Resilience of individuals is not the answer in healthcare; we need resilient workplaces
19 April 2022
In physics, resilience is the ability of an elastic material (such as rubber or animal tissue) to absorb energy (such as from a blow) and release that energy as it springs back to its original shape. The recovery that occurs in this phenomenon can be viewed as analogous to a person's ability to bounce back after a jarring setback. The word resilience derives from the present participle of the Latin verb resilire, meaning "to jump back" or "to recoil."
The concept of resilience in healthcare has become a term disliked by many healthcare professionals due to misuse of the term in relation to the performance of an individual which can lead to victim shaming. Many of us have been told words to the effect of “You would have been able to manage this situation if you were more resilient” or “You need to develop more resilience if you want to get on to the training program.” We are also often presented with the idea that resilience will protect us from burnout. The implication is that untenable situations and heavy stressful workloads are acceptable and those who cannot manage them are failures and not suited to the work environment.
The other misconception about resilience is that it makes us tougher and better able to cope in difficult situations. However, there is no place for this “toughen up” attitude in a compassionate healthcare environment. We need empathy and compassion to function well as caring health professionals. Imagine if patients were routinely told to be more resilient when they are in pain – sadly this still does happen at times, but it is generally deemed to be unacceptable in medical practice today. Healthcare professionals are human and have a need for adequate rest and nutrition. Healthcare professionals have emotions and when showing empathy will experience the suffering of their patients and their families.
In the words of Dr Geoff Toogood: “Medicine takes a bright group of people who are caring, self-reflective and sensitive – is this not what one requires in a doctor? – and places them in a hostile and increasingly unforgiving environment. The result is an increase in mental health issues, especially in that first year of residency. It’s hardly the place to thrive rather survive, and where does that leave the very people we wish to look after?”
In the same article Geoff also wisely comments: “The development of resilience is not just the domain of the individual, or the worker in the health care system. It’s a community effort, within the micro- and macro-environment in which we work. It requires connections, both social and professional. It’s so much more than a seminar or workshop, or another PowerPoint presentation, and much more than a simple platitude about doing more.”
These thoughts point to a need for resilient workplaces. Work environments where individuals are supported and encouraged. As Geoff further explains: “Resilience requires health professionals to have and feel a connection, a sense of belonging. It requires a system that allows one to learn from mistakes without fear of reprisals, but with positive suggestions about how to improve. It requires systems to develop individual signature skills and work on deficiencies. It requires positive peer support, and realistic goal setting, especially around time and money. It needs to help doctors learn the skill of asking for support, and then support them when one does. It needs to give doctors room and time to allow resilience to develop – down time, exercise, outside connections and rest, with adequate sleep.”
A positive workplace culture is essential for a resilient working environment. Feeling connected and being able to trust others in a workplace which provides psychological safety will allow everyone to do their best work. Learning is most effective in a psychologically safe environment. Encouragement and supportive guidance rather than competition and criticism is required if we want healthcare professionals to thrive. It needs to be safe for individuals to ask for help or advice. We need good communication and teamwork to manage heavy workloads and make sure that everyone has time to take a rest break when there are a lot of patients requiring care. We need strong leadership to coordinate teamwork, ensure good communication and support individual team members. A resilient workplace will enhance the resilience of the individuals in it by allowing them to recover from stress and workplace pressure in a safe and supportive environment.
In conclusion, let’s replace the concept of resilient individuals with the concept of resilient workplaces. Resilient workplaces have strong leadership and psychological safety which support every team member for the benefit of the patients in their care.
Resources and further reading
- The resilience myth in medicine | InSight+ (mja.com.au)
- Self-Care is Not the Solution for Burnout — The Beautiful Truth
- Psychological Safety in Healthcare | Psychological Safety (psychsafety.co.uk)
- Psychological Safety and Learning Behavior in Work Teams (mit.edu)
- Harassment in the Field of Medicine: Cultural Barriers to Psychological Safety - ScienceDirect