Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor


Second Advisor

Copyright © 2014 Terrence Allison

Third Advisor

Doctor of Philosophy (PhD)


This research examined how the structure of a modern day psychiatric institution shapes the work experiences of subordinated, non-licensed-workers. I found that that the work experiences of PAs are shaped by their institutional positions. The PA position by default is one of subjugation and servitude, and these carry meanings. PAs are positioned on the ward to service and control patients. In spite of their absolute importance to the day-to-day running of the hospital, frontline PA work is devalued institutionally. This devaluation is internalized rationally (what bureaucracies do) by PAs, who often work understaffed and underappreciated. I found that PAs lack control over their work, which impacted their sentiments toward their work. This caused PAs to perform a type of emotional labor in order to do their jobs. In spite of this, PAs are the unsung heroes of patient service. They are the frontline patient experts. They work to survive and find dignity in having a job to sustain their livelihood. Short staffing was found to be the number one institutional practice that makes work difficult for PAs and undermines the values and mission of the institution. Further research is needed in areas of gender, race, and long-term coping skills for workers in these positions.

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