Nurse Cathy was sitting in the break room early one Saturday, waiting for report. She got to work extra early since this was her weekend to round with the weekend attending. She wanted time to review the charts, check in with the night shift staff, and get something quick to eat before starting her shift.
As she was reading progress notes from the previous day, the charge nurse came in and said: “You have to go down to the ED. We need you to work there this weekend. We’ve had some staffing issues and Jim is coming in for his on-call. He’ll be rounding with the doctors today.”
“What?!? That’s not fair! I’ve been with the physician team all week! I know these patents!! I am here… getting prepped now. Why can’t Jim go down to the ED? I cannot STAND this place!” Cathy’s eyes welled up into tears as she slammed her chair against the wall. She grabbed her lunch bag from the fridge and stormed out of the break room, on her way to the ED.
Sitting down to write this blog post, I looked up the definition of resilience. According to the Merriam-Webster Dictionary, resilience is:
the ability to become strong, healthy, or successful again after something bad happens
the ability of something to return to its original shape after it has been pulled, stretched, pressed, bent, etc.
Reading that, I thought to myself- resilient nurses don’t act the way the nurse did in the scenario above. Cathy heard news from the charge nurse and immediately reacted. She lashed out in an angry and unreasonable way. Sure, there may have been many things that led up to Cathy’s outburst… but this type of reaction is not a healthy one of resilience.
Think about the profession of nursing. Actually- let’s expand that even further. Think about the healthcare system as a whole. Always evolving, shifting. Fluid and constant change. Whether it’s a new piece of technology or a change in management. It could be a revised policy or a research protocol to follow.
As a nurse, when you report to your shift, you’ve got to expect some element of surprise.
Why is resilience such an important topic in nursing? Well, nurses who are not resilient put themselves in danger. According to an article in Nurse Leader by Stephanie B. Turner, EdD, MSN, RN, an assistant professor at Capstone College of Nursing, being unable to cope put nurses at greater risk for unhealthy levels of stress. When nurses are faced with stressful environments they are at greater risk for decreased job satisfaction, burnout, exhaustion, and feelings of lack related to personal accomplishment. If a nurse is unable to bounce back in a healthy way after something challenging happens, the consequences can be devastating.
On the other hand, nurses who experience a tense experience and have these healthy coping skills (which we will get to in a moment)- they are much more likely to return to a state of equilibrium in a faster, easier way. Doing some research on nurse resilience and the strategies that can help nurses cope, I came across a great resource. Diane Sieg, RN, CYT, CSP, a former emergency room nurse turned speaker, author, mindfulness coach, and yoga teacher, wrote an article outlining strategies for resilient nurses. Diane’s article introduces seven qualities of mindfulness that highly resilient nurses practice.
OK- so we’ve learned a few things thus far:
- Healthcare is an ever-shifting, ever-changing environment.
- The profession of nursing can also be in a state of constant flux- providing both good and bad experiences for nurses.
- Nurses are presented with no two shifts that are the same.
- A resilient nurse practices certain coping strategies that help them deal with stress.
So, let’s look back at our scenario above and reflect on how Nurse Cathy could have reacted differently.
Sure, Cathy got to work early and was involved in reading charts and preparing for her shift. When the charge nurse came in and burst out the news that Cathy would be floated to the ED- Cathy had a choice. She could react as she did- pissed off and miserable at the change. Or she could have taken time to pause, take a deep breath in and out, and engage in dialogue about the situation.
How could Cathy have done that? What strategies could she use to help her navigate this unpleasant news in the moment?
- Breathe. First off, in any hectic or high tension situation, remember to breathe. I notice this all of the time. When something has upset me (I am thinking back to an ex-neighbor who used to scream and yell at me any time I got to my home) I would find myself holding my breath. So much so that after I had left the situation, I was literally out of breath. So- the first thing you want to do is notice your breath. Before you react. Before you yell or lash out or say something you regret- take a deep breath in and out of the nose. This very act will slow you down and help you calm, if even a little bit. Take a few breaths before reacting at all. You’ll be super glad that you do in the end.
- Inquire. An important point to remember is that everyone at work is in the same high stress situations. It’s not just you that is being targetted with the unpleasant requests. Think about all of the other staff on the unit and the compromises they have to make to ensure a safe shift. Going back to my own time spent as a psychiatric nurse, I know there were days when we were short staffed. But it was crucial to us that the charge nurse stay out of the numbers. S0- each floor nurse would step up and take just one more patient, when we had a call out, so that the charge nurse stayed free of patient duties and able to help the workflow of the entire nursing staff. When a situation arises that you view as unfair or harsh, have a conversation. Ask if you can brainstorm another way. Seek solutions with your nursing colleagues. Instead of blowing up in the moment, think about if you can have a quick discussion to solve the problems for all.
- Re-frame. So in the scenario above, I am sure some of you reading are thinking to yourselves: “Why did that charge nurse just burst in with that news? Couldn’t they have approached it in a more professional way?” And while I agree, I will tell you that we can never know what another person is thinking, feeling, or experiencing. On top of that- we have no control over another person’s behavior. We can only be accountable for ourselves. So moment to moment, as you go about your nursing shift, can you take a moment to quietly re-frame? Instead of thinking to yourself that work is unfair and your entire unit has it ‘out for you’- why not view the challenges as opportunity? In the above scenario, one way to re-frame the situation would be to see the request to go down to the ED as an honor. The nursing staff on your unit has such high views of you that you are the one they chose to go work in another area. I know this is a stretch… and some of you reading may be thinking, ‘Yeah, right’… but this takes time and practice. When we have the ability to re-frame our experiences we approach life (and work) in a much more appreciative way.
What did we miss? I’d love to hear how you increase your capacity for resilience. Leave a stress-reducing tip in the comments below. Thanks for reading!
About the Author: As a keynote speaker, bestselling author and virtual conference host, Elizabeth partners with hospitals, organizations, associations, and nursing groups to help transform the field of nursing from the inside out. During the National Nurse’s Week online conference, ‘The Art of Nursing‘, Elizabeth supports nurses in achieving professional goals of continued learning and development. Click here to find out more about how The Art of Nursing appreciates and celebrates our profession in a meaningful way.