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Journal of Business Ethics (2009) 85:403–410  Springer 2008

DOI 10.1007/s10551-008-9779-z

Impact of Emotional Intelligence,


Ethical Climate, and Behavior of Peers Satish P. Deshpande
on Ethical Behavior of Nurses Jacob Joseph

ABSTRACT. This study examines factors impacting argue that this heavy reliance on a business model by
ethical behavior of 103 hospital nurses. The level of healthcare administrators has made it very difficult for
emotional intelligence and ethical behavior of peers had a doctors and nurses to function in the best interests of
significant impact on ethical behavior of nurses. Inde- their patients (Deshpande et al., 2006; Weinstein and
pendence climate had a significant impact on ethical Nesbitt, 2007). In spite of the fact that the Joint
behavior of nurses. Other ethical climate types such as
Commission on Accreditation of Healthcare Orga-
professional, caring, rules, instrumental, and efficiency did
not impact ethical behavior of respondents. Implications
nizations (JCAHO) manual has clear standards on
of this study for researchers and practitioners are patient rights and organizational ethics, hospitals have
discussed. been accused of performing unnecessary surgery,
charging uninsured patients more than the insured,
KEY WORDS: hospitals, ethical behavior, nurses, emo- and signing exclusive agreements with selected doc-
tional intelligence tors (Appleby, 2004; Galewitz, 2006). In addition, a
recent survey conducted by the American College of
Physician Executives (ACPE) reports that nearly 54%
Introduction of the respondents believed that there was a healthcare
organization in their community that was involved in
In the last 5 years, the healthcare-related industries unethical business practices (Medical News Today,
added 1.7 million jobs to the US economy. 2005).
Employment in the rest of the private sector did not Nurses play a critical and intimate role in pro-
increase in the last 5 years (Mandel, 2006). In the viding healthcare to patients and encounter ethical
healthcare sector, over 478,000 jobs have been issues on a daily basis (Loewy and Loewy, 2004). A
created in hospitals over the last 5 years. Since the nurse typically faces over 30 different types of ethical
demand for healthcare needs are projected to grow dilemmas daily (Raines, 2000). The 2001 American
significantly in the next decade, it is evident that the Nurses Association Code of Ethics for Nurses sets
healthcare sector will continue to be the engine of some standards for the ethical behavior of nurses.
private sector job growth in the US (Mandel, 2006). While nurses are ethically responsible for promoting
Hospitals are the largest segment of healthcare and patient safety and reporting errors in the healthcare
employ over 40% of all healthcare workers (Bureau system, many are unlikely to do so (Erlen, 2007).
of Labor Statistics, 2006). Nurses are more likely to discuss the offence with
Healthcare institutions are focusing more on busi- the offender, and not report it to a superior, espe-
ness-related areas (e.g., occupancy rate, staff produc- cially if it was unintentional (King, 2001). Nurses are
tivity, cost containment) to address issues such as also less likely to report errors outside the scope of
inadequate reimbursement from government pro- their practice (Espin et al., 2007).
grams, new federal regulations, drastically increasing One factor that may impact the ability of nurses to
costs of professional liability insurance, and increased deal with these environmental issues and job stress-
competition (Weinstein and Nesbitt, 2007). Many ors is emotional intelligence (Landa et al., 2007).
404 Satish P. Deshpande and Jacob Joseph

