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Monday, November 29, 2021  

Emotional Labor: A Timely Concept for NursesPublished 6/15/2004

My partner and I both work in the health care field. For 8+ hours a day, Monday through Friday, we interface with people in their suffering, despair, rage, denial,frailty, and often depression. My area is geriatric nursing, his is C.T. radiography.

One night, after a particularly difficult week, we half-jokingly thought up an invention that would make our work easier: a machine that would automatically make empathic sounds, sense our patients’ emotional needs, and supply the requisite (genuine-sounding) response. I like being empathic, but I suffer a kind of repetitive motion strain, the repetitive ‘e-motion’ of pulled heart strings. Within the fast-paced industrial model of health care, there is a near constant need for emotion on demand. In much the same way that my wrists get stiff and sore, my emotions get worn out by the work I do. It therefore pleased me to learn recently that the concept of emotional labor is receiving air time in nursing circles. The American Nurses’ Association had an article published on their website just this past March, " Emotional vs. Physical Labor: The Demand of Using Emotions as a Job Duty," by A. B. de Castro, senior staff specialist at the ANA Center for Occupational Health and Safety. Castro writes that " Although emotional labor may not be explicitly stated in a nursing job description, the implicit requirement exists. Consequently, the impact of emotional labor on nurses’ well-being is not fully realized appreciated. Nurses must recognize how they may be adjusting or altering their emotions or expressions to meet organizational expectations or the needs of others…" (AJN, March 2004;

Emotional labor can indeed amount to an occupational health hazard. Castro cites Arlie Hochschild, the sociologist who first pioneered the concept and documented the phenomenon of emotional labor in the book, The Managed Heart: Commercialization of Human Feeling. The extent of the issue is such that a researcher studying this phenomenon testified before the U.S. House of Representatives on the topic, "Emotional labor, burnout, and the nationwide nursing shortage," (Managed Heart, 2003 edition, p. 202). The way I see it, burnout is the emotional equivalent of carpel tunnel syndrome.

It’s a job hazard to be on the frontlines in health care (or in the trenches, as they say) for a number of reasons. In addition to helping vulnerable persons in their time of need, patients and families sometimes unleash misdirected aggression and frustration at nurses. Such ‘episodes’ can occur at any time, just like a landmine exploding out of nowhere. We can try and justify it any way we want, but emotional abuse is abuse is abuse. According to Hochschild, nurses and other workers who lack (or historically lacked) status, do not have what she calls a ‘status shield’ that might protect against unrestrained anger or obnoxiousness. In other words, the husband that did not get angry at the neuropsychiatrist who diagnosed his wife with Alzheimer’s, might easily misplace anger about the diagnosis onto me. Because females have historically lacked status, female nurses might in general be more vulnerable to abuse. Still, I know many men on the frontlines who get their share of misplaced anger.v

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