How to Boost Your Resilience in the Workplace
Editor's Note: When this piece was initially published, the Covid-19 pandemic had just begun. At Write Medicine, we believe resilience at work and in our daily lives remains a more important aspect of mental health than ever before. This piece has been updated to reflect time passed.
Imagine you're on a hike - and it's much harder than you thought it would be. The incline is steeper than you're used to. How do you react? Do you give up or take a deep breath and keep going?
From a young age, we're prepared for moments like these. From sleep training, when our parents teach us that we can self-soothe, to being left at daycare, humans are inherently resilient. Dealing with adverse events in a healthy way is necessary in a life that introduces us to hardships like difficult hikes as well as illness, death, and pandemics.
Of course, there's a fine line between resilience and pushing ourselves too hard. Similarly, there's an important distinction between resilient coping mechanisms and unhealthy ones. Today, we'll explore what resilience is, how to build it, what it looks like, and why it's a crucial tool for those in the healthcare space.
What Is Resilience?
I think a lot about resilience. Early in my academic career, I worked on a World Health Organization-inspired project that focused on how schools could put measures in place to foster resilience among school-aged kids (known as the Health Promoting School). That professional experience affirmed what I knew from my personal story: That resilience is vital for adaptation to stress and is the foundation for good mental health.
In the 1980s, research on child development, family dynamics, school effectiveness, and community development coalesced around the idea that humans are innately equipped with a biological imperative for growth and development. That is, when faced with adversity and stress at work, we already have the capacity to recover or “self-right,” boosting our resilience.
Resilience is this capacity for recovery or self-righting. Psychotherapist Linda Graham identifies 5 components of resilience in her book Bouncing Back:
These components are also reflected in how, when asked, people describe their experience of resilience. For instance, respondents to a recent survey in Mindful magazine described resilience as:
Seeing past the darkness to the sunshine
Carrying on with grace and strength when times are tough
Staying on track in the face of setbacks
Showing up
Fielding difficult emotions
The Importance of Resilience in the Workplace: Burnout Burden and COVID-19
When this piece was written in 2020, COVID-19 was exacting a daily toll on the world as infection rates continued to rise. The calculus of suffering associated with the causative virus SARS-CoV-2 was especially evident among health professionals, who were expected to stay in a state of high alert (or “fight or flight” mode) for the foreseeable future.
The New England Journal of Medicine termed this fight or flight mode a parallel pandemic. Little was known at the time about the psychological impact on healthcare workers of managing patients with COVID-19 and dealing with high mortality, shortages in healthcare supplies, and the stress of ongoing uncertainty.
But what made this acute stress environment additionally challenging was the extensive dissatisfaction and burnout that was already evident among many healthcare workers, especially physicians. In 2020, almost half of working physicians—an occupational group that is rigorously trained to embrace complex challenges—reported experiencing work, reflecting the need for workplace resilience. dissatisfaction and burnout.
But physicians aren’t the only health professionals to experience burnout. Work stress and burnout among nurses have been documented since at least the 1950s and many recent studies point to burnout in other health professions across a range of settings and countries.
How Resilience Can Help Us Tackle "Superhuman Culture"
As many, many researchers and commentators have argued, the US health system is increasingly dysfunctional not only for patients but also for healthcare workers, many of whom experience restricted autonomy over their work combined with unrealistic expectations about what is possible in a given day.
Clearly, we need organizational and cultural change to address burnout in dysfunctional health systems as well as to create working conditions that reduce pressure on healthcare providers and help them thrive in the work they do.
As part of its Steps Forward initiative, the American Medical Association (AMA) encourages a range of interventions to specifically tackle physician burnout in health organizations, such as including wellness as a quality indicator, identify a Wellness Champion, and measure wellness.
The AMA has also created a Self-paced CME course to help employees handle stress and build workplace resilience. Other system-level strategies that have been, or are being, piloted by the National Academy of Medicine to address burnout, improve clinician well-being, and build resilience include:
Workflow optimization at Virginia Mason, Kirkland WA, via a Plan-Do-Study-Act process of continuous learning and quality improvement.
Enabling advanced practice providers to practice to the full extent of education and training.
Integrating clinician well-being as a core value of nursing can help reduce workplace stress.
Promoting programs that build cognitive behavioral skills, stress coping mechanisms, and resilience.
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How Does Resilience Help Us At Work?
