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QXD 3/17/01 1:26 PM Page 42

Article

Emotional labour of nursing

revisited: Caring and
Learning 2000
Pam Smith and Benjamin Gray

Hochschild (1983) suggests that emotional labour involves the induction or suppression of
feeling in order to sustain in others a sense of being cared for in a convivial safe place.
James (1993) highlights the similarities and differences between emotional and physical
labour, with both requiring experience and skill which are subject to immediate conditions,
external controls and gendered divisions of labour.
Smith (1992) applied the notion of emotional labour to the study of student nursing,
concluding that further research was required to grapple with the conceptual complexity of
defining care, especially in relation to its emotional components and demands (Smith 1992).
This means investigating what is often seen as a tacit and uncodified skill.
A follow-up qualitative study was recently conducted to seek current definitions and
clarification of emotional labour in the context of changes in health policy, nurse education,
locations and methods of practice. Data were collected during interviews and focus groups
with student and qualified nurses, nurse educators and doctors in primary and acute care
settings.
The paper covers current definitions and meanings of emotional labour; students’ views of
education and clinical support; contexts of emotional labour in which students learn with
specific reference to mental health and oncology care in both the original and follow-up
Pam Smith PhD,
MSc, BNurs, RGN,
studies; a proposal to introduce complementary theoretical models to expand and develop
RNT, Professor of educators’ and practitioners’ understanding of the role emotional labour plays in student
Nursing,
Benjamin Gray
nurse learning and caring; a summary of the main findings and their implications for
PhD, BA (Hons), education and practice. © 2001 Harcourt Publishers Ltd
Research Fellow,
South Bank
University, Faculty
of Health, Essex Introduction Smith (1992) applied the notion of emotional
Campus, Harold
Wood Education Definitions and application labour to the study of student nursing,
Centre, Gubbins concluding that further research was required
Lane, Harold of emotional labour
to ‘grapple with the conceptual complexity
Wood, Romford
RM3 0BE, UK. Hochschild (1983) suggests that emotional of defining care, especially in relation to its
Tel.: ;44(0)20 labour involves the induction or suppression of emotional components and demands’ (Smith
7815 5914; Fax: feeling in order to sustain in others a sense of 1992, p. 9). This means investigating what are
;44(0)20 7815
5907; E-mail: being cared for in a convivial safe place. The often seen as a tacit and uncodified skills
smithpaa@sbu.ac. phrase emotional labour highlights the associated with emotions at work in order to
uk similarities as well as differences between assure their transferability.
(Requests for emotional and physical labour, with both being A follow-up qualitative study was recently
offprints to PS) skilled work requiring experience and effected conducted to seek current definitions and
Manuscript by immediate conditions, external controls and clarification of emotional labour in light of
accepted: 14
December 2000
subject to divisions of labour (James 1993). changes in health policy, nurse education,

42 Nurse Education In Practice (2001) 1, 42–49 © 2001 Harcourt Publishers Ltd

doi:10.1054/nepr.2001.0004, available online at http://www.idealibrary.com on
NEPR-04.QXD 3/17/01 1:26 PM Page 43
different clinical locations and methods of
practice (Smith & Gray 2000, DoH 1999, UKCC
1986, 1999a,b). The United Kingdom Central
Council for Nursing, Midwifery and Health
Visiting (UKCC 1999a), for example, calls for
better support systems and innovative
approaches to practice education to be
developed by service providers and lecturers
for pre-registration students and newly
qualified staff. Data were collected from
student nurses and qualified staff in hospital
and primary care settings.
Hochschild’s model was then applied to the
data to describe specific empirical examples
from nursing, while also investigating the
relevance of the concept of emotional labour to
different patterns and clinical learning contexts
of care in nursing. In other words, the
strengths, weaknesses, horizons and
limitations of Hochschild’s notion of
emotional labour were assessed and
complementary frameworks identified by
which emotions in student nurse learning
and caring may be addressed.
In this paper, the Methodology includes
study design, sample and methods. Findings
include current definitions of emotional labour;
students’ views of education and clinical
support; and application of the concept in the
mental health and children’s oncology settings.
Discussion includes an outline of
complementary frameworks to address the
study of emotions in nursing. Conclusion
includes a summary of the main findings and
their implications for nurse education and
practice.
Methodology
The 6-month pilot study on which this paper is
based, drew from three traditions of empirical
qualitative data collection in the social sciences:

Ethnomethodology (Garfinkel 1967) which
looks at ‘members’ meanings’ and the sense
making activities of people in their everyday
lives. Ethnomethodology explores ways in
which people make sense of the world and
other people around them, describe
themselves, their different commonsense
notions and expectations. This means a
focus on the ways in which nurses give care
© 2001 Harcourt Publishers Ltd
Emotional labour of nursing revisited
and reflect on the care that they give to
patients.

