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Hospital doctors' anxieties at work: Patient care as intersubjective relationship and/or as system output

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Purpose ‐ The purpose of this paper is to examine how maternity doctors deal with anxieties generated through their interactions with patients. Design/methodology/approach ‐ The authors juxtapose two critical stories, collected as part of a large mixed method field study of leadership and patient care in three UK hospitals. The study of "organizational stories" is particularly relevant in health care settings that are liable to unleash strong emotions and fantasies, stories have a great advantage of offering an outlet for unconscious emotions and fantasies. The authors collected stories (n=48) from different stakeholders, and after extensive discussions and analysis, it was decided to focus this article on two stories told by two different doctors. These stories sum up not only the storytellers' own personal experiences but also reveal something more profound and general about the nature of doctors' anxieties and the means used to contain them. By restricting the discussion to two narratives, many variations are left outside our remit; the benefit, however, is that the nuances contained in these stories can be looked at in far greater detail. Findings ‐ The principal cause of doctors' anxiety in this study was a constant balancing between an objectifying "I-it" and a communicative "I-Thou" relations with their patients and the organization. If the doctors were unable to deliver what in their personal scale would have been good or even satisfactory patient care, anxiety levels started rising. The coping with and managing of anxiety was mainly done through controlling of relations with patients and colleagues. Originality/value ‐ The paper offers insights into situations that prompt diverse challenging emotions.
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Keywords: Doctors; Patient care; Phenomenology; Social interaction; Storytelling; Stress; Unconscious phantasies

Document Type: Research Article

Publication date: 2011-03-15

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