There has been no test of resilience as there is happening right now with the COVID-19 pandemic. Even before this time, depression, burnout, compassion fatigue, and secondary traumatic stress among health care professionals have been researched and are being addressed by ongoing initiatives, such as Healthy Nurse/Healthy Nation and the Action Collaborative on Clinician Well-Being and Resilience. Resilience is often identified as an attribute to describe clinicians who face challenges time and time again, but are we doing a disservice by setting the expectation that we must be willing and strong enough to keep facing adversity? In an editorial last year, Linda Laskowski-Jones, editor-in-chief of Nursing2020 wrote, “A singular focus on resilience as the fix could portray the clinician who is not resilient enough as the problem.”

Are there really strategies to promote resilience or is this a buzzword being used to mask underlying issues? I’d like to think that we are resilient, but there comes a point when we must be okay with asserting our need for support and resources to achieve and maintain our resilience. 

The 7 Cs of Resilience

In his 2011 book, Parent’s Guide to Building Resilience in Children and Teens: Giving Your Child Roots and Wings, Kenneth R. Ginsburg MD MSEd FAAP identifies 7 Cs of resilience to help children and adolescents cope with illness. Can we apply these strategies for resilience in other situations? Let’s break down these 7 Cs and their relevance for clinicians facing COVID-19.

Control
While this COVID-19 enemy has shut down whole countries and many of us feel a lack of control, there are some things that are within our control; however, we can only control ourselves and what we do. Though we can’t control the actions of others, we do have the responsibility as nurses to inform and educate. And when we don’t agree with the actions of others, we can control our reactions to it; this is important for our own well-being.
 
Competence
We are very familiar with the concept of competence. In fact, most of us must demonstrate ongoing competence for our licensure and jobs. This is no different. As we learn more about this virus, we have to share our experiences and base our care on the evidence as it unfolds. Staying updated on the disease process and management recommendations is essential.
 
Coping
We teach coping skills to our patients all the time. It’s time for us to recognize how we cope best and to make sure we take the time to cope. This is a stress like none of us have ever experienced. Think about how you cope best – talking about your experiences, exercising, meditation, journaling?
 
Confidence
Confidence brings two approaches to mind:

1. Be confident that we will get through this. Our new “normal” will likely be different, but we will get through this.
2. Build confidence among your teammates, whether by praising or celebrating successes, or providing encouragement. It can go a long way.

 
Connection
For many patients and families, you are the connection. As visitors are restricted in many facilities, you are keeping people updated and in touch. Also, our own connections with family and friends are much different now as we rely more on technology and less on touch. Make the effort to keep up with those connections.
 
Character
The public is certainly getting a glimpse into the character of those on the frontlines of care. Be proud of the work you are doing. Your integrity and your commitment to care exemplify the nursing profession.  
 
Contribution  
The contributions you are making are immeasurable. Your work, whether on the frontlines on the COVID-19 floors, making administrative decisions, or supporting patients in the community, is making a difference.

Long-term resilience

There is no way to predict how resilient we will be over the long-term. To handle immediate stressors, stay focused and remember these 7 Cs, support one another, and take breaks – physical and mental – as needed. For longer term resilience, seek out and take advantage of resources to help you prioritize self-care. Your experiences now will be transformative; look for ways to incorporate them to add to the meaning of your life and your work. We are facing a harsh reality right now that will lead to growth and yes, I believe, resilience.  

References:
Ginsburg, K. (2011). Building Resilience in Children and Teens: Giving Kids Roots and Wings. Illinois: American Academy of Pediatrics.

Laskowski-Jones, L. (2019). Clinician burnout and resilience. Nursing2019, 49(11).