Emotionally Resilient Healthcare Professionals
Introduction
In 2010, a 7.0-magnitude earthquake hit Haiti and areas of the Dominican Republic, leaving more than 300,000 people displaced without homes or families (Pallardy). During this chaotic time, many Haitian citizens claimed that their emotional resilience was essential to resume “normal activities despite the devastation levied by the earthquake” (Rahill). Emotional resilience is the ability to “respond to stressful or unexpected situations and crises” (“Emotional Resilience: The Children’s Society”). Incorporating such traits into their lives, the Haitian citizens were able to cope with and adapt to the stressful life event.
Is resilience truly advantageous to overcome life challenges? Guitele Rahill,Professor of Behavioral Science at the University of South Florida, explores such in his paper: “In their own words: Resilience among Haitian Survivors of the 2010 Earthquake.” Rahill discusses the importance of resilience for the Haitian earthquake survivors as it permitted them to rebuild their lives; they perceive themselves to be “flexible as bamboo trees, which can withstand strong elemental forces without being destroyed.” Similarly, Nelson Mandela, who was unjustly imprisoned for twenty-seven years and subsequently became South Africa’s first democratically elected president, analyzes resilience through his book a “Long Walk to Freedom.” He describes the importance of emotional resilience during his prison sentence: “There were many dark moments when my faith in humanity was sorely tested, but I would not and could not give myself up to despair” (Mandela). Together, they convey that in the face of adversity, emotional resilience empowers individuals to cope with demanding circumstances. Emotional resilience is shown to be valuable not only during times of crisis like natural disasters or civil injustices but also in regular situations, like in the healthcare industry (Robertson).
Each day, healthcare workers (HCWs) are expected to work in stressful environments and are pressured by the lives of others. As such, they are expected to maintain professional standards under high-pressure circumstances. During the COVID-19 outbreak, HCWs were required to work in increasingly stressful environments due to a lack of staff and longer hours. This caused up to 70% to report “psychological distress with high rates of depression, anxiety, and insomnia” (Cabarkapa et al.). In the healthcare industry, psychological distress commonly leads to physician burnout, the opposite of emotional resilience; “physician burnout is the long-term stress reaction which can cause emotional exhaustion, depersonalization, and/or feeling of decreased personal achievement” (“What Is Physician Burnout?”). Through analyzing various perspectives, this paper will argue that emotional resilience contributes to a better healthcare professional, namely for patient care and their mental health.
The Importance of Emotional Resilience for Patient Care
High-standard patient care is “providing care that is free from harm, minimizes redundancy and waste, allows timely access to needed services, follows best practices, and incorporates patients’ preferences and treatment priorities” (James). For healthcare workers, emotional resilience is valuable to provide better care for their patients.
Emotionally resilient healthcare workers are better equipped to provide high-quality patient care as they are skilled in their specialties to combat burnout. Nurhanis Syazni Roslan, Professor of the Medical Education Sciences at the University Sains Malaysia, and her team adopted a synthesis and systemic comparison approach to research the differences between individual HCWs, specifically for patient care. The study focused on analyzing the emotional resilience of HCWs by examining a plethora of qualities such as tenacity, commitment, support, control, coping, and other relevant factors (Roslan et al.). They discovered that emotionally resilient HCWs could show “interest in the person behind the symptom,” which leads to positive doctor-patient relationships (Roslan et al.). Additionally, they highlight the importance of teamwork for the HCWs, which helped them manage heavy workloads, give feedback, foster organization, and overall “absorb the sources of stress” to provide high-quality patient care (Roslan et al.). In essence, they claim that emotionally resilient HCWs can provide quality care to patients as they’re able to empathize with them and collaborate efficiently.