McQueen (2003) strongly argues that emotional appraisal and recognition of emotion in others,
intelligence skills can help nurses meet the demands regulation of emotions in oneself, and the use of
of modern nursing. While previous research has emotions to facilitate performance. These four
found that people who could better read emotions of dimensions also form the basis of the emotional
others were more successful at work and social set- intelligence survey used in this study. VanRooy and
tings, healthcare professionals have not embraced Viswesvaran (2004) in a meta-analytic investigation
this widely (Freshman and Rubino, 2002). Holian found that emotional intelligence can successfully
(2006) in a study of management decision making predict performance across various employment and
recommends that future researchers must examine if nonemployment settings. It is also suggested that
ethical decision may be influenced by skills associ- people with high emotional intelligence can effec-
ated with emotional intelligence. Mesmer-Magnus tively understand their own emotions and regulate
et al. (2008) found that emotional intelligence is a them for focused actions (Law et al., 2004). Brackett
significant predictor of perception of ethical behav- et al. (2004) found that emotional intelligence was
ior of peers and self-reported ethical behavior of significantly associated with harmful behavior among
undergraduate students. Unfortunately, current re- male college students.
search has not empirically investigated whether both Very little research has been done to examine the
emotional intelligence and ethical behavior of peers impact of emotional intelligence on practices of
have a direct impact on ethical behavior of professional nurses (Kooker et al., 2007). In a theo-
employees of a firm. It is the major purpose of this retical analysis of the value of emotional intelligence
research to do so among a sample of nurses. to nursing, McQueen (2004) propose that emotional
intelligence skills can positively impact patient care
Literature review and staff welfare. Similarly, Akerjordet and Seve-
rinsson (2007) suggest that emotional intelligence
Previous reviews of studies done in business ethics may enable nurses to cope better with stress, apply
have raised a number of concerns on the state of more successful coping strategies, and improve their
empirical research into business ethics (Ford and quality of working life within nursing. Codier et al.
Richardson, 1994; O’Fallon and Butterfield, 2005; (2008) in their study of clinical staff nurses report that
Randall and Gibson, 1990). First, they have dem- the performance level of nurses was positively cor-
anded more studies based on a theoretical grounding related with their level of emotional intelligence.
and formal hypotheses. Second, they have raised Mesmer-Magnus et al. (2008) in a study of 198
concerns over the use of student samples due to their undergraduate students reported that emotional
easy access and the lack of appropriate samples. In intelligence can also help us in predicting ethical
addition, reviews have called for the additional testing behavior. We will examine if this relationship will
of ‘‘individual, situational, and issue-related influ- hold true among nurses working in hospitals.
ences’’ of the ethical decision-making process Accordingly,
(O’Fallon and Butterfield, 2005, p. 399). Hypothesis 1: Nurses who self-report a high level
One topic that has garnered a lot of attention of emotional intelligence are more likely to self-
among organizational psychologists in recent years report engaging in ethical behavior.
is emotional intelligence (Salovey and Grewal,
2005). This topic has also gained a lot of attention O’Fallon and Butterfield (2005) in their literature
in the popular media after the publication of Daniel review proposed that one area of research that shows
Goleman’s book, Emotional Intelligence, in 1995. much promise is the impact of peer influence on
While a number of definitions of emotional intel- ethical behavior. Coworkers often serve as role
ligence exist, the four-dimensional definition of models for others and their actions often create norms
emotional intelligence proposed by Davies et al. for the workplace. This is based on social learning
(1998) has been considered to be the most com- theory, which states that referent others can have a
prehensive (Law et al., 2004). The four dimensions significant impact on the behavior of individuals
are appraisal and expression of emotion in oneself, (Bandura, 1977). However, it is important to note
Impact of Emotional Intelligence, Ethical Climate, and Behavior of Peers 405

