Stephanie Parsons
Healthcare roles, especially nursing, have long been established as requiring extensive amounts of emotion work. This type of work requires healthcare professionals to employ various strategies to manage their own emotions and that of their patients. They are expected to be able to anticipate and influence the emotions of others in order to maintain professionalism within healthcare and medical settings.
Emotion work is often presented as relatively de-valued labour even though healthcare workers go above and beyond what Sharon Bolton (2000, p.582) calls ‘professional prescription’. In order to examine this further, her research utilised a combination of Arlie Hochschild’s concepts of emotion work and emotional labour and suggested that this type of additional and authentic caring behaviour is offered to patients as a ‘gift’. She argues that this form of supplementary emotion work extends typical understandings of emotional labour (emotional labour is considered to be a productive and obligatory mode of work when caring for patients). She also proposes that this type of emotion work is ‘special’ because there is no requirement for a gift in return.
During the Covid-19 pandemic, it has been evident there is a demand to encourage the public to give thanks and to ‘give back’ to healthcare workers for their ‘gift’ of emotionally exhausting work. This can be seen in the recent ‘Clap for Carers’ campaign. Every Thursday evening people in the UK are urged to take part in the ‘big applause’. During this weekly event, the public engage in clapping, cheering or banging on pots and pans to show their appreciation and support for healthcare workers. This initiative has received mixed reviews however, from members of the public and healthcare workers. For example, in a recent interview with H.W. News, NHS Doctor Meenal Viz urges the public not to distract themselves from the ‘reality of what is happening’. She argues that the campaign is being used as an attempt to hide the devastating effects of this global pandemic and how clapping will not bring back the lives of those we have lost.
In light of this, Bolton’s notion of emotion work as a ‘gift’ is particularly useful in examining the responses from healthcare workers and members of the public. I utilise her concept of emotion work as a ‘gift’ to highlight the normative limits of gratitude in the ‘Clapping for Carers’ campaign. I show how gift rhetoric is employed throughout the campaign and how this narrative presents itself as a burden to members of the public and healthcare workers. I also question whether this initiative is useful in sustaining emotional support for healthcare workers.
While there have been many social science based accounts of ‘gift related work’, it is mainly understood as a form of emotional transaction. These transactions are underpinned by an obligation to give and a responsibility to reciprocate. In relation to the ‘Clap for Carers’ campaign, it is evident that the campaign uses gift related language such as ‘support our heroes’ and ‘they need to know we are grateful’. This discourse is used to engage the nation in acts of social solidarity and encourage good citizenship. For some, promoting the campaign this way is useful.
For example, in an article for LBC, Fiona Jones notes how frontline nurse Sarah was extremely moved by the clapping. Sarah spoke about how she had shed ‘tears of joy’ at the appreciation she had received and ‘tears for the 40 years in the health service’ where she had felt ‘unappreciated’. Newly qualified nurse Claire echoed Sarah’s sentiments in a post for The Nursing Times. She stated that she couldn’t explain the ‘feeling this brought’ when she heard the clapping in her street and that she felt it was a ‘lovely motivation booster’ for those key workers struggling to cope under such unprecedented conditions.
The above interviews show how the use of gift rhetoric is useful for some healthcare workers during this campaign and how this public display of gratitude is meaningful to them. These examples also highlight the positive aspects of gift rhetoric and how it can successfully engage society in acts of social solidarity. However, for others, the campaign raises a host of social and political issues which render the campaign ‘bittersweet’. For example, in an article by Corrine Fowler for The Guardian, the unprecedented show of collective gratitude highlights deep-rooted post-Brexit issues. In particular, the fact that people had voted for a government that ‘caused a shortage of medical staff as it sent EU citizens away.’ For her, the clapping partly symbolises this political divide and emphasizes the irony of this display as she points out, ‘the clap was a show of appreciation by a public that elected a government that has been rapidly privatising the very service we were applauding’. However, she also acknowledges that this initiative has created a sense of community which has ‘transcended the bitter rows of the last few years’.
The post by Fowler highlights the complex nature of gift rhetoric and how the obligation to ‘give back’ can strengthen social relationships but it could also de-stabilise them. Moreover, further responses to this campaign underpin the unequal relationship between gift giver and receiver. Marcel Mauss suggests that by engaging in gift giving practices there is an obligation to ‘give back more than we have received’ (p.83). For example, Ian Martin for The Guardian, shares his experiences of taking part in the big applause in his neighbourhood and that he felt the intention behind the initiative had altered within the first few weeks. He notes that the message was clear and ‘uncomplicated’ in week one and that the clapping was evidently about saying ‘thank you’. However, in week two he points out that he felt guilty about applauding because healthcare workers had made it clear that they ‘didn’t want applause, they wanted proper equipment and decent conditions’. Then in week three he highlights how the clapping felt like ‘an angry vow to make it up to all those people who are the best of us, dying on their feet for us’.
Martin’s short article highlights the unequal, burdensome nature of the gift in relation to the ‘Clapping for Carers’ campaign. His perception of the changing nature of the applause within the first few weeks also highlights the limitations of gratitude in this context. He makes it clear that he felt that the clapping was not sufficient as the weeks went on and how this public display of appreciation was unable to provide what healthcare workers really needed to be safe and protected at work. However, it could be argued that people continue to take part in this even campaign, even if they are uneasy about the purposes of clapping because they feel what Mauss (p.83) would call a ‘moral pressure’ to participate.
To further complicate matters, what has also become clear is that this campaign has produced appropriate behaviours or social etiquette around clapping on a Thursday evening. It is evident that there is an expectation for all to participate and that there are implications for not conforming to this act of social solidarity. Recently, a woman was ‘named and shamed’ by neighbours on social media for not taking part in the weekly applause. Richard Williams for Sky News reports how this woman saw on her local community page that someone had written that she did not ‘deserve to use the NHS’ if her, or her family, got ill.
Such examples further emphasise the burden of responsibility in relation to re-paying the gift of healthcare workers emotionally exhausting work. It also highlights how parties to this campaign have different understandings of what it means to give back and how they also question the value of using collective clapping as symbol of gratitude. What is particularly clear is that this burden of responsibility emphasises the indebted nature of the gift- or in other words, giving back will never be equal to what has been received. This, indeed, can be seen in some of these examples to be causing a social divide. The expectations of being able to fully ‘give back’ to health care workers in this campaign may never be fully satisfied and raises issues around the usefulness of trying to show and sustain emotional support for these workers.
Future research in this area should engage more deeply with the emotional experiences of healthcare workers during this pandemic. For example, by applying notions of emotion work as a gift, it is possible to challenge standardised responses to viral movements and allow for a deeper engagement in invisible forms of care work in crisis.
References:
Bolton, S., 2000. Who cares? Offering emotion work as a ‘gift’ in the nursing labour process, Journal of Advanced Nursing, 32 (3) pp. 580-586.
Hochschild, A., 1983. The Managed Heart: Commercialisation of Human Feeling. California: University Of California Press.
Mauss, M., 1950. The Gift The Form and Reason For Exchange In Archaic Socieites. London: Routledge.
Stephanie Parsons is an early career researcher in sociology at Anglia Ruskin University. Twitter: @DrStephParsons
Image: autor’s own