Grounded theory (Glaser & Strauss 1967)
is the collection of data based upon nurses’
views of the processes associated with
emotional labour. The data are then used
as evidence to build models of nurses’
emotional labour and depict their
experiences from the frontline in ways
relevant to policy, education and practice
development.

Feminist methods in health are especially
relevant given that on average 84% of
student nurses in the local trusts surveyed
are women. Feminism is also helpful in
looking at gendered divisions of labour, for
example the types of work that go paid or
unpaid in society, and is pertinent in
assessing the nursing profession’s work in
comparison to the work expected of other
professions in the NHS (Oakley 1974, 1981,
Webb 1993).
Study design, sample and methods
The 6-month pilot investigation gathered
qualitative data from a variety of sources
(Smith & Gray 2000). Local ethics committee
approval was sought and obtained. The sample
was opportunistic and purposive and the
respondents were selected to address the
aims of the study. Current definitions and
clarification of emotional labour in
contemporary health care and educational
contexts were sought from key respondents
who included 16 interviewees and 27
questionnaire respondents. The main data
sources were:

Indepth and semi-structured interviews
with pre-registration nurses and qualified
staff from both hospital and primary care
settings

Focus groups, seminars and meetings with
mentors, students, and local representatives
from the Student Council for Nursing (SCN)

Questionnaire data including two sets of
sample questionnaires on emotional labour
and images of nursing

