Contributions & Limitations

Conclusion

This goal of this study was to provide a picture of emotion labor within the context of a nursing home. Specifically, the case study approach demonstrated how organizational members who are employed at the management level of the organization convey, confirm, and negotiate emotion labor differently than the employees who report to management. To do so, this paper summarized the relevant literature, described the methodology, reported the results, and finally, highlighted the study’s implications. Next, this study will conclude by describing how this paper contributes to the current knowledge on emotion labor, discussing the limitations of the study, and explaining how these limitations present opportunities for future research.

Contributions. This examination of emotion labor in a nursing home raises practical concerns for organizations that care for frail elderly and the employees who experience emotion labor in their workplace. First, given the high levels of burnout and turnover of nursing home staff, the discussion of stress in this study is particularly pertinent for future researchers. Like X expressed in Case Study X, the relationships with management and staff can often be more stressful than working with the residents. This finding is not unique to this study. In an in-depth analysis of cruise ship workers, Tracy (2000) found that cruise staff often found escape from their personal life in their “front-stage performances” (p. 121). Therefore, future researchers should continue to investigate how this escape changes the organizational experience of nursing home employees and the potential relationship it may have with the levels of burnout and turnover in nursing homes.

Second, this analysis uncovered a lack of clarity on where and when nursing home staff could talk about personal matters. Like X conveyed in Case Study X, she often found talking about her personal life with the residents was a way to connect and form relationships with residents. Similarly, Tracy (2000) found that cruise staff often discussed “confusion about the boundaries between front stage and backstage” (p. 121). A practical concern for nursing homes may be more complete guidelines and training on what is appropriate to talk about with residents. Additionally, nursing homes may reconsider the amount of area in the nursing home that is dedicated only to staff. (Insert example from participant here.) Furthermore, the connection and relationship with residents was extremely encouraged at this nursing home; therefore, future researchers should examine the complex interaction between nursing home staff and residents.

Limitations. A limitation of this study lies in the case study method. While this method presented a detailed look at lived experience of nursing home employees, it is difficult to generalize the experiences of these participants across other nursing homes. Our understanding of emotion labor within the context of a nursing home would be enhanced through future research with a larger subject pool in a variety of health care institutions.

Functional Outline: On Stage & Off Stage in Nursing Homes

I. Introduction

In this section I would like to introduce the project by explaining the context and providing rationale for the study. I will also explain how a case study approach to studying emotion labor in a nursing home fills a gap in the research. Finally, I will introduce the main theme (the “so what?”) that emerges from the paper’s case studies (yet to be discovered).

Transition: An examination of emotion labor in a nursing home by using a case study approach to organizational experience can provide insight into how expectations for emotion in the organization are conveyed, confirmed, and negotiated.

II. Literature Review

In the LR, I want to build an argument from the known to the unknown. In this section I will synthesize the relevant research within the context of emotion labor. Finally, I will clearly identify the gap in the research. This will be accomplished by the subheadings listed next.

A. Theoretical Framework

In this section, I will explain the difference between emotion work and emotion labor. Then, I will explain how emotion labor is enacted by organizational members (surface acting & deep acting). Next, I will explain how the theoretical framework was used by organizational communication scholars (Kramer & Hess) to uncover communication rules that are used to govern emotion in organizations.

Transition: The communication rules used to govern emotion in organizations require interpretation within specific organizational contexts thus there is a call for more research.

B. The Nursing Home

This is where I will explain how emotion labor differs in the context of a nursing home because employees work out of concern for the frail elderly residents. I will support this with the Sass (2000) research study. However, I will point out a gap in the research: the current literature does not address how employees in a nursing home may become desensitized to the caring aspect of their job and may struggle with communicating a “caring” persona.

Transition: While employees use context as a guide for emotion labor, there is also evidence that organizational control over emotions is dispersed among groups of people.

