Concept analysis: resilience
Examining concepts pertinent and emerging from nursing practice by determining their
core elements and exploring relationships between them, namely concept analysis, is a
predecessor and b
...
Concept analysis: resilience
Examining concepts pertinent and emerging from nursing practice by determining their
core elements and exploring relationships between them, namely concept analysis, is a
predecessor and basis for developing nursing theory. The nursing concept chosen here for
discussion is resilience of nursing professionals in relation to Roy’s Adaptation Model (Roy,
2009). This concept analysis will contain a definition of resilience, literature review, defining
attributes, antecedent and consequence of resilience, empirical referents, construct cases,
theoretical applications and conclusions.
Definition
Resilience is defined as an ability to correctly perceive and react to stressful occurrences
(Sieg, 2015), as well as an ability to bounce back from crisis into a state of optimism (Turner,
2014). This concept is applicable to both, everyday life and work situations, as well as to the
instances of trauma. The importance of resilience is amplified by continuous changes in
healthcare systems and policies, as well as by nursing shortages and increased incidence of
professional burnout (Sieg, 2015). Turner declares that resilience is an “imperative quality”
(Turner, 2014) in nursing profession on account of its distressing constitution. Resilience, or lack
of there of, has been linked to negative consequences for healthcare systems and for individuals
(Rushton, Schoonover-Shoffner, & Kennedy, 2017). Examples include decline in patient
outcomes and in quality of care, higher rates of turnover, professional discontentment, and
emotional detachment (Rushton, Schoonover-Shoffner, & Kennedy, 2017).
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Literature review
Literature recognizes the importance of resilience for leadership as it can affect staff
retention (Turner, 2014). Hart et al. (2014) declare that a good understanding of resilience helps
leaders provide support and create strategies enhancing and empowering nurses. Research proves
that resilient nurses have lesser incidence of stress disorders and have higher chances of staying
within the profession (Turner, 2014). Rushton et al. (2017) recommends the necessity of
institutional support to raise resilience, including providing ethics consultants, resources for staff
education and mentoring, as well as creating best practice guidelines that enhance
communication and early resolution of moral dilemmas.
There have been several studies published globally on the effect of resilience on
education of nursing students at different levels of study. It has been recognized that teaching
nursing students how to be resilient makes them more productive and accounts for a smoother
transition into practice. A large study conducted in China on both medical and nursing students
denotes that resilience increases the subjectively perceived state of wellbeing, which then
translates into productivity (Zhao, Guo, Suhonen, & Leino-Kilpi, 2016). The same source
strongly correlates peer caring with the concept of resilience.
Peer support however, is just one of many characteristics of resilience. In order to
develop and facilitate resilience one should not only maintain positive relationships with
colleagues, but also learn to accept things that cannot be influenced, remain focused on the longterm goals, stay hopeful, and be optimistic (Sieg, 2014). Additionally, Hart et al. (2014) include
coping, work-life balance, cognitive reframing, and reconciliation as effective strategies. The
diagram found in another article illustrates a resilient employee as a product of personal
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perception, personal work context: job description, education, training, as well as organizational
procedures: legislation, facility policy etc. (Ngoasong & Groves, 2016, p. 241)
Defining attributes
Optimism is an important attribute of resilience (Turner, 2014). Despite difficult
circumstances, moral distress, and high demands of ever changing healthcare environment
resilient nurses remain a hopeful outlook (Sieg, 2014). It’s that ability to keep a long-term
perspective despite adversity, that allows for restoration and recovery.
Acceptance of the situation is another vital attribute (Sieg, 2014). Recognizing and
accepting what one cannot change allows reframing the circumstances and fosters reconciliation.
It allows handling the distressing situation more effectively and secures easier recovery from
setbacks.
The last attribute of resilience is self-care, which is achieved by letting go of worry,
disappointment and guilt (Sieg, 2014). Resilient nurses take care of their emotional health by
utilizing coping skills, addressing their spiritual and physical needs, movement, taking time for
themselves, and self-reflection. Living a balanced life allows to face the challenges of the
nursing profession successfully.
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