Participant and non-participant observation
during student nurse classes.
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Emotional labour of nursing revisited
Findings
Qualitative data analysis was undertaken to
identify themes which addressed the research
questions pertaining to current definitions and
the role and processes of emotional labour in
learning and caring in nursing. The themes,
which address current definitions of emotional
labour and students’ and nurses’ views in
a variety of clinical contexts, are presented
below.
Nurses’ definitions of emotional labour
Several nurse respondents echoed Hochschild’s
(1983) definition and said that emotional
labour was ‘continuous contact’, ‘feeling like
you’re on-call 24 hours a day and always
available to the public’, and ‘giving the patient
the feeling of being safe and warm’.
Indeed, all of the nurses identified
emotional labour as a chief part of the nurse’s
role in making patient’s feel ‘safe’,
‘comfortable’ and ‘at home’. One student
nurse said:
I feel that emotional labour is the way
that nurses look after people so they feel
comfortable and their relatives feel that
they are safe … A part of nursing is to
show you care for them, even if you’re
having a terrible day and are fed up
yourself and with everyone else. You
have to give them that extra support they
need … Clinical and emotional skills
come with the experiences of the job and
you have to get in contact with your
emotions and how the patient feels.
Against some of the more critical literature on
emotional labour in nursing, none of the nurse
respondents discounted emotional labour
from the work that they did in clinical and
non-clinical settings. ‘Talking about emotions’,
as one nurse said, ‘is a key part of the job that
helps you to understand what to do’.
Emotional routine of nursing and its
social and psychological components
Emotional labour was also seen as ‘part and
parcel of the normal routine of nursing’.
Emotional labour was identified as social, in so
far as it related to ‘making patient’s feel at
44 Nurse Education In Practice (2001) 1, 42–49
home’, fostered a ward environment that was
based on the model of ‘a sort of family’. It
involved talking about how staff and patients
felt.
Emotional labour also touched upon
psychological aspects of care such as
‘friendship’, ‘ being more intimate and building
up trust with the patient’ and ‘showing the
patient a little bit of love’. This might involve
‘just making a gesture to the patient and
holding their hand to make them feel better’.
These social and psychological aspects of
emotional labour were viewed as a routine part
of nursing that helped maintain the running of
clinical areas. All the nurses interviewed said
that emotional labour helped in ‘oiling the
wheels’ of nursing work, like secretaries in
another study who ‘moved consumers through
the system’ (Saks 1990). These social and
psychological aspects mean that emotional
labour is a key component of interpersonal
relations in nurse–patient contact and integral
to methods of support in the health services
in general and student nurse education in
particular. As one nurse said: ‘It’s just sitting
with the patient and feeling that there’s a
link … It helps with the running of the ward
and everyone getting to know each other.’
Thus, emotional labour was reported as
making nurse and patient contact easier and
‘moving things along’ in terms of organising
the ward and the culture of care. This in turn
enhanced the student’s capacity to care. As one
student put it in the original research: ‘If know
the ward sister cares then I feel a bit more at
ease. Otherwise I feel that I have to take the
whole caring attitude of the whole ward on my
shoulders’ (Smith 1992, p. 76).
Sustaining emotional labour
in student nursing
In the current study, it was no longer the ward
sister who held this pivotal role in supporting
student nurses to care but the link lecturer and
the mentor (Smith & Gray forthcoming).
Consequently, the students had few leadership
models to draw upon in their education
suggesting the need to make the development
of new models of clinical leadership a priority
(RCN 1997, 1998). As they went through
3 years of education, the students developed
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their views on emotional labour and the job of
nursing through experience and being able to
talk reflectively about it while in the clinical
setting.
Link lecturers provided continuity between
educational and clinical contexts and fostered
reflective learning and informal emotional
support. As one student explained, the link
lecturer was able to help by talking through
upsetting situations, such as on one occasion
after a patient died, she ‘took a little extra time’
to talk issues through. For her part, the link
lecturer described how she used examples
from her own past experience to make links
with any difficulties the student might be
encountering in order to ‘work it through with
them and to see what to do next.’ The link
lecturer, therefore, was able to use reflective
learning as a form of emotional labour to shape
the student’s educational experience of caring
for patients in upsetting situations.
As a permanent member of the ward staff,
the good mentor was particularly helpful in
organising reflection on emotional labour
(Williams 1999) and assisting student nurses
to overcome transitions in their emotional
experiences. For example, the good mentor
would help students reflect on the ways in
which their professional and home lives
impacted on each other. The good mentor,
therefore, linked private emotions in the home
with public responses to emotions in the
nursing profession. This allowed the student to
reflect and learn from the connections that they
made in the mentoring relationship and gain
understanding through talking about
emotions. Egan’s (1990) model of the skilled
helper touches on similar themes as the ‘good
mentor’. Both the skilled helper and good
mentor help with pragmatism and ward
work, competence and problem resolution,
