Sociology PhD Highlights Emotional Labour of Nurses Working on Epidemic Care Frontline

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Healthcare systems depend not only on clinical expertise but also on the emotional strength of those delivering care.

This insight was very evident in the doctoral research of Dr Manchoko Phatela, who graduated with a PhD in Sociology. Her thesis titled: ‘Emotional Labour of Professional Nurses Working with Synergistic Epidemic Disease Patients: A Case Study of Professional Nurses at a Private Hospital in Durban, KwaZulu-Natal, South Africa’, completed under the supervision of Professor Mariam Seedat-Khan, examined the psychological demands placed on nurses caring for patients affected by overlapping epidemic conditions such as HIV, tuberculosis and related illnesses.

Phatela’s research grew from a strong interest in the sociology of work and clinical sociology, with a particular focus on how professional identity and emotional resilience shape the experiences of healthcare workers in demanding clinical environments.

“My research explored the psychological and emotional aspects of professional nurses’ work, the coping strategies they use, and the systemic and personal resources that either support or hinder their emotional wellbeing,” Phatela explained.

Her study highlights the intensity of emotional demands faced by nurses working in epidemic care settings, where exposure to trauma, patient suffering and loss form part of daily professional life.

“It is crucial to better understand the emotional demands placed on nurses working in high pressure clinical environments because of their frequent exposure to trauma, patient suffering, and loss,” Phatela said.

Participants in the study described the expectation to maintain calmness and empathy even while managing their own emotional responses to difficult situations.

“The nurses shared many experiences, including being required to suppress genuine emotional responses and convey calmness, empathy and composure despite their internal feelings,” Phatela noted.

The research also revealed how changing workplace conditions influence both stress levels and professional satisfaction. Improvements such as the introduction of digital systems helped reduce administrative pressure, although some nurses reported reduced opportunities for peer collaboration as responsibilities became more individualised.

“Nurses shared experiences of improving working conditions by utilising technology such as transitioning from paper based to digital systems like iPads, which helped alleviate stress and reduced paperwork,” Phatela explained.

At the same time, nurses described challenges related to maintaining professional boundaries, balancing personal and professional responsibilities, and coping with emotionally demanding patient relationships.

“They shared challenges such as lack of peer support, emotional attachment, difficulty maintaining professional boundaries, and the inability to balance their professional and personal lives,” Phatela said.

Many participants also highlighted the role of personal belief systems and reflective practices in helping them manage workplace stress.

“They shared that prayer, meditation, and their belief systems helped them manage stress, avoid workplace conflicts and practise empathy,” she noted.

Importantly, her research identified progress in how nurses experience working with patients affected by HIV and tuberculosis compared with earlier years, when fear of transmission was more common.

Participants emphasised the value of safety procedures and protective equipment in strengthening confidence and wellbeing in clinical environments.

“All hospitals in South Africa should prioritise Personal Protective Equipment (PPEs) for their nurses. This will give them a sense of protection as they do their work,” she said.

Her findings also highlight how emotional labour contributes not only to strain but also to professional pride and fulfilment when supported by fair working conditions and recognition.

“Nurses linked their emotional efforts to professional pride, fulfilment, and rewards, particularly in relation to higher salaries and supportive working environments,” Phatela explained.

During her postgraduate journey at the University of KwaZulu-Natal (UKZN), Phatela said her understanding of emotional wellbeing expanded beyond clinical settings to include broader workplace cultures and relationships.

“My postgraduate studies at UKZN showed me that emotional labour is integral to professional nursing and necessitates targeted institutional support alongside the development of emotional intelligence and coping strategies,” Phatela said.

She also drew on her experience as a Sociology lecturer during her studies to deepen her understanding of empathy in professional environments.

“I would always remind my students that empathy sets the standard for the kind of workplace we all deserve,” Phatela said.

Phatela hopes her research will contribute to strengthening policy responses and workplace support systems for nurses across South Africa.

“The study advocates for more structural and institutional recognition of emotional labour,” she said. “It calls for the integration of emotional labour into nursing curricula and systematic interventions to address burnout and moral distress.”

Reflecting on her doctoral journey, she thanked those who supported her throughout the process.

“I would like to extend deep gratitude to my supervisor, Professor Mariam Seedat-Khan, for the support and direction she gave me to complete this thesis. Her encouragement gave me confidence and inspiration to make this study a success.”

Words: Lee Rondganger

Photograph: Sethu Dlamini