C. Control

In this section, I will explain how organizations communicate expectations for emotion display among clients or residents by using the following studies as evidence: Sass (2000), Tracy (2000), and Ashforth and Humphrey (1995). Then, I will identify how a case study seeks to address the gap in the research by exemplifying how emotion labor is conveyed, confirmed, and negotiated across the hierarchy of an organization.

Transition: Since this is a preliminary examination of the way emotion labor is experienced in a nursing home, the research question that guides this study is: How do employees of nursing home experience emotion in the workplace?

III. Methods

In this section, I want to explain how the collection of detailed and descriptive narratives from employees across the hierarchy of a nursing home is the way to answer the research question. Next, I want clearly explain and provide rationale for the methods for data collection and data analysis. Finally, I will describe the site where the research took place. This will be accomplished by the subheadings listed next.

A. Study Design

Here I will describe why narrative as a form of qualitative inquiry allows the research to view research participants as narrators who shape their experience and reality in their own voice. I will also describe the case method approach.

B. Data Collection

In this section, I will explain how data for this study were draw and the research procedures used during the in-depth interviews. I will also provide a few examples of the research questions that were used to elicit responses.

C. Data Analysis

In this section, I will describe how the data were analyzed. Specifically, I will tell the reader how I read the transcripts many times, then conducted open coding, axial coding, and selective coding.

D. Site

Here I will describe the nursing home used for the study. Specifically, I will describe the level care that is provided at the nursing home and explain how this is very similar to the other 4 nursing homes in the community. Next, I will state how many employees work at the nursing home, what the mission statement is, and the type of job positions that are employed there.

Transition: As the case studies presented will illustrate, emotion labor is experienced-conveyed, confirmed, and negotiated- differently across the hierarchy of the organization.

IV. Results

In each case study, I will (1) describe the participant’s work, (2) explain how they experience emotion labor (convey, confirm, negotiate, and resist), and (3) provide examples using the participant’s voice. This will be accomplished by the subheadings listed next.

A. Case Study 1

B. Case Study 2

C. Case Study 3

V. Discussion

Here I will highlight the similarities and differences across the three case studies. I hope to synthesize one big “SO WHAT?”. Perhaps my “so what?” will be an insightful discussion on how emotion labor is experienced differently (big assumption here) depending on where in the organization’s hierarchy the employee is?

VI. Conclusion

The finale of my paper will describe how this paper contributes to the current knowledge on emotion labor, discuss the limitations of the study, and explain how these limitations present opportunities for future research. This will be accomplished by the subheadings listed next.

A. Contributions

In my contributions section, I will describe how the results of this paper contribute to what is known about emotion labor. I would like to also reiterate why this research is important to the field of organizational communication, organizations that care for frail elderly, and the employees who experience emotion labor in their workplace.

B. Limitations & Future Research

In my limitations section, I would like to present the opportunities for future research emerging from the limitations for the study.

Ads for Analysis: BMW & Eternity Moment

Emotion Labor in Organized Care Facilities

A. Emotion Labor

1. Situate organized care in the emotion labor literature
2. Define emotion work and emotion labor
3. Describe job characteristics that call for emotion labor
4. Describe how the performance of emotion labor can have two outcomes (surface acting & deep acting)
5. Define emotion display rules and describe how communication is central to their existence

B. Emotion Dissonance

1. Define emotion dissonance
2. Describe how organizations have been found to create emotion dissonance
3. Detail the negative aspects of emotion dissonance
4. Detail the positive aspects of emotion dissonance

C. Emotion Labor in Nursing Homes

1. Describe Lopez (2006) research on emotion labor in nursing homes. Pose RQ1: How do employees of nursing homes manage emotion?
2. Discuss how emotion labor is "learned" in organizations. Pose RQ2: How are employees of nursing homes socialized to manage emotion?
   

