a moderate level of occupational stress, meaning that most nurses are expected to have in-depth knowledge of health problems, the dynamics of patient psychology, the ability to communicate therapeutically, and the ability to manage their emotional conditions well. Lack of these abilities can hinder the smooth running of tasks, create conflicts both with colleagues and with clients, and their families which in turn lead to increased stress at work.

The Relationship between Emotional Intelligence and Occupational stress
Based on the results of the study, it was shown that of the 43 (53,5%) nurses who had high emotional intelligence had moderate occupational stress (53,5%). From the results of the analysis with the Spearman's test, it showed a significant value (p sign = 0,002), meaning that p <0,05 and a value of rs = 0,581. To conclude, there is a relationship between emotional intelligence and nurse occupational stress. According to (Nursalam, 2014) in determining the interpretation of the strength of the relationship between the two research variables, if rs = 0,25 -0,50, the correlation between the two variables is strong. In this case, there is a relationship between emotional intelligence and occupational stress of nurses with a strong level of closeness. The results of another study conducted by Maria, (2017) stated that emotional intelligence can significantly reduce occupational stress in nurses. Zuhkri, (2016) mentioned that the relationship between emotional intelligence and occupational stress levels in nurses is very close. The higher the emotional intelligence possessed by the nurse, the lower the stress experienced by the nurse or it can be said to be normal, and vice versa, the lower the emotional intelligence possessed by the nurse, the higher the stress. If the emotions are not controlled, it will affect the nursing care that will be given, so that in carrying out the work of nurses will experience occupational stress.
Almost all work conditions have stressors which can cause occupational stress. Nurses with high emotional intelligence will also form a positive attitude towards positive action in doing the work being undertaken. Sarafino, (2019) explained that several conditions caused the nurses' job to be very stressful. These conditions are responsibility for other people's lives, the heavy workload of having to always deal with life-or-death issues, and an illustration of the severe consequences that must be borne if they make a mistake in several parts of the hospital such as the Intensive Care Unit (ER) department. The decisions must be made quickly and implemented immediately and precisely. In addition, nurses often deal with frightening conditions of death or dying.
Basically, when a nurse is faced with a situation that has the potential to cause stress, such as excessive workload, deadlines and unpleasant coworkers, a stress reaction will occur. However, all stressors will affect or not a nurse is very dependent on internal factors which are aspects of emotional intelligence, namely; how far the individual perceives a situation as a stressor. Thus, factors originating from within the individual function as a modifier factor between stimuli from the external environment which is a potential stress generator. This modifier factor determines how nurses react to potential occupational stress generators (Munandar, 2018).
Nurses who have high emotional intelligence will always be able to get along more easily with new people, so that they will be able to reduce high levels of occupational stress. Emotional intelligence can form a person who is optimistic, enthusiastic, easy to get along with, can display feelings and thoughts, especially in controlling emotions so that they know when to take the right action in certain situations, so that they can avoid occupational stress. Nurses who can control stress while on duty will be of good quality and friendly service will be established between nurses and patients, therefore nurses must have high emotional intelligence.

CONCLUSION
Based on the results of the research and discussion, it can be concluded that 1) most nurses have emotional intelligence with a high category, 2) most nurses have moderate occupational stress, 3) there is a relationship between emotional intelligence and nurse job stress. In this study, it is hoped that nurses will have high emotional intelligence so that they can control their emotions, be able to establish good social relations and add insight and knowledge about emotional intelligence so that they are not affected by occupational stress and provide nursing care in accordance with Standard Operating Procedures. For further research, it is suggested to examine other influencing aspects such as the length of service of nurses, work location of nurses, and work status of nurses.