The Emotional Labour of Nursing Revisited: Can Nurses Still Care?

The Emotional Labour of Nursing Revisited: Can Nurses Still Care?

by Pam Smith

Paperback(2nd ed. 2011)

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As nurses become responsible for increasingly technical service delivery, has
the profession lost its focus on the emotional and human aspects of the role?
Do care and compassion remain at the heart of contemporary nursing practice?

In this major reworking of a classic text, respected author Pam Smith emphasizes
the continued relevance of emotional labour within the modern healthcare
context. Revisiting her original findings in light of fresh theoretical perspectives
and data drawn from her own new research studies, Smith explores the ways
in which the experience of learning nursing and caring is changing in the twentyfirst

A vivid example of the significance of nursing's evidence base, this timely new
addresses the most emotionally challenging aspects of the nursing role,
including encountering death and dying on the ward;
examines the impact of race, age, gender and violence in providing patientcentred
interrogates the importance of the role of practice educators and mentors in
practice settings.

An inspiring text for the next generation of nurses, The Emotional Labour of
Nursing Revisited is an essential read for anyone interested in the contemporary
challenges of keeping the whole person at the centre of their practice.

Product Details

ISBN-13: 9780230202627
Publisher: Macmillan Education UK
Publication date: 01/15/2012
Edition description: 2nd ed. 2011
Pages: 248
Product dimensions: 6.10(w) x 9.10(h) x 0.70(d)

About the Author

PAM SMITHis Professor of Nurse Education and Head of Nursing Studies in the School of Health in Social Science at the University of Edinburgh, UK. As the General Nursing Council (GNC) Trust Endowed Chair in Nurse Education, she held the post of Director of the Centre for Research in Nursing and Midwifery Education at the University of Surrey, UK from 2002 to 2009.

Table of Contents

List of Illustrations ix

Acknowledgements x

Preface xi

Foreword xiv

1 Introduction 1

'The little things' 1

What is care? 10

The emotional labour of care 12

Emotional labour and emotional intelligence 15

Nursing and care 16

The body-mind dichotomy 18

The politics of care 20

Emotional labour costs 23

Everybody's ideal 26

The nurse as emotional labourer 27

2 Putting their toe in the water: selecting, testing and expecting nurses to care 30

Research subjects, settings and methods 30

The 1984 study 30

The need for a new study in the 2000s 31

Who train as nurses? 32

1984-1985 32

2006-2008 32

Ward learning environment questionnaire respondents 32

Demographic characteristics 32

Educational qualifications 33

Programme and year of study 33

'Too posh to wash' 34

Recruitment and retention 35

The job prospectus 35

Selection procedures 39

1984-1985 39

2006-2008 42

Standing up in the NHS environment 44

Methods of testing and assessment to ensure students are 'up to standard' 48

The role of the mentor/assessor 48

Meeting with the mentor/assessor in practice to review progress 49

Mentor/assessor's assessment of and statement of achievement 49

In Nightingale's image 51

1980s style 51

Perspectives for the 2000s 53

Summary 54

3 Nothing is really said about care: defining nursing knowledge 56

The impact of policy on nurse education and the nursing workforce 57

Caring not nursing, working not learning 58

The content of nurse training 64

City Hospital in the 1980s 64

The NHS in the 2000s 66

The curriculum in four case study sites 67

Linking theory and practice 68

Mentoring systems and training 70

Supernumerary status 70

Student support 70

Implementing the 'Living Curriculum' 71

The 1980s 71

Nursing process: philosophy, conceptual device or work method? 72

The 2000s 72

Affective/psychosocial nursing and learning to do emotional labour 73

Patient-nurse perceptions: first-year students 73

Critical incidents: third-year students 75

The psychiatric nursing module 76

Informal training for people work: feeling rules and emotion management 77

Learning to communicate and emotion management: patients' views 79

Patients' views: 2000 80

Summary 81

The 1980s 81

The 2000s 82

4 You learn from what's wrong with the patient: defining nursing work 84

You learn from what's wrong with the patient: how medical specialities legitimize nursing work 85

Recognizing emotion work 91

The 1980s 91

The 2000s 93

When the feelings don't fit 94

There are some patients you'd rather nurse than others: issues of age, gender and race - then and now 99

When emotional labour is the work: the case of violent patients 102

The 1980s 102

The 2000s 103

Dispelling the stereotypes: issues of race 104

The 1980s 104

The 2000s 105

Summary 106

5 The ward sister and the infrastructure of emotion work: making it visible on the ward- from ward sister to ward manager and the role of the mentor 108

Everybody's ideal: characteristics of ward sisters and nurses 109

Producing and reproducing emotional labour in the ward 112

Reproducing emotional labour, management styles and the nursing process 114

The ward learning environment in 2006-2008 119

Managers and mentors 119

From ward sister to ward manager: who sets the emotional tone? 124

The changing infrastructure of emotional labour and learning in the 2000s 126

Summary 130

6 Death and dying in hospital: the ultimate emotional labour 132

Introduction 132

Defining death and dying in hospitals in the 1980s 132

Feelings about death and dying 134

Death's unpredictability 135

Packaging death 136

'You knew exactly what to do': a death well managed 137

The technical and emotional labour of death 138

Death and bereavement 140

The role of the hierarchy in managing death 144

Facing death and dying in the 2000s 144

Death and dying - still the ultimate emotional labour 147

Students' stories in the 2000s 149

'No one to help when your first patient dies' 149

'Talking and cups of tea' 150

'I'd never done care work before' 151

New ways of packaging death 152

Caring not nursing 153

Summary 154

7 The caring trajectory: caring styles and capacity over time 156

The student nurse trajectory in the 1980s 158

First-year students: 'so good to have around' 159

Third-year students: 'the blues time' 163

Reflections for the 2000s 164

Personal emotion work 164

Being thrown in at the deep end 165

Caring factors 170

Ward management styles: recognizing or repressing individuality 170

Ward management styles: recognizing the student's learning role 175

Personal support 176

The caring-learning relationship and emotional labour 177

Emotional labour: styles and strategies 178

The 1980s 178

The 2000s 181

8 Conclusions 183

Concepts of care and emotional labour 183

At what cost care? 187

The future of nursing theory and practice 189

Agenda for Change 189

Modernising nursing careers 190

Maintaining morale and wellbeing 191

Emotions, experiential learning and new knowledge 192

The disappearing ward sister 195

Death and dying in hospital: still the ultimate emotional labour 196

Facilitating caring trajectories 197

The effects of emotional care on patient outcomes 199

Notes 204

References 214

Index 225

What People are Saying About This

From the Publisher

This is an excellent text, timely and much needed in health care today. It was such a pleasure to read a very important contribution to nursing knowledge and I'm sure that so many nurses and health care workers would benefit from reading it. I suggest it should be core reading on all health care programmes, especially nursing.' - Dr D.M. Mazhindu, Senior Research Fellow, Faculty of Health and Applied Social Science, Liverpool John Moores University, UK

''An extremely well presented text which offers a great breadth of discussion, drawn from a robust evidence base. This is a book that I would imagine students and post registered staff referring back to time and time again.' - Brigid Purcell, Senior Lecturer, University of Huddersfield, UK

""This book has many [highlights]…but it has an important message to pass on - emotional labour takes its toll…At times it is uncomfortable and difficult reading but thought provoking and necessary…Smith raises some salient points regarding how we teach and support nurses, the importance ward structures and supportive environments play in encouraging our workforce." - Nursing Times

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