Managing Absolute Hope within the Client Nexus during Consultations with Terminally Ill Patients

• In Event: 50220 - Section on Organizations, Occupations, and Work Roundtables
  In Refereed Roundtable (60 minute): Table 22: Emotional Labor

Abstract

We tell the story of how healthcare providers in India constructed a novel form of hope during consultations with terminally ill patients and their families. A compelling pattern of interaction starts the story: providers repeatedly told terminally ill patients, “You will be fine.” Why would providers say this when their expert opinion was that the patients’ conditions would not improve? Using and extending Hope Theory, we argue that providers create ambiguous goals so that they can set one clear pathway: only through medicine can the patients’ situations improve. One pathway to an ambiguous goal produces a relational, absolute hope, where hope in seemingly hopeless situations is found within relationships, that helps providers manage the client nexus, which we define as the triadic relationship between the provider, patients, and their family members. This form of hope allows providers to fulfill the wishes of everyone in the nexus, as the providers understand them. The patients receive therapeutic hope. Family members receive the time and grace to deliver bad news to their loved ones on their terms. Providers can deliver the best care to their abilities, and they can save time by avoiding emotional outbursts that would occur if patients heard bad news directly from providers. We extend Hope Theory by showing one way that a sense of hope can be created, which is by limiting pathways, rather than generating multiple pathways to a goal. Relational, absolute hope provides leverage for professionals and managers to create hope in other situations that seem hopeless.

Authors

• Clayton Thomas, Iowa State University

• Shibashis Mukherjee, XLRI