RESILIENCE

It is a rare nurse that at times has not found the workplace to be hostile, abusive and unrewarding.

As part of their daily working life, nurses see the full range of human tragedies, suffering and anguish.

Resilience is a part of being a nurse, whether it is personal, or whether it is part of helping others to become resilient in the face of, what seems at times to be, insurmountable odds.

As Remen observed, 

“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet”.

So what is resilience?

It is hard to define.

Maybe a little like pornography, you know it when you see it.

Jackson et al. describe it as

“…the ability of an individual to positively adjust to adversity…”

The adversity that nurses face in the workplace can be hostile, abusive and unrewarding.

Workplace adversity arises with

“…widespread shortages of experienced nurses, an ageing workforce, increased use of casual staff in the nursing workforce, bullying, abuse and violence, issues around professional autonomy, imposed organizational change, occupational health and safety issues and constant restructuring “ Jackson et al.

Why do some nurses thrive in this environment and achieve satisfaction while some do not?

Nurses that build workplace resilience do so using five strategies.

The first is building positive and nurturing professional relationships and networks.

We all need someone we can call upon for guidance and support whenever necessary.

Ideally a mentor could play this role but it could be anybody that you trust.

That person would be a sounding board for what perplexes you.

The second is maintaining positivity.

In the worst of times, nurses can be relied upon to be optimistic and see the full gamut of choices available.

This ability to see the positive aspects and potential benefits of a situation can be beneficial in building resilience.

Laughter in the face of overwhelming stress is a usual behaviour of nurses.

Thirdly, nurses need to develop emotional insight.

Understanding your own emotional needs and reactions gives insight into how to cope with adversity.

This can lead to awareness of how to do things differently in the future.

One way to achieve this is through journalling.

Another is talking it through with some one who understands what you have been through.

The fourth strategy is achieve life balance.

Whatever belief system you have, it will provide existential meaning, a coherent story about life and a regard for yourself.

In conjunction with a range of healthy activities outside work, life balance should tend to your emotional, spiritual and physical well being.

Lastly, the final strategy is become more reflective.

It is a way of gaining insights and understanding about what you have experienced. 

And using that knowledge in future situations.

Again journalling is the tool of choice.

Writing regularly about what is happening to you can be illuminating. 

It can be a catalyst for developing more positive responsesto the circumstances that you find yourself in.

A paper by Tahghighi et al. looked at nurse’s shift work and resilience among other things.

We all know that working shift work has a massive impact on family life, social and leisure activities.

You can’t work shifts and do all the social and leisure activities that are part of everyday life for everyone else.

Particularly, nurses who may have primary responsibility for child rearing or other caring roles.

They found no clear answer to the question: Do nurses who work shifts have poorer psychological functioning and lower resilience than those who do not work shifts? 

There are negative psychological outcomes for nurses doing shift work but the findings were not consistent.

The authors called for more studies.

Workplace adversity has a negative impact on nurses but it is just not the individual nurse that has responsibility for change.

A natural outcome should be that nurse managers could propose creative and different ways to work so that work does not impact on nurse’s resilience.

To learn more about resilience:

Jackson, Debra, Angela Firtko, and Michel Edenborough. “Personal resilience as a strategy for surviving and thriving in the face of workplace adversity: a literature review.” Journal of advanced nursing 60.1 (2007): 1-9.

Ramen, Rachel. Kitchen Table Wisdom: Stories That Heal.

Tahghighi, Mozhdeh, et al. “What is the impact of shift work on the psychological functioning and resilience of nurses? An integrative review.” Journal of Advanced Nursing (2017).