The Emotional Labour of being a Surgeon

Stewart scored his job as 3-10/10 depending on the day (with ten being the most fantastic job imaginable).

by Laura Fruhen

A team consisting of surgeons, anaesthetists and nurses has come together to operate on several patients. Each case is different and complex. Each operation has the potential to change someone’s life. The team has a huge responsibility.

Stewart is the lead surgeon today. He discusses what aspects of his work are the most difficult. One might expect that the biggest challenge are technical. After all, Stewart has to choose the exact right surgical technique, and then execute this technique with amazing precision, under time pressure, and with a huge cost of error.

In fact, Stewart talks about emotions and his work. He reflects that:

“There is this image of the surgeon as cold and uncaring. What people don’t realise is that most of us see things and deal with situations that are difficult, like where someone is terminally ill. Most people don’t face such things regularly. You must deal with this dispassionately in order to diagnose and treat but later it is vital to consider things from the patient’s point of view and engage with what they are feeling.”

What Stewart describes is an aspect of work that has been labelled as emotional labour. Some jobs require us to show emotions that we don’t feel, or to hide some of our real feelings [1]. These can be customer-facing professions, such a retail. Healthcare is a classic example of a job that requires emotional labour. Emotional labour takes a toll, and indeed can impair well-being.

In Stewart’s case, what is especially difficult is switching. Sometimes, emotions can get in the way and hinder him from doing a good job, and so he must engage in emotional labour. But at other times, emotions are critical for his work: “The difficult bit is then to re-engage with the patient and to understand what they are going through emotionally. Compassion is vital for the patient and for the surgeon as, for both, it directs the empathy towards providing support either directly or through others. It is this switching from distancing himself emotionally, to really caring about his patients, that is challenging."

Emotions are a core theme for Stewart. In his view, there are “three things make a great surgeon: vulnerability, compassion and humility.” These aspects are all very personal, and require courage and emotional strength to develop. For example, vulnerability means:

“you are trained to make decisions, to be certain and in charge. But sometimes it is hard when you are not quite sure what to do for the best. Taking yourself out of the situation, taking a moment, sticking your hand up to ask for help is hard, but it becomes easier the more often you do it. There are times when even experienced surgeons don’t know the answers. Being able to feel vulnerable (even if in truth you are not) but at the same time not react to it, or at least understand your reactions to it and modify your behaviour is an important skill to master.”

For Stewart, one of the best things about his job is that “you can see the outcomes of what you have done really quickly.“  He explains that how much he enjoys his job can actually vary quite a bit: “Most days, it's a10. Sometimes it is a 3.” He identifies key factors that sometimes make his job harder: “What makes it a 3? It is your own failures, when things don’t go go as well as you had hoped or when errors occur. Also other hassles, when management are after you, or communication with the patient is causing problems.”

What he highlights in particular is an aspect of work that psychologists label as error cost responsibility. The consequences of mistakes that we make at work can be a key stressor, and this is clearly affecting Stewart. When this causes the surgeon to feel vulnerable it may push them towards trying to numb the pain.  This may take a variety of forms; for Stewart it takes the form of snacking. “When I am stressed, I head for the biscuit tin,” he says, patting his stomach.

A little more..

What an anaesthetist said about his job

“The main hassles of being an anaesthetist are funding and bureaucracy”

​“My job is a 10.”

​“My work starts and stops in theatre. It is great that I get to concentrate on one person at a time, rather than having to focus on 20-30 patients throughout the day.”

​“My hours are good, I can see my daughter before I head into work and afterwards.”

​“My job wouldn’t happen without technology. Anaesthesia is only 150 years old, but technology has developed rapidly.“

What a nurse said about her job

“My job is a 10.”

​“Helping people and the people you work with is what makes this job great.”

​“The best thing about working in theatre is that you know each other as a team.”​

“I am here because I love my job. It is the joy of helping people.”​

“The variety of tasks and operations is great.”

“The worst things about my job are equipment issues. When a machine doesn’t work you go into problem solving mode, you know, when you have to run around.

References

[1] Ashforth, B. E., & Humphrey, R. H. (1993). Emotional labor in service roles: The influence of identity. Academy of management review, 18(1), 88-115

[2] Martin, R., & Wall, T. D. (1989). Attentional demand and cost responsibility as stressors in shopfloor jobs. Academy of Management Journal, 32(1), 69-86. (Raine study)

Robyn - Volunteer Exercise Instructor

Keeping young by keeping others young

Robyn scored her job as 9.5/10 (with ten being the most fantastic job imaginable).

by Yukun Liu

It is 9:00 AM on a Wednesday morning when we walk into an indoor stadium located at a community centre in Australia. 