Pursuing this further, Emily O’Dowd and her team at the Department of General Medical Practice at the National University of Ireland, Galway, analyzed the need for emotional resilience for HCWs to maintain high standards of patient care due to the widespread burnout in the healthcare industry. Through a clinical study with 68 Irish HCWs, the interviews revealed that the HCWs with emotional resilience have self-awareness and reflexivity, which allows them to “hold [themselves] accountable for [their] actions, and understand [their] role and abilities in each situation” (O’Dowd et al.). O’Dowd adds that the HCWs accept the fact that mistakes will be made, yet they value the personal advancements they could incorporate to reduce them and show higher and safer patient care. Fundamentally, she states that emotionally resilient HCWs can stay accountable for their errors, permitting them to adapt to future issues and thus offering high-quality patient care.
In contrast to the vast evidence that claims emotional resilience increases quality patient care, Tait Shanafelt, a Medical Oncology Professor at Stanford University, highlights that although it may seem that emotional resilience increases the standards of patient care, this is not necessarily true since there are plenty of other factors that affect patient care. The study presents a limitation in that there may be unacknowledged variables that may be contributing to increased or decreased patient care (Shanafelt et al.). She states that variables such as personality traits, fatigue, sex, age, and others may be associated with the findings from earlier (Shanafelt et al.). In essence, Shanafelt’s findings question the role that emotional resilience plays in patient care.
Despite Shanafelt’s findings, similar studies support akin results from Roslan and O’Dowd: emotional resilience increases the standard of patient care. The study adds stance by contributing research with HCWs from the UK, which describes similar conclusions to those from the United States. Professors at the Department of Psychology at the University of Leeds, Jenny Firth-Cozens and Joanne Greenhalgh, explore the relationship between physician burnout — a lack of emotional resilience — for HCWs and the standard of patient care by interviewing 318 HCWs in the UK. The results present that a third of the HCWs saw that their standards of care were lowered, which they attributed to feeling ‘burned out,’ “10.5% of these were serious mistakes, two of which led to death” (Firth-Cozens and Greenhalgh). Fundamentally, HCWs with low levels of emotional resilience — thus ‘burned out’ or highly stressed — provide decreased patient care and are likely to make errors; therefore, emotional resilience is highly valuable to provide high-standard patient care.
Overall, Rosland and O’Dowd conclude that emotionally resilient healthcare workers are more capable of producing better patient care due to the qualities they present. Though Shanafelt points out that other factors may affect patient care standards, Firth-Cozens and Greenhalgh defend the idea that emotionally resilient healthcare workers produce better patient care by describing the adverse effects of burnout, a lack of emotional resilience. For this reason, emotional resilience is highly beneficial towards increasing patient care standards and, hence, forming better healthcare professionals.
The Importance of Emotional Resilience for HCWs’ Mental Health
Mental health, as defined by the Centers for Disease Control and Prevention, “includes emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make healthy choices” (“About Mental Health”). Findings on the mental health of HCWs have surfaced throughout the past years, demonstrating that emotional resilience is highly advantageous for healthcare professionals’ mental health.
When HCWs lack emotional resilience, their mental health can suffer. Therefore, emotional resilience is favorable to maintaining healthy mental health for HCWs. Health Professors at the University of Auckland, Clare M. McCann and her team performed a study by surveying 518 New South Wales HCWs to determine the impacts of burnout — a lack of emotional resilience — on their mental health. They discovered that the HCWs that were ‘burned out’ used “escape-avoidance (e.g., sleeping, drinking, smoking, using drugs)” and “self-control (e.g., keeping feelings to oneself)” as coping mechanisms (McCann et al.). Fundamentally, a lack of emotional resilience for HCWs can lead to detrimental life choices, thus demonstrating that it is beneficial for the maintenance of stable mental health as they can make healthy choices.
Such is affirmed by Fiona Cameron and Sonya Brownie, Professors of Science at Southern Cross University Lismore, New South Wales, who explored the experiences of residential age care facility HCWs in Australia and their correlations with self-care on the Connor-Davidson resilience scale, a standardized method that examines the individuals’ “tolerance of negative effects,” “tenacity,” “personal competence,” “positive acceptance of change and secure relationships,” “control,” and others (Riopel). The professors discovered that 75% of those with high levels of emotional resilience included frequent self-care practices, including but not limited to exercise, healthy eating, and more (Cameron and Brownie). In essence, the professors show that emotional resilience predicts self-care practices and promotes positive mental health through healthy choices.
