The Merriam-Webster online dictionary defines resilience as "the ability to become strong, healthy, or successful again after something bad happens," or "the ability of something to return to its original shape after it has been pulled, stretched, pressed, bent, etc."
Nurses regularly face situations where they are "stretched, pressed and bent," and they also frequently find themselves in situations where "something bad happens." Thus, we can readily draw the conclusion that resilience in nurses is a quality to be promoted and championed by nurse managers and leaders throughout the profession.
Resilience is not a luxury
Nurses face daily situations that can powerfully challenge their personal and professional resilience. Compromised nurse resilience is one factor that contributes to nurse burnout, compassion fatigue, absenteeism and, ultimately, attrition from the profession.
Resilience is not a luxury for nurses, and the forward-thinking nurse manager will monitor the nurses under her charge for signs of weakening resilience.
As the veritable connective tissue of the healthcare industry, nurses are a valuable human resource well-deserving of the implementation (and consistent evaluation) of interventions seeking to prevent burnout, injury and decreased resilience. The nurse's role in healthcare is crucial, and it should not be left up to nurses alone to guard themselves against such insidious and deleterious processes.
The conscientious nurse leader
A conscientious nurse leader carries a heavy load of multifaceted responsibilities. Not only is she responsible for the safe and effective delivery of patient care. Depending on the institution, a nurse leader may also be charged with the management of scheduling, quality assurance, quality improvement, infection control, employee wellness and a multitude of other weighty aspects of management and supervision.
Be that as it may, a healthy workforce is essential for the smooth operation of any enterprise. Unhealthy, unbalanced nurses will contribute less richly to patient outcomes and smooth facility operations than those who are balanced, resilient and properly supported.
The nurse manager must bear in mind the resilience of the nurses under her employ, ascertaining where they need more support, and then developing interventions for the timely delivery of such support.
Assessing for compromised resilience and burnout
Signs of compromised resilience and nurse burnout may include, but not be limited to:
- High absenteeism
- Increased rates of on-the-job injury
- Increased medication error rates
- Decreased patient satisfaction
- Decreased employee satisfaction
- Bullying and lateral violence among staff
- High rates of staff conflict
- Substance abuse
- Nurse attrition
According to this article published on NurseTogether.com, nurse burnout can be likened to a forest fire, "a destructive depletion of life-sustaining resources" that compromises nurses' ability to function.
"Burnout is the frustration, loss of interest, decreased productivity and fatigue caused by overwork and prolonged stress," Laura Wisniewski writes. "The potential consequences of burnout are emotional distress, physical illness and interpersonal conflict in nursing. In the workplace, burnout leads to low morale, high absenteeism, high turnover rates and occupational injuries."
Taking the apt metaphor of a forest fire to heart, the nurse manager can see that burnout and decreased nurse resilience can quickly sweep through a unit, agency or facility, destroying morale while negatively impacting patient outcomes and the "double bottom line" of people and profits.
Taking action
Understanding the power of decreased nurse resilience to undermine the very mission of a healthcare institution, the nurse manager must creatively and assiduously employ tactics and techniques for the assessment of nurse resilience, followed by interventions for improving that resilience over time.
Methodologies for the strengthening of nurse resilience may include decreased nurse-patient ratios, planned rest periods, mandatory meal breaks, nurse support groups and wellness initiatives, as well as the involvement of the Employee Assistance Program (EAP) and Human Resources Department in actively supporting nurse resilience.
The improvement of nurse resilience cannot solely occur during annual celebrations of National Nurses Week. The awarding of mugs, pens and flowers, coupled with special events is a kind gesture, but nurse resilience must be fortified on a daily basis.
Nurses need support from the upper levels of healthcare management and leadership. Conscientious nurse managers must consider nurse resilience and regularly take inspired action in order to foster it.
The nurse manager, supervisor or leader is in a strategic position to deliver the support and interventions that will foster nurse resilience, while simultaneously improving the desired outcomes sought by any well-meaning and effective healthcare institution.
Fostering nurse resilience is an investment with the potential of returning exponential dividends to those institutions and leaders willing to step up to the plate in the interest of nurse wellness and effective healthcare delivery.
