“I don’t have any emotions”: An ethnography of emotional labour and feeling rules in the emergency department

Abstract

Aims This study aims to apply Hochschild's theory of emotional labour to emergency care, and uncover the ‘specialty‐specific’ feeling rules driving this labour. Despite the importance of positive nurse well‐being, the emotional labour of nursing (a great influencer in wellbeing) remains neglected. Design and Methods Ethnography enabled immersion in the ED setting, gathering the lived experiences and narratives of the ED nursing team. We undertook first‐hand observations at one major trauma centre ED and one district general ED including semi‐structured interviews (18). A reflexive and interpretive approach towards thematic analysis was used. Results We unearthed and conceptualized four feeling rules born from this context and offer extensive insights into the emotional labour of emergency nurses. Conclusion Understanding the emotional labour and feeling rules of various nursing specialties offers critical insight into the challenges facing staff ‐ fundamental for nursing well‐being and associated retention programs. Impact What problem did the study address? What were the main findings? Where and on whom will the research have impact? Academically, this research expands our understanding ‐ we know little of nurses’ feeling rules and how specialties influence them. Clinically, (including service managers and policy makers) there are practical implications for nurse well‐being.

“What Is the Matter With Me?” or a “Badge of Honor”: Nurses’ Constructions of Resilience During Covid-19

“…Those who were redeployed seem to have identified themselves as having less resilience than those who were not redeployed, such as Amie, which emphasizes the importance of known colleagues and supportive teams for nurses. We argue that our data have revealed how, during “unprecedented times,” the concept of resilience, which has been utilized by health organizations and policy makers, has been internalized by nurses as a method of legitimizing emotional labor and organizational feeling rules (Kirk et al, 2021; Maben et al, 2006). These emphasize stoicism and, therefore for the majority, limited their agency, preventing them from speaking out or seeking change.…”

“…there's the odd patient that comes in that really moves you, like when kids come in to say goodbye, you do get quite emotional, but otherwise I don't really struggle at work. Similar to Kirk et al's (2021) participants who emphasized the importance of stoicism in their discussion of "emotion rules," Sandra's conceptualization of herself as a "resilient person" entailed "not struggling at work" which for her meant not letting the majority of her patients get to her emotionally. Previous research (e.g., Jackson et al, 2021) has highlighted the complex and multi-faceted nature of nursing work which can be understood as a composite of physical, emotional, cognitive, and organizational labor and the fact that much of this work is invisible (Allen et al, 2014).…”

“…The value to Sandra of attending the psychologist session resonates with other research, which has indicated that emotional expression or catharsis, particularly in groups, whereby individuals can reflect upon their emotional reactions, facilitates emotional adjustment, enhances mental health and life satisfaction, and can promote positive outcomes, thus, reducing the risk of emotional exhaustion for nurses (Kinman & Leggetter, 2016). It can be argued that acknowledging emotional vulnerabilities in a group situation such as the one described by Sandra, gives nurses the opportunity to step outside the normal emotion rules which dictate that nurses should be able to keep going come what may or show resilience (Kirk et al, 2021). Sandra, similar to the majority of the nurses we spoke to, revealed that she felt unable to share her COVID-19 working experiences with friends or family.…”

Lived Experiences of Female Nurses with COVID-19 Deaths on Their Watch

“…The assumption that stoicism and resilience are interchangeable was widespread in a recently published study [ 63 ]. This might be due to stereotyped nursing feelings [ 65 ].…”

Role of affective commitment in the relationship between emotional labor and life satisfaction in nurses

“…Nurses should know and control the process required for managing their emotions and expressions (Arnold & Connelly, 2013). However, we know little about nurses' feeling rules and how job settings influence them (Kirk et al, 2021). Even so, there is always a contradiction between not displaying and surpassing emotions when actual feelings are mostly needed (Grandey & Sayre, 2019).…”