Lökman, P., Gabriel, Y., & Nicolson, P. (2011). Hospital doctors' anxieties at work: Patient care as intersubjective relationship and/or as system output. International Journal of Organizational Analysis, 19(1), 29-48. (original) (raw)

Chapter 6 Emotional affects – developing understanding of healthcare organisation

Research on Emotion in Organizations, 2006

This paper looks at the current portrayal of emotion in healthcare as delivered within formal organisational settings, notably the UK National Health Service (NHS). Its purpose is to set out some examples of the problems and suggest new ways of conceptualising issues that will assist healthcare organisations in gaining a better understanding of the role of emotion and its impact, using appropriate examples. Developing understanding of the location of emotion and its differing constructions indicates that interdisciplinary and interpersonal boundaries differentiate interpretations of emotion, often for instrumental purpose as examples drawn particularly from the Public Inquiry into Paediatric Cardiology at Bristol Royal Infirmary (The Kennedy Report) demonstrate. The privileging of rationality over emotion as part of the dominant paradigm within the healthcare domain is shown to affect outcomes. However, the boundaries between organisations and individuals are changing, so are the location, access, technologies and timing of activities, and these are reconstructing healthcare organisation and the patient's experience of healthcare at both rational and emotional levels. It is suggested that in healthcare it is the patients' journey through their lives (the macro con-1 3 5 7

Project 08/1601/137 Leadership and Better Patient Care: Managing in the NHS Professor Paula Nicolson 1 , Ms. Emma Rowland 2 , Dr. Paula Lokman 1 , Dr. Rebekah Fox 3 , Professor Yiannis Gabriel 4 , Dr. Kristin Heffernan 5 , Mr. Chris Howorth 1, Ms. Yael Ilan-Clarke 1 , and Dr. Graham Smith 1 .

International Journal of Organizational Analysis, 2011

Purpose – The purpose of this paper is to examine how maternity doctors deal with anxieties generated through their interactions with patients. Design/methodology/approach – The authors juxtapose two critical stories, collected as part of a large mixed method field study of leadership and patient care in three UK hospitals. The study of “organizational stories” is particularly relevant in health care

Organizing emotions in health care

Journal of Health Organization and Management, 2005

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How do you feel doctor? An analysis of emotional aspects of routine professional medical work

Social Theory & Health, 2008

Although there has long been a fascination with the emotional responses of doctors to their everyday working lives within the popular media, this has not generally been matched by a parallel analytic interest within medical sociology. Indeed, in a recent paper published in this journal has argued that the discipline lacks much in the way of a compassionate appreciation of the lives of doctors. This paper explicitly responds to this observation by offering an analysis of the emotional aspects of routine professional medical work. This analysis is based upon qualitative interviews with 52 doctors working in the UK National Health Service (NHS) in England. The paper aims to provide an empathetic understanding of their views on, and responses to, their professional working lives. We are interested in how they 'feel' about being a doctor. The feelings they articulate are riven with ambivalence. We suggest that this is generated by a contextual tension which presumes that the medical profession are required to reproduce medicine as an abstract system -an objective, trustworthy, reliable, effective, competent and fair mode of healing -and yet individual practitioners are also required to be caring, emotionally intelligent, intuitive, and sensitive.

Introduction: Healthcare Practitioners’ Emotions and the Politics of Well-Being in Twentieth Century Anglo-America

Journal of the History of Medicine & Allied Sciences, 2023

From the stress of burnout to the gratification of camaraderie, medicine is suffused with emotions that educators, administrators, and reformers have sought to shape. Yet historians of medicine have only begun to analyze how emotions have structured health care work. This introductory essay frames a special issue on health care practitioners’ emotions in the twentieth-century United Kingdom and United States. We argue that the massive bureaucratic and scientific changes in medicine after the Second World War helped to reshape affective aspects of care. The articles in this issue emphasize the intersubjectivity of feelings in healthcare settings and the mutually constitutive relationship between patients’ and providers’ emotions. Bridging the history of medicine with the history of emotion demonstrates how emotions are instilled rather than innate, social as well as personal, and, above all else, change over time. The articles reckon with the power dynamics of healthcare. They address the policies and practices that institutions, organizations, and governments have implemented to shape, govern, or manage the affective experiences and well-being of healthcare workers. And they point to important new directions in the history of medicine.

“We've all had patients who've died …”: Narratives of emotion and ideals of competence among junior doctors

Social Science & Medicine, 2018

Although there is reasonably rich literature on socialisation in medical schools, few studies have investigated emotional socialisation among qualified doctors; specifically how specialist training reproduces the norms, values, and assumptions of medical culture. This article explores expressions and management of emotion in doctors' narratives of work and training for insights into how socialisation continues after graduation. The study employed qualitative methods-in-depth interviews-with fifty doctors at early and advanced stages of specialist training in teaching hospitals in Ireland. The study found that performance of competence, particularly for doctors at earlier training stages, required them to hide signs of struggle and uncertainty. Competence was associated with being emotionally tough, which involved hiding emotional vulnerability; however, some challenged the assumption that doctors should be able to transcend emotionally painful events. Tensions between this expression of competence and making time for self-care meant that the latter was often neglected. Some participants highlighted how they enjoyed more personal interactions with patients, which was juxtaposed with the expectation of being detached and an associated potential to objectify patients. This theme resonates with recent debates on "appropriate" expressions of empathy and its implications for patient-doctor relationships. The article discusses how ideas underpinning the image of medical invincibility should be questioned as part of efforts to reform medical culture and in the training of specialists in emotional wellbeing and self-care.

Emotions of Medical Personnel versus the Status and Power at Work in Hospital Wards

Przegląd Socjologii Jakościowej, 2021

The hospital is characterized by one of the most formalized structures with a strict division of tasks and responsibilities. An essential element of any formal organization is the system of authorities and power. There is a hierarchy and a system of power between hospital departments and within each of them. This hierarchy structure overlaps with the level of power and status felt and perceived by each employee, which implies the emergence of specific emotions. They influence interactions, shaping their course. When describing emotions in the context of power and status, I will refer to Theodore Kemper’s concept that interactions and changes in the relative power and status (prestige) of individuals have an impact on arousing both negative and positive emotions. The aim of this article is to show how an individually-determined level of power and status can shape relations between employees, their methods of communication, and emotions in the workplace. The paper answers the question...

Leading change in health care: the challenge of anxiety

Leadership in Health Services, 2021

Purpose The purpose of this paper is to identify the centrality of anxiety in health care, especially in the context of leading change. It identifies the importance of emotional labour for clinical professionals and the resultant development of defensive routines. The idea of containment is central to addressing anxiety. Design/methodology/approach The approach involves identification of anxiety as a key factor in leading change in health care, but one which is often ignored. Findings Anxiety is the elephant in the room vis-a-vis leading change in health care. To address the use of defensive routines, a range of activities can act as “containers” for anxiety and help with leading change. Practical implications To lead change in health care implies addressing the existence and importance of anxiety and the emotional labour which health-care professionals undertake. Originality/value The existence of anxiety and the profound impact it has on leading change in health care has typically...