Resilience During Times of Change
by Eileen Frazer
reprinted from Air Medical Journal : http://www.airmedicaljournal.com/
In the Commission on Accreditation of Medical Transport Systems (CAMTS) 11th Edition Accreditation Standards, we included resilience training as part of stress management in the list of didactic education for managers and crewmembers, and we also included post−critical incident counseling in section 04.00.00 for communications specialists. In the current health care and economic change environments, care providers are not only challenged by adapting to change but also the “ordinary” stressors of dealing with emergency and life-critical situations.
It is more apparent than ever that managers (who also have to deal with a higher stress value) need to recognize and address employees who may not have resilience or the capability to “bounce back” after traumatic and tragic situations they deal with on a regular basis, often resulting in posttraumatic stress disorders.
In the CAMTS publication Safety and Quality in Medical Transport Systems: Creating an Effective Culture, the chapter entitled “Provider Resilience” was written by John Overton, MD, Laurie Shiparski, BSN, MS, and Philip Arthier, RN, MPH.1 The authors presented a self-assessment tool to identify the 10 symptoms of your capacity for resilience that is worth sharing.
Symptoms of low resilience Absent Present
- Forgetfulness and inability to access information you have
learned to respond in the situation
- Inability to focus on individuals and the bigger picture of the situation
- Overwhelmed with emotion, uncontrollable crying, outbursts
of anger, or frustration
- Complete sadness, sorrow, depression, despair
- Hopelessness, cynicism
- Inability to act on priorities
- Self-doubt about ability to impact the situation effectively
- All issues seem big and overwhelming
- Feeling alone and isolated Low energy, fatigue, exhaustion
According to the authors, if you answered “present” to any of the questions, it is time to focus on your resilience and stop any further progression of energy-draining behaviors.
In my opening paragraphs, I also talked about change. We know we do not function at our best when we are stressed and tired, and, on top of that, we are in the environment of constant change. When we consider the many changes we encounter, planned and unanticipated, it is even more critical to manage how we navigate through changes. The authors referenced earlier asked many health care providers how they effectively manage change in their personal and professional lives.
The following are the top responses they received that may sound familiar or interesting to our readers:
*I believe in myself and know I can handle any situation.
*The more I tap courage and act on it, the stronger I feel.
*I get enough rest and take care of myself.
*I find people I can talk to and find support.
*I recognize when I am feeling stressed & take a break, reassess, & adjust.
*I offer help to others and have an attitude of gratitude.
*I realize everything happens for a reason and I may not know why.
*I remind myself why I choose this profession & identify what brings joy.
*I know I make a difference in the lives of many with the work I do *Humor and fun help me get through tough times.
*I learn from every situation and seek challenges that grow me.
*When something feels overwhelming, I remind myself that I can break it
down into smaller manageable steps.
*I know time heals and sometimes I need to detach, think, and come back
*I show up every day with all my talents and flaws, knowing it is all needed.
*I remember to have patience with myself and others as we adjust to new
*I resist engaging in judgment and blame of myself and others.
*I notice now if I am in a downward spiral of negative thinking or being and remind myself to engage in energizing behaviors.
We are all called on to deal with stress and change. The Executive Staff of CAMTS recently recognized that we also need to be aware of site surveyors who may be asked to visit a program that experienced a recent fatal accident where interaction with management and staff can be very emotional. Having an open and caring culture is always our goal and we encourage surveyors to relate situations that dealt with difficult and
emotional situations. Storytelling is always a way to release stress.