that researchers in the past had difficulty separating organizational decision makers must consider ethical
peer effect from confounding factors. Fortunately, climate perceptions to facilitate overall well-being
controlled field experiments in labor economics has within their organization. Therefore we propose:
shown a clear evidence of peer effects on work
behavior in the absence of confounding factors (Falk Hypothesis 3: Ethical climate types will impact eth-
and Ichino, 2006). Thus we hypothesize: ical behavior of respondents.
Hypothesis 2: Ethical behavior of peers will impact
ethical behavior of respondents.
Study methodology
A number of researchers have suggested that the
ethical climate of an organization can impact ethical Sample and measures
behavior of employees (Deshpande, 1996; Victor
and Cullen, 1987, 1988). Martin and Cullen (2006, The sample of this study is a part of a larger study
p. 177) identify the ethical climate of an organization conducted among employees of three hospitals in
as ‘‘a group of prescribed climates reflecting the the USA. One hospital was in the Midwest USA (a
organizational procedures, policies, and practices 248-bed facility) while the other two were in the
with moral consequences.’’ Most of the empirical Northwest USA (a 150-bed and a 341-bed facility).
work examining the ethical climate of an organization Contacts within the hospitals were used to get their
is based on the six ethical climate types identified by address directories to distribute the surveys. Two
Victor and Cullen (1987). Their classification of hundred and three employees (66.7% response rate)
ethical climate types was based on previous research returned completed surveys. The sample consisted of
on ethical theory (Fritzche and Becker, 1984; Wil- different occupations including doctors, pharmacists,
liams, 1985), moral development (Kohlberg, 1984), technicians, nurses, and office staff. Only responses
and sociocultural theories of organizations (Schnei- by nurses (n = 103) were considered for this study.
der, 1983). Specifically, they were based on two Eighty-one percent of the responding nurses were
dimensions: type of criteria (benevolence, principle, women. The average age of the respondents was
and egoism) and level of analysis (individual, organi- 46 years. In addition, 81% of the respondents were
zational, or cosmopolitan). Based on a sample con- white. On average, a nurse had worked for the
sisting of MBA students, university faculty, and hospital for over 10 years. Detailed demographic
managers of a trucking firm, Victor and Cullen (1987) information is presented in Table I.
proposed six distinct climate types (professionalism, The survey covered a variety of items including
caring, rules, instrumental, efficiency, and indepen- measures of various ethical climate types, ethical
dence). Victor and Cullen (1987, 1988) laid a strong behavior of self, ethical behavior of coworkers,
foundation to support their thesis that work climates emotional intelligence, and demographic measures.
can significantly shape ethical behavior of employees. Ethical behavior of self was measured using four
Deshpande (1996) developed global measures for the items: it is acceptable for me to take office supplies
six ethical climate types and used them to examine the
ethical practices of managers of a large American
nonprofit organization.
Martin and Cullen (2006) conducted a meta- TABLE I
analysis of studies in ethical climate to resolve Demographics of the sample
inconsistencies in previous findings and determine
support for Victor and Cullen’s (1987, 1988) ethical Variable Mean Range SD
climate theory. Among other things, they found a
positive relationship between the professional and Gender (1 = female, 0 = male) 0.81 0–1 0.40
rules climates and various organizational outcomes. Age (years) 46 26–66 10.01
They also found a weak relationship between the Job experience (years) 10.13 0–35 7.67
Full-time (1 = yes, 0 = no) 0.86 0–1 0.34
independent climate and most organizational out-
Race (1 = white, 0 = nonwhite) 0.81 0–1 0.40
comes. One of their recommendations was that
406 Satish P. Deshpande and Jacob Joseph

