Interpretations of stress in institutions: the cultural production of ambiguity and burnout.

This ethnographic study of interpretations of stress among hospital social workers reveals concrete ways in which institutional systems take form in the mundane actions and interpretations of individuals embedded in these systems. It also reveals how organizational cultures reflect and reinforce institutional conditions that have been negotiated in the interactions of individuals. Here, the institutional systems of medicine and social work come together in the everyday work of the social workers and result in two patterns of cultural dominance. Within these distinct types of culture emerge two forms of stress experience, including a dominant form, consistent with medical ideology, and a marginalized form, consistent with social work ideology. Some surprising patterns of interpretation emerge, including interpretations of ambiguity and burnout as normal, social, and desirable when the social work ideology is dominant. This institutional analysis of stress has theoretical, practical, and epistemological implications.