An exploration of emotional labour and emotion work in emergency pre-hospital care

WILLIAMS, ANGELA

doi:10.23889/SUthesis.58634

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An exploration of emotional labour and emotion work in emergency pre-hospital care / ANGELA WILLIAMS

Swansea University Author: ANGELA WILLIAMS

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DOI (Published version): 10.23889/SUthesis.58634

Abstract

This thesis explores emotional labour and emotion work in the context of the emergency ambulance service. The emergency medical service (EMS) provides constant response to life threatening situations and complex health care issues in the pre-hospital care setting. The emotional challenges of this ty...

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Published:	Swansea 2021
Institution:	Swansea University
Degree level:	Doctoral
Degree name:	Ph.D
Supervisor:	Coffey, Michael ; Hughes, David
URI:	https://cronfa.swan.ac.uk/Record/cronfa58634

first_indexed	2021-11-12T14:59:05Z
last_indexed	2021-11-13T04:25:42Z
id	cronfa58634
recordtype	RisThesis
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Hochschild’s theory on emotional labour (1983, 2003) and Goffman’s (1959) dramaturgical concepts of front stage and backstage are utilised, supplemented with features of discourse and conversational analysis. An ethnographic approach involving 280 hours of participant observation over a 10-month period and 24 in-depth interviews with EMS crews in one busy, urban, inner city ambulance station serving a large geographical area in the UK has been utilised to explore the emotional challenges of this work and the local ways of dealing with these. The study findings suggest that EMS crews appraise and categorise their front stage work in positive and negative ways. Positive calls are expressed through local descriptors such being able to ‘make a difference’ and perceived ‘genuine’ need for the EMS and appear alongside emotions such as excitement which some crews suggested helped them deal with the more mundane types of work. Negative call appraisal was associated with questions of legitimacy of need for emergency assistance and predicated on normative ideologies. Crews constructed and populated categories displaying features of identity work, moral work and “negotiated order” (Strauss, Schatzman, Ehrlich, Bucher, & Sabshin, 1963), mobilizing their perceptions of the role of the EMS and the kind of work they should be doing. Negative categorisation was associated with frustration necessitating emotional labour by crews in the disguise and suppression of emotion and appeared to influence the interactions between them and patients. The backstage setting in the form of the crew room was a central, regular, social gathering point where frontline frustrations were shared and processed through moaning, complaining, talking and humour. The crew room was a setting to talk to each other about difficult calls; where reflection was verbalized in questioning if they had done the ‘right’ thing and where reassurance was sought from colleagues. The reflexivity displayed by crews in the backstage setting appeared to emphasise positive affirmations rather than challenge and contributed to a sense of group identity. This thesis offers new understandings of the challenges of the frontline EMS role, emotional labour and emotion work and drawing on participant observation, offers tentative implications these appear to have for crews’ interactions with those who use the service. The backstage context and behaviours represent local ways in which frontline role challenges appear to be expressed and managed from the perspective of those who are directly involved in it. The findings of this thesis offer unique contributions to the theory of emotional labour and emotion work in the emergency pre-hospital care context. 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spelling	2021-11-12T15:16:38.0593273 v2 58634 2021-11-12 An exploration of emotional labour and emotion work in emergency pre-hospital care a3405900920699861fcd4c4e5303f213 ANGELA WILLIAMS ANGELA WILLIAMS true false 2021-11-12 This thesis explores emotional labour and emotion work in the context of the emergency ambulance service. The emergency medical service (EMS) provides constant response to life threatening situations and complex health care issues in the pre-hospital care setting. The emotional challenges of this type of health care work in the context of high demand is a crucial, though somewhat neglected area of research attention. Hochschild’s theory on emotional labour (1983, 2003) and Goffman’s (1959) dramaturgical concepts of front stage and backstage are utilised, supplemented with features of discourse and conversational analysis. An ethnographic approach involving 280 hours of participant observation over a 10-month period and 24 in-depth interviews with EMS crews in one busy, urban, inner city ambulance station serving a large geographical area in the UK has been utilised to explore the emotional challenges of this work and the local ways of dealing with these. The study findings suggest that EMS crews appraise and categorise their front stage work in positive and negative ways. Positive calls are expressed through local descriptors such being able to ‘make a difference’ and perceived ‘genuine’ need for the EMS and appear alongside emotions such as excitement which some crews suggested helped them deal with the more mundane types of work. Negative call appraisal was associated with questions of legitimacy of need for emergency assistance and predicated on normative ideologies. Crews constructed and populated categories displaying features of identity work, moral work and “negotiated order” (Strauss, Schatzman, Ehrlich, Bucher, & Sabshin, 1963), mobilizing their perceptions of the role of the EMS and the kind of work they should be doing. Negative categorisation was associated with frustration necessitating emotional labour by crews in the disguise and suppression of emotion and appeared to influence the interactions between them and patients. The backstage setting in the form of the crew room was a central, regular, social gathering point where frontline frustrations were shared and processed through moaning, complaining, talking and humour. The crew room was a setting to talk to each other about difficult calls; where reflection was verbalized in questioning if they had done the ‘right’ thing and where reassurance was sought from colleagues. The reflexivity displayed by crews in the backstage setting appeared to emphasise positive affirmations rather than challenge and contributed to a sense of group identity. This