There is a profound need to bridge the gap between medical and emotional aspects of care. The aim of this paper was to develop a health-care model of emotional labor that could be used to help health-care managers’ better deal with the causes and consequences of emotional labor for staff and patients. It has been shown that emotional labor is a crucial part of the role of many health care professionals, especially nurses, and that these skills are not adequately taught within health-care education programmers. Similarly, the stress and effects of mental health of emotional labor performance have also not been sufficiently acknowledged or addressed. Specific recommendations from this review include the following: The study of emotional labor should be widened to include other professions outside of nursing such as doctors, counselors, clinical psychologists and other health-care providers.




Initiatives leading to changes in the organization of care in recent years may inadvertently affect the levels of emotional labor performed by care workers and this should be considered when considering future policies. For example, a drive to provide “continuity of care” from midwifes in the Department of Health’s Changing Childbirth report (1993) may have important implications for a midwife’s personal life that can result in increased emotional labor as they attempt to juggle home and work roles. This leads to the issue of the effects of emotional labor on the laborer which has been outlined in detail earlier in this paper.



This seems to reflect little change from the views of student nurses in 1992 who suggest that the skills needed to perform emotional labor are most frequently learnt informally in the workplace (Smith, 1992). This suggests that placements and other in situ elements of the training process are the best place to learn the emotional requirements of the job. Another suggestion is offered by McCreight who notes that training for gynecological nurses which involved visits from bereaved parents was regarded as very helpful in helping nurses see things from the patient’s perspective; this idea of “patient-centered” emotional skills training could be delivered across a wider range of disciplines; recovered patients, for example, could attend formal training days to share their experiences on the emotional aspect of the care delivery.




Acknowledgement of the role of emotions in terms of education within health-care training certainly appears to be patchy, with some provision better than others. A gynecological nurse in Northern Ireland comments in McCreight’s recent paper that she was not given guidance on dealing either with her own or her patient’s emotions and consequently felt that she was inadequately prepared for a part of her job that is central to her role; for example, nurses were trained in recognizing symptoms of miscarriage as well as appropriate forms of medical intervention, but not in the emotional aspects of such incidents.



The aim of health-care managers in respect of emotional labor must be to attempt to reduce its negative consequences whilst retaining the positive outcomes for both patient and career. There are thus two parts of the model where input from managers would be most valuable. First, at the “emotional labor inducing event” stage; what can health-care managers do to reduce either the number or impact of such events? Second at the “outcomes” stage; what can they do to moderate the negative consequences of emotional labor performance? The answer to both questions must lie within the range of educational and training initiatives currently offered to health careers.




An examination of the literature reveals very little in the way of causal frameworks or models of the origins, consequences or moderators of emotional labor. One model, that of Harris (2002) that has been proposed is in the specific context of barristers and suggests a framework of the origins, content and consequences of emotional labor for barristers. Within this model, origins include “structural change”, “audience expectations”, “occupational acculturation”, “self-image” and “nature of the work”. These contribute to either private (during interactions with solicitors, barristers and court clerks) or public (during interactions with clients, witnesses and judges) emotional labor, or to emotional suppression.



Another study that has examined emotional labor outside of the nursing arena involved assessing the degree to which clinical psychologists performed emotional labor during patient sessions. Using a questionnaire the study revealed that 80 per cent of patient interactions involved the performance of emotional labor by the clinical psychologists (Mann and Jones, 1996). Clearly, although studies examining emotional labor outside of the nursing professions are rare, the evidence that there suggests that emotion management is just an important part of these health-care settings and should be considered just as much within healthcare management.


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