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Analyzing Emotional Labour as a Challenge to Nurses

Hildegard Peplau Theory

Nursing interpersonal relationship with her patients is a critical issue that medical experts take

caution of when handling. To solve the problem, Hildegard Peplau published a theory in 1952

and 1968 known as the Theory of Interpersonal Relations (D'Antonio et al.). In her concept,

Peplau proposes four sequential phases that make interpersonal relations when nurses deal with

their patients. The stages include orientation, identification, exploitation, and resolution.

Firstly, the orientation phase identifies the problem, which begins when the patient meets

the nurse as a stranger. Progressively, the phase continues to define the services the patient

needs. Ideally, the patient asks assistance from the nurses by telling them their needs, as

questions, and sharing expectations based on experiences. The nurse assesses the patient's health

and scenario during the orientation phase. Secondly, the identification phase takes shape when

the health professional selects the appropriate assistance for the patient. At this stage, the patient

develops a feeling of belonging and the capability of dealing with the problem, reducing

hopelessness and sadness. This step enhances the development of a nursing plan customized to

the patient's situation and goals.

Thirdly, the exploitation phase occurs when the patients acquire professional services.

Ideally, the patient develops a feeling of integration due to the environment the nurses create.

During this stage, the patients may make minor requests or seek attention from the nurses.
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Lastly, the final one is the resolution phase, which involves the termination of a professional

relationship after patients get medical assistance from health practitioners.

Peplau advises that the nurse should use interview techniques when communicating with

patients. Such technology enables nurses to explore, understand, and deal with imminent

problems. Additionally, the nurses must know the various communication stages because the

patient's independence is likely to stagger. Nevertheless, nurses should help patients reach the

final phase by implementing a goal-oriented nursing plan. Cautiously, Peplau asserts that nurses

must terminate any bond between them and patients upon completion of the task. As such, her

theory is essential to the study topic in that it empowers nurses who face difficulty handling

emotional attachment to their patients. In other words, health professionals find fundamental

ideas for coping with the situation without interfering with their profession.

Literature Review

Gray, Benjamin. 'The Emotional Labour of Nursing 1: Exploring the Concept.' Nursing Times

105.8 (2009) 26-29. Web. 4 July 2015

In his article, Gray analyzes the emotional labor that nurses and other medical

practitioners face and its implications for nursing practice. The author asserts that future research

on emotional energy should associate with other professions, relatives, and patients (26). Again,

he insists that there is a need to research more on factors such as gender, personal, and

professional barriers since they hamper the recognition of emotional labor.

Ideally, Gray refers to emotional labor as the suppression of feelings to maintain an

outward outlook that indicates any sense of care in a friendly place (26). He continues to

illustrate that emotional labor happens in face-to-face interaction with the public when workers

produce an emotional feeling in front of another individual. For instance, nurses are expected to
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attach emotionally to control their patients. Most importantly, Gray's work is a rich source of

literature concerning the problem of the emotional attachment of nurses to their patients. The

author does not only give models of emotional labor in health settings but also gives implications

of his study to future nursing. For example, he says that nurses usually divide their patients

depending on how well or deficient such patients are (28). Healthcare professionals consider

patients who resist professional help wrong, while those cooperating are classified as healthy.

Such stratification of patients strains the interpersonal relationship between healthcare

professionals and their patients, hence, playing the concept of emotional labor on the nurses.

Gray's work is intense because it borrows from other scholars to make his arguments firm.

Lachman, Vicki D. 'Strategies Necessary for Moral Courage.' The Online Journal of Issues in

Nursing 15.3 (2010): n. p. Web. 4 July. 2015.

Secondly, Lachman also highlights some critical issues concerning the emotional

attachment that a nurse may feel towards their patients. Practically, he borrows a lot from other

authors, such as Nightingale, to explain that morality, as virtue, is necessary for the healthcare

sector. The author reminds us that the existing professional nursing associations, such as the

American Nursing Association (ANA), give an explicit code of ethics for the nurse and other

healthcare professionals to follow. However, given the intermediary nature of the health care

setting, sometimes, the ethical dilemmas possess emotional labor to medical practitioners

overwhelmingly. For instance, nurses need to keep a professional distance from their patients to

uphold integrity, but what if neglecting a particular code of ethics sometimes enables a nurse to

save a patient's life?