Livingston's Oral History of Internet Use

Overview

This interview took place with John Livingston Reynolds in his apartment on Sunday, September 27th. Per the participant’s request, he will be called Livingston in the summary of our interview. Interestingly, during our conversation, the participant could not resist leaving the interview site to use the internet. When asked what site he was on, his response was “fantasy baseball.”

Interview Protocol

(Follow up questions were asked based on the participant’s responses.)

Do you remember a time without the internet?

When you first started using the internet, how did you use it? How often?

How does this differ from the way you use the internet now?

How often do you use it now?

How has the internet changed the way you interact with people/friends/family?

How did you use the internet in college?

How has the internet enhanced your life?

How does it detract from your life?

Which do you value more – your cell phone or internet? And, why?

What would you do without the internet?

Where do you see the future of the internet going?

Summary

Currently, Livingston considers the internet part of his “daily routine.” In the morning, after he makes coffee, he immediately checks his email. After reading his email, he views ESPN.com, his fantasy baseball team, NYtimes.com, and political blogs. Usually, he noted during the interview, he flips from site to site in a matter of 30 seconds. If he finds a particularly long article interesting, he’ll save it to read during downtime at work. Since Livingston has recently relocated, he also uses the internet to communicate and share photos with friends and family. The internet behavior of Livingston, however, has changed since he first began to use it.

In addition to the types of internet sites Livingston visited, his internet behavior was different in his childhood compared to present day. Livingston started using the internet when he was around 11 years old. His family was one of the first family’s among his friends to use the internet. His parents paid for America OnLine by the hour so his usage was limited to a couple hours a week. During this time he dialed into America OnLine to follow sports, instant message with friends, and chat with other people in common interest chat rooms. He did not use the internet as a source of information during his childhood. Instead, he explained, “you had to ask your parents or look it up on an encyclopedia.”

Although Livingston reported spending more time on the internet in college than during his childhood, he admitted that the internet was still not as engrained into his daily routine like it is now. In contrast with his current behavior, he explained that he didn’t go to sites without thinking about it; he had to make a conscious thought about what he wanted to see or read. While Livingston was in college, America OnLine instant messaging (AIM) was popular among his friends but during his senior year, he disengaged from AIM completely. He reported that he was surprised that many people were shocked by his decision, but he had his reasons. He explained, “I was tired of having conversations with people that I never saw.”

The internet, for Livingston, enhances and detracts from his life. Livingston values the internet for connecting him to people who have different opinions than his own. He explained, “I think it helps you understand where other people are coming from without having to engage with other people.” While it enhances Livingston’s life, he also believes it deters face-to-face communication. The ability to read the news and catch sports headlines online, he explained, discourages him from going to the store and engaging with people “from the outside world.”

Project Proposal: The Organizational Experience of Nursing Assistants

This purpose of this study is to describe how nursing assistants make sense of organizational experience in a nursing home. This study will examine how nursing assistants in a nursing home understand, interpret, and describe their work. Caring for the elderly exists on a spectrum from informal care (family care) to formal care (nursing home care). The formal care for the elderly is provided mostly by nursing assistants in nursing homes. The occupation of nursing assistants consists of mostly women (91 percent), a disproportionate number of minority groups (30 percent are African American, and 55 percent are white), and in 2000, were paid an average annual income of $15,751 (Montgomery et al., 2005). Due to the demanding nature of the work (physically and emotionally), odd and long hours, and an unattractive salary, it is not a surprise that high levels of stress, burnout, and turnover is common among nursing assistants. As an organization, the nursing home has bureaucratic requirements reward and penalize nursing assistants for certain behavior. This study specifically analyzes nursing assistants experience as a worker in a nursing home, and how they interpret their occupation.

Research questions

RQ1: How do nursing assistants make sense of their work experience?

RQ2: How do nursing assistants make sense of their occupation?

Proposed sites and artifacts

Golden Living is a for-profit nursing home in Moorhead, MN, and is the proposed site for this study. The research participants for this study will be the nursing assistants who work there and their reflections on their work experience will be the basis for analysis.

