Juliette Cosgrove, Chief Nurse & Director of Clinical Governance, NHS Professionals, argues that a focus on flexible worker resilience is needed to support those who support the NHS
Resilience is an essential and ever-growing requirement within any healthcare setting. And resilience is necessary at every level: individual, organisational and systemic. Now, in the midst of a pandemic, as we continue to face rapid change and unexpected disruption, it is resilience that will enable us to work together, to support one another and prepare for, respond and adapt to the coming months and years of working through a changing environment.
But what exactly do we mean by resilience? Simply put, resilience is the ability to face and recover quickly from difficult situations. It is a particularly vital characteristic for healthcare leaders and workers during these extraordinary times, with so many dealing daily with patients and their families during some of the most challenging and vulnerable experiences, through pain, fear, and loss.
Yet, at the same time, resilience must not become a characteristic that manifests itself as a constant state of survival. It is critical that it also incorporates individual and organisational strategies to minimise crises and identify improvements, both personally and professionally. Measures that equip flexible healthcare workers, who have been and continue to be so crucial during the pandemic response, with the tools and motivation to belong and flourish as part of a team – not just survive.
How to build individual resilience
Resilience is an important personal attribute that can have a wide-ranging influence on wellbeing and performance at work. It plays a central role in how individuals cope with stress, respond to change and adversity, and recover from setbacks. While we are aware that individuals respond differently to different situations, the good news is there are actions we can all take to increase our own – and other people’s – capacity to cope with stress. These might include:
- Ensuring you take a break from duties to talk to a friend or colleague about a problem.
- Taking the time to recognise and appreciate a colleague’s achievements.
- Simply saying a friendly ‘hello’ to help nurture that essential sense of belonging.
- Encouraging and nurturing your own individual reflective learning, by looking back on an experience and preparing for similar challenges in the future.
From a personal perspective, building individual resilience can have a positive impact on emotional and psychological wellbeing, as well as on an individual’s work and home life. It can help to reduce burnout, increase empathy and compassion, reconnect with the joy and purpose of practice, and improve overall physical and mental health. All factors are key to staff retention and maintaining the quality and safety of care.
However, it is paramount that achieving resilience isn’t a challenge that healthcare workers must face alone. Individual resilience is potentially short-lived if the support is not focussed on the whole team and broader healthcare setting. If we are to respond and adapt to both ongoing change and unexpected disruptions, robust organisational and systemic resilience also needs to be in place.
How to maintain organisational resilience
Amidst the second wave of COVID-19, resilience is now fundamental to maintaining improvements and innovations that are running through our healthcare system, as well as delivering the further transformation needed to ensure we are able to meet the challenges ahead. So it is a cause for both alarm and action that studies show NHS Trust leaders are concerned about the resilience and wellbeing of their staff, with a reported 99% either extremely or moderately concerned about the current level of burnout across their workforce. (1)
While stress might often be associated with the physical and emotional demands of being a healthcare worker, it is not reasonable to expect doctors, nurses and other healthcare workers to cope with extreme or ongoing stress. By examining and alleviating the causes of stress from an organisational perspective, this can also help leaders reinforce resilience in their workers and build a system of team belonging and support.
Recent improvements, where NHS Professionals has worked with NHS Hospital Trusts to tackle stress and build resilience, include:
- Increased workforce capacity so there are more hands to carry the load, particularly at critical times.
- Workforce strategies and process improvements so we use the skills, experience and knowledge of flexible workers in the right places.
- Building on the initial COVID-19 recruitment drive to encourage more healthcare workers to join and remain a part of the flexible workforce.
- Fostering a culture where every team member feels valued and supported. Having the basics in place is critical to this and often simple to achieve – proper inductions, a welcome to a new placement and signposting to sources of additional support, are all important
- Clear and accessible development opportunities, so flexible workers as well as their substantive colleagues can continue to learn new skills and progress in their career. For example, developing the specialist nature of the flexible nurse role, and support for Healthcare Support Workers to progress into nursing.
Supporting resilience for everyone
Support for resilience needs to be universal. When any group within a healthcare setting is treated differently from others, there is a risk – both to the individual and, ultimately, to patient care and service quality. For instance, when flexible healthcare workers don’t receive the support, recognition and development opportunities they need, resilience is gradually eroded and they can feel marginalised. This can result in burnout and inevitably good workers will leave the health service, which affects the whole team, organisation and society as a whole.
The NHS People Plan for 2020/21 states, “it has never been more urgent for our leaders to take action and create an organisational culture where everyone feels they belong”. Yet the very nature of being a flexible worker can sometimes lead to individuals feeling isolated, with a sense of not belonging to a team.
As resilience is the quality that enables people to flex and adapt, to be knocked down and come back again, it is vital that it runs through a whole organisation. From leaders to substantive and flexible workers alike. With the support that is joined-up at every level: individual, team and organisation. This approach will not only support healthcare workers to manage the current crisis, but it will also contribute to a positive environment that attracts and retains healthcare workers for the future. And ensures the best possible outcomes and experiences for patients and communities.
(1) Workforce flexibility and the NHS: Utilising COVID-19 innovations. NHS Providers, 2020.
