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in working through the system (e.g., with insurance companies, doctors, and other service providers) to get their needs met. Anger expression appeared justified when the anger was directed toward protecting the clients’ interests. For example, one social worker described her anger expressed toward a doctor:

“The doctor was extremely rough with [the patient] on the examination…She started bleeding. The patient was afraid that the doctor would retaliate [if she complained]…so I expressed to [the doctor] very angrily, I do not appreciate the treatment that you just gave this patient…You cannot take out …your frustration at her and cause her more pain… And I told [the doctor]… as a social worker who’s an advocate for patients, I would not tolerate that behavior from her or any others. I did tell her that I had recommended that the client write a letter of complaint… She went in with me and apologized to the patient, and then everything was all right after that.” S#7-157

This social worker adheres to the anger norm of not expressing anger in front of patients, but uses anger to advocate for the patients’ interests.  

Hospital Surgical Center. The surgical center also exhibited contingent anger norms. Respondents were generally critical of anger expressions, reporting that most anger was not appropriate although expressions in urgent situations were more acceptable. These respondents reported rare organizational response to anger expressions. Most—62% (10/16) of respondents—stated that anger expressions were not appropriate, although expressions were often tolerated. Respondents reported,

“[Anger is] not appropriate. It’s tolerated pretty well. It’s put up with, maybe more than it should be.” RA#11

“It’s not appropriate at all. It’s not professionalIt’s a stressful area. We overlook a lot of things… Even our bosses will hear it and not do anything about it.” RA#10

Anger expressions that appeared self-serving (e.g., complaints about schedules) garnered the most criticism. Concern about others seeing or hearing anger expressions was somewhat lower than at either the nursing home or the social work departments, possibly because often patients were not present or were anesthetized and not in a position to overhear anger expressions. This may account for why only 19% (three out of 16) of respondents mentioned a rule that anger should not be expressed in front of patients. Thus, unlike the clear display rules of the nursing home or the social work department, in the surgical unit anger suppression display rules were weak and not uniformly held.

Another interesting difference that emerged in this setting is that in ten out of sixteen of the interviews (63%), respondents mentioned their childhood anger socialization norms. There were no other

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