The author summarizes the argument by insisting that nurses must uphold the values at

any cost to avoid liability. However, she proposes that the relationship between emotional labor
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and moral dilemma needs scrutiny. Critically, Lachman's work contributes to the issue of

emotional labor by illustrating how ethics may also be a burden to those practices; hence, it

creates emotional attachment, especially to health care practitioners.

Sawbridge, Yvonne, and Alistair Hewison. 'Thinking About the Emotional Labour of Nursing –

Supporting Nurses to Care.' Journal of Health Organization and Management 127.1 (2013): 127

- 133. Web. 4 July 2015.

Sawbridge and Hewson portray some of the issues nurses face in the line of work, which

promotes the emotional burden they feel. They assert that most hospitals have no appropriate

measures and conditions to enable nurses to cope with their emotional labor problems.

Interestingly, this article acknowledges that healthcare professionals face challenges when

handling their patients (130). Some practitioners find it challenging to offer patients the

emotional support needed to help them recover well. On the contrary, some nurses get over

emotions when treating patients, an ethical phenomenon, according to medical ethics. The

authors insist health institutions should create a favorable environment that facilitates nurses

dealing with their emotional burden. Ideally, Sawbridge and Hewson are critical to this study

research because it illustrates that even hospitals and other medical facilities should play a role in

helping their workers cope with emotional challenges.

Msiska, Gladys, Pam Smith, and Tonks Fawcett. 'Exposing Emotional Labour

Experienced by Nursing Students During their Clinical Learning Experience: A Malawian

Perspective.' International Journal of Africa Nursing Sciences (2014): 43-50. Web. 4 July. 2015.

Msiska, Smith, and Fawcett expose the emotional labor concept from an African

perspective. They bring out another view that consists of the new variable: African health setting

and health students' concerns. Practically, the study revealed that emotional problems accompany
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clinical learning. Eventually, medical students such as nurses have to meet the actual practice in

the medical field where they have to deal with actual patients, not experiments. The authors

assert that even when students learn in the areas, they engage in emotional labor management.

To reach their conclusions, the authors documented the narrative accounts of students'

experiences while in clinical practice. Vividly, the students narrated their caring escapades,

encountering the death of patients they cared for and the fatigue they had to endure after such

incidents during their attachments at the hospitals in Malawi.

Most importantly, the study shows that effective teaching and learning need to

incorporate the aspects of emotional labour seriously to enable clinical students to manage their

passionate encounters in the field appropriately. Fundamentally, understanding emotional labor

will facilitate the creation of a clinical learning environment that conceptualizes emotions in all

dimensions, especially for students in Malawi. The study also shows that emotional labor is a

component that most nurses encounter around the globe.

To summarize all the facts and findings, the above literature references the concept of

emotional labor by covering all aspects that the challenge may present to health practitioners. My

project investigates the extent of the emotional burden to nurses in their nursing profession.

Additionally, the study will use the above literature to research the measures leaders in the

healthcare sector use to help practitioners cope emotionally.

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Works Cited

D'Antonio, Patricia et al. "The Future in the Past: Hildegard Peplau and Interpersonal Relations

in Nursing." Nursing Inquiry 21.4 (2014): 311-317. Web.

Gray, Benjamin. "The Emotional Labour of Nursing 1: Exploring the Concept." Nursing Times

105.8 (2009): 26-29. Web. 4 July 2015.

Lachman, Vicki D. "Strategies Necessary for Moral Courage." The Online Journal of Issues in

Nursing 15.3 (2010): n. pag. Web. 4 July 2015.

'Msiska, Gladys, Pam Smith, and Tonks Fawcett. "Exposing Emotional Labour Experienced by

Nursing Students During their Clinical Learning Experience: A Malawian Perspective."

International Journal of Africa Nursing Sciences (2014): 43-50. Web. 4 July. 2015.

Sawbridge, Yvonne, and Alistair Hewison. "Thinking About the Emotional Labour of Nursing -

Supporting Nurses to Care." Journal of Health Organization and Management 127.1

(2013): 127 - 133. Web. 4 July 2015.