The contours of context: The impact of occupational setting, worker social location and interactional targets/participants on emotional labour (EL) and emotion work (EW) in the helping professions


Alison Starkey, OISE, University of Toronto

This work seeks to outline empirical differences seen in the scholarly literature between commercial and healthcare settings by exploring how occupational context, the social location of the worker, and type of interactional target/participant impacts healthcare workers’ experiences. It will address how EL and EW theories insufficiently describe the conditions of work for gendered racialized healthcare workers (HCWs), specifically retail pharmacists in southern Ontario. Doing so will elucidate the stratification gendered racialized workers experience within healthcare institutions and organizations, how this stratification challenges notions of mobility within these spaces, and how actualities of workplace violence (WPV), precarity and immobility undergirds discourses around the conceptions of healthcare work as safe, secure, and a pathway to ‘success’. As the conditions of work are the conditions of care and the conditions of care are the conditions of work (Mehra, 2020; Keith and Brophy, 2021), the quality of workplace experiences are directly correlated with worker retention, effective patient care, and functionally sustainable healthcare systems. In an era of healthcare polycrises, HCW retention is a key concern in developing and maintaining sustainable and effective patient care. The frequency of violence against HCWs has risen over the years with the understanding that it is often under-reported. Globally in 2022, more than half of HCWs (55%) experienced WPV firsthand and 16% reported witnessing it against their colleagues (Banga, et al., 2023). Of those who regularly experienced verbal, emotional, and physical violence, 55% felt less motivated and more dissatisfied with their jobs, and 25% expressed a willingness to quit (Banga, et al., 2023). Retail pharmacists are part of a worldwide trend in the increase of WPV (Bhagavathula, et al., 2022). Bhagavathula and colleagues (2022) estimate almost half of pharmacists experience WPV – violence that includes both serious assaults and threats. This is significantly higher than collective reports of WPV among HCWs (Bhagavathula et al., 2022). In the Canadian context, 37% of all working pharmacy professionals experience abuse or harassment from patients at least weekly and 19% report daily occurrences (CPhA, 2023). The Abacus Data Mental Health and Workforce Wellness Survey (2022) revealed that almost half (48%) of polled pharmacists indicated they wanted to or were thinking of leaving the profession (CPhA, 2022, 2023). Women, and increasingly racialized women, are overly represented in the ‘caring’ professions. In 2016, women comprised 75% of the paid care workforce in Canada, 21.1% of which were, in government parlance, of a visible minority (Khanam, et al., 2022). Women make up 62% of the national (Khanam, et al., 2022) and 58% of the Ontario provincial pharmacy profession (OCP Annual Report, 2022). The gendered nature of ‘caring’ jobs assumes a ‘natural’ or ‘essential’ nature to carework/labour (Erickson and Stacey, 2013). Gender bias in medicine is well-documented and is compounded when women are concomitantly racialized (Wingfield, 2019). The ‘meaning’ and consequences of emotion experiences within the increasingly racialized demographics of these workers is rarely or inadequately addressed. These ‘racial silences’ (Mirchandani, 2003) are endemic across disciplines. Seldom the explicit focus when discussing either WPV, equity work, the process of coping with sexism and racism in workplaces, or their aftermath outside of work and impact on health and well-being, emotions do, however, inform much of this research. Gendered racialized women HCWs cope with daily practical demands, work intensification, and WPV through practices and strategies that combine EL and EW and yet extend beyond these concepts on an emotional continuum. Scholarly frameworks show empirical variations between EL and EW in commercial and healthcare environments that are insufficiently addressed in the literature by these approaches (Erickson and Stacey, 2013). The occupational context of retail pharmacist is one that is simultaneously commercial and healthcare. Interrogating this occupational context, the social location of gendered racialized women pharmacists, and the interactional targets/participants of patients, who are also customers, occurring in retail pharmacies will shed light on other HCW contexts. Drawing on an analysis of the multi-disciplinary application of EL and EW theory to the experiences of various HCWs, comparisons to the literature on retail pharmacists will be made and supplemented by empirical interviews with gendered racialized women pharmacists from the southern Ontario region. Such comparisons will serve to bridge the empirical variations noted above.

This paper will be presented at the following session: