Distributed Responsibility and the Extended Patient: The Emotional Work of Healthcare Professionals in Neonatology

Abstract

The purpose of this paper is to examine how different aspects of emotional work are structured for physicians and nurses working in neonatal care. The paper is based on focus group data, self observations of a neonatal intensive care physician, and participant observation conducted by social researchers. The data was collected in 2019–2023 in the framework of the project entitled “The Birth of the Patient”. We focus on how different organisational and institutional settings, as well as the professional status of medical professionals, affect the amount and nature of emotional work. On the one hand, neonatology is in many ways an area of medical care that requires teamwork; on the other hand, the performance of teamwork relies heavily on containing the dissatisfaction, irritation, and criticism of colleagues from other professional groups. Another sphere of emotionally intense communication is the interaction with parents and other relatives of the newborn. Drawing on the conceptual apparatus proposed by Monique Scheer, we address emotions as practices embedded in actual social relations, drawing on habitus and simultaneously fulfilling different communicative tasks. The analysis of the material collected revealed that the key features of the field under study are: 1) the clinical uncertainty of the patient’s condition and trajectory, 2) the mistrust between the different sectors and stages of neonatal care, and 3) the need for each medical professional to take responsibility for medical decisions, which in their turn are partly determined by previous professional decisions and the patient’s prior trajectory.