The Emotional Labour of Nursing Can Nurses Still Care?

by Smith, Pam

• ISBN13: 9780230202627
• ISBN10: 0230202624
• Edition: 2nd
• Format: Paperback
• Copyright: 2012-01-15
• Publisher: Palgrave Macmillan

Summary

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?

Author Biography

Pam Smith is 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	p. ix
Acknowledgements	p. x
Preface	p. xi
Foreword	p. xiv
Introduction	p. 1
'The little things'	p. 1
What is care?	p. 10
The emotional labour of care	p. 12
Emotional labour and emotional intelligence	p. 15
Nursing and care	p. 16
The body-mind dichotomy	p. 18
The politics of care	p. 20
Emotional labour costs	p. 23
Everybody's ideal	p. 26
The nurse as emotional labourer	p. 27
Putting their toe in the water: selecting, testing and expecting nurses to care	p. 30
Research subjects, settings and methods	p. 30
The 1984 study	p. 30
The need for a new study in the 2000s	p. 31
Who train as nurses?	p. 32
1984-1985	p. 32
2006-2008	p. 32
Ward learning environment questionnaire respondents	p. 32
Demographic characteristics	p. 32
Educational qualifications	p. 33
Programme and year of study	p. 33
'Too posh to wash'	p. 34
Recruitment and retention	p. 35
The job prospectus	p. 35
Selection procedures	p. 39
1984-1985	p. 39
2006-2008	p. 42
Standing up in the NHS environment	p. 44
Methods of testing and assessment to ensure students are 'up to standard'	p. 48
The role of the mentor/assessor	p. 48
Meeting with the mentor/assessor in practice to review progress	p. 49
Mentor/assessor's assessment of and statement of achievement	p. 49
In Nightingale's image	p. 51
1980s style	p. 51
Perspectives for the 2000s	p. 53
Summary	p. 54
Nothing is really said about care: defining nursing knowledge	p. 56
The impact of policy on nurse education and the nursing workforce	p. 57
Caring not nursing, working not learning	p. 58
The content of nurse training	p. 64
City Hospital in the 1980s	p. 64
The NHS in the 2000s	p. 66
The curriculum in four case study sites	p. 67
Linking theory and practice	p. 68
Mentoring systems and training	p. 70
Supernumerary status	p. 70
Student support	p. 70
Implementing the 'Living Curriculum'	p. 71
The 1980s	p. 71
Nursing process: philosophy, conceptual device or work method?	p. 72
The 2000s	p. 72
Affective/psychosocial nursing and learning to do emotional labour	p. 73
Patient-nurse perceptions: first-year students	p. 73
Critical incidents: third-year students	p. 75
The psychiatric nursing module	p. 76
Informal training for people work: feeling rules and emotion management	p. 77
Learning to communicate and emotion management: patients' views	p. 79
Patients' views: 2000	p. 80
Summary	p. 81
The 1980s	p. 81
The 2000s	p. 82
You learn from what's wrong with the patient: defining nursing work	p. 84
You learn from what's wrong with the patient: how medical specialities legitimize nursing work	p. 85
Recognizing emotion work	p. 91
The 1980s	p. 91
The 2000s	p. 93
When the feelings don't fit	p. 94
There are some patients you'd rather nurse than others: issues of age, gender and race - then and now	p. 99
When emotional labour is the work: the case of violent patients	p. 102
The 1980s	p. 102
The 2000s	p. 103
Dispelling the stereotypes: issues of race	p. 104
The 1980s	p. 104
The 2000s	p. 105
Summary	p. 106
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	p. 108
Everybody's ideal: characteristics of ward sisters and nurses	p. 109
Producing and reproducing emotional labour in the ward	p. 112
Reproducing emotional labour, management styles and the nursing process	p. 114
The ward learning environment in 2006-2008	p. 119
Managers and mentors	p. 119
From ward sister to ward manager: who sets the emotional tone?	p. 124
The changing infrastructure of emotional labour and learning in the 2000s	p. 126
Summary	p. 130
Death and dying in hospital: the ultimate emotional labour	p. 132
Introduction	p. 132
Defining death and dying in hospitals in the 1980s	p. 132
Feelings about death and dying	p. 134
Death's unpredictability	p. 135
Packaging death	p. 136
'You knew exactly what to do': a death well managed	p. 137
The technical and emotional labour of death	p. 138
Death and bereavement	p. 140
The role of the hierarchy in managing death	p. 144
Facing death and dying in the 2000s	p. 144
Death and dying - still the ultimate emotional labour	p. 147
Students' stories in the 2000s	p. 149
'No one to help when your first patient dies'	p. 149
'Talking and cups of tea'	p. 150
'I'd never done care work before'	p. 151
New ways of packaging death	p. 152
Caring not nursing	p. 153
Summary	p. 154
The caring trajectory: caring styles and capacity over time	p. 156
The student nurse trajectory in the 1980s	p. 158
First-year students: 'so good to have around'	p. 159
Third-year students: 'the blues time'	p. 163
Reflections for the 2000s	p. 164
Personal emotion work	p. 164
Being thrown in at the deep end	p. 165
Caring factors	p. 170
Ward management styles: recognizing or repressing individuality	p. 170
Ward management styles: recognizing the student's learning role	p. 175
Personal support	p. 176
The caring-learning relationship and emotional labour	p. 177
Emotional labour: styles and strategies	p. 178
The 1980s	p. 178
The 2000s	p. 181
Conclusions	p. 183
Concepts of care and emotional labour	p. 183
At what cost care?	p. 187
The future of nursing theory and practice	p. 189
Agenda for Change	p. 189
Modernising nursing careers	p. 190
Maintaining morale and wellbeing	p. 191
Emotions, experiential learning and new knowledge	p. 192
The disappearing ward sister	p. 195
Death and dying in hospital: still the ultimate emotional labour	p. 196
Facilitating caring trajectories	p. 197
The effects of emotional care on patient outcomes	p. 199
Notes	p. 204
References	p. 214
Index	p. 225
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