Method

Semi-structured, in-depth interviews with 10 nursing assistants will be used to collect data. Interview questions will be probed based on broad categories (i.e., resistance and control, feminine and masculine roles, sexism in the workplace, social and economic class, and emotion). Probing questions that address the broad categories will be determined later in the research process. Follow-up questions will be asked during the interview based on how participants respond to the broad categories. Once the interviews have been transcribed, data will be analyzed using thematic analysis.

Contribution

A recent study funded by the National Institute of Health found a significant difference in the quality of care provided to the elderly between for-profit nursing homes and non-profit nursing homes, with non-profit nursing homes provided better care. The quality of care, or output of a nursing assistant’s care, is the primary attention of health researchers. Therefore, by interviewing the people who provide care in a for-profit nursing home, this study is an opportunity for nursing assistants to reflect on their work experience without taking in account their quality of care.

Annotated Bibliography

1) Aronson, J. & Neysmith, S. M. (1996). ‘You’re not just in there to do the work’: Depersonalizing policies and the exploitation of home care workers’ labor. Gender & Society, 10, 59-77.

This study depicts the care for the elderly workforce as a low-status, and exploited group of workers. This research will be used to describe work for the elderly.

2) Lopez, S. H. (2006). Emotional labor and organized emotional care. Work and Occupations, 33, 133-160.

This study is an exemplary qualitative study done at three nursing homes, and describes emotional labor in a care organization. This study will be used to define a care organization and will be used to describe the method section.

3) Jervis, J. L. (2002). Working in and around the ‘chain of command’: Power relations among nursing staff in an urban nursing. Nursing Inquiry, 9, 12-23.

This research focused on the power relations among the nurses and nursing assistants in a nursing home. It used ethnographic methods to uncover class conflict and power struggles in the work environment. The study will be used as a potential direction for my research study.

4) Stacey, C. L. (2005). Finding dignity in dirty work: The constraints and rewards of low-wage home care labour. Sociology of Health & Illness, 27, 831-854.

This qualitative research study used interviews to uncover how home care workers found their work with the elderly as both demanding and rewarding. The study will be used in the method section to show how qualitative interviews can uncover information about the work experience. It will also be used to show the abundance of research on home care workers, and the lack of research on nursing assistants.

5) Mumby, D. K. (2005). Theorizing resistance in organizations. Management Communication Quarterly, 19, 19-44.

In this article, Mumby reviews and critiques resistance in the workplace. He promotes a dialectical approach to research control and resistance in an organizational setting describes. Control and resistance is a potential direction for my study.

6) Buzzanell (1994). Gaining a voice: Feminist organizational communication theorizing. Management Communication Quarterly, 7, 339-383.

In this article, Buzzanell promotes for, outlines and describes how the use of feminist theories can be used in organizational research. The theoretical lens she provides is a potential perspective to take in my research.

7) Mumby, D. K. and Ashcraft, K. L. (2006). Organizational communication studies and gendered organization: A response to Martin and Collinson. Gender, Work and Organization, 13, 68-90.

Mumby and Ashcraft argue gender in organizational communication “is enacted in a complex field of discursive and nondiscursive relations of power, accommodation and resistance” (p. 75). This article is a possible direction for the analysis of my research.

8) Foner, N. (1994). The caregiving dilemma: Work in an American nursing home. Berkely, CA: Unversity of California Press.

Foner’s ethnographic research study provides a detailed description of a nursing assistant’s place within a regulated and bureaucratic organization. Her work will be used to describe the work, and organizational experience of nursing assistants.

9) Farmer, B. C. (1996). A nursing home and its organizational climate. Westpoint, CT: Greenwood Publishing Group.

Farmer describes the organizational climate in a nursing home in her ethnography. Her historical overview of the nursing home in the United States and her description of the nursing home as an organization will be used in this study.

