If nurses fail to address these issues or nurses’ leaders fail to coach and support, we may witness a mass exodus from nursing.
Nurses have always faced difficult and challenging situations—ethical issues, futile treatment, patient suffering, staff suffering—but never have we faced a worldwide pandemic like the coronavirus disease 2019 (COVID-19). As a nurse leader, my priority is to encourage nurses to develop their resiliency muscle through education and promotion of nursing self-care. The World Health Organization designated 2020 as the Year of the Nurse and Nurse Midwife, and we should make the development of nurse resilience a priority for all health care systems and professional organizations. It should be integral to every nurse’s professional development.
Since the start of the pandemic, nurses have experienced burgeoning moral distress and burnout. They are concerned for their safety, their patients’ safety, and the safety and care of their own families. They must provide care that seems unconventional and often not fair. There are changing personal protective equipment (PPE) guidelines, and general information overload. We nurses are experiencing unprecedented anxiety. The human brain has limits on its ability to absorb change, and if nurses fail to address these issues or nurses’ leaders fail to coach and support, we may witness a mass exodus from our profession.
This summer, I have the privilege of coaching 5 new graduate residents who are starting their nursing careers on COVID-19 medical/surgical unit. These nurses interviewed for and accepted positions in an oncology unit, but in the interim, the oncology patients were consolidated and a COVID-19 unit was formed. Keeping the new nurses focused and less anxious, while all of us are working in full PPE, will be among the biggest challenges in my 35-plus years of nursing. I will provide them with support and education, and I hope that in the near future I will have the opportunity to help develop them into stellar oncology nurses. I will teach them the power of resiliency and self-care, the most important lessons of their nursing future.
Resilience allows a person to adapt well in the face of adversity, trauma, tragedy, threats, or significant sources of stress. The characteristics of resiliency include adaptability, self-control, self-sufficiency, creativity, optimism, persistence, and humor.1 Resilience can be learned and further developed. Factors that can promote resiliency include individual temperaments, family bonds, and external support systems, while personal resiliencebuilding qualities include the ability to ask others for support, optimism, faith, and the belief that stress makes you stronger. Working toward personal goals also is important.1 Innovative educational programs can help cultivate resilience in both new and experienced nurses.
In response to the moral distress and burnout clearly conveyed in many accounts from the epicenters of the virus, the CDC published recommendations for nurses on how to decrease stress and increase resiliency during these trying times.2
They include as follows:
• Communicate clearly about job-related stress.
• Identify and accept the things over which you have no control.
• Realize the crucial role you are playing in the COVID-19 pandemic, especially with limited resources.
• Keep a daily routine to maintain a sense of control, including getting adequate sleep.
• Know how to step away from work at the end of the shift, as well as take breaks from social media and other potential sources of negativity.
As a nurse, recognize that developing or improving your resilience is not only one that is ethically necessary to care for patients in difficult situations, but a crucial personal journey. Research results clearly show that nurses with high levels of resilience have are less likely to experience posttraumatic stress disorder, burnout syndrome, anxiety, and depression.2
We need you to care for yourselves and other nurses as we find our way out; we don’t want to lose nurses during this difficult journey. Keep yourself safe and always listen to your heart and body.
Be well, my fellow nurses.
1. Palmiter D, Alvord M, Dorlen R, et al. Building your resilience. American Psychological Association. February 1, 2020. Accessed July 6, 2020. https://www.apa.org/topics/resilience
2. Centers for Disease Control and Prevention. Healthcare Personnel and First Responders: How to Cope with Stress and Build Resilience During the COVID-19 Pandemic. May 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/mental-health-healthcare.html