Emotions and personal accountability: insights from emotional labour in healthcare

Purpose This paper explores how healthcare workers' emotional experiences, moral deliberations and relational encounters with others influence the way personal accountability is perceived, negotiated and enacted in emotionally demanding organisational settings. Design/methodology/approach The interpretive case study of a large Italian nursing home draws on organisational documents, direct field observations and semi-structured interviews. Interviewees were also invited to describe their emotional experiences through images, which were interpreted as metaphors capable of revealing subtle, tacit and difficult-to-verbalise emotional reflections. Findings Emotional labour transforms personal accountability into an emotionally and socially performative practice. Healthcare workers continuously negotiate tensions that emerge from conflicting personal values, professional ideals, organisational display rules, patient expectations and their families' emotional demands. They mobilise emotional management strategies, especially surface acting and expressive or corporal techniques, to reconcile the emotions they feel with morally and professionally appropriate conduct. Empathy emerges as a fragile but crucial resource that enables healthcare workers to preserve their emotional integrity while responding to the needs of others. Research limitations/implications Organisations can support personal accountability by acknowledging emotional complexity, encouraging positive emotional display, protecting emotional authenticity and providing safe spaces for emotional reflection. Emotional monitoring, however, may constrain workers' agency and intensify emotional dissonance. Originality/value The paper theorises the emotional dimension of personal accountability. It demonstrates how personal accountability becomes performative as it turns into a social, relational and emotional practice.