Why do healthcare workers need resilience

and what steps can we take to build it?

By: Sandy Weiss, DBA, MBA-HCM, RN, CPHQ, CPPS, PMP

As a registered nurse, project manager in the healthcare industry, faculty member, and self-declared high-strung type-A person, I can tell you that I have had trouble coping with all that is going on in the world of late.  My hope is that by sharing some of the tools in my proverbial toolbox, it may help you as well! One amazing tool is resilience!


Resilience is the ability for one to bounce back from, cope with, and recover quickly from stressful situations. During a time like this, amidst a pandemic, most of us have been faced with more stress than we ever thought possible. In every aspect of our lives we seemingly are staring down the face of adversity. In healthcare, patients and practitioners alike are experiencing horrifically stressful and traumatic situations that benefit from resilience.

 

In recent months, simple things like going to the grocery store, going out to dinner, or socializing with friends have become rare, cumbersome, and murky reflections of pre-pandemic life. Even activities like going to school or work have changed drastically. When health insurance is tied to your job, and unemployment rates are high, this places additional stress on individuals. In June of 2020, the unemployment rate in my home state of Florida was 10.5%! Those without jobs are stressed and many with jobs are simply waiting for the other shoe to drop. Healthcare, while in demand, is not immune to adversity. Many healthcare professionals have seen shifts in their patient numbers, some are busier than they have ever been, while others are seeing a large reduction in volume.    


Here are three steps to help nurses build resilience:


1. Having a positive attitude goes a long way towards coping with stressors. It’s not what we go through, but how we go through, react to, and overcome adversity. Having a sense of hope, value, meaning, and purpose in life can help reduce the impact of stressful events. One study showed that nurses’ emotional exhaustion was the greatest predictor of burnout. And those nurses who felt a higher sense of personal accomplishment were more resilient, which led them to feel an increased sense of hope and decreased stress.
 

  • Do this: Take time every day to stop, breathe deeply, and reflect on your values, what drives you, and all that you have to be thankful for. 

This may sound so basic, but taking a few moments out of every day to remind yourself why you work as hard as you do is helpful. What are you working for? What drives you? For most of us, this is not a simple question. I am a big fan of writing things on marker boards or using sticky notes. Write down what drives you, what your values are, and what you are thankful for. I have found the exercise of writing these things out to be incredibly therapeutic.

2. Get adequate sleep! Resilience has the potential to impact sleep quality through its reduction of perceived stress. Additionally, lack of sleep has been noted to reduce quality of patient care and negatively affect nurse work performance. This is particularly important in a pandemic, when quality of care and the safety of the patient and the practitioner are critical. 

  • Do this: Focus on getting sleep!

Sleep is one of those things that many, including myself, struggle with. I have found that sticking to a regular sleep-wake cycle has been key. Unfortunately, the reality healthcare workers often face includes variable shift schedules and taking calls overnight. I try to limit screen time and turn my phone in airplane mode when possible. Eating a healthy diet and reducing alcohol intake has a positive effect on my sleep quality too. 

3. Exercise has long been understood to reduce stress. Regular exercisers are better able to maintain a positive attitude when faced repeatedly with stressful situations.5

 

  • Do this: Exercise!
     

When I worked at a hospital, a few fellow nurse friends and I would take quick walk breaks during lunch. We were fortunate enough to work at a hospital close to the beach; the combination of fresh air, getting our heart rates up, and being on the water provided moments of unexplainable joy. As an Ironman triathlete, I can say that at some point you will face the law of diminishing returns when it comes to your stress and the amount you exercise. You do not need to train for or compete in an Ironman triathlon or ultra-marathon to reap the benefits of regular exercise!


Something I told my graduate and undergraduate students throughout the last semester, “We will get through this, and we will get through this together.” At the beginning of every airplane flight, there is a video that discusses safety. The attendants remind you to place oxygen on yourself before that of another adult or child. Why? If we can’t care for ourselves, we can not care for others. Nurse friends, please take care of yourselves! 
 

References
1.    Rushton, C. H., Batcheller, J., Schroeder, K., & Donohue, P. (2015). Burnout and resilience among nurses practicing in high-intensity settings. American Journal of Critical Care, 24(5), 412–421. 
2.    Liu, X., Liu, C., Tian, X., Zou, G., Li, G., Kong, L., & Li, P. (2016). Associations of Perceived Stress, Resilience and Social Support with Sleep Disturbance Among Community-dwelling Adults. Stress & Health: Journal of the International Society for the Investigation of Stress, 32(5), 578–586. 
3.    María del Carmen Pérez-Fuentes, María del Mar Molero Jurado, María del Mar Simón Márquez, & José Jesús Gázquez Linares. (2019). Analysis of Sociodemographic and Psychological Variables Involved in Sleep Quality in Nurses. International Journal of Environmental Research and Public Health, 16(20), 3846.
4.    Childs, E. & DeWit, H. (2014). Regular exercise is associated with emotional resilience to acute stress in healthy adults. Frontiers in Physiology, 5.