Robyn, the exercise instructor, walks to a podium and stands in front of 60 class participants. The participants, all in white uniforms, quickly self-organise into rows. In a gentle voice, Robyn greets everyone, warmly welcomes new members, and gives her best wishes for the forthcoming Chinese New Year. Then Robyn turns on her cassette player, faces people as a mirror-image, and the class is underway. 

Perfectly synchronized movements

The first song of the set, carefully selected by Robyn, is ABBA’s Gimme! Gimme! Gimme!. With the ups and downs of the familiar melody and the cheerful lyrics, the participants follow Robyn’s lead: “Two steps right, two steps left, one step backward, one step forward...” Their movements are perfectly synchronized and enthusiasm abounds. 

After a few more aerobic exercises, including some slow-paced ones for stretching muscles, Robyn leads a mindfulness meditation, and recites a beautiful poem. The atmosphere in the stadium is peaceful. The class ends, with participants refreshed and eager to come back for their next class. 

Robyn is a non-paid volunteer who has been working as a voluntary exercise instructor role for fifteen years, ever since she retired from her full-time job as a secretary. Every week Robyn runs four classes, each with a different structure and content. Behind the scenes, she needs to spend considerable time and effort designing each session, selecting songs and poems, and recording songs from CDs to cassette tapes. Like any job, this volunteer job also has its challenges, with the biggest ones being getting the class ready on time and remembering everything to run the class well. 

"When I see their faces and they are enjoying it, I’m relaxed and I’m happy."

Robyn loves this volunteer job and rates it as 9.5 out of 10. It helps keep her fit and healthy, yes, but mostly she is happy to see her students – many well into their 60s and some even in their 90 - benefiting from the classes. She experiences a strong sense of achievement: “When I see their faces and they are enjoying it, I’m relaxed and I’m happy, and I got a lot out of it!” 

Robyn is part of a team – there are more than 30 volunteer instructors doing similar classes in the community centre. Defined as “the act of freely giving one’s time, knowledge, or skills for the benefit of other people, groups, or causes” [1], volunteering is very prevalent in Australia, with 5.8 million people every year contributing a total of 743 million hours [2]. 

Research [3,4] shows that one of the strongest motivators for volunteering work is the enjoyment and meaning that the work can provide. Importantly, volunteering doesn’t only improve ‘hedonic’ well-being in the form of happiness and more positive emotions, but it also contributes to ‘eudemonic’ well-being in the form of enhanced meaning and stronger feelings of fulfilment and achievement.

Robyn brings these research findings to life, showing us the power of well-designed volunteer work. 

References

[1] Grant, A. (2012). Giving time, time after time: Work design and sustained employee participation in corporate volunteering. Academy of Management Review, 37, 589-615.

[2] Australian Bureau of Statistics. (2015, June 30). Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/latestProducts/4159.0Media%20Release102014 

[3] Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation and self-determination in human behaviour. New York, NY: Plenum.

[4] Gagne, M., Cordery, J., & Dunlop, P. 2015-2019, 'Designing Human Resource Practices that Promote the Retention of Volunteers', ARC Linkage Projects.

A little more...

Volunteer work in Australia

According to the statistics from the 2014 General Social Survey [1], 16.8% of Australians who volunteered in the past 12 months are aged 65+; while in the US the percentage in 2016 is 34.6% [2].

[1] Australian Bureau of Statistics. (2015, June 30). Retrieved from http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4159.02014?OpenDocument[2] Dunn, M. (March 2018). Who chooses part-time work and why?  Monthly Labour Review. Retrieved from https://www.bls.gov/opub/mlr/2018/article/who-chooses-part-time-work-and-why.htm

Beauty Therapist Entrepreneur

The Female Entrepreneur: Multiple Roles and Dynamic Work Design in Service Start-up

Julianna scored her job 10/10 (ten being the most enjoyable job you can imagine).

by MK Ward

A spa is a space for clients to relax and de-stress. But what is it like to work in a spa?

Let’s find out with Julianna who is a beauty therapist and the owner of Limon Health & Beauty Spa. There’s relaxing Enya-like music playing and Julianna’s voice is calm and soothing. Everything in the room, from paint colour, music volume, scents, towel texture, and flooring were chosen with the intention to invoke a sense of calm. The ambiance put me so at ease that the interview was one of the more difficult ones because all the subtle details of the environment made it hard to concentrate and work rather than relax. Yet, we soon found out that cultivating such a calm experience is complex and challenging work.

