Coping with Stress and Building Resilience

Resilience is a multidimensional characteristic that embodies the personal qualities that enable one to thrive in the face of adversity. Resilience can be built and fostered and is a dynamic, evolving process of positive attitudes and effective strategies. Four main aspects of resilience have been identified: (1) attitudes and perceptions, (2) balance and prioritization, (3) practice management style, and (4) supportive relations.  Personal qualities associated with resilience include the ability to engage the support of others, optimism, faith, the belief that stress can be strengthening, and striving towards personal goals. Psychological resilience in intensive care unit nurses has been independently associated with a lower prevalence of posttraumatic stress disorder and burnout.

Exercise, fitness, and nutrition are also important when coping with stress. Stanford’s WellMD website offers helpful tips, exercises, and stretches to help individuals remain physically active even while at work. Stanford also offers helpful tips for work-life integration and finding balance.

Steps Forward from the American Medical Association offers a variety of modules for preventing physician distress and suicide, improving resilience, and for promoting well-being in residents and fellows. You can explore their website in greater depth to find activities aimed to help individuals enhance their professional well-being. CME credits are available for most modules.

The American Nurses Association recently launched its Healthy Nurse, Healthy Nation Grand Challenge which aims to broadly connect and engage individuals and partner organizations to take action within five domains: activity, sleep, nutrition, quality of life, and safety.

Skills and Abilities

As clinicians follow the trajectory of their careers, they must deal with technological flux and continually changing interpersonal relationships.

Challenges along the Journey

The world of the health care novice is vastly different from that of the expert clinician. Stressors occur at every step along the professional journey and they change over time. To effectively deal with the challenges of clinical life in today’s health care environment, mastering the art of teamwork is as important as mastering technology. The ability to recognize and mitigate stressors and respond to them in a healthy way as they arise plays a major role in clinician well-being and resilience. Those who embrace lifelong learning regarding both interpersonal skills and technology will be better equipped to manage new challenges. Individuals can develop new skills and strategies at each career stage. Organizations, too, will benefit from the provision of needed training in these areas.

Interpersonal 

The historical model that set physicians at the top of the decision-making pyramid is shifting. Health care has moved toward team-based care that recognizes the equally important roles of nurses and other allied health professionals. Clinicians who cling to an image of themselves as solo healers may fall prey to burnout and moral distress. In addition, overarching institutional structures and payer models put more restraints on clinician autonomy. Health care providers and institutions benefit from the creation of environments in which all team members can contribute their maximum value.

Traditional, siloed education processes may not effectively teach clinicians how to function in today’s model of team-based care. Successful teams depend upon both the skills of the leader and those of the members. Knowing how to fit into a team and how to leverage support from it helps health care professionals feel less isolated and frustrated. The development of communication and collaboration skills is essential to establish effective teams and maintain healthy work environments.

 Clinical and Technical

Technological advances have led to improved tools for learning, communication, data gathering, organization, real-time patient monitoring and record keeping. Conversely, technology has also led to a disruption of traditional routines, more time spent at screens, the expectation of faster work pace, and potential overexposure to information. These aspects of technology can make the health care professionals feel distanced from both patients and colleagues.

The same new communication tools that allow health care professionals the flexibility to perform documentation from home may also be new sources of stress. “Work after work” does not allow clinicians to fully separate from their jobs so that they can rest and renew in an emotionally calm and safe home environment.

Clinical technology rapidly evolves, which results in equipment and software upgrades that require continual learning. This can make workers feel unable to keep up, anxious and uncertain. When it comes to resiliency in the face of technological flux, an individual’s outlook is pivotal. Workers who perceive technology as a threat, rather than as a helpful tool, are more likely to suffer burnout.

 Overall, multidimensional interventions, which take into consideration the clinical skills and interpersonal abilities of health care professionals, are most likely to help prevent clinician burnout and support resilience across the span of clinicians’ careers.