Recognizing, relating, and responding: hospice workers and the communication of compassion

In a mere thirty years, hospice has grown from a purely ideological philosophy of care for terminally ill individuals and their families, to a large and well organized healthcare entity. And government statistics project that healthcare will generate more new jobs than any other industry in America until at least 2018. While most of the extant literature that has been published on healthcare workers has focused on negative organizational processes, such as stress and burnout, there has been a recent shift in scholarly ideology in which researchers have been challenged to consider the positive aspects of organizational life as well. Compassion, theorized as a three-part interrelated process, is one area that is garnering interest within organizational studies. Utilizing grounded theory, this study engaged literature from organizational studies on emotional labor, stress, and burnout, as well as literature on positive organizational communication. What emerged from the data is a richly detailed picture of the emotional highs and lows that hospice workers experience in their jobs. Research was conducted at two large hospices in the desert southwest, utilized qualitative methods of participant observation (161 hours), and informal and semi-structured interviews (29 interviews) as a means to understand hospice workers--nurses (32), nursing assistants (23), social workers (14), and spiritual care providers (4)--experiences of emotion. Through data analysis, compassion emerged as a salient concept in worker's daily experiences. Yet, my data suggested a reconceptualization of the way in which compassion has been theorized in the past--as noticing, feeling, and responding. Based on my findings, I argue that the three subprocesses could more accurately be described recognizing, relating, and responding.