It’s like having two jobs

Julianna has over a decade of experience in this industry and deeply understands the work.  After she launched Limon Julianna found that although we was working in the same industry she knew well, the work design of an entrepreneur was different from her previous jobs.

“In the beginning I overdid it, which you have to do when you have your own business. It’s like having a baby I would think, because it’s constant and it consumes you.”

She described how she had little to no down time because it is as if she’s dealing with the work demands of two jobs. On the one hand, she’s a beauty therapist performing treatments for clients in the spa. This involves specialized tasks and activities, which is a knowledge characteristic of work.

On the other hand, Julianna would work wherever there was internet connection to reply to emails, work on the website, and manage her social media. In addition to virtual upkeep, Julianna positioned the spa in a way that makes it essential to source quality products (organic, plant-based, vegan, animal cruelty free, eco-friendly). Sourcing requires searching for suppliers, sampling products to see which toxin-free products are effective, and deciding to order a selection. The knowledge characteristics of her job includes lots of information processing and can be cognitively demanding. Although her work design has changed to include more interaction outside the organization.

Demands becoming resources

Julianna’s work design has changed as her work tasks shifted from when she started Limon.

“In the last 6 months I still do as many hours, but less treatments and more work on the business itself including workshops, event networking, and online presence. Networking at events is a challenge because I am introverted.”

The networking events and workshops can be draining. However, over time the contacts made, relationships developed (social support), and knowledge acquired (cognitive development) become resources.

While her work design has evolved alongside her business, some aspects remain constant. For example, Julianna relishes in the creativity of the business and the ability to create something that fits her priorities, one of which is environmental sustainability. “I like creating something that takes care of the environment because we live in a world where we are destroying it so that is very important to me.” Julianna has consistently put time and effort into sourcing and using toxin-free, organic where possible, vegan, plant-based products. She sees nature as a stakeholder, similar to how she sees her clients as beneficiaries of the spa. This ability to do what she loves in a business that follows what she considers best-practices meant that despite the complexity and many demands of the job, Julianna rates it 10 out of 10. “There’s only so much time and you spend so many hours at work so what’s the point if you don’t like it .”

A little more...

Same Industry, Very Different Work Design

Similar to Julianna, Nell founded her business in the health and beauty industry. Nell makes and sells skin products for people with extremely sensitive and extremely problematic skin. Unlike Julianna, the inspiration of sorts for Nell began with a thorn prick from a rose.

Years ago, Nell happily worked as a masseuse until one day a thorn from a rose bush pricked her and triggered a bodily reaction that gave her arthritis. Consequently, she had to quit giving massages and shakes prevented her from giving manicures and pedicures. She liked working in the industry and decided to make skin products. She taught herself everything she needed to know to create a skin product that would suit extremely sensitive and problematic skin. Her proactivity to start her business required problem solving, information processing, and a shift in her specialization.

Although she managed to work in the same industry, her work context has changed dramatically. She now works in a garage space all day filling orders. While it pays the bills, the work context is very isolating. For that reason, she rates the job itself a 6 out of 10 (ten being the most enjoyable job you can imagine). We see that transition is difficult and good work design can also be constrained by the type of work being done. However, there are adaptations that may be possible to improve Nell’s work design. For example, social characteristics can be increased by talking with other on the phone while doing some of the more routine order filling tasks, relocate to a shared workspace (if possible), or increase the number of product expos she attends to increase social support via networking.  It will be important for Nell to change the work to fit her, rather than the other way around.

Cognitive work demands: Lingual challenges

At the beginning, a major challenge for Julianna was language. This lingual challenge added a layer of cognitive demands to Julianna’s work. Originally from Hungary, she had the added job demand of improving her English to be able to communicate with clients more effectively.

“I didn’t know that every country has a different accent. Irish, Scottish, Australian—at first I couldn’t follow any of it. Trying to sound professional and give advice during work was very stressful because you have knowledge that you want to give but can’t verbalize it.”

Training in the Australian beauty certification programs helped Julianna to learn the language and simultaneously get familiar with the beauty industry requirements here in Perth. Cognitive neuroscience research supports the notion that the additional job demand of processing a foreign language makes work more difficult and depleting (Volk, Kohler, & Pudelko, 2014 ). Fortunately, people like Julianna can learn over time and improve their ability to process what clients say.

References

Volk, S., Köhler, T., & Pudelko, M. (2014). Brain drain: The cognitive neuroscience of foreign language processing in multinational corporations. Journal of International Business Studies, 45, 862-885.

Article here: http://www.palgrave-journals.com/jibs/journal/v45/n7/abs/jibs201426a.html