Reexamining Resilience

Words matter.

As I have been presenting at various nursing gatherings and conferences about the topic of resilience in light of work-related grief, I have been struck anew by the definitions of resilience that I find in the literature.

  • The ability to return to a state of normalcy or to “bounce back” from adversity or trauma and remain focused and optimistic about the future (Dyer & McGuinness, 1996).
  • The “ability to face adverse situations, remain focused, and continue to be optimistic for the future” (Kester & Wei, 2018).

While I understand and very much appreciate the intent (and necessity) behind these definitions, I have to ask whether we are adequately exploring the meanings of the words used within these definitions and the implications for what nurses should expect of themselves in seeking to be resilient.

Does short-term resilience look different from long-term resilience?

For example, in the definition presented by Dyer and McGuinness, a resilient nurse should be able to return to a state of normalcy. There is certainly a need for nurses to be able to maintain a steadfast mind and emotional state in the short-term moments of acute crises with their patients. A nurse returning to work after a difficult shift just the day before has to […]

2018-10-23T10:04:47-04:00October 23rd, 2018|Nursing, nursing perspective, wellness|0 Comments
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Tallying Losses and Gains of Being a Nurse, and Finding Profit

I was talking with a dear friend who was telling me how she went through a period when she had wondered whether nursing was destroying her. I can’t say what she actually meant by this for her own self, but the comment stood out to me. I found myself chewing on this notion that we can feel slowly worn down by the overall experience of nursing to a point where we feel the losses are not being offset by the gains quickly enough.

A certain loss of innocence.

Given all of the random tragedy, self-sabotage, and violence that nurses may witness in their patients’ stories, nurses can experience the loss of a more innocent, optimistic perspective about people and the world. Nurses often say there are things you cannot “un-see” in this line of work. Those experiences can darken the lens through which we see the world. The loss of faith in the assured wellness in the world can feel disheartening. It can be difficult to know how to process this in a way that does not simply leave us more fearful or cynical people.

The energy drain.

On a less philosophical level, it […]

2018-01-18T10:04:58-05:00January 5th, 2018|healthcare social media, Nursing, writing|2 Comments
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Report Draws Attention to Nurse Burnout, Seeks to Restore Joy to Profession

AJN has been asked to share with our readers a new report on nurse burnout: “A Gold Bond to Restore Joy to Nursing: A Collaborative Exchange of Ideas to Address Burnout” (pdf). The report is the result of a November 2016 retreat of leading thinkers in health care and nursing at the Johnson Foundation’s Wingspread campus in Racine, Wisconsin.

Among conference participants well known to AJN were Cynda Rushton, professor at the Johns Hopkins University School of Nursing and Berman Institute of Bioethics, and noted author and nurse Theresa Brown.

The post below detailing the report’s findings is by Cindy Richards of QPatient Insight, the consulting firm that organized the conference. An experienced journalist, she worked closely with conference attendees to prepare the report on the conference’s findings.

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We often hear that America faces a nursing shortage—the United States Bureau of Labor Statistics said in 2015 that we would need 1.2 million more registered nurses by 2024. In addition, surveys of nurses continue to find high levels of job dissatisfaction and high percentages of nurses who express an intention to change jobs or leave the profession in the coming years.

Why? In too many cases, because they are overwhelmed by demands that […]

2017-05-03T11:40:29-04:00May 3rd, 2017|Nursing|5 Comments
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Adapting to the Emotional Toll of Nursing

take2refectionsillustrationsept2016New nurses may find themselves confronted with great human suffering, enormous technical challenges, and the norms and pressures of the nursing profession and the individual workplace.

Most eventually learn the skills and knowledge they need to succeed in the profession. But some may struggle more than others with the emotional intensity of the work. A question that seems to come up a lot when nurses write about their work goes something like this: How do you keep caring as a nurse and not get burned out? How do you develop a resilient professional persona?

This month’s Reflections essay, “How I Built a Suit of Armor (and Stayed Human),” by Jonathan Peter Robb, enumerates the challenges faced by a sensitive new nurse and the ways he found to protect himself over time. Here Robb, a district nurse for the National Health Service in London, England, describes one kind of challenge he faced:

The weight of being responsible for a person’s health wasn’t one I had prepared for. Sitting in lectures doesn’t train you for the moment when you’re standing at the end of a bed looking at a patient who is struggling to breathe, semiconscious (but who just last week was sitting up and talking), and thinking: Did I miss something? Is this my fault?

As Robb writes, “caring hurts.” […]

2016-11-21T13:00:58-05:00September 14th, 2016|Nursing, nursing perspective, Patients|0 Comments
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Nurses Take Action on Moral Distress

Nurses gather at the Johns Hopkins School of Nursing to address this growing problem.

A nurse struggles to reconcile repeated surgeries and transfusions for a premature infant with the child’s slight chance of survival. An oncology nurse knows a patient wants to refuse treatment but doesn’t do so because his physician and family want him to “fight on.” A nurse on a geriatric unit knows she is not giving needed care to patients because of inadequate staffing.

From left, Katherine Brown-Saltzman, Kathryn Trotochaud, Lisa Lehmann, Heidi Holtz From left, Katherine Brown-Saltzman,
Paula Goodman-Crews, Lisa Lehmann, Heidi Holtz

Situations like these are not rare for nurses and often give rise to moral distress—that is, when nurses recognize their responsibility to respond to care situations but are unable to translate their moral choices into action.

Moral distress in nursing has risen to unprecedented levels, contributing to burnout and staff shortages and imperiling safe, quality health care.

Seeking solutions.

Nursing researchers, clinicians, organization representatives, and other stakeholders convened in Baltimore on August 11-12 for an intense invitational workshop called State of the Science Symposium: Transforming Moral Distress to Moral Resiliency in Nursing. The meeting focused on how to best address moral distress.

The 46 participants heard from […]

2017-02-03T14:50:26-05:00August 16th, 2016|Nursing, nursing perspective|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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