home; in order to get ahead in my career, I believe these ethical climate types as proposed by Deshpande
that one has to compromise personal ethical stan- (1996). They are: professional climate (people were
dards; I believe that it is acceptable on occasion to expected to comply with the law and professional
discuss aspects of cases with friends and others not standards), caring climate (the major consideration
employed within their organization; and I believe was what is best for everyone in the organization),
that it is okay to by-pass established protocols in rules climate (everyone was expected to stick by
order to be more efficient or effective at work. organization rules and procedures), instrumental
Ethical behavior of coworkers was measured using climate (people protected their own interest above
four similar items: co-workers feel that it is accept- all else), efficiency climate (the most efficient way of
able to take office supplies home; in order to get doing something was the right way in the organi-
ahead in their career, my co-workers believe that zation), and independence climate (each person in
one has to compromise personal ethical standards; the firm decided for him/herself what is right
my co-workers believe that it is acceptable on oc- and wrong). A four-point Likert scale, with 1 rep-
casion to discuss aspects of cases with friends and resenting ‘‘strongly agree’’ and 4 representing
others not employed within their organization; and ‘‘strongly disagree’’, was used to measure the climate
my co-workers believe that it is okay to by-pass types.
established protocols in order to be more efficient or
effective at work. These items were measured using
four items that were rated on a four-point Likert Findings
scale (4 = strongly agree, 1 = strongly disagree).
The Cronbach’s alpha for ethical behavior of self and Means, standard deviations, reliabilities, and Pear-
coworkers was 0.81 and 0.83, respectively. son’s zero-order correlations for all variables are
Emotional intelligence was measured using a 16- presented in Table II. The reliabilities (coefficient
item scale developed by Law et al. (2004). These alphas) of ethical behavior of self, ethical behavior of
items are: I have a good sense of why I have certain others, and emotional intelligence are shown on the
feelings most of the time, I have good understanding diagonal in parentheses. Emotional intelligence,
of my own emotions, I really understand what I feel, ethical behavior of coworkers, and caring climate
I always know whether or not I am happy, I always were significantly correlated with ethical behavior of
know my friends’ emotions from their behavior, I self. None of the other ethical climate types signif-
am a good observer of others’ emotions, I am sen- icantly impacted ethical behavior of self. But sig-
sitive to the feelings and emotions of others, I have nificant intercorrelations among the variables as seen
good understanding of the emotions of people in the correlation matrix can impact the significance
around me, I always set goals for myself and then try of the hypothesized relationships. In addition, cor-
my best to achieve them, I always tell myself I am a relations give us an estimate of the association among
competent person, I am a self-motivating person, I the variables but do not tell us if a variable is
would always encourage myself to try my best, I am dependent upon the others. On the other hand,
able to control my temper so that I can handle dif- regression analysis allows us to examine the depen-
ficulties rationally, I am quite capable of controlling dence of a variable on various explanatory variables.
my own emotions, I can always calm down quickly Therefore, regression analysis will allow us to draw
when I am very angry, and I have good control of more valid conclusions. The most widely used
my own emotions. method of estimation for the regression model is
This scale was recently used by Mesmer-Magnus ordinary least squares (OLS).
et al. (2008) to examine tendency of undergraduate Thus, OLS regression analysis results as seen in
students to engage in unethical behaviors. Cron- Table III provide stronger evidence on the signifi-
bach’s alpha for this scale was 0.92. cance of the hypothesized relationships. Standard-
Victor and Cullen (1987) introduced an ethical ized regression coefficients show that emotional
climate framework of six climate types (profession- intelligence, ethical behavior of coworkers, and
alism, caring, rules, instrumental, efficiency, and independence climate significantly impacted ethical
independence). We will use global measures for behavior of self.
Impact of Emotional Intelligence, Ethical Climate, and Behavior of Peers 407

TABLE II
Means, standard deviation, reliabilities, and Pearson’s zero-order correlations for all variables

Mean SD 1 2 3 4 5 6 7 8

1 Ethical behavior of self 3.48 0.51 (0.81)


2 Emotional intelligence 3.19 0.40 0.30** (0.92)
3 Ethical behavior of coworkers 2.96 0.67 0.44** 0.01 (0.83)
4 Professional climate 3.76 0.57 0.12 0.35** 0.02 1.00
5 Caring climate 2.72 0.90 0.20* 0.36** )0.03 0.15 1.00
6 Rules climate 3.62 0.55 0.11 0.06 0.09 0.17 0.23* 1.00
7 Instrumental climate 2.68 0.79 0.00 0.00 )0.10 )0.11 )0.12 )0.19 1.00
8 Efficiency climate 2.69 0.86 )0.02 )0.08 0.09 )0.26** )0.11 )0.04 0.14 1.00
9 Independence climate 2.14 0.94 0.08 )0.07 )0.18 )0.12 )0.05 0.02 0.19 )0.21* 1.00

