Just a week ago, I was delighted and surprised to learn that our graduating students knew and found resonance in my 30-year-old research about the emotional labour of nursing.

I first heard about emotional labour in a 1983 study about flight attendants by sociologist Arlie Hochschild who developed the notion of ‘emotional labour’ to describe the emotional component of work (smiling, friendliness, kindness) as a paid requirement of the job. Emotional labour is “the induction or suppression of feeling in order to sustain an outward appearance that produces in others a sense of being cared for in a convivial safe place”. This helped to make sense of my own research. 

It was the 1980s: most nursing students were apprentices, earned NHS salaries and provided 75% frontline care. As I interviewed students, I began to connect care, emotions and work through the language they used. Hard emotional labour was required to maintain a smile, remain calm and care for patients. The leadership style of the ward sister was key in setting the emotional tone. 

As one student put it: “Sisters are critical because of their influence on staff nurses. They in turn influence how the students work and how they feel – their morale’. Another student described feeling “more at ease” when she knew the ward sister cared, so she didn’t need to “take the caring attitude of the whole ward on my shoulders”. The ward sister’s emotional tone improved patient care by encouraging nurses to listen actively to help patients’ ‘emotional side’ and improve their chances of recovery.  It also gave nurses a feeling of “togetherness” to remain engaged and “get through the work”.  

Emotional labour provides a language to recognise, support and manage emotions especially in uncertain times. This was evident during the COVID-19 pandemic. Nurses created ways to communicate at a distance to help the emotional side of very sick and dying patients isolated from loved ones. Nurses also recognised that acknowledging the emotional side helped them to be kind to themselves, taking frequent breaks, talking to counsellors and finding online resources. The pandemic revealed not only what nurses and other nursing staff do but also the urgent need to address extreme inequalities among global majority communities, many of them nurses. 

Early on, UK and US researchers recognised that the high incidence of COVID-19 among diverse communities was not a simple matter of biology and genes but a lot about social and structural inequalities. Surveys revealed more global majority workers including nurses, particularly in London, were in frontline jobs and therefore at extra risk. The findings of an RCN survey were particularly disturbing. They suggested that personal protective equipment (PPE) was less accessible to global majority health workers than their white European colleagues. I am a Nurse, Not a Hero, A Memory Book, by frontline nurses in and around London during COVID-19’s first wave, vividly recalls their lived experiences. 

As the clapping and hero status faded, the extraordinary contribution nursing staff made during the pandemic was forgotten. So, how to keep the light shining to value and protect the emotional labour of nursing? I think it’s about handing the baton to the next generation of nurses to give them a lens to recognise and manage their emotional labour. 

I was delighted to find my research still resonated with our newly graduating students. They reaffirmed the importance of the ward manager, despite mixed experiences of their influence on their learning. They also felt, although supernumerary, that they made a significant contribution to frontline care. They loved the highs and embraced the lows of their nursing programme, were delighted to have secured NHS employment and aspired to give the best patient care. 

Their excitement was palpable at the prospects of an exciting career and a powerful antidote to the gloomy predictions of a 35% drop in applications to study nursing. To counter the crisis and implement the NHS reforms, the RCN urges the UK government to launch a fully funded student recruitment campaign. 

Emotional labour is about exchange value. It doesn’t come free. Reducing the burden of debt and increasing bursaries and wages puts emotional labour at the heart of nursing to make it a valued and attractive career.