Emotional geographies of care work in the NHS

Carescapes, such as the National Health Service (NHS), are highly complex emotional landscapes that engender intense feelings in health care professionals and their patients. Whilst emotions saturate care work they have been given limited consideration. Re-focusing care work through an emotional geographies lens enables greater emphasis on the places and spaces in which care is delivered.

Ethnographic observations and semi-structured interviews were conducted across four NHS Trust sites to explore the emotional care experiences and practices of health professionals. Qualitative data were analysed using thematic analysis, from which five themes emerged: i) geographies of emotional attachment ii) geographies of emotional detachment iii) spatialities of care logistics iv) workplace relationships and v) affective qualities of care work.
Findings emphasise that different carescapes impose discrete challenges to the emotion management of health professionals. The spatial and temporal characteristics of carescapes are fundamental to the construction of emotional care relationships. Carescapes, characterised by slow patient turnover and limited clinical intervention, facilitate the development of emotionally attached care relationships through care practices that encourage proximity and tactile care behaviours. Conversely, carescapes characterised by rapid patient turnover, intensive clinical intervention and / or death may result in emotionally detached care relationships. The mobility of ambulance care work however complicates this mapping of care.

Logistical spaces are used to manage and contain health professionals’ emotions. Additionally, logistical decision-making is emotionally exhausting, especially for those working at the interface between private and public care. Finally, workplace relationships mediate between closeness and distance. Working in close proximity encourages emotional talk, reducing the emotional burden of care but may also provoke tensions that challenge professionals’ emotional labour.
Understanding the emotional terrain of the NHS may support health professionals to more effectively manage their emotions within different carescapes. This could lead to better emotional and psychological well-being for health professionals.