Strategies to Improve Nurse Resilience

Oncology nurses are no strangers to burnout and compassion fatigue, but then the COVID-19 pandemic introduced a whole new layer of stress. Now, more otherwise healthy patients were dying and nurses had to navigate their careers in an already overburdened healthcare system.

One major source of stress is when there is a clash of moral perspectives among healthcare providers. This can be exacerbated when there is increased and urgent demand among clinicians, yet limited resources – such as when multiple COVID-positive patients are coding.

“Ethical dilemmas are happening all the time in oncology, and they just intensified for people taking care of COVID-[positive] patients,” said Patricia Jakel, RN, MN, AOCN, clinical nurse specialist at UCLA.

Jakel, who is also co-editor in chief of Oncology Nursing News, recently discussed burnout and resiliency at the 38th Annual Miami Breast Cancer Conference. She explained that nurses can improve their resiliency to help decrease feelings of burnout or compassion fatigue.

“Some people say that you’re born with resiliency. I think you can build resiliency; you can change it over time. You can improve it,” Jakel said. “It’s the ability to adapt; it’s the ability of self-control and self-sufficiency.”

Some characteristics of resiliency people, according to Jakel, are those who are optimistic, persistent, and use humor. “It’s like being able to bend and recover and come back and bend again,” she said.

To build resiliency, Jakel said, nurses should recognize the things that they have no control over – such as a worldwide pandemic – and realize when help is needed. While venting to a spouse or family member may be a common way to decompress and find support after a long shift, it should not be the sole place for a nurse’s concerns.

“It’s OK to share and be comforted, but [spouses] don’t have anywhere to put that information,” Jakel said.

Nurses should recognize when it may be appropriate to find other forms of support, such as therapy, mindfulness, or other self-care practices. Maintaining a positive outlook and resiliency takes practice, and involves that nurses are ethically competent, Jakel said.

“Make sure that you spend time to build your professional resiliency. There’s a lot of help out there,” Jakel said, listing resources such as a wellbeing initiative through the AMA, as well as the Health Nurse Health Nation campaign by the ANA.

Jakel also mentioned that mindfulness at work could improve stress levels as well. “There’s so much research that shows that healthcare workers who are present in that moment, when they go home, they don’t bring those moments with them. They leave it because they were fully present for the patient in that moment. And that takes work.”