The Problem with Resilience
This blog is written by Heather Fitzgerald, DBe, MS, RN. Heather is a 3 Vital Questions ® Certified Trainer and Director of the Office of Professional Fulfilment & Resilience at Stanford Medicine Children’s…
This blog is written by Heather Fitzgerald, DBe, MS, RN. Heather is a 3 Vital Questions® Certified Trainer and Director of the Office of Professional Fulfilment & Resilience at Stanford Medicine Children’s Health.__________________________________________________“What you measure, you produce.”I heard this wise counsel from a mentor during my doctoral studies. I was in that particular phase of looking for direction yet staggering around beneath unwieldy ideas.
My main idea was that I wanted to get at healthcare organizations’ moral obligations to create the conditions for healthcare professionals to thrive in their work. My mentor’s provocative wisdom that, what we measure we produce, illuminated for me in an instant that burnout in the health professions has been examined through a problem-oriented lens.
Burnout and its hallmark features of emotional exhaustion, depersonalization, and decreased self-efficacy are undeniably significant concerns for healthcare professionals and leaders. However, the growing volume of burnout studies have yet to result in significant shifts because, it suddenly became clear to me, the focus is always on the problem.
My clarity expanded from there. I realized, too, that resilience has gotten a bad rap. In the problem orientation, the term “resilience” can be perceived as a persecuting message of “couldn’t-you-just-cope-better?” as the solution to navigating the unique occupational challenges in healthcare. This persecuting sense of resilience risks driving people even further into defensiveness, self-protection, and isolation, shut off from other ways to relate to ourselves, to others, and to work that matters.
I realized in that moment, it's time to ask—and study—different questions. Questions about what we do want. Questions about an engaged, invigorated, and visionary workforce. Questions like:
- How can we quickly, compassionately shift out of drama and reactive patterns into a resourceful capacity to consider what’s possible and generate solutions?
- How can we build personal and collective empowerment to sustain ourselves in this vitally important work that we do?
- How can we develop a challenge response, versus a threat response, to stay steady and effective even in the face of complexity, ambiguity, uncertainty, and volatility?
- How do we build our inherent capacity for resilience, a healthier relationship with the challenges we face,* and cultivate well-being at work? (*Definition from Kathryn McEwen, Resilience at Work®.)
These very questions guide my approach to healthcare professional well-being. I draw on the 3 Vital Questions® and TED* (The Empowerment Dynamic) ® every day.
Like anyone, I do have to continually bring my focus back to what I do want, rather than the ever-present, tractor beam pull of what I don’t want, as I support individuals, teams, and leaders.
I am as susceptible as anyone else to reactivity. I am abundantly aware of the dynamic tension between a desired state of a universally engaged and invigorated workforce and the current state of post-pandemic recovery and repair.
Yet the baby steps I take each day to increasingly embed TED* into our work supporting healthcare professionals connect me to meaning and purpose. Both the meaning and purpose inherent in healthcare and the meaning and purpose of TED* and its capacity-building “special sauce.” Tapping into meaning and purpose through baby steps stokes resilience (the sustaining meaning of the word, not the “suck it up buttercup” interpretation!).
Our organization just wrapped up a system-wide Wellness Survey (notice it isn’t called a burnout survey). The survey includes domains of well-being, burnout, teamwork, gratitude, belonging, and mattering. Yes, burnout is on the list. It is the other side of the coin of what we truly want to produce, and it reflects the reality that we are and will continue to be faced with challenges in healthcare.
There is no promise that those will subside. Yet developing a healthy relationship to those challenges is possible. Cultivating our inherent capacity for resilience is possible. Living from and through the essence of who we are as Creators is possible—and not in some hoped-for future. Right now.