In recent years, resilience in healthcare has become a lauded and valuable attribute. Courses and tool kits aimed at improving and increasing resilience are offered by Trusts all over the country. As our jobs and lives become increasingly challenging, resilience is often cited as the magic solution to coping.
But what exactly does resilience mean? The Oxford English dictionary defines resilience as “the ability of a substance to return to its original shape after it has been bent, stretched or pressed”. When applied to human psychology it describes “the ability of people... to recover quickly after something unpleasant, such as shock, injury, etc” - in other words, to ‘bend and not break’.
A recent study by the BMA suggests that almost half of UK doctors are suffering from depression, anxiety or burnout. The Out of Programme Pause initiative, set up as a response to COVID, allows trainees to ‘pause’ their training to, amongst other reasons, focus on their wellbeing. There has been a significant reduction in staff retention rates since 2012, and there are concerns that the recent COVID pandemic will further compound these issues, leading to even higher attrition rates .
Any patient-facing role provides its own unique set of challenges and stressors. In our day to day work we are faced with situations which challenge us both mentally and emotionally. Delivering bad news and managing the responsibility of making clinical decisions with life-altering implications, as well as communicating with vulnerable patients and their families, takes its toll. Increasing issues with workforce planning, recruitment and retention, mean that these difficult roles are often carried out with the added pressure of too few staff. Long hours, shift work, and regional commutes can add to the physical strain of the job. Portfolio demands, projects and audits are often undertaken in our own time. The advent of the zoom era has seen webinars and meetings often scheduled for weekends and evenings, further tipping the work life balance. These factors combine to create a working environment that has the ability to negatively impact both our physical and mental health.
The idea of resilience, and returning to ‘normal’ after a crisis, undermines both our capacity for change, and the impact these crises have on both our personal and professional lives. Challenges and difficult experiences inevitably change us. Our ability to reflect on, learn and grow from them, is what makes us better practitioners.
Perhaps the answer is not a focus on increased resilience, but a move towards a culture that promotes recognition, reflection, and a space to feel. A culture that says “This is hard, and it is ok not to be ok”. A culture that doesn’t focus on “bend don’t break”, but instead supports us to “break and reshape”. The Indian philosopher Jiddu Krishnamurti said “It is no measure of health to be well adjusted to a profoundly sick society”. Perhaps equally, it is no measure of resilience to expect survival, unchanged, of a system that continually tests your mental, physical and emotional wellbeing.
Danielle Banfield
@miss_d_banfield
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