IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v215y2018icp152-159.html
   My bibliography  Save this article

“We've all had patients who've died …”: Narratives of emotion and ideals of competence among junior doctors

Author

Listed:
  • Crowe, Sophie
  • Brugha, Ruairi

Abstract

Although there is reasonably rich literature on socialisation in medical schools, few studies have investigated emotional socialisation among qualified doctors; specifically how specialist training reproduces the norms, values, and assumptions of medical culture. This article explores expressions and management of emotion in doctors' narratives of work and training for insights into how socialisation continues after graduation. The study employed qualitative methods - in-depth interviews - with fifty doctors at early and advanced stages of specialist training in teaching hospitals in Ireland. The study found that performance of competence, particularly for doctors at earlier training stages, required them to hide signs of struggle and uncertainty. Competence was associated with being emotionally tough, which involved hiding emotional vulnerability; however, some challenged the assumption that doctors should be able to transcend emotionally painful events. Tensions between this expression of competence and making time for self-care meant that the latter was often neglected. Some participants highlighted how they enjoyed more personal interactions with patients, which was juxtaposed with the expectation of being detached and an associated potential to objectify patients. This theme resonates with recent debates on “appropriate” expressions of empathy and its implications for patient-doctor relationships. The article discusses how ideas underpinning the image of medical invincibility should be questioned as part of efforts to reform medical culture and in the training of specialists in emotional wellbeing and self-care.

Suggested Citation

  • Crowe, Sophie & Brugha, Ruairi, 2018. "“We've all had patients who've died …”: Narratives of emotion and ideals of competence among junior doctors," Social Science & Medicine, Elsevier, vol. 215(C), pages 152-159.
  • Handle: RePEc:eee:socmed:v:215:y:2018:i:c:p:152-159
    DOI: 10.1016/j.socscimed.2018.08.037
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953618304696
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.socscimed.2018.08.037?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Underman, Kelly, 2015. "Playing doctor: Simulation in medical school as affective practice," Social Science & Medicine, Elsevier, vol. 136, pages 180-188.
    2. Underman, Kelly & Hirshfield, Laura E., 2016. "Detached concern?: Emotional socialization in twenty-first century medical education," Social Science & Medicine, Elsevier, vol. 160(C), pages 94-101.
    3. Brown, Brian & Crawford, Paul & Nerlich, Brigitte & Koteyko, Nelya, 2008. "The habitus of hygiene: Discourses of cleanliness and infection control in nursing work," Social Science & Medicine, Elsevier, vol. 67(7), pages 1047-1055, October.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Vinson, Alexandra H. & Underman, Kelly, 2020. "Clinical empathy as emotional labor in medical work," Social Science & Medicine, Elsevier, vol. 251(C).
    2. Underman, Kelly & Hirshfield, Laura E., 2016. "Detached concern?: Emotional socialization in twenty-first century medical education," Social Science & Medicine, Elsevier, vol. 160(C), pages 94-101.
    3. Underman, Kelly, 2015. "Playing doctor: Simulation in medical school as affective practice," Social Science & Medicine, Elsevier, vol. 136, pages 180-188.
    4. Grace, Matthew K. & VanHeuvelen, Jane S., 2019. "Occupational variation in burnout among medical staff: Evidence for the stress of higher status," Social Science & Medicine, Elsevier, vol. 232(C), pages 199-208.
    5. Kroll, Camille & Murphy, Julia & Poston, Lindsay & You, Whitney & Premkumar, Ashish, 2022. "Cultivating the ideal obstetrical patient: How physicians-in-training describe pain associated with childbirth," Social Science & Medicine, Elsevier, vol. 312(C).
    6. Jenkins, Tania M., 2023. "Physicians as shock absorbers: The system of structural factors driving burnout and dissatisfaction in medicine," Social Science & Medicine, Elsevier, vol. 337(C).
    7. Aaron Baugh & Reginald F. Baugh, 2020. "Assessment of Diversity Outcomes in American Medical School Admissions: Applying the Grutter Legitimacy Principles," Sustainability, MDPI, vol. 12(12), pages 1-17, June.
    8. Menon, Alka V. & Sariego, Chloe, 2022. "Engendering connection: The embodied emotional labor of U.S. cosmetic surgeons," Social Science & Medicine, Elsevier, vol. 306(C).
    9. Grace, Matthew K., 2017. "Subjective social status and premedical students' attitudes towards medical school," Social Science & Medicine, Elsevier, vol. 184(C), pages 84-98.
    10. Goranson, Amelia & Sheeran, Paschal & Katz, Julia & Gray, Kurt, 2020. "Doctors are seen as Godlike: Moral typecasting in medicine," Social Science & Medicine, Elsevier, vol. 258(C).
    11. Mackintosh, Nicola & Humphrey, Charlotte & Sandall, Jane, 2014. "The habitus of ‘rescue’ and its significance for implementation of rapid response systems in acute health care," Social Science & Medicine, Elsevier, vol. 120(C), pages 233-242.
    12. MacIntosh, Robert & Beech, Nic & Martin, Graeme, 2012. "Dialogues and dialetics: Limits to clinician–manager interaction in healthcare organizations," Social Science & Medicine, Elsevier, vol. 74(3), pages 332-339.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:215:y:2018:i:c:p:152-159. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.