respect, and are informal and genuine (Egan
1990, p. 56).
Several strategies were mentioned as being
particularly helpful in augmenting emotional
labour and being of value to students in their
education, such as the selection of the mentor
by the student. Thus voluntary relationships
were favoured above mandatory ones. The
maintenance of good quality relationships and
the opportunity to change mentors if necessary
was also deemed important. Students
© 2001 Harcourt Publishers Ltd
Emotional labour of nursing revisited
expressed preference for mentors who had
contemporary knowledge, a fit of interests and
a match of personalities. Time and space to
invest in mentoring also needed to be
acknowledged, particularly as regards guided
reflection on emotions.
Clinical contexts of emotional labour
The mentor was particularly important to
student nurses given they reported the majority
of their learning took place on the wards. The
clinical contexts in which they nursed were
found to involve different requirements for
emotional labour. Several examples are shown
here in order to illustrate the variation and skill
required to engage emotional labour with
patients under very different circumstances.
The examples show the different ways in
which emotional labour works and the
different methods that nurses use in order to
manage emotions. The examples show the
methods that are employed by nurses to
sustain a comfortable and functioning health
service and the ways in which student nurses
can learn to manage their emotions.
Mental health
According to one mental health nurse:
It’s almost impossible not to take the way
you feel home with you. We do get some
chance to talk about patients at work but
I usually end up taking work home with
me and feeling very stressed … I talk
things over with my family … One of the
most emotionally difficult things about
mental health is trying to get to know the
patient and feeling that they might do
something like hit you.
There are two interrelated points to look at in
this nurse interviewee’s account. First, stress
and ‘taking work home’ are seen as a direct
result of not enough reflection with colleagues.
Second, stress is caused by difficulties that the
nurse has with the care and social control
elements of his work. ‘Trying to get to know
the patient’ sits in sharp contrast to the
image of mental illness as physical
aggression.
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Emotional labour of nursing revisited
A study by Handy (1990) shows that the
mandate to both care for and control patients
with mental health problems leads to
unresolved conflicts and distresses for all
involved. This is said by Handy to reproduce
distress and inequalities in health, especially
where discrepancies arise between daily
practices and therapeutic ideals, as is
recognized by the nurse in the above excerpt
(Handy 1990, 1991, Newton 1995; pp. 94–96).
The nurse indicates that talking about
conflicting emotions, which might involve
group work or one-to-one sessions after a shift,
would directly reduce the stress for him and
his family. This would not only lead to better
and clearer objectives in practice, in so far as
conflicting emotions would be reflected on and
moved forward, but would also help to
contribute to decreasing staff stress, burn-out
and attrition rates.
In the original study student nurses
particularly identified their psychiatric
experience as giving them models of emotional
support not encountered in the general setting.
As one student said:
If there was an intense staff reaction, say
when the patient’s being very aggressive
and you get upset. It would be put directly
to someone in charge. Everything would
stop. There would be a discussion … the
trained staff would start on you ‘How
does this effect you? Are you sure you
feel all right?’ (Smith 1992, p. 56)
The focus of the work on the psychiatric ward
was clearly defined around relationships
and feelings and how to manage them
systematically. The person in charge would
‘stop everything’ to discuss a patient issue and
how it affected the nurses which was a stark
contrast to the general wards (with the possible
exception of oncology) where patient care was
geared to keep going irrespective of how
nurses felt.
Over the past decade, speed up has occurred
in the current psychiatric setting and the
importance of mentoring relationships for
students and trained staff as the most recent
account demonstrates, cannot be
underestimated.
46 Nurse Education In Practice (2001) 1, 42–49
Children’s oncology care
As noted above, in the original study, oncology
was possibly the only specialty, other than
psychiatry, in which emotional labour was
explicitly recognized as part of the work.
Rather than issues of aggression and violence
associated with the psychiatric context, nurses
in the oncology setting had to deal with other
issues such as dying, death and bereavement
(Gray & Smith 2000, Kelly et al. 2000). In the
follow-up study, a nurse working in the
children’s oncology setting gave the
following account:
You get attached to the patient and
attached to the family. The last little boy I
looked after was diagnosed as leukaemic,
had chemotherapy and had a bone
marrow transplant … He was dying and
his parents just wanted him to be an
ordinary little boy. They were encouraged
to do that by (a specialist cancer centre).
I think that’s what all caring agencies
promote, what’s normal … But it was
taken to an extreme by health and social
services and the parents. The little boy
was apparently having nightmares and
could see ghosts, but because the little
boy’s parents had been told to maintain
the norm they didn’t know when to step
away and show their emotions.
As in the preceding extracts from the mental
health setting, systems of support and ways to
cope are central, especially given the rates of
burn out and the obvious emotional difficulties
of nursing staff. As the nurse added during her
interview:
I think if you are emotionally burnout,
you don’t give anything emotionally and
patients soon cotton onto that fact. There
are lots of nurses who are burnt-out and
who don’t know how to cope and do
erect a wall. But then if you continually
give and give and give and give, all the
things I might be saying might be the
right things, and I might have learnt
to say all the right things, but they
might not really mean anything to me
anymore.
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Huy (1999) confirms the nurse’s view:
Individuals obliged continually to enact
a narrow range of prescribed emotions
are likely to experience emotional
dissonance. This reflects the internal
conflict generated between genuinely
felt emotions and those required to be
displayed. This can result in emotional
exhaustion and burn out (Huy 1999, p. 13).
For a student in Smith’s original study the
encounter with a dying child was a particularly
difficult and lonely one (Smith 1992, p. 14).
The student who was in her second year found
herself on a paediatric ward caring for a 6-
year-old girl ‘who for some reason took to me,
her mother did and her family did too’. The
child eventually died, but during the dying
process, the student cared for her and her
family. The student recounted how surprised
she was that the trained staff had not asked her
if she was managing. ‘They think ‘cos you’re a
nurse you can manage. Outwardly you might
be managing but I used to go home and cry my
eyes out’. Eventually the student reported that
she learnt to cope by ‘trial and error’ and ‘by
switching off and being different at home’. The
question arises as to whether she did this by
becoming detached and alienated or by
remaining therapeutically involved.
Although the accounts are over 10 years
apart, both the qualified nurse and the student
share similar perceptions. Support for
emotional labour in these demanding contexts,
still appears to be in limited supply. However,
on an optimistic note, perhaps the student of
the 1980s has become the nurse of the
millennium, who because of her own
experiences, is better able to support and
mentor others. This was evident in the case of a
nurse working in the HIV/AIDS field who
described the need to:
… get emotionally in touch with the
patient and their needs. Part of what we
do is just acting as a long-term emotional
buttress for everyone and helping people
get over the difficult times. That’s what’s
expected. We get much closer because
that’s what we’re trained to do now.
This last comment is interesting in that
the nurse infers that she is prepared for the
© 2001 Harcourt Publishers Ltd
Emotional labour of nursing revisited
difficult task of managing complex emotions
and that she recognizes that training is
required in order to get closer to patients rather
than remain distant and detached as was
suggested by the nurses working with dying
children (Smith & Gray 2000). It may also be
inferred that training helps the nurse to be
better able to manage the interface between the
public emotions of the workplace and the
private emotions of the home as well as
mentoring others to do so. Furthermore, the
finding that the nurse working in the
HIV/AIDS setting wants to emotionally
engage, has resonance with findings by Bolton
(2000) who studied a group of gynaecology
nurses . The nurses described their emotional
work with patients as a ‘gift’ which they
regarded as an integral part of the labour
process of nursing.
Discussion
What is new? The need for
complementary frameworks
Given the complexity of emotions touched on
so far in these findings, especially as indicated
in what the respondents say at interview, it
is crucial to look at appropriate models of
understanding and development to inform the
future education of nurses and other health
professionals. It is necessary to assess the
horizons and limitations of Hochschild’s
concept of emotional labour. Hochschild’s
model has been thought about and applied in
several studies. It has been shown to be an
astute and useful tool in analysing emotions.
However, it may be appropriate to bring new
frameworks and models to the job so as to
complement existing studies on emotions in
health and provide a flexible theoretical base
for nurse educators, practitioners and
researchers.
One essential point to mention is that
Hochschild (1983) does not explicitly deal with
care and the provision of care in the health
services. Further study and complementary
frameworks are required to ‘grapple with the
conceptual complexity of defining care’ (Smith
1992, p. 9). As implied in the above excerpts
from the mental health and children’s oncology
settings, it is necessary to have complementary,
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Emotional labour of nursing revisited
theoretical frameworks in order to understand
the specialized skills of managing emotions
and illustrate the different ways in which care
and emotions are engaged in nurse–patient
relationships. Two complementary models are
outlined below.
Critical Companionship
Critical companionship (Titchen 1998) is a
model that draws from phenomenology and
explores the ways in which emotions are
engaged in nurse–patient relationships.
Critical companionship touches on ways of
managing emotional relationships and
sustaining contact, the need to reflect both
rationally and intuitively, and the importance
of the facilitative use of self in understanding
what we do. These are helpful in developing
‘craft knowledge’ (the know-how, spontaneous
and practical knowledge that is involved in
nursing). The use of experiential learning
and guided reflection develop supportive
relationships at work.
Containment
Containment (Bion 1961, 1991) is a
psychotherapeutic model that is relevant in
addressing responses to emotions in
organisations, such as the NHS. The basic
foundation of containment lies in the view that
people project anxieties onto one another.
Rather than negating emotions in nursing, so
as to describe emotions as aberrant or
irrational, the model of containment views
problems of care as difficult in emotional terms
but as a normal aspect of work. This in turn
