Sharon C. Bolton

Changing faces: nurses as emotional jugglers

Nursing has long been distinguished as an occupation requiring extensive amounts of ‘emotion work’. Various studies highlight the importance of a nurse’s ability to manage emotion and present the desired demeanour in a number of health care settings. This paper adds to the existing understanding of the emotional elements of nursing work and proposes that Goffman’s (1959, 1961, 1967) insights into the ‘presentation of self’ may be a useful approach to recognising a nurse’s ability to present many ‘faces’. Set against the backdrop of structural changes affecting the British public sector services, and using qualitative data collected from a group of nurses working in a National Health Service trust hospital, it will be shown how nurses are able to juggle the emotional demands made of them whilst still presenting an acceptable face.

The (mis)representation of customer service

The growth of service work has introduced the customer as a third party to the employment relationship. Yet dominant images of customer relations portray docile service workers offering de-personalized care to sometimes aggressive but otherwise not much more agential customers. This paper seeks to bring humanity back into an analysis of customer service, and to reinterpret customer service interaction as a human relationship. Using labour process analysis and data from call-centre workers and their customers, we rerepresent customers as many-faceted, complex and sophisticated social actors and introduce a new conceptual framework of the roles customers play: as mythical sovereigns, functional transactants and moral agents, thereby offering a more accurate representation of customer service and the role of the actors involved in it.

The paradoxical processes of feminization in the professions: the case of established, aspiring and semi-professions

The past three decades have been characterized by dramatic labour market developments including the mass entry of women to exclusively male domains. Professional work is particularly indicative of this trend where growth in female membership has fuelled optimistic predictions of shattered glass ceilings and gender equality. This article seeks to challenge these predictions and to explore the associated assumptions linked with the feminization of work in the UK. It does so by focusing on three professional groups: law, teaching and management which, despite some substantial differences, present a common and recurrent theme in the gendered processes of professional projects that marginalize, downgrade and exploit women and womens work. It is argued that the fluidity of such processes lead to a series of paradoxes as the professions are increasingly dependent on the contribution of their female members and yet numerical feminization, without truly including women, serves to undermine and even reverse professional projects.

Can't Live with 'Em; Can't Live without 'Em: Gendered Segmentation in the Legal Profession

Successful professions have historically relied on the establishment of effective closure regimes. The last 30 years or so have witnessed a gradual erosion of the legal professions external closure regime, which seems to be associated with the gradual feminization of the legal profession. Women now represent the majority of salaried solicitors; yet, despite some recent progress,they still represent a mere quarter of partners. In reference to these developments this article seeks to cultivate a typology of patterns of gendered segmentation in the legal profession. We argue that gendered segmentation, which thrives on the ideology of womens difference, has become a defence mechanism of an embattled profession, ensuring that the elite segments hold onto their status and associated rewards while the feminized segments increase leverage without rocking the partnership system, effectively forming a reserve army of legal labour with lesser terms and conditions.

Multiple roles? Nurses as managers in the NHS

Recent government proposals seek to extend the role of nurses into management at a time of (yet another) cultural transformation for the British National Health Service (NHS). This is especially the case for line managers involved in service‐delivery, ward managers and clinical nurse managers for instance, roles typically undertaken by senior nurses. This paper aims to give some insight into the role of nurses as managers in the NHS hospital service. Data presented were collected as part of a longitudinal qualitative study, 1994 to date, in a North West trust hospital. The role of ward and unit management has significantly changed since the early images of the nurse as manager and it is hardly surprising that, given the fundamental shift in the framework of values and attitudes, senior nurses have greeted the management role with mixed feelings.

'Making up' managers: the case of NHS nurses

The incorporation of health professionals into the management of the British National Health Service (NHS) is a distinctive strategy ultimately aimed at involving senior nurses and doctors through normative devices. Rather than attempting to directly manage professionals, which has proved to be enduringly problematic, it is deemed more effective to ‘recreate’ professionals as managers. Data collected from nurses who are middle managers, i.e. ward and unit managers, indicate a mixed response to such endeavours. Drawing on survey and interview data, and using Goffman’s concept of role analysis as an analytical framework, it can be seen how senior nurses enthusiastically embrace many aspects of the management role but remain suspicious of, and distance themselves from, a management philosophy that emphasizes entrepreneurial activity.

Consumer as king in the NHS

Over the last two decades, in response to political and financial pressures, the NHS has been subjected to considerable changes in its organisation. There is increasing emphases on containing the costs of hospital provision and making the treatment available from hospitals more responsive to consumers’ needs. “New” public sector management (NPM) philosophy clearly reflects an ideological shift toward newly valued entrepreneurial attitudes and behaviours, where patients and health service‐users are re‐defined as “customers” and “consumers”. Through a consideration of the recent changes, this paper will argue that the increasing emphasis on efficiency, cost‐cutting and most especially consumer satisfaction has transformed how nurses manage their emotions at work, adding new dimensions to their caring role. Nurses now find themselves having to present the detached, calm, but caring, face of the health professional whilst also having to present a smiling face to patients who now behave as demanding customers.

Getting to the heart of the emotional labour process: a reply to Brook

In an article published in this volume of WES Paul Brook suggests the need to strongly defend Hochschild’s emotional labour concept, as it is claimed that I threaten it with extinction with the development of a new typology of emotion management in the workplace.This article seeks to reply to Brook’s core concerns and deal with issues of substance about the phenomena Brook and I are both interested in. Mainly this paper considers how we conceptualize emotional labour and work, and how might that fit into labour process analysis? In response to the misgivings of Brook, the discussion will reveal why and how there is a need to develop analytically the idea of emotional labour, that the typology introduced in Emotion Management in the Workplace (Bolton, 2005a) offers a nuanced explanatory framework; and that labour process analysis is its theoretical home.

It is not Taylorism: Mechanisms of Work Intensification in the Provision of Gynaecological Services in a NHS Hospital

The development of a managed National Health Service (NHS) has been a central element of government policy for a substantial part of the last two decades. Within months of taking office in 1979, the first Thatcher administration repudiated the idea of a centrally planned and administered NHS in favour of a declared policy of managed localism (Klein 1995: 124–26; Pollitt 1993: 68–9). However, a somewhat more considered process of policy formation was soon set in train with the commissioning of the Griffiths enquiry and, following the acceptance of its conclusions in 1983, with the introduction of what was called ‘general management’. Since the middle of the 1980s, the management which Griffiths recommended (which allocates considerable decision-making independence to managers within a framework of prescribed budgets) has been consolidated and developed.

Work, employment and society through the lens of moral economy:

In this article a moral economy approach is proposed that is informed by Karl Polanyi and E. P. Thompson, who capture the ubiquitous tension between a stable, moral and human society and the economic practices of self-regulating markets, and by Andrew Sayer’s consideration of lay morality. Moral economy is an analytical framework that gives voice to critical concerns for the workings of an increasingly disconnected capitalism, its inherent tendencies to treat labour as a ‘fictitious commodity’ and the impact this has on the well-being of individuals and wider society. Hence, at the heart of the approach suggested here is a normative understanding of mutual reciprocality and embedded sociality that raises questions about how to support the human capacity to flourish.