**Correlation is significant at the 0.01 level (two-tailed), *Correlation is significant at the 0.05 level (two-tailed).

TABLE III Nurses need a lot of emotional energy to interact


Regression results with patients and be understanding towards those for
whom they are responsible (Amendolair, 2003). This
Variable Beta t study suggests that emotional intelligence may have a
significant impact on ethical behavior of nurses. A
Emotional intelligence 0.26 2.58** major component of a nurse’s job is to take care of
Ethical behavior of coworkers 0.48 5.26** patients. Thus, nurses with personal qualities such as
Professional climate 0.03 0.29 self-confidence, personal honesty, empathy, self-
Caring climate 0.12 1.26 management, and knowledge of personal strengths
Rules climate 0.02 0.19 and weaknesses are more likely to make ethical
Instrumental climate 0.03 0.35
decision. It is possible that training and development
Efficiency climate 0.02 0.16
efforts aimed at increasing emotional and social
Independence climate 0.19 1.99*
R2 0.33 competence can help nurses understand their own
Adjusted R2 0.27 emotions and the emotions of others. This is con-
N 103 sistent with Ancel (2006), who in a study of 263
nurses, found that in-service communication train-
**p £ 0.01, *p £ 0.05. ing significantly enhanced nurses’ empathic skills. It
would be interesting to examine if testing for soft
skills such as emotional intelligence during the
Discussion and implications selection process can have a positive impact on
ethical decision making and overall performance of
Since nurses are at the front line of healthcare ser- the nursing staff. Future research must look at the
vices and supposed to meet the psychosocial needs of impact of various facets of emotional intelligence on
patients, it is vital for both healthcare practitioners ethical behavior of nurses and other occupations.
and researchers to pay more attention to how they This study also suggests that peers can have a
make ethical decisions. Our research suggests that strong impact on the ethical behavior of employees.
both individual factors (e.g., emotional intelligence) In our study, the standardized regression weight of
and attributes of the hospital (ethical behavior of ethical behavior of coworkers was nearly twice that
peers, independence climate) may impact ethical of the next most significant factor (0.48 versus 0.26).
behavior. While the results of this study have unique Thus, a peer group with high ethical bent may
implications for healthcare providers, they also have significantly impact a nurse’s behavior at the work-
broader implications for other types of organizations place. Previous research has consistently shown that
and the field of business ethics. peers even have a greater impact than managers on
408 Satish P. Deshpande and Jacob Joseph

ethical behavior of employees (Deshpande et al., legal, some nurses may refuse to perform an abortion
2006; Zey-Ferrell et al., 1979). It is possible that one because it violates their moral beliefs. Other nurses
way to ensure ethical behavior of nurses is to take may think it is the right thing to do only when the
immediate and severe action against their coworkers pregnancy threatens the life or the health of the
who are in violation of work rules or have con- mother. Any climate that allows for moral relativism
ducted an unethical act. For example, if a hospital will result in inconsistent behavior among nurses at
takes no action against nurses who wear surgical the hospital. Future research should examine if
scrubs outside the hospital, even though it is against independence climate has a similar impact on other
the rules, it may become a part of the social norm. healthcare employees such as doctors and adminis-
Learning theory suggests that expected behavior at trators.
the workplace must be reinforced through rewards
and punishment (Sims, 1992). While hiring nurses,
Limitations and conclusions
hospitals, besides testing for emotional intelligence
(as stated earlier), may find it beneficial to pay more
This study has a number of limitations. Since the
attention to personal ethics and off-the-job behavior
work environment and ethical issues faced by
of candidates (Andrews, 2005). Psychological tests
healthcare employees are unique, it is possible that
and background checks can be effectively used for
the results of this study may not be applicable to
this purpose. Screening for factors such as machia-
non-healthcare organizations. All our measures were
vellianism, value system, and locus of control that
self-reported by the respondents which raises the
impact ethical decisions can help hospitals weed out
possibility of a self-selection bias. The respondents
those who are more likely to make unethical deci-
may also be providing socially desirable responses.
sions (O’Fallon and Butterfield, 2005). Future
Most people are reluctant to admit behaving
research needs to examine the impact of various
unethically or possessing low emotional intelligence.
human resource management practices on ethical
Past research has found low correlations between
behavior of nurses. For example, are nurses who are
self-report and ability-based measures of emotional
compensated above the market rate more ethical
intelligence (Brackett and Mayer, 2003).
than those who are paid market wages?
In spite of these limitations, this research has some
In our study, only independence climate had a
important conclusions. The level of emotional intel-
significant impact on ethical behavior. Surprisingly,
ligence significantly impacts ethical behavior of nur-
professional and rules climates were not significant in
ses. In addition, the study demonstrates that nurses are
our study. Further analysis of the data revealed that
more likely to behave ethically if they feel that their
this happened because 97% of the responding nurses
peers also behave ethically and have a work climate
reported the presence of both professional and rules
that encourages them to use their personal values at
climate respectively, while only 36% of the nurses
work. In short, our research suggests that both indi-
reported the presence of an independent climate.
vidual factors (e.g., emotional intelligence) and
The fact that responses for professional and rules
attributes of the hospital (ethical behavior of peers,
climates are heavily skewed can impact the signifi-
independence climate) impact ethical behavior.
cance of those variables in the regression analysis
(Cohen et al., 2003). This does not mean that pro-
fessional or rules climates are not prone to ethical
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