Although McCann and Cameron claim emotional resilience helps maintain stable mental health, Andria Pragholapati, Lecturer at the Universitas Pendidikan Indonesia in the Department of Nursing, claims that emotional resilience does not positively impact HCWs’ mental health substantially. Pragholapati examined the link between emotional resilience and the ability to handle workplace stress, focusing on emergency room healthcare workers at the Al Islam Bandung Hospital. Pragholapati provides evidence stating that emotional resilience has an insignificant value in reducing stress in HCWs. He asserts that the contribution that emotional resilience made towards lowering workplace stress impacts on HCWs was 12%, meaning the “remaining 88% is caused by other factors that can affect work stress,” which are factors influenced by “individual perceptions and differences, such as gender, self-esteem, and personality types” (Pragholapati). Fundamentally, other factors in a HCW’s identity impact the levels at which they can manage workplace stress; thus, emotional resilience does not play a large factor in reducing the impacts of stress on their mental health.
Regardless, studies have contradicted Pragholapati’s claim that emotional resilience has little effect on reducing workplace stress among HCWs. Clinical psychologist Mariagrazia Di Giuseppe and her team at the University of Rome Tor Vergata refute his argument by depicting how emotional resilience permitted HCWs to reduce stress during the COVID-19 outbreak. Giuseppe conducted a study with 233 healthcare workers in a plethora of Italian hospitals, including COVID-19 frontline workers. They prove that the defense mechanisms that “foster resilience” permitted HCWs to better adjust to the “stressful experience” of the COVID-19 pandemic (Giuseppe et al.). Additionally, it is shown that these levels of emotional resilience led the HCWs to “a greater sense of personal accomplishment and ability to withstand or adaptively recover from stress and, conversely, to lower perceived stress, emotional exhaustion, and depersonalization,” and the aforementioned factors listed by Pragolpati led HCWs to “greater stress and burnout” (Giuseppe et al.). Giuseppe’s findings contribute to the conversation by refuting Pragolpati’s claims; she verifies that emotional resilience allows healthcare workers to manage and reduce the impacts of stress on their mental health, hence describing the advantages associated with the trait for HCWs.
In summary, McCann and Cameron found that emotional resilience allows HCWs to maintain or continue self-care and keep up with their mental health. However, Pragholapati argues that emotional resilience does not contribute towards reducing stress levels, yet Giuseppe rebuts this by describing how emotional resilience helped HCWs manage workplace stress to uphold stable mental health during the COVID-19 pandemic.
Conclusion
After examining several perspectives on the impacts of emotional resilience, it can be determined that it is an advantageous quality for healthcare workers as it has significant impacts on both patient care and healthcare workers’ mental health. In terms of patient care, it can be seen that a lack of emotional resilience can lead to medical errors that span from insignificant to life-threatening, and emotionally resilient healthcare workers present higher standards of patient care. Regarding their workers’ mental health, it can be concluded that emotionally resilient healthcare workers maintain higher standards of personal care and have tactics to maintain stable mental health levels, including stress levels. Thus, emotional resilience is highly benifical for healthcare professionals.
Due to this, it is logical to conclude that promoting emotional resilience for healthcare workers through programs or practice is valuable and should be a priority for the healthcare industry. By doing so, more healthcare professionals would be able to reap the advantages of providing higher-quality patient care while maintaining steady mental health. This would lead to improved patient care and reduced burnout for medical staff.
The benefits of promoting emotional resilience among HCWs may be challenging due to the systemic issues inside the healthcare system. Understaffing, a lack of resources, and support from management contribute to healthcare workers’ stress levels, making it hard to maintain high levels of emotional resilience. Additionally, emotional resilience training may not work for all healthcare workers, as personality traits can affect how they respond to the training.
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