I met amazing “Lorna” a year ago. I could introduce her as “a great NHS senior medical manager, a former passionate nurse” and give her a tribute on the basis of her work related achievements. Instead, I chose to introduce Lorna the Native American way, focusing on who she is, rather than what she is doing and “delivering”. Lorna is a mother of four children, a wife, a lover of travelling, a lifelong learner and a career woman.
When I met Lorna I was amazed with her compassionate presence and positive, inspiring attitude. What was even more striking was listening to Lorna’s story- a story about burnout, humility and resilience.
Lorna’s career was thriving, however in the process she suffered work-related stress which lead to burnout and depression. She had to take time off work, her GP prescribed antidepressants and advised her to explore a different career pathway. At this end, Lorna started exploring different methods of support, including the principles of coaching, aiming to understand who she really is and what she really wants. During this journey she appreciated that she can be in control of her own self, that no matter what she would be OK and she could handle anything. She found her inner strength, her own resilience and well being.
Lorna is a senior manager, passionate about improving quality of care for patients and promoting well being in the workspace. She has a thriving career.
“The only time is now. Anything else is LaLaLand. Resilience is related to one’s insight, what one sees for themselves and calling it out at times of difficulty is a personal journey. We all are resilient. It is a matter of finding our own way”.
Reflecting on Lorna’s story, all sounds pretty easy; but is it as simple as described?
Psychology tells us resilient people are the ones who focus on what they have personal control over. There is also evidence resilience is enhanced when one feels they make a positive difference in the life of others and there is sense of belonging. Exercise, meditation, acts of kindness to oneself and others, and agency are ways of enhancing resilience in our lives.
I attended the IHI Conference in Glasgow earlier this year and Maureen Bisognano and Don Berwick had a discussion about the value of compassion in healthcare. The evidence presented showed that patients cared for in healthcare organisations that nurture compassion at all levels have better outcomes, including safer, more person-centred care. In addition, healthcare professionals in these environments have a better sense of purpose, belonging, agency, and experience joy at work. What was described was there are more resilient people, teams and organisations when compassion is what we all live and breath. So, there is an association between kindness, civility, compassion, resilience and improvements in patient care.
Evidently, we as healthcare professionals face a number of challenges within our daily practice and working environments. Workload, competing demands, time pressure and various roles are only a few of the stressors that can have negative influence on the physical and mental well being, leading to burnout. In some instances they can lead to more severe mental health conditions, such as depression. The impact on the individual can be detrimental and also affect ability to practice safely and effectively. The domino effects in teams and organisations can’t be ignored.
It is therefore imperative that a preventive approach is adopted. Building resilience in the health care professions is a key preventive strategy, helping not only individuals but teams and organisations. This should provide safe, patient centred, timely, equitable and effective care to patients. We should also be clear that resilience is not a “tool” to make individuals do more or be taken advantage of. Rather, it is a vehicle for them, for teams and organisations to not only sustain, but to best develop, and thrive towards the delivery of better, safer, person centred care.
A reactive approach is also not enough. We all need to work together, nurturing a culture of resilience and compassion. Let’s take a step back and think about what the Health Care System is made of. It is made up of people for the people. We are the culture and we can be the change now. Today. We can make the choice to be kind to ourselves and to others.
Finally, I would like to share with you all what Kintsugi is. Kintsugi is the Japanese art of repairing broken pottery and as a philosophy it treats breakage and repair to create something new- a new balance, not a “bounce back”. To me this describes resilience, a personal inner strength we all have and we can all find and nurture.
To my 8 year old son: “birds don’t just fly. They fall down and get up. Nobody learns without getting it won. I won’t give up’’, quoting his favourite song from zootopia. To him, this is resilience.
Finally, I will leave you with a question that only you can answer.
What can you do to build up resilience for yourself and others around you?
Dr Ioanna Nixon is an oncologist at the Beatson West of Scotland Cancer Center and National Lead for the Scottish Sarcoma Network. She is an Honorary Clinical Senior Lecturer, a Scottish Quality Improvement Fellow, a Founding Fellow of the Faculty of Medical Leaders(FFMLM) and Chair for the NCRI CSG Epidemiology and Survivorship Subgroup.