This paper explores the interpretive negotiation of professional values by nurses working in a large public-sector organisation in the UK, namely the NHS Direct (NHSD). Reported are findings from a number of case studies of NHSD, undertaken in response to calls for more research into so-called professional call centre settings.

‘We are nurses, we are supposed to care for people’: professional values among nurses in NHS Direct call centres

This paper discusses employee resistance to the emotional labour of face-to-face service work. It identifies a difficulty with the extension of the concept of resistance from the more traditional manufacturing industries to service work, asking how far apparently resistant behaviours can sensibly be conceptualised as a challenge to management control of the labour process. This difficulty is explored through a discussion of data drawn from ethnographic research into a chain of public houses. Various forms of resistant behaviour are identified, although the precise nature of this resistance is often blurred by the complex relations between employee, management and customer.

Reacting to the demands of service work: emotional resistance in the Coaching Inn Company

The objective of this study was to determine the relationship between emotion work (emotional labour), emotional intelligence, organisational factors (job autonomy, supervisor and co-worker support) and well-being (burnout and engagement) of secondary educators. A cross-sectional survey design was used. A non-probability convenience sample (n=257) was taken from educators in high schools from the Pretoria Region in the Gauteng Province. The Schune Emotional Intelligence Scale (SEIS), The Utrecht Work Engagement Scale (UWES), Oldenburg Burnout Inventory (English version) (OBLI), Scales from the Frankfurt Emotion Work Scales (FEWS), and the Organisational Factor Scale (OF) were administered. The Product-Moment regression coefficients showed exhaustion to be positively correlated to negative emotion work and mental distance, and negatively correlated to engagement, job autonomy and supervisor support. Engagement was positively related to mood regulation/optimism, emotion managementlsocial skills, supervisor support and co-worker support. The regression analysis showed that in the education profession, the presence of emotion work, supervisor support and mood regulationloptimism can predict a level of engagement. The presence of negative emotion work without supervisor support and a lack of job autonomy can predict exhaustion and without support from the environment or job resources negative emotion work reinforces mental distance.

Emotion work and well-being of secondary school educators

Aim. The aim of this PhD thesis is to report the sociological position, power dynamics and expertise in the communication between specialist nurses and doctors within NHS acute hospitals. 

Background. Nursing and healthcare have continually evolved, with new nursing roles interfacing professionally at a more advanced level with doctors. Historically the relationship and interactions have been characterised as the ‘Doctor-Nurse’ game which has been reviewed from many sociological perspectives. However, little has been added to understand the basis of these transactions that take place in the clinical setting between advanced practice nurses and doctors in hospitals. 

Methods. The primary methods comprised a critical realist approach ethnography, undertaking: fieldwork observations, follow-up interviews and artefact analysis on teams of specialist nurses and doctors working in three NHS hospitals. Seven specialist teams comprising 30 specialist nurses and 53 doctors of all grades were directly studied, alongside other peripheral members of the healthcare team as they delivered care. 

Results. The findings in this study demonstrate that much has changed concerning the role of the specialist nurse: professionally, clinically and sociologically. Four main themes emerged from the research: defining a new relationship between medicine and nursing; social space, development of ‘field’ in hospital care, division of labour, expertise and a new interaction model. The basis of the relationship has changed through bureaucratic challenges to the medical role which has resulted in changes to nursing power and its application in the clinical field in the new care models. There are a number of new strategies employed by both groups in the management of professional role, knowledge base, expertise and clinical work in the field. The communication strategies are more complex with a sophisticated coalition model of organisation. However, some ‘doctor-nurse games’ are still played out in the clinical setting, based upon traditional divisions of labour and power. This relationship has also created other tensions in the workspace particularly with junior medical staff, nursing staff and administrators.

Power dynamics and professional expertise in the communication between specialist nurses and doctors in acute hospital settings

Research into emotions in organisations has grown considerably in recent years, inspiring both academic and practitioner interest. This thesis reviews the growing literature on the subject, especially considering Hochschild's (1983) concept of emotional labour and the possible emotional demands and impacts of service work. Concepts such as emotional exhaustion, burnout and desensitisation are often referred to in the literature although relatively few researchers draw attention to any more positive cffects. This prOject sought to widen the study of the emotional implications of service work to include the large, but under researched, public house sector of Britain's hospitality industry. This thesis investigates the nature of cmotion rules in public houses, how such rules arc leamt and identifies a variety of both negative and positive emotional demands of pub work and how workers rcact to these. A single ethnographic study was undertaken within a large chain of public houses. A mixture of participant observation and in-depth interviews provided a rich variety of data resulting in a broad picture of the nature of the emotions within a number of individual public houses within the chain, with the fieldworker taking on the role of an employee in five such units. When discussing the emotional demands of their work, there was a common assertion among study participants that pubs were rather different to other types of hospitality outlet. This was seen as particularly relevant to the nature of emotion rules, which were influenced by a variety of stakeholders, including management, colleagues, customers and self. The idea that bar staff need to be and be seen to be genuine with customers was often stressed. Although all were able to recall some specific incidents when some surface and deep acting was called for, these were perceived to be exceptions rather than the norm. Some negative emotional aspects were raised by participants, especially relating to dealing with unpleasant customers or situations. More positive 'effects' of emotional labour were also alluded to, with bar staff claiming to enjoy much of their work dealing with customers. They described pleasure from satisfying customers and even 'enjoying' dealing with less pleasant ones when they felt they could maintain an element of control over potentially damaging situations.

Steve Taylor

Papers

Emotional Labour and Sexual Difference