Emotional Labour: Implications for Nursing Practice

INTRODUCTION

Emotions are a crucial part of human life. Many a times we need to display different kinds of emotions as a part of our job. As long as the displayed emotions and felt emotions are congruent everything is perfect. However the problem arises when the true inner feeling felt by the person does not match with those displayed by the person as a part of his/her job. Emotional labour affects the employee as well as the quality of work. 

Meaning: Emotional labour is the control of a person’s behaviour to display the appropriate emotions.This means that a person evokes or supress certain emotion so to confirm to social norms¹ . As the “appropriate” emotional response will not always arise spontaneously, employees are required to suppress emotional reactions that are unsuitable for the job role (such as frustration and disgust) and display those (such as patience and empathy) that are more congruent2 . The concept of emotional labour is not confined to the work place: it invades every aspect of life.

Emotional Labour jobs include: 

• Customer-centric/service environments: salesmen, administrative Clerks, retail clerks, call centres, and food servers/wait staff.
• Helping professions: doctors, therapists, nurses, police, and firemen
• Media talent: radio, TV, and improvisation actors.

Definition: Emotional labour is a relatively new term, Arlie Hochschild first coined the term in her book, The Managed Heart’1.Hochschild,defined emotional labour as ‘the management of feeling to create a publicly observable facial and bodily ABSTRACT Nursing is a profession that requires extensive amount of emotional work. Nurses have to manage their feelings and expressions to fulfil the emotional requirement of job and their behaviour pass through emotional labour. This article explores the concept of emotional labour and discusses emotional labour in nursing and its effect on nurses. Emotional labour seems to be an underappreciated aspect of caring work.This article also addresses the prevention and management strategies of emotional labour. Key Words: Nursing, Emotional Labour RGUHS Journal of Nursing Sciences, June 2018 / Vol-8 / Issue-1 59 display; emotional labour is sold for wage and therefore has exchange value³ . 

Whenever a person alters their outward behaviour (emotions, verbal cues, body language) to confirm to an ideal something that every human does, it is emotional labour.

Basic characteristics of emotional labour

1.  Face-to-face or voice contact between employees and clients.
2. Expression of specific emotions and attitudes during work that might be in contrast with the real feelings that the individual experiences. 
3. The display rules derive from three main sources: a) Training programs for a particular profession, b) Organizational norms of work behaviour, c) Social stereotypes of behaviour for certain occupational categories⁴ .

Types of emotional labour: Service employees perform emotional labour using three acting techniques namely; Surface acting, Deep acting, Genuine acting 

Surface acting: Service providers employ surface acting when they alter their outward appearance to simulate the required emotions i.e. emotions that are not necessarily privately felt.

Deep acting: The second acting mechanism is “deep acting.” Deep acting occurs when employees change not only their physical expressions, but also their inner feelings. This can be done through imaging or recalling similar emotional experiences. 

Genuine acting: The last acting mechanism is “genuine acting.” Genuine acting occurs when employees’ felt emotions are congruent with expressed emotion and display rules²

Emotional labour in nursing

Nurses experience a lot of emotional labour as a part of their job. However, to deal with these emotions effectively one needs a high level of skill as well as honesty, tenacity and perseverance. Such a high degree of personal investment has both negative and positive effects.

• There are two elements that constitute nursing as one of the occupational categories high in emotional labour  Social representations of nurses. 
• The constant management and suppression of real feelings⁴ .

Nurse’s environment includes an enclosed atmosphere, timepressure, excessive noise or undue quiet, sudden swings fromintense to mundane tasks, no second chance, unpleasant sights andsounds, and long standing hours. In spiteof all these they are still expected to put on their “caring” face always⁴ .

This type of an atmosphere becomes a routine for them and it causes lot of stress. The chronic stress takes a toll on their health when there are additional stress factors like home stress, conflict at work, inadequate staffing, poorteamwork, inadequate training, and poor supervision. Their home life is disturbed due to night shifts, overtime, transport delays, and difficulty in getting leave. Worry about children and their studies notbeing properly supervised are common² .

Effects of emotional labour on nurses One of the prominent reasons for nurses’ stress is the display of a “caring” face. Emotional labour may also affect employees’ somatic health. Continuous suppression of “real”emotions has a negative impact on the immune system, with further implications on health, that range from sleeplessness and fatigue to hypertension and cancer⁴ .

The emotional dissonance between real and displayed emotions may influence negatively other aspects of employees’ well-being, such as self-esteem, alienation, cynicism, depression and moral distress.Emotional labour may also affect employee’s performance. Low involvement, dissatisfaction, low performance and high withdrawal intentions are among the various outcomes of performing emotional tasks^3,4

Student nurses also experience emotional labour that can affect their health and wellbeing.A study conducted to examine link between emotional labour and emotional exhaustion among student nurses showed a strong positive relationship between emotional labour and emotional exhaustion² . 

Rafaeli and Sutton proposed that there might be some situations in which performing emotional labour can bring positive consequences. They suggested that when expressed feelings are congruent with experienced emotions, employees are then experiencing “emotional harmony,” which is an indicator of good fit between person and job requirement³ . 

Prevention of emotional labour: Acting before the problem occurs or prevention is the best approach to deal with the emotional hurdles of nursing work.

Key to prevent emotional labour 

• Teaching nursing students about the practical and emotional aspects of their future work.
• Encouraging student nurses to evaluate their personal attitudes and behaviours in order to allow and help them to explore their interests, abilities and difficulties. 
• Promoting critical thinking. 
• Promote/Increase student’s clinical practice in order to help them understand more fully their future professional role. 
• Develop a nursing curriculum that includes problem-solving/ problem based learning.

Management of emotional labour

The core of good emotional labour management is making sure that emotional labour staff feel connected to their organization’s mission, their customers, their peers, their leaders and themselves. The connection should be professional, but emotionally authentic.

Screening for emotional labour abilities:Hire the right people by identifying employees whose values,background and personality match the job’s emotional labour requirement.

Allowing employees to vent: Employees who exert emotional labour often need to have an outlet to let off steam. Allowing employees to vent lets them get rid of their frustrations. If such venting is done in a group setting, it provides emotional support and encouragement, allows employees to see that others are experiencing the same problems, and delivers a message to employees that the company is aware of and acknowledges the emotional contribution that they have made⁶ .

Recovery: Recovery refers to process during which an individual’s functioning returns to its pre stressor level. Off job activities (e.g. playing a sport,going to gym) helps to recover from job stress and to replenish depleted resources^{5, 6}

Regular scheduled break: Offering regular scheduled breaks and time-out rooms where people can emotionally vent is necessary for the health and wellbeing of workers.

Stress management programs: Stress management programs that include learning about stress and stressors, the lifestyle choices that emotional Labourers can make such as diet, exercise and sleep and relaxation techniques such as yoga,meditation are useful⁷

Provide high quality and available employee assistance program: employee assistance programs can be conducted to provide psychological and life counselling which ultimately pay for the organisation in terms of increased productivity, reduced anti-social behaviour, lower health care costs, and reduced turnover.⁽⁷⁾

CONCLUSION

Emotional labour is a universal part of every job and of life. A person can act deep in a way tha the is connected with his or her core values and beliefs at work or surfaceact.The tendency to engage in surface acting,where there is a high level of inconginity between what people feel and what they show, either through faking or suppressing their emotion comes with real costs to the person and organisation.Empowering student nurses is the best method for preventing emotional labour. Hiring the right person for emotional laboured job, recovery, stress management program and employee assistance programs are some of the means for effective management of emotional labour.