Pain and nurses' emotion work in a paediatric clinic: Treatment procedures and nurse-child alignments
Issue: Vol 10 No. 1 (2013)
Journal: Communication & Medicine
In the treatment of cancer in children, treatment procedures have been reported to be one of the most feared elements, as more painful than the illness as such. This study draws on a video ethnography of routine needle procedure events, as part of fieldwork at a paediatric oncology clinic documenting everyday treatment negotiations between nurses and young children. On the basis of detailed transcriptions of verbal and nonverbal staff–child interaction, the analyses focus on ways in which pain and anxiety can be seen as phenomena that are partly contingent on nurses’ emotion work. The school-age children did not display fear. In the preschool group, though, pain and fear seemed to be phenomena that were greatly reduced through nurses’ emotion work. This study focuses on three preschoolers facing potentially painful treatment, showing how the nurses engaged in massive emotion work with the children, through online commentaries, interactive formats (delegation of tasks, consent sequences, collaborative
‘we’-formats), as well as solidarity-oriented moves (such as praise and endearment terms). Even a young toddler would handle the distress of needle
procedures, when interacting with an inventive nurse who mobilized child participation through skilful emotion work.
Author: Camilla Rindstedt
Alderson, P. (2007) Competent children? Minors’ consent to health care treatment and research. Social Science and Medicine 65: 2272–2283. http://dx.doi.org/10.1016/j.socscimed.2007.08.005
Aronsson, K. and Rundström, B. (1989) Cats, dogs, and sweets in the clinical negotiation of reality: On politeness and coherence in paediatric discourse. Language in Society 18: 483–504. http://dx.doi.org/10.1017/S0047404500013877
Baumann, R. and Briggs, C. L. (1990) Poetics and performance as critical perspectives on language and social life. Annual Review of Anthropology 19: 59–88. http://dx.doi.org/10.1146/annurev.an.19.100190.000423
Billig, M., Condor, S., Edwards, D., Gane, M., Middleton, D. and Radley, A. (1988) Ideological Dilemmas: A Social Psychology of Everyday Thinking. London: Sage.
Bolton, S. C. (2000) Who cares? Offering emotion work as a ‘gift’ in the nursing labour process. Journal of Advanced Nursing 32 (3): 580–586. http://dx.doi.org/10.1046/j.1365-2648.2000.01516.x
Brown, P. and Levinson, S. C. (1987) Politeness: Some Universals in Language Usage. Cambridge: Cambridge University Press.
Duranti, A., Ochs, E. and Schieffelin, B. B. (eds) (2012) The Handbook of Language Socialization. Malden, MA: Wiley-Blackwell.
Edwards, D. (1997) Discourse and Cognition. London: Sage.
Goffman, E. (1981) Forms of Talk. Philadelphia: University of Philadelphia Press.
Goodwin, M. H. (2006) Participation, affect, and trajectory in family directive/response sequences. Text and Talk 26 (4–5): 515–543. http://dx.doi.org/10.1515/TEXT.2006.021
Hedén, L. (2012) Distressing Symptoms in Children with Cancer in General; During Needle Procedures in Particular. Unpublished Doctoral Dissertation, Uppsala University, Uppsala.
Heritage, J. and Stivers, T. (1999) Online commentary in acute medical visits. A method of shaping patient expectations. Social Science and Medicine 49: 1501–1517. http://dx.doi.org/10.1016/S0277-9536(99)00219-1
Hochschild, A. R. (1979) Emotion work, feeling rules, and social structure. American Journal of Sociology 85 (3): 551–575. http://dx.doi.org/10.1086/227049
Hochschild, A. R. (1983) The Managed Heart: Commercialization of Human Feeling. Berkley: University of California Press.
Hochschild, A. R. (1990) Ideology and emotion management: A perspective and path for future research. In D. Kemper (ed.) Research Agendas in the Sociology of Emotions 117–142. Albany: State University of New York Press.
Hochschild, A. R. (2009) Through an emotions lens. In D. Hopkins, J. Kleres, H. Flam and H. Kuzmics (eds) Theorizing Emotions: Sociological Explorations and Applications, 29–38. New York: Campus Verlag. http://dx.doi.org/10.1046/j.1365-2648.2001.01772.x
Hunter, B. (2001) Emotion work in midwifery: A review of current knowledge. Journal of Advanced Nursing 34 (4): 436–444.
Hydén, L. C. and Baggens, C. (2004) Joint working relationships: Children, parents and child healthcare nurses at work. Communication & Medicine 1 (1): 71–83. http://dx.doi.org/10.1515/come.2004.007
James, N. (1992) Care = organisation + physical labour + emotional labour. Sociology of Health and Illness 14 (4): 488–509. http://dx.doi.org/10.1111/1467-9566.ep10493127
James, V. and Gabe, J. (eds) (1996) Health and the Sociology of Emotions. Oxford: Blackwell.
Miller, K-L., Reeves, S., Zwarenstein, M., Beales, J. D., Denaszchuk, C. and Gotlieb Conn, L. (2008) Nursing emotion work and interprofessional collaboration in general internal medicine wards: A qualitative study. Journal of Advanced Nursing 64 (4): 332–343. http://dx.doi.org/10.1111/j.1365-2648.2008.04768.x
Ochs, E., Graesch, A. P., Mittmann, A., Bradbury, T. and Repetti, R. (2006) Video ethnography and ethnoarchaeological tracking. In M. Pitt-Catsoupes, E. E. Kossek and S. Sweet (eds) The Work and Family Handbook: Multi-Disciplinary Perspectives, Methods and Approaches, 387–409. Mahwah, NJ: Lawrence Erlbaum.
Potter, J. (1996) Representing Reality: Discourse, Rhetoric and Social Construction. London: Sage.
Rindstedt, C. and Aronsson, K. (2012) Children’s intent participation in a pediatric community of practice. Mind, Culture, and Activity 19: 325–341. http://dx.doi.org/10.1080/10749039.2012.663449
Rogoff, B., Paradise, R., Mejía Arauz, R., Correa-Chavéz, M. and Angelillo, C. (2003) Firsthand learning through intent participation. Annual Review of Psychology 54: 175–203. http://dx.doi.org/10.1146/annurev.psych.54.101601.145118
Schieffelin, B. B. and Ochs, E. (1986) Language socialization. Annual Review of Anthropology 15: 163–191. http://dx.doi.org/10.1146/annurev.an.15.100186.001115
Smith, P. (1992) The Emotional Labour of Nursing. London: Macmillan.
Stivers, T. (2007) Prescribing Under Pressure: Parent–Physician Conversations and Antibiotics. Oxford: Oxford University Press. http://dx.doi.org/10.1093/acprof:oso/9780195311150.001.0001
Strong, P. M. (2001) The Ceremonial Order of the Clinic: Parents, Doctors and Medical Bureaucracies. Aldershot: Ashgate.
Tannen, D. and Wallat, C. (1987) Interactive frames and knowledge schemas in interaction: Examples from a medical examination interview. Social Psychology Quarterly 50 (2): 205–216. http://dx.doi.org/10.2307/2786752
Theodosius, C. (2008) Emotion Labour in Health Care: The Unmanaged Heart of Nursing. London: Routledge.