A Twitter Chat for @WeNurses on Resilience (Hosted 7th March 2013)
Following a recent twitter chat I joined forces with Maxine Craig (@maxine_craig) and Andrew Moore (@steesimprove), two Organisational Development NHS professionals from South Tees, to co-host a twitter chat on the #WeNurses hashtag. We found that we shared a common interest in the idea of ‘resiliency’ and elected to collaborate and develop a twitter chat on this topic. You can find the archive of this twitter chat via WeNurses.co.uk. Here’s my covering blurb from that twitter chat, that I have subsequently edited a little.
“Resilience” is a topic of particular interest to a growing variety of stakeholders in health and social care and beyond. This is evident in the relatively recent call for science to adopt a more positive mind-set (Luthar and Zelazo, 2003: cited in Mohaupt, 2009) and the rise of ‘positive psychology’. You can find resiliency research present in fields as diverse as ecology, physics, medicine, social psychology, and psychiatry as far back as the 1940’s (Mohaupt, 2009).
Coming from the Latin ‘resilio’ meaning ‘spring back’ (Oxford Dictionary, 2010) in a therapeutic context it describes how people can get through adversity by drawing upon their various strengths (Kyuken, Padesky and Dudley, 2009). Definitions and the usage of resilience have changed over time, but the bottom line is that resilience is currently conceptualised as “a dynamic concept referring to a person’s ability to maintain or regain health after exposure to adversity” (Herrman and Jane-LLopis, 2012, p.1).
Our question, and topic for our nursing twitter chat, is – how do we build personal resilience as nurses? The idea of nursing (and indeed we could argue any kind of person-focused work) as a kind of “emotional labour” with a concomitant risk of “burnout” is well established in the literature and across the fields of nursing (Henderson, 2001; Brotheridge and Grandey, 2002, Mann and Cowburn, 2005). It would seem to make sense then to join these things up and consider carefully how nurses can apply the developing expertise from well-being and positive-psychology research (e.g. Seligman and Csikszentmihalyi, 2000) to themselves, colleagues and those they care for.
Positive-psychology interventions (PPI) are not primarily about treating people with significant emotional and psychological health difficulties (SEPHD), although there is considerable interest and research into this (see Sin and Lyubomirsky, 2009). PPI strategies run the gamut of: writing thank-you letters, practicing optimistic thinking, re-living/rehearsing positive experiences, to practicing mindfulness skills. These interventions have been shown to increase well-being in people without SEPHD (e.g. Lyubomirsky et al. 2011). The need for national and local NHS strategies to develop staff health and well-being was recognised on the back of the Boorman report (Boorman, 2009) and led to the development of the Department of Health (DH) “Healthy Staff, Better Care for Patients” National guidance for the NHS (DH, 2011). Your NHS trust should have a health and well-being strategy and policy.
That’s the rhetoric – what of the reality? The national guidelines places staff at the top of the chain of responsibility in their illustrative diagram of how we should go about “embedding improvements to the health and well-being of staff in the NHS” (DH, 2011, p.6). There is, naturally, the predictable raft of guidelines for managers, the organisation, the wider health system and the community beyond that. So, in the light of all this how do we build personal resilience as nurses?
Boorman, S. (2009), NHS Health and Well-being: Final Report, DoH.
Brotheridge C.M. and Grandey A.A. (2002), Emotional Labor and Burnout: compating Two Perspectives of “Perople Work”, Journal of Vocational Behaviour, 60: pp.17-39.
Department of Health (2011), Healthy Staff, Better Care for Patients: Realignment of Occupational Health Services to the NHS in England, DoH.
Henderson A. (2001), Emotional Labor and nursing: an under-appreciated aspect of caring work, Nursing Inquiry, 8(2); p130-8.
Herrman H. and Jane-Llopis E., (2012), The status of mental health promotion. Public Health Reviews, 34(2).
Kuyken W., Padesky C.A. & Dudley R., 2009, Collaborative Case Conceptualization: Working Effectively with Clients in Cognitive Behavioural Therapy, New York: Guildford Press.
Lyubormirsky, S., Dickerhoof, R., Boehm, J.K., and Sheldon, K.M. (2011). Becoming happier takes both a will and a proper way: an experimental longitudinal interventions to boost well-being. Emotion. 11(2): pp 391-402.
Mann S. and Cowburn J. (2005), Emotional labour and stress within mental health nursing, Journal of Psychiatric and Mental Health Nursing, 12 (2), pp154-162.
Mohaupt, S. (2009), Review Article: Resilience and Social Exclusion, Social Policy and Society, 8 (1), pp 63-71.
Oxford Dictionaries. (2010) Oxford Dictionaries Oxford University Press.http://oxforddictionaries.com/definition/english/resilience (accessed February 18, 2013).
Seligman, M.E.P. and Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55, p5-14.
Sin N.L. and Lyubomirsky S. (2009), Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: A practice-friendly meta-analysis., Journal of Clinical Psychology, 65(5): pp.467-487.