The challenges of emotional labor and emotional dissonance for the hospital phlebotomy team.

Competitive pressures are forcing hospital leaders to closely examine the role of direct caregivers in improving the level of satisfaction for the treatment and services received by patients. Often, the clinical laboratory's sole representative in bedside care is the phlebotomist. Despite the physical and behavioral challenges presented by difficult patients, laboratory managers expect phlebotomists to perform their duties in a consistently efficient and friendly manner. However, time constraints often prevent phlebotomists from engaging in lengthy conversations with their patients to build trust or convey compassion. Balancing task requirements with people skills prompts phlebotomists to develop coping strategies that emphasize professional demeanor, the display of skillful technical judgment, and the creation of an image of personal concern for the patient's illness and well-being. While these behaviors may or may not be authentic, the patient's perception of the behavior is genuine. Caregivers who perform procedures directly on patients, such as phlebotomists, must be able to find the right balance of scripted, authentic, and projected behaviors to satisfy patient expectations and maintain their own level of job satisfaction. The inability of the phlebotomist to handle high levels of emotional dissonance may lead to burnout, job dissatisfaction, and increased personnel turnover.