Debate: Resilience

The Oxford English dictionary defines resilience as “the capacity to recover quickly from difficulties” or “toughness”.

Resilience first emerged as a theory in the 1970s when child psychologists identified that some children had good outcomes despite being exposed to childhood trauma and adversity. Researchers focussed on protective factors that promote mental health and positive development in the face of risk. An ecological model of resilience evolved, which identifying three key factors that influence resilience, namely: individual factors such as personal attributes and temperament; familial factors including family cohesion and the presence of a caring adult; and the availability of external support factors such as teachers, social workers or community support. Theories of resilience have further evolved to include factors such as adaptability, humour and a sense of control.

Resilience theory is now widely applied in the workplace and the use of resilience at an individual level has gained traction within health care environments, in particular, as a means of supporting the nursing and wider clinical workforce with ever increasing pressures and to prevent burnout. The rate at which nurses are leaving the profession is a case for concern, related to being overstretched, demand and the impact of these on morale and standards of care. Developing resilient health care staff is seen by some as important in promoting wellbeing, workforce sustainability and the consistent delivery of quality care.

The 2017 NMC’s Future Nurse: Standards of Proficiency for Registered Nurses require nurses in all practice areas to demonstrate resilience alongside emotional intelligence.

Developing resilience for nursing staff within a workplace setting can take many guises including raising awareness on the importance of self–care, stress management training or peer support networks. A number of guides and toolkits including one for hospice nurses and the RCN’s Healthy You resources, have been developed to support the development of resilience in nursing staff.

Critics of resilience argue that its use within the nursing workforce is overwhelmingly submissive, with Traynor (2017) observing that it is dominated with phrases like ‘roll with the punches’ or ‘helping the nurse to survive at the bedside for longer’. Some academics, including Traynor also argue that asking individuals to improve their personal resilience without addressing the environments they are working in is self-defeating and could build resentment amongst the workforce.

RCN Wales has sponsored a PhD in collaboration with Cardiff University to explore resilience particularly from an organisational level. RCN Wales and Cardiff University will report on findings upon completion.