Health providers experience many stressors and complex situations as they administer patient care. Its estimated that 25%-50% of hospital nurses suffer from some type of burnout even during “normal times,” resulting in stress or work anxiety. But during Spring of 2020, it is probable that these numbers have been higher. Nurse resilience as a concept has been attracting more attention and research in the past couple of years but has never been more important than it is in Spring of 2020. Sustaining nurse resilience requires action and engagement from organizations from the top down.
Nurse resiliency is the ability to prepare for, recover from and adapt to stress, challenges or adversity in the workplace. It is a way to combat and cope with burnout, stress, and feelings of nursing inadequacy by practicing self-care, self-awareness, connectedness, and management of work stressors. While our nation has been dealing with a viral crisis, nurse burnout is also a crisis to our public health community.
How can I Promote Nurse Resiliency from the Top-Down?
One of the best ways to help nurses as they provide care is to promote resilience, and help RNs feel prepared enough to tackle challenges the job throws at them. But how?
First, encourage nurses to foster resilience by taking emotional breaks. During times of personal distancing, you could encourage nurses to take an online class that is stimulating but not work focused. Encourage them to exercise, journal, listen to music, enjoy general hobbies, video chat with loved ones, and enjoy personal spiritual practices. Another way to encourage nurses to take a mental break is to encourage them to spend time outdoors when the weather permits, and hopefully even enjoy the sun.
Another way to help nurses deal with stress or burnout is to offer early interventions by training Nurse Managers to listen and encourage. At Children’s Hospital & Medical Center in Omaha for example, managers are trained to listen and provide safe spaces for nurses to talk through work stressors. Omaha Children’s early intervention program began with a need to address secondary trauma, then saw there was also a need to reduce workplace stress.
Encourage nurses to practice self-awareness. One of the most important steps in being able to stop energy drains is to expand self-awareness and identify unnecessary energy expenditures. There are several quick coherence techniques which you could encourage your teams to do. One is to focus all attention in the area of the heart. Imagine one can see their breath and breathe slow and deep. Another self-awareness technique is to make a deliberate and sincere attempt to experience a regenerative feeling such as appreciation for someone or something. One suggestion is to ask nurses to re-experience feelings of caring, a special place, a proud accomplishment, or special past memory. Heart focused breathing, or activation of a positive or renewing feeling are easy ways to de-stress, even while at work.
When huddling with your work teams, remember to tell nurses to recognize what they can and cannot control. Remind them to focus on the optimistic ways they help people rather than all the possible negative outcomes which could occur. Tell your nurses that when they are doubtful, scared, or feeling inadequate, to remember that every other nurse feels the exact same way. There has been much we’ve been unable to control in 2020. Ask nurses to give themselves mental empathy, and when self-doubt creeps in, give themselves compassionate words.
To encourage nurses to pursue emotional support and connectedness to peers, have your work teams find a buddy who they can reach out to when workload is intense. Maybe instead of a buddy, connect nurses to a nurse mentor, counselor, or other Employee Assistance Programs which your health system has for support. Or bring nurses together and let them feel the social support they have in their hospital; for example, a debriefing session can help nurses bond and learn from each other, while sharing stories and experiences. Consider bringing in someone to lead a session who is trained to structure reflection, learning, and healing.
You may have the best Nurse Managers or Charge RNs in the country, in leading, administering, and organizing care. But that doesn’t mean these leaders are trained to build resilient teams. So, encourage these leaders to engage staff, rollout, and coordinate these nurse interventions to provide a sense of camaraderie, teamwork, and trust. And if you show that building nurse resiliency is important to you, your mid-line managers will probably follow your lead.
Keeping nurses safe and supported during the ups and downs of the COVID-19 pandemic is a major priority. Even as the country is giving support for these vital members of our workforce, stressful situations generally make people feel isolated, not supported. Prioritize helping nurses with resiliency building techniques to help their physical, mental, emotional, and spiritual domains. The consequences of not doing so are too high. The country desperately needs to prioritize nurse satisfaction, productivity, health outcomes, and stress. Not doing so will cause the next public health crisis; a stressed and burnt out nurse workforce.
“How to Measure Resilience With These 8 Resilience Scales,” Positive Psychology, Courtney E. Ackerman, MSc, April 5, 2020
“7 Habits of Highly Resilient Nurses,” Reflections of Nursing Leadership, Diane Sieg
“Developing resilience: the roles of nurses, healthcare teams and organizations,” Nursing Standard, Caroline Barratt
“Nurse Resilience: A Concept Analysis,” Wiley Online Library, Alannah L. Cooper, Janie A. Brown M.Ed, PhD, Clare S. Rees BA (Hons), MPsych, PhD, Gavin D. Leslie BAppSc, Post Grad Dip (Clinical Nursing), PhD
“Building Emotional Resilience in Nursing,” Catherine Kelsey from Queens Nursing and blog
“Building personal resilience,” American Nurse, Teresa M. Stephens, PhD, MSN, RN, CNE, August 13, 2019
“A Call to Leadership: Navigating Uncharted Waters,” American Association of Colleges of Nursing, a Webinar by Randolph F.R. Rasch, PhD, RN, FNP, FAANP, March 20 2020
“Nurses well-being: Supporting staff and encouraging resilience,” Becker’s Healthcare, Jackie Drees, May 30 2019
“Help Hospital Employees Find Resilience and Reduce Burnout,” Children’s Hospital Association, Kelly Church, October 24 2019