Heart Work: Challenges and Adaptations of Hospice Workers

This dissertation analyzes the everyday work experiences of hospice, a type of end-of-life care. The following chapters integrate micro-sociological perspectives with meso- and macro- level explanations of organizational behavior to account for workers' performances of emotional labor, care-related identities, constraints on their daily work, and ultimately hospice workers' strong commitment to their jobs and the hospice philosophy. Using a mixed methodological approach, I argue that hospice workers engage in emotional labor, but that instead of feeling dissonance or alienation, hospice workers develop a positive identity around their work. Their identities and work experiences are still constrained by institutional forces, however. Hospice workers' experiences highlight two tensions in the administration of caring labor: keeping commitment during times of organizational change and balancing the needs of the self with the needs of the care recipient. The main contributions of this work include new understandings of the relationships between identity, emotions, and work; a novel combination of theories that better explain care workers' behaviors and constraints on their action; and, a refined approach to thinking about emotional labor