Healthcare Professionals’ Emotional Labor and Management of Workplace Violence with Underserved Patients in the Safety Net Context

ABSTRACT

Healthcare providers (HP) work in high-stress situations, interacting with patients and families who are often in crisis. HPs who work in safety net clinics, which provide care to uninsured, Medicaid recipients and other vulnerable populations, interact with patients who are frequently frustrated by long wait times, extensive paperwork, short appointments, and have generally lower health literacy. Many patients have chronic conditions and substance use disorders which has been associated with higher likelihood to be perceived as verbally aggressive and/or perpetrate workplace violence (WPV). Using interviews with 26 HPs at safety net clinics, we investigated how HPs manage interactions with aggressive patients and avoid burnout. Findings are based on emotional labor constructs describing why and how workers use emotion management strategies to smooth communication and relationships with clients/patients. According to our participants, HPs perform emotional labor to de-escalate interactions, prevent WPV, and to develop relationships with patients who might become regular clinic patients. We found that HPs perceive an influence of the clinic context on patient aggression management, hold initial perceptions that shape engagement with aggressive patients, and report emotional labor and burnout that came from interacting with aggressive patients to prevent WPV. We offer implications that extend research on emotional labor and burnout, provide guidance to healthcare organizations, and offer directions for future theory and research.

Acknowledgments

The authors would like to thank the students who assisted with this study’s data collection and audio recording transcription, especially Amber Klein, Laurent Wang, and the health professionals who participated in the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. All participants have been assigned a pseudonym using a random name generator that matches the age range and gender identity of participants. Given that their real names were never documented by any member of the research team to maintain confidentiality, their pseudonyms are not meant to capture their essence.

Additional information

Funding

This project was supported by the McCune Dissertation Fellowship Award.