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RESILIENCE IN THE WORKPLACE
We now go on to look at the influence of the workplace environment. While reading this next section you might like to consider how some of the personal factors, we have considered interact with the workplace context. It is almost inevitable that at some time or another we will encounter situations at work that challenge our resilience. If the workplace environment is supportive, we are likely to be able to manage these challenges. Unfortunately, this is not always the case.
Workplace adversity
Jackson and colleagues (2007) define workplace adversity as a ‘stressful, traumatic, or difficult situation or episode of hardship that is encountered in the occupational setting’. They carried out a literature review to explore the concept of personal resilience as a strategy for responding to workplace adversity and to identify strategies to enhance personal resilience in nurses. They suggest that although there are aspects of life and experience that we cannot change, we may be able to modify our reactions to them. It can be more helpful to focus on the development of skills and resources rather than focusing on problems. We all encounter adversity and stress and it is how we respond to these that demonstrate our resilience.
CASE STUDY
Jane is a nurse working in a GP surgery. She is on a phased return to work after treatment for breast cancer. It is a very busy morning and she is running late. Her next patient has recently been diagnosed with breast cancer and needs sutures removed. The woman gets angry with Jane for keeping her waiting. The next patient comes for a depot injection and becomes tearful as she tells Jane of her concerns about her mother who has dementia. Just as she has seen the last patient on her list and is about to go out for her lunch break, one of the GPs asks Jane to see a child who needs a dressing on a laceration. Jane responds abruptly and realises that she is feeling overwhelmed, angry and upset.
Questions:
- What might be making the situation difficult for Jane?
- What protective factors could be put in place in the work environment?
- What steps could Jane take to increase her personal resilience?
Click the following tabs to see other aspects of resilience in the workplace:
A question to consider
Research has shown that if work-related incidents are coped with by avoidance, dismissal or denial, people are more likely to suffer higher symptom levels (Firth-Cozens & Morrison 1989). They used a qualitative approach to look at stress and coping in a group of 173 pre-registration doctors.
The top four areas identified as causing stress were:
- events concerning death
- relationships with senior doctors
- mistakes seen as personally caused
- overwork
This study was carried out in 1989. What might be similar today and what might be different?
Most people cope with work-related problems by either tackling the problem or asking for help. However, those who try to cope with the event by dismissing it from their mind tend to feel consistently stressed and isolated and report making significantly more perceived mistakes than a consistently unstressed group. Some people use drugs and alcohol to try to manage their responses to stress and adversity. This is not uncommon among healthcare professionals. You will probably not be surprised by the results of a study by Holahan et al (2004) which suggested that using alcohol or drugs to help cope is linked to depression. There are a number of resources available to support healthcare professionals with these issues. Please see the resources on the Professional Support Unit website: https://london.hee.nhs.uk/professional-development
Self-criticism measured in students, also proved to be an important predictor of depression. These people experience harsh self-scrutiny and a fear of being disapproved of and criticised (Firth-Cozens 2004). It can be a challenge for supervisors and managers to give feedback to people who appear to be self-critical and also to competitive people who strive for excessive achievement and perfection (Blatt and Zuroff 1992). On the other hand, having low self-criticism might be good for one’s own mental health and resilience, but might not be as helpful for relationships and teamwork.
What do you think? Is it possible to be self-critical and resilient?
Undermining and conflict at work can affect the most resilient of people. Sadly, these behaviours are still widespread within the NHS and healthcare professionals are reluctant to report it.
What is undermining?
This means lowering someone’s confidence or self-esteem. It may result from bullying.
What is bullying?
‘A situation where one or several individuals persistently over a period of time perceive themselves to be on the receiving end of negative actions from one or several persons, in a situation where the target of bullying has difficulty in defending him or herself against these actions. We will not refer to a one-off incident as bullying’ (Einarsen et al, 1994).
Clinical and educational supervisors are sometimes fearful of being accused of bullying if they give negative feedback to junior colleagues or trainees. It is important to understand that consistent, fair, negative feedback is not bullying if given in an objective and non-judgmental way. You may want to look at an e-learning module on Giving Feedback: https://www.e-lfh.org.uk/programmes/educator-hub/
Being bullied or witnessing others being bullied is associated with:
- Higher levels of psychological distress
- Lower levels of job satisfaction
- Increased anxiety asking certain consultants for help
- Lower satisfaction with leadership climate
- Increased sickness absence
Although bullying and undermining of healthcare professionals may have a serious impact on patient care, trainees and junior staff are often reluctant to report it.
Barriers to reporting: (Illing et al 2012):
What might you add to this list?
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Typical examples of bullying and undermining of medical trainees:
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What do you think could be done to reduce bullying in your place of work?
Who could you discuss these ideas with?
How might you be able to raise some of your ideas as points for action?
The Exhaustion Funnel
Professor Marie Åsberg of The Karolinska Institute in Sweden, (as discussed in Williams and Penman 2011) developed the concept of an exhaustion funnel which shows how we may be pulled towards exhaustion and burnout if we do not care for ourselves and our emotional and psychological needs.
She points out that at times of stress we tend to give up the things that nourish us. This behaviour risks leading us into a downward spin towards more stress and physical and psychological symptoms of burnout.
Exercise
- Write down the things that nourish you and help to prevent you from burning out.
- Underline any that you have given up in the last few months.
- If none, what does that tell you?
- If several, which of these might be a priority for you to re-start?
- What would be your first steps?
You might want consider adding this to your Personal Development Plan (Click Here)
Follow this link to watch a TEDxNHS talk about the personal story of an air ambulance doctor: Dr Sammy Batt-Rawden, The Empathy Switch: https://www.youtube.com/watch?v=VN9VwX2rUqk
Exercise
- Think about someone you know whom you consider to be very resilient at work. How do they show this?
- Now think of someone you know whom you consider to be lacking in resilience. How do they show this?
- Next think about yourself. What is going on when you are able to be resilient and when you are unable to be so? What else might be happening? What other contexts need to be considered?
- Think about a time in your working life when you were feeling resilient and in balance. Also think of a time when you weren’t feeling resilient and life was out of balance. Make a note of when those times were and briefly jot down what you were doing – a few points to describe that time in your life.
- Finally, reflect on those two polarised periods in your life. Try completing your personal ‘resilience matrix’ below. This may help to heighten your awareness of things to be wary about and personal strengths to develop further.
