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Reexamining Resilience

Sato, Hui-Wen (Alina), MPH, MSN, RN, CCRN

AJN The American Journal of Nursing: April 2019 - Volume 119 - Issue 4 - p 53
doi: 10.1097/01.NAJ.0000554550.39146.ed
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Hui-Wen (Alina) Sato is a pediatric intensive care nurse in Southern California. Her blog can be found at http://heartofnursing.blog. Off the Charts is coordinated by Jacob Molyneux, senior editor: jacob.molyneux@wolterskluwer.com.

As I have been presenting at various nursing gatherings and conferences about the topic of resilience in light of work-related grief, I have been struck anew by the definitions of resilience that I find in the literature.

  • The ability to return to a state of normalcy or to “bounce back” from adversity or trauma and remain focused and optimistic about the future (Dyer and McGuinness, Archives of Pediatric Nursing, 1996).
  • The “ability to face adverse situations, remain focused, and continue to be optimistic for the future” (Kester and Wei, Nursing Management, 2018).

While I understand and very much appreciate the intent (and necessity) behind these definitions, I have to ask whether we are adequately exploring the meanings of the words used within these definitions and the implications for what nurses should expect of themselves in seeking to be resilient.

Does short-term resilience look different from long-term resilience? For example, in the definition presented by Dyer and McGuinness, a resilient nurse should be able to return to a state of normalcy. There is certainly a need for nurses to be able to maintain a steadfast mind and emotional state in the short-term moments of acute crises with their patients. A nurse returning to work after a difficult shift just the day before has to find a way to be present and focused for the next patient—to be resilient.

But in the longer term, when I consider what my normal state was as a person before I became a nurse, I find that I have been so transformed by my experiences as a bedside nurse in a pediatric ICU that I will simply never return to that state of prenursing normalcy. There is a deeper and slow adaptation that I find I have had to make over time to a new normal, where exposure to grief and traumatic experiences as a nurse become a regular part of my life. I must learn how to regularly incorporate these into my worldview as I seek to be resilient in both vision and spirit as a nurse.

Toward a more deeply rooted, reality-based optimism. Both definitions of resilience include an end goal of being able to remain optimistic for the future. When I read these words at face value, it feels unclear to me what optimism “ought” to look like for a resilient nurse. I have seen children die. I have seen families filled with hope for full recovery, only to be profoundly disappointed as their child's disease process could not be remedied by all that modern medicine threw at it.

Does optimism mean the ability to maintain an upbeat demeanor; does it require a reassuring insistence that “Everything will be OK!” every time I come to work? It is worth considering how we may—with all good intentions in desiring our well-being and that of others—at times subconsciously place an expectation on ourselves and our nursing culture to be immune to the reality of grief and closed off to our own healthy expression of it.

This work has meaning. But I am coming to the conclusion that maintaining a sense of optimism for the future as a nurse has to do with being deeply rooted in the reality that suffering and death are real, that goodbyes happen too soon, that sometimes we all fall apart. And even still, I can endure in this bittersweet profession with a conviction that my work has meaning, that my heart does not need to inevitably be overcome with cynicism, and that my presence—with the worldwide community of nurses—can continue to bring a healing balm in the midst of harsh realities.

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