Everyone in the healthcare field faces higher levels of stress, particularly during times of crisis like those we saw during the Covid-19 pandemic. On a day-to-day basis, clinicians may need to cope with witnessing death, traumatic injury, unsuccessful procedures, or not being able to provide life-saving services to someone if their insurance won't cover it.
Conversely, educators in the healthcare field are tasked with creating and delivering content meant to close the knowledge gap between clinicians and current best practices. They may also be tasked with creating engaging content designed to build resilience at work.
These are just two examples of the complex nature of jobs that deal with caring for human life. To properly manage stress and become resilient employees who want to keep coming to work, we need to understand how resilience helps us and implement techniques to build our resilience muscles.
Emotional regulation
Resilience helps increase our capacity for difficult emotions. From frustration over facing a difficult problem to grief over losing a patient, resilience allows us to remain more even-keel in these situations while staying present in the moment. A simple way to practice emotional regulation is to observe what you're feeling throughout your day without overidentifying or needing to talk about it excessively. You may begin to notice how quickly your colleagues become consumed with their emotions or make emotion-driven decisions.
Emotional regulation isn't asking you to stop feeling; it's a way of resilience training that empowers you to manage the intensity of your feelings, control them instead of allowing them to control you, and feel your emotions at an appropriate time.
Cognitive agility
On a similar note, personal resilience also empowers us to use our critical thinking skills, even in difficult - maybe life or death - situations. While we may naturally exhibit a flight, fight, or freeze response when faced with challenges that seem too difficult, developing resilience allows us to regulate our emotions and stay calm so that the logical parts of our brain can still function even when our stress levels are heightened. This is a critical skill for providers dealing with high levels of stress on a daily basis in their work environment.
Self-compassion
None of us are superhuman. We all need some help solving problems or reducing our stress sometimes. And realistically, we're all going to drop the ball at one point or another. We build resilience when we recognize that this is normal and okay. It doesn't make us inherently bad people. Mistakes are made so that we can learn from them.
When we show ourselves the compassion we would show a friend who had made a mistake, we aren't "being soft" or "too emotional". While these attitudes may be common in certain healthcare environments, they'll hinder your personal development. Learning from past actions with an attitude of compassion, not shame, can help boost your resilience at work.
How to Build Resilience
Now you know a few ways resilience can help your performance at work. Let's talk about how to continue your resilience training so you can face challenges at work confidently and touch on conditions that can make it difficult to build resilience at all.
Arm yourself with the right tools
Social and economic arrangements that confer disadvantage like poverty, income inequality, exposure to interpersonal violence, neurotoxins, and organizational stress—as in health systems—make it incredibly challenging for many of us to be, or feel, resilient at work and in our daily lives.
The good news is that we can arm ourselves with the right tools to build resilience as individuals and as communities by building social support and by fostering presence for ourselves. We can boost resilience by developing tools like social competence (e.g., empathy, and a sense of humor); problem-solving and creative thinking; self-identify and self-awareness; and a sense of purpose.
Here’s the American Psychological Association roadmap to building resilience
Build connections—relationships are everything in developing a resilient workforce.
Foster wellness—cherish your body and mind through self-care, contemplative practices, and a willingness to be present
Find purpose—develop resilience at work through kindness and understanding. Extend that kindness to yourself and others.
Embrace healthy thoughts—accepting change is one of the most important lessons I’ve learned in my own life
Seek help to reduce stress—it’s OK, we all need to borrow a life jacket sometimes. You may find individual therapy, group therapy, or support groups led by licensed clinicians helpful.
Emerging research points to the potential benefits of mind-body practices as ways to promote resilience. Practices such as self-regulation of attention, breathing techniques, and mindful movement may facilitate bidirectional brain-body communication and conserve psychophysiological resources in ways that enable us to "bounce back" following illness, trauma, and other forms of adversity. In short, resilience-building takes practice, and, indeed, is a form of deliberate practice.
Resilience Is a Part of The Human Story
As a yoga educator as well as a CME practitioner, I know that resilience is needed more than ever right now. The CME/CPD community has a golden opportunity here to join organizations like the AMA in creating programs that not only move clinicians from surface to deep learning (as Chitra Subramaniam, President of the Alliance of Continuing Education in the Health Professions has described), but that also build resilience in ways that help learners manage adversity in the present, improve their performance, and foster a positive work environment so that they can thrive in their work.
Bring Resilience to Your Medical Writing Career Today
Resilience is a learned skill, but an important one for clinicians and medical educators alike. It's important to arm yourself with the right tools, including self-compassion, meaningful connections, a sense of purpose, and support.
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