Emotional Labor During Disruptive Times: a Collective Responsibility Imbalance Image by Asian Development Bank is licensed under CC BY-NC-ND 2.0 https://creativecommons.org/licenses/by-nc-nd/2.0/

Emotional Labor During Disruptive Times: a Collective Responsibility Imbalance

Society will always be grateful for medical workers because saving the most lives possible became their priority during the crises produced by COVID-19. The sacrifices made, the dilemmas faced, the efforts invested in curbing the pandemic have been documented by journalists and academics and should not be forgotten so soon. Nevertheless, it is still important to draw attention to other aspects of their practice during the pandemic, especially in contexts with high damage and challenging conditions. Knowledge on these situations can help inform policy and managerial decisions in the future. The circumstances and consequences of performing or not performing emotional labor during the pandemic, for example, need to be considered extensively.

Emotional labor is a choice to regulate emotions and show them according to organizational expectations. There is a public interest aspect to emotional labor, and it is very important during a crisis. In such moments police officers might need to project anger, empathy, or fear to elicit compliance from citizens. Doctors and paramedics might choose to portray neutrality to avoid negative emotional contagion to patients at risk. Nurses might want to use a variety of emotions to convince patients to consent to emergency treatments they fear. Treating patients humanely requires emotional labor, especially when working is dangerous, stressful, and exhausting. Securing a team of frontline workers that maintains a high morale also needs emotional labor, both to hide feelings that might conflict with such goal, or to inspire, for instance, hope.

A recent study on how this aspect of medical practice fared in Mexico during the COVID-19 crisis showed that some public hospitals faced disruptive conditions. The need to reorganize turned employees without emergency training into frontline responders. By collecting stories of those involved and using an interpretive method, the study highlighted that using protective equipment to interact inside COVID-19 units radically changed the way emotional labor was performed. Physical barriers deprived people of some of the means most used to convey (or hide) feelings. Facial and other bodily expressions were not visible. Holding hands and the occasional touch on the shoulder to convey solidarity became impossible. Physical barriers hampered communication and contributed to creating an atmosphere of fear exactly when saturated hospitals could have benefited from calm.

Making decisions that could have produced dissonance and stress, as well as facing death more frequently than ever, pushed some to stop doing emotional labor. Burnout and psychiatric disorders were frequently signaled as its causes or consequences. This puzzling finding calls for further study. Literature suggests performing emotional labor leads to burnout considering some moderators. Less is known of situations when burnout caused by different factors makes workers stop regulating emotions in organizationally acceptable ways.

One of the most interesting lessons that can be learned from the stories collected for the study is that: facing a crisis, people are capable of resilience, adaptation, and hope. Not all workers reached exhaustion or burnout. Some performed more emotional labor as a functional coping strategy. Others used their creativity to alleviate the burden of this type of work. Technology and props often took the place of bodies to convey positive emotions to patients. Researchers have an opportunity to focus on revealing the organizational and policy conditions that allow this to happen.

Overall, stories revealed that performing emotional labor became a secondary organizational goal to that of saving the most lives. However, stopping it was costly for hospitals as it is fundamental for securing sensitive treatment to patients, for good relations, and for conflict resolution. Managing this aspect of medical practice became a pressing challenge. What was the perception of supervisors about it and how did they cope with the situation?

Stories collected from frontline managers reveal variation; however, many cared for employee’s wellbeing and sought to help them handle negative feelings, thus improving the possibility of performing emotional labor. Some managers chose to train personnel as much as they could, others performed the necessary labor themselves, setting the example. A story revealed that creating an ambiance of tolerance for the possibility of emotionally “breaking” before colleagues was helpful to release pressure. Several stories spoke of the use of both positive and negative incentives to elicit compliance with emotional labor rules.

The study is interesting not just for those whose research is focused on human resource management or emotional labor. It also speaks to crisis researchers. Listening to voices of emotional workers and their supervisors in a context that was extremely damaged by the virus helps understand the need to strengthen or include mental health care and emotional labor training in prevention and preparation plans. Doing so will not only be beneficial for hospitals, but it will also alleviate the burden placed on frontline personnel and protect those who safeguard society.

The study also speaks to society more broadly because emotional labor is frequently overlooked and undercompensated. During the pandemic, medical personnel and their managers needed to understand the nature of the virus, the evolution of cases and the most effective ways to treat them, diffuse knowledge, learn as fast as they could, help “flatten the curve”, keep patients’ families informed, make ethically challenging decisions, continue to treat other urgent and threatening health conditions, avoid contagion, care for their families, keep their careers going, and a long etcetera. Ignoring that they performed emotional labor, frequently to the best of their capacity during one of the worse pandemics of our time means passing the buck of societal crises to the lower echelons of public (or private) service. This places too big a burden on doctors and nurses´ hands for problems that are very much public, collective, and ecological in nature. An appropriate way to thank medical personnel for what they have done during COVID-19 is to recognize and compensate emotional labor, and to devise good policy to prepare and protect them in the future.