10) Diamond, T. (1992). Making gray gold. Chicago: The University of Chicago Press.

This ethnographic study describes the work of nursing assistants, and depicts how their work is situated in a political, economic, and cultural context. His description will provide an overview of nursing assistants’ work. The theoretical perspective he uses may be used for this study.

11) Preidt, R. (2009, August 5). Not-for-profit nursing homes fare better in studies. Retrieved September 10, 2009 from the National Instituted of Health website, http://www.nlm.nih.gov/medlineplus/news/fullstory_87774.html

This study funded by the NIH compared the quality of care between for-profit and not for-profit nursing homes. The article will be used to justify the use of qualitative methods in nursing homes.

12) Ashcraft, K.L. (2004) Gender, discourse, and organizations: Framing a shifting relationship. In Grant, D., Hardy, C., Oswick, C., Phillips, N. and Putnam, L.L. (eds), Handbook of Organizational Discourse, pp. 275–98. Thousand Oaks, CA: Sage.

Ashcraft describes how discourse analysis can be used in organizational research. This is a potential methodological approach to the research study.

13) Ashcraft, K.L. and Mumby, D.K. (2004) Reworking Gender: A Feminist Communicology of Organization. Thousand Oaks, CA: Sage.

This article promotes a framework to researching gender in organizations. This is a potential area to focus on and framework for my research study.

14) Oglensky, B.D. (2008). The ambivalent dynamics of loyalty in mentorship. Human Relations, 61, 419-448.

This article uses a dialectical approach to studying mentoring. Dialectics, specifically resistance and control, is a potential area of research in this study.

15) Ashcraft, K. L. (2005). Resistance through consent? Management Communication Quarterly, 19, 67-90.

This article describes how resistance and power are played out in an organizational setting. Again, this is a potential area of research in this study and would be used in the methodology section.

16) Ashcraft, K. L. (2007). Appreciating the ‘work’ of discourse: Occupational identity and difference as organizing mechanisms in the case of commercial airline pilots. Discourse & Communication, 1, 9-36.

Ashcraft provides a feminist and critical perspective on the airline pilot occupation. Her theoretical perspective is a potential theory that could be used to interpret data in my research study.

17) Montgomery, R., Holley, L., Deichert, J., and Kosloski, K. (2005). A profile of home care workers from the 2000 census: How it changes what we know. The Gerontologist, 45, 593-600.

This article provides a nice overview of working with the elderly. It will be used to describe the nursing assistant profession.

18) Gass, T. E. (2004). Nobody’s Home. Ithica, NY: Cornell University Press.

Gass provides a rich description of the care giving provided in a for-profit nursing home. His experience of working in a nursing home will be used to describe the demanding, and sometimes downright gross, work provided by nursing assistants in nursing homes.

19) Anderson, R. A., Ammarrell, N., Bailey Jr., D., Colon-Emeric, C. Corazzini, K. N., Lillie, M., Piven, M. L. S., Utley-Smith, Q., McDaniel Jr. R. R. (2005). Nurse assistant mental models, sensemaking, care actions, and consequences for nursing home residents. Qualitative Health Research, 15, 1006-1021.

This qualitative research study analyzed observation and interview data to describe two mental models of nurses in a nursing home. The study will be used in the method section to show how interview techniques has been used to examine work experience in nursing homes.

20) Mumby, D. K. (2001). Power and politics. In F. M. Jablin and L. L. Putnam The New Handbook of Organizational Communication, pp. 585-623. Thousand Oaks, CA: Sage.

Mumby outlines methodological implications for researching power in organizations. This is a potential area in my research study, and his suggestions for methodology may be used in the methodology section.