means that emotional problems and learning to
care are dealt with actively to contain them.
Containment metabolises, responds and makes
feelings bearable so that feelings are listened
to, heard and acted upon at both an individual
and organizational level.
Conclusion
Recent research has revealed that there
has been a shift from the central role of the
sister/charge nurse to the link lecturer and
mentor. Identifying clear role models for
student nurses, and organizing reflection,
appreciation and development of emotions, is a
48 Nurse Education In Practice (2001) 1, 42–49
crucial step in sustaining the culture of care
that is a building block of nursing in the NHS.
Nurses and students continue to see emotional
labour as vital to care and part of the NHS
culture of care. Clinical leadership schemes
offer one approach to filling the gap created by
the loss of the ward sister as the central source
of support to nurses, students and ultimately
patients (DoH 1999, p. 54). Examples from
mental health and children’s oncology settings
demonstrate different situations in which
emotional labour techniques are required both
to care for patients and support student
learning. Given the recent emphasis on the
developing the multi-disciplinary workforce
for the NHS (DoH 2000) these findings have
implications for future skill development and
cross boundary working in order to ensure
holistic patient centred approaches to care.
Hochchild’s (1983) model of emotional
labour was useful as a device for defining ways
of managing emotions but was limited by
explicitly dealing with the complexity
associated with the education, practice and
management of care in the health service. This
suggests that there is no one single theoretical
approach to explain emotional labour. A
multi-model form of research may be
preferable in future studies. This will allow
research to address the management of
emotions and the complexities of both learning
to and providing care, as well as touching on
the social and psychological aspects. The
complementary frameworks of critical
companionship (Titchen 1998) and
containment (Bion 1961, 1991) were outlined to
illustrate ways forward in the study of
emotional labour, and to contribute to the
understanding and development of an
evidence base to inform more effective ways of
teaching and learning to care in a variety of
educational and clinical contexts.
Acknowledgement
The authors would like to thank the RCN and
Brunel University Emotional Labour and
Clinical Leadership focus group, who have
greatly contributed to the discussion.
References
Bion W 1961 Experiences in groups. Tavistock, London
Bion W 1991 The Long Weekend. Karnac Books, London
© 2001 Harcourt Publishers Ltd
NEPR-04.QXD 3/17/01 1:26 PM Page 49
Bolton SC 2000 Who cares? Offering emotions as a ‘gift’ in
the nursing labour process. Journal of Advanced
Nursing 32(3):580–586.
Department of Health (DoH) 1999 Making a difference.
Department of Health, London
Department of Health (DoH) 2000 A Health Service of all
the talents: Developing the NHS workforce
Consultation Document on the Review of Workforce
Planning. Department of Health, London
Egan G 1990 The Skilled Helper: A Systematic Approach to
Effective Helping. Brooks Cole Company, California
Garfinkel H 1967 Studies in Ethnomethodology. Prentice
Hall, NJ
Glaser B, Strauss A 1967 The Discovery of Grounded
Theory. Weidenfeld and Nicolson, London
Handy J 1990 Occupational Stress in a Caring Profession.
Avebury, Aldershot
Handy J 1991 The social context of occupational stress in a
caring profession. Social Science and Medicine 32(7):
819–830
Hochschild AR 1983 The Managed Heart. University of
California Press, Berkeley
Huy Q 1999 Emotional capability and corporate change.
Mastering Strategy
James N 1993 Divisions of Emotional Labour: Disclosure
and Cancer. In: Stephen Fineman (ed). Emotion in
Organizations. Sage, London
Kelly D, Ross, S, Gray, B, Smith P 2000 Death, dying and
emotional labour – problematic dimensions of bone
marrow transplant. Journal of Advanced Nursing
32(4):952–960
Newton T 1995 Managing Stress. Sage, London
Okaley A 1974 The Sociology of Housework. Martin
Robinson, London
Oakley A 1981 Interviewing women: a contradiction in
terms. In: Helen Roberts (ed). Doing Feminist Research.
Routledge and Kegan Paul, London
© 2001 Harcourt Publishers Ltd
Emotional labour of nursing revisited
Royal College of Nursing RCN 1997 RCN Ward Nursing
Leadership Project - A Journey to Patient Centred
Leadership. RCN, London
RCN 1998 Royal College of Nursing Leadership
Programme - Clinical Leadership. Development
Programme: Phase 2. RCN, London
Saks KB 1990 Does it pay to care? In: Abel EK, Nelson MK,
(eds). Circles of Care: Work and Identity in Women’s
Lives. SUNY Press, New York
Smith P 1992 The Emotional Labour of Nursing.
Macmillan, Basingstoke
Smith P, Gray B 2000 The Emotional Labour of Nursing, A
report for South Bank University and local trusts.
http://www.health-fc.sbu.ac.uk/emlab
Smith P, Gray B 2000 emotional labour in the routine of
nursing and in processes of death, dying and bereave-
ment. Nursing Times, 96(27):29–31
Smith P, Gray B (forthcoming) Reassessing the concept of
emotional labour in student nurse education – the role
of link lecturers and mentors in a time of change. Nurse
Education Today (accepted for publication November
2000)
Titchen A 1998 A Conceptual Framework for Facilitating
Learning in Clinical Practice. Centre for Professional
Education Advancement, Australia: Occasional Paper
No.2
United Kingdom Central Council for Nursing, Midwifery
and Health Visiting (UKCC) 1986 Project 2000: A New
Preparation for Practice. UKCC, London
UKCC 1999a Fitness for Practice. UKCC, London
UKCC 1999b Nursing Competencies, a circular of the
UKCC (ncomp). UKCC, London
Webb C 1993 Feminist Research: definition, methodology,
methods and evaluation. Journal of Advanced Nursing
18:416–423
Williams S 1999 Student carers: learning to manage
emotions. Soundings 11:180–186
Nurse Education In Practice (2001) 1, 42–49 49