Emotionally demanding

In our personal and professional lives, we all must manage our emotions, and this often means bringing them in line with society’s unspoken rules and expectations.

The sociologist Arlie Hochschild, who wrote the pioneering work on emotional labour – The Managed Heart – underlined that it is important, hard, skilled work requiring experience, but it’s often an unrecognised part of employment.

Hochschild also wrote about how we as individuals manage our emotions in two main ways, by deep acting and surface acting. Surface acting refers to how we outwardly appear to others – we often talk about putting on a mask at work. 

Our most recent employment survey explored emotional labour and its impact on nursing staff. Just over half (52%) of the respondents agreed that they regularly or always show feelings in their job which are different to what they are feeling inside.

One agency nurse told us: “I don’t need to work hard to feel for people in my care, but I do work hard to leave my own needs and feelings at the door and pick them up again on the way out.”

It’s a feeling many can relate to.

Meanwhile, deep acting involves attempting to regulate our inner feelings in order to actually feel what we are displaying. Again, this is illustrated in the survey findings – a third of respondents stated that they regularly or always work hard to feel the emotions they need to show in their job.

One GP practice nurse said: “Despite often feeling the pressures of the job for the sake of patients I always strive to show compassion, dedication and enthusiasm within my working day.”

So why does this matter?

Dealing with emotions is an intrinsic part of many jobs, and particularly nursing. Yet it is nursing’s deep identification with caring that can make working in health and social care today an alienating and often frustrating experience.

Our biennial employment surveys consistently show that it is staff shortages, lack of time and managerial processes that many nurses and support staff feel are the major barriers to being able to do their job properly. 

On the one hand, caring and compassion are important attributes of nursing, but on the other hand, the pace of work all too often takes precedence.

As one staff nurse working in a care home expressed: “Looking after patients with dementia is stressful and demanding, but requires you show constant patience and kindness. It takes huge strength to keep showing this when you are constantly under huge stress and pressure from low staffing levels.”

We also know when our cognitive powers are drained by emotional demands, we are more likely to make mistakes, or take longer to do our work.

And when we are stressed out by the demands of surface acting, we are more prone to depression and anxiety, decreased job performance, and burnout. 

What can we do about it?

Respondents offered a range of suggestions for dealing with the emotional demands of nursing. Senior and more experienced nurses highlighted the importance of building a strong team culture and being available and approachable to other colleagues to talk through difficult issues. 

Other respondents described how debriefs, peer support and initiatives such as Schwartz Rounds can help with supporting emotional needs.

But real support must go beyond individual solutions towards a broader recognition that emotional labour is both a role requirement and a valued component of nursing. And this needs to be understood and properly supported in management practice.