Project Timeline: Waterford Retirement Community

Week 1: September 2nd

Project timeline – Think/write/edit schedule for the semester

IRB amendment – Write amendment to my open IRB form

Week 2: September 9th

Project timeline – Post on my course blog (DUE DATE)

IRB amendment – Submit amendment to Dr. Platt for review (DUE DATE)

Project site – Schedule meeting with Kari Dick (Executive Director) at Waterford (DUE DATE)

Literature review – Begin searching and gathering literature

Paper proposal – Think/write/edit

Week 3: September 16th

IRB amendment – Submit to IRB for approval (DUE DATE)

Literature review – Post annotated bibliography on my course blog & start writing (DUE DATE)

Paper proposal – Post final paper proposal on my course blog (DUE DATE)

Project site – Discuss and plan (new) project with Kari Dick at Waterford (DUE DATE)

Week 4: September 23rd

Project site – Waterford/Kari Dick revises or approves focus group dates and times

Literature review – Think/write/edit

Week 5: September 30th

IRB amendment – (hopefully approved)

Literature review – Think/write/edit

Data collection – Begin collecting data at Waterford (focus group #1)

Data transcription – Start transcribing audio from FGs

Methods section – Think/write/edit

Week 6: October 7th

Literature review – Post on my course blog (DUE DATE)

Data collection – Continue collecting data at Waterford (focus group #2)

Data transciption – Continue transcribing audio from FGs

Methods section – Think/write/edit

Week 7: October 14th

Methods section – Post on my course blog (DUE DATE)

Data collection – Continue collecting data at Waterford (focus group #3 & #4)

Data transcription – Continue transcribing audio from FGs

Week 8: October 21st

Data collection – Complete data collection (DUE by 5:00 p.m. on Friday, October 23rd)

Data transcription – Continue transcribing audio from FGs

October 23rd

Data transcription – Complete transcribing audio from FGs

Data analysis – Start analyzing & coding transcriptions from FGs

Week 9: October 28th

Data analysis – Continue analyzing & coding transcriptions from FGs

Week 10: November 4th

Data analysis – Continue analyzing & coding transcriptions from FGs

Contribution/limitations – Think/write/edit

Functional outline of final paper – Think/write/edit

Week 11: November 11th

Data analysis – Continue analyzing & coding transcriptions from FGs

Contribution/limitations – Think/write/edit

Functional outline of final paper – Think/write/edit

Week 12: November 18th

Data analysis – Complete analyzing & coding transcriptions from FGs (DUE DATE)

Contribution/limitations – Post on my course blog (DUE DATE)

Functional outline – Post on my course blog (DUE DATE)

First draft of final paper– Think/write/edit

Week 13: November 25th

First draft of final paper– Think/write/edit

Week 14: December 2nd

First draft of final paper – Submit electronically (DUE by 5:00 p.m. on Friday, December 4th

Classmate papers – Review & write letters to the journal editor

Week 15: December 9th

Classmate papers – Submit letters to the journal editor (DUE by 5:00 p.m. on Friday, December 11th)

Week 16: December 16th

Final draft of paper – Submit (DUE by 5:00 p.m. on Friday, December 18th)

Waterford presentation – Discuss presentation date/time with Kari Dick at Waterford

Week 17: December 23rd

Waterford presentation – Think/write/edit

Waterford presentation – Present findings of my research project to Waterford residents & staff by end of March, 2010

Academic Biography

Kristina Wenzel is a Master’s student and Graduate Teaching Assistant in Communication at North Dakota State University. She received her B.A. in 2006 from the University of St. Thomas (St. Paul, MN) in Business Communication with a Minor in Women’s Studies.

Wenzel’s area of interest is in organizational communication. She is primarily interested in the transition from work to retirement, and long-term care organizations that serve the elderly. Wenzel’s current research explores how people make sense of layoffs, and how nursing assistants in nursing homes make sense of their work experience and occupation. In addition, she hopes to begin research on communal coping in long-term care organizations.

Wenzel currently teaches Fundamentals of Public Speaking and Introduction to Women’s Studies. She plans to earn her M.A. under the direction of Dr. Amy O’Connor in May, 2010.