Some seven years ago, when I started to tweet and to blog, social media in nursing was unheard of. There were only a few pioneers and even fewer of our national nursing leaders communicating in social media spaces.
Thankfully things have changed and it’s great to see the workforce leaders encouraging and role modeling the use of social media as part of nursing.
Last week Twitter was alight with tweets from the chief nursing officer’s summit (7 and 8 March), using the hashtag #CNOsummit. It was great to see, especially for those of us not in the room to be able to attend from afar. I spent some time lurking and ‘listening’ to tweets and noticed that many of them mentioned resilience, which concerned and frustrated me somewhat.
Back in July last year I noted that the word resilience was becoming en-vogue in nursing and wrote a blog post called ‘The problem with resilience’, expressing concerns about the misuse of the word in nursing and calling for a rethink of how we equip the nursing profession with the skills needed to cope with adversity.
The blog post attracted a lot of attention and discussion, many people agreed with my caution over the word and shared their experiences of how resilience is referred to in day-to-day nursing. Yet here we are some months later and resilience is being tweeted about by the leaders of our profession and I grow more and more concerned.
I am a great believer in not just listening to the words that people say but also looking at the wider meaning behind those words. Resilience is one of those words where I always try to hear what people are saying rather than reacting to the words that they are using. What do people mean when they talk about resilience? In my humble opinion resilience falls into three categories:
Firstly, it can mean bouncing back or the ability to recover quickly from adversity. To bounce back or recover implies that a nurse must be in a situation of great adversity to start with and to think of nurses in this way makes me feel like the system has let them down. I was concerned to see Tweets throughout the #CNOsummit Twitter stream talking about this type of resilience, discussing the ability to grow or build resilience and increase the ability to bounce back. The emphasis in this case is on the individual and not the responsible support systems. To encourage bounce-back-ability in nursing means that when nurses find themselves in a situation of distress they should just dig deep and get on with things. For a caring profession this, to me, seems like a very uncaring approach.
The purpose of Resilience and Co is to share their ability to cope under extreme circumstances. And now they want to help others do that #cnosummit @tomray99 @RayHudsonandray pic.twitter.com/WYBO5DY2nO
— Jenni Middleton (@nursingtimesed) March 8, 2018
Secondly, resilience can mean toughness or hardiness. There were a few tweets from the #CNOsummit where nurses were thanked by healthcare leaders for their resilience and I find this worrying as it makes resilience into a badge of honor, something to be celebrated and the danger here is what happens when a nurse is unable to be tough or hardy? How do they feel when the pressure to be resilient in this sense is overwhelming? What happens to the nurse who can’t be tough or hardy yet this is what is celebrated and commended? Are we in danger of creating feelings of inadequacy by promoting this type of resilience? And whilst we may feel resilient at that point in time are we recognising that in our role as nurses, events may affect us days, months and even years later – where does this type of resilience fit then? In addition to this is it realistically sustainable to wear the resilient badge of honor throughout prolonged challenging times?
Secretary of State for Health & Social Care thanks all nursing, midwifery & care staff for their tremendous hard work, leadership & resilience. #cnosummit pic.twitter.com/vpqlinYGIB
— 6CsLive! (@6CsLive) March 8, 2018
Thirdly, and this is where I hope the #CNOsummit was actually coming from (as I realise that tweets often don’t reflect the true intention of speakers or give the full picture), there is the more holistic approach to resilience. This approach takes the onus off of the individual and acknowledges that it’s ok not to be ok and provides comprehensive systems of support. Dr Alys Cole-King explains this beautifully in her tweets around resilience, stating that we need to avoid traps of ‘resilience shaming’ as resilience is actually having enough resources and support to cope with stress.
Avoids traps ‘resilience shaming’ ‘mental toughness’ or having to cope in toxic situations #gmcconf#resilience #resiliencechat pic.twitter.com/bqfNbQrHCd
— Dr Alys Cole-King #NHSLove (@AlysColeKing) March 7, 2018
Resilience is not and never should be a badge of honour for bouncing back, and the emphasis should not be on the individual. It should mean that it’s ok not to be ok. It should be about supporting and empowering nurses and it should be about ensuring that we have the resources in place to do this. I am not sure that this came through in the #CNOsummit tweets, which worries me greatly. As I look for the meaning behind the words in the tweets, I am hoping that it got lost in translation and that the wider issue of supporting nurses’ mental health and wellbeing was addressed.
My worry is that somewhere out there is a hardworking, stressed out and upset nurse who is not coping with a toxic situation and it is an acceptable approach that they are told that they must be more resilient. Whilst I understand that a conferences Twitter stream is comprised of soundbites and not the whole and I remain cautious of the buzzword ‘resilience’ and stand by my original blog post that this terminology is spoiled fruit and we need to seriously think about dropping it.
Teresa Chinn MBE is a registered nurse, social media specialist and founder of @WeNurses on Twitter