thesis offers new understandings of the challenges of the frontline EMS role, emotional labour and emotion work and drawing on participant observation, offers tentative implications these appear to have for crews’ interactions with those who use the service. The backstage context and behaviours represent local ways in which frontline role challenges appear to be expressed and managed from the perspective of those who are directly involved in it. The findings of this thesis offer unique contributions to the theory of emotional labour and emotion work in the emergency pre-hospital care context. These have implications for the inclusion of the concepts of emotional labour and emotion work in pre- and post-registration paramedic curricula, organisational recognition of the emotional demands of emergency ambulance work and staff support and for further research into the emotional challenges of this type of work. E-Thesis Swansea Emotional labour, emotion work, pre-hospital, emergency care, ethnography, negotiated order 12 11 2021 2021-11-12 10.23889/SUthesis.58634 COLLEGE NANME COLLEGE CODE Swansea University Coffey, Michael ; Hughes, David Doctoral Ph.D Swansea University 2021-11-12T15:16:38.0593273 2021-11-12T14:54:47.0749499 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing ANGELA WILLIAMS 1 58634__21514__513275d0b4ad4e88873624723feb43b5.pdf Williams_Angela_PhD_Thesis_Final_Redacted_Signature.pdf 2021-11-12T15:09:22.0631007 Output 3114657 application/pdf E-Thesis – open access true Copyright: The author, Angela Williams, 2021. true eng
title	An exploration of emotional labour and emotion work in emergency pre-hospital care
spellingShingle	An exploration of emotional labour and emotion work in emergency pre-hospital care ANGELA WILLIAMS
title_short	An exploration of emotional labour and emotion work in emergency pre-hospital care
title_full	An exploration of emotional labour and emotion work in emergency pre-hospital care
title_fullStr	An exploration of emotional labour and emotion work in emergency pre-hospital care
title_full_unstemmed	An exploration of emotional labour and emotion work in emergency pre-hospital care
title_sort	An exploration of emotional labour and emotion work in emergency pre-hospital care
author_id_str_mv	a3405900920699861fcd4c4e5303f213
author_id_fullname_str_mv	a3405900920699861fcd4c4e5303f213_***_ANGELA WILLIAMS
author	ANGELA WILLIAMS
author2	ANGELA WILLIAMS
format	E-Thesis
publishDate	2021
institution	Swansea University
doi_str_mv	10.23889/SUthesis.58634
college_str	Faculty of Medicine, Health and Life Sciences
hierarchytype
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hierarchy_top_title	Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id	facultyofmedicinehealthandlifesciences
hierarchy_parent_title	Faculty of Medicine, Health and Life Sciences
department_str	School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
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description	This thesis explores emotional labour and emotion work in the context of the emergency ambulance service. The emergency medical service (EMS) provides constant response to life threatening situations and complex health care issues in the pre-hospital care setting. The emotional challenges of this type of health care work in the context of high demand is a crucial, though somewhat neglected area of research attention. Hochschild’s theory on emotional labour (1983, 2003) and Goffman’s (1959) dramaturgical concepts of front stage and backstage are utilised, supplemented with features of discourse and conversational analysis. An ethnographic approach involving 280 hours of participant observation over a 10-month period and 24 in-depth interviews with EMS crews in one busy, urban, inner city ambulance station serving a large geographical area in the UK has been utilised to explore the emotional challenges of this work and the local ways of dealing with these. The study findings suggest that EMS crews appraise and categorise their front stage work in positive and negative ways. Positive calls are expressed through local descriptors such being able to ‘make a difference’ and perceived ‘genuine’ need for the EMS and appear alongside emotions such as excitement which some crews suggested helped them deal with the more mundane types of work. Negative call appraisal was associated with questions of legitimacy of need for emergency assistance and predicated on normative ideologies. Crews constructed and populated categories displaying features of identity work, moral work and “negotiated order” (Strauss, Schatzman, Ehrlich, Bucher, & Sabshin, 1963), mobilizing their perceptions of the role of the EMS and the kind of work they should be doing. Negative categorisation was associated with frustration necessitating emotional labour by crews in the disguise and suppression of emotion and appeared to influence the interactions between them and patients. The backstage setting in the form of the crew room was a central, regular, social gathering point where frontline frustrations were shared and processed through moaning, complaining, talking and humour. The crew room was a setting to talk to each other about difficult calls; where reflection was verbalized in questioning if they had done the ‘right’ thing and where reassurance was sought from colleagues. The reflexivity displayed by crews in the backstage setting appeared to emphasise positive affirmations rather than challenge and contributed to a sense of group identity. This thesis offers new understandings of the challenges of the frontline EMS role, emotional labour and emotion work and drawing on participant observation, offers tentative implications these appear to have for crews’ interactions with those who use the service. The backstage context and behaviours represent local ways in which frontline role challenges appear to be expressed and managed from the perspective of those who are directly involved in it. The findings of this thesis offer unique contributions to the theory of emotional labour and emotion work in the emergency pre-hospital care context. These have implications for the inclusion of the concepts of emotional labour and emotion work in pre- and post-registration paramedic curricula, organisational recognition of the emotional demands of emergency ambulance work and staff support and for further research into the emotional challenges of this type of work.
published_date	2021-11-12T14:10:41Z
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score	10.947329

An exploration of emotional labour and emotion work in emergency pre-hospital care / ANGELA WILLIAMS

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