It’s Time to Double-Down On Resilience Training

By Wayne M. Sotile, PhD, and Gary R. Simonds, MD, MHCDS

Across the U.S., the COVID-19 infection rate is exploding. As states ease restrictions, many are seeing a substantial uptick in reported cases. The curve is not flattening everywhere; in fact, it’s going in the opposite direction. One thing’s for sure: Healthcare professionals are still struggling—and that underscores the need for them to take an almost military approach to building up their resilience.

Being able to stay calm and focused on the front lines of healthcare in a pandemic doesn’t just happen. It requires rigorous training, like a special forces soldier or an elite athlete. And it needs to be ongoing.

If healthcare workers don’t build up their resilience, they may experience burnout or PTSD later on down the road. (Consider that studies done on survivors of the 1995 Oklahoma City bombing six months later found that 45 percent of participants were suffering from a post-disaster psychiatric disorder and 34.3 percent had PTSD.1)

The remedy is to practice fundamental resilience-building tactics daily. Not only can this help you avoid PTSD in the future, it can lead to what has been termed post-traumatic growth.

The idea is to make these coping skills habits. Then, when the heat is on, your training will kick in. And even if the pandemic went away tomorrow—which, obviously, it won’t—healthcare workers will always face stressful, traumatizing conditions.

We have spent much of our careers figuring out what those habits are. We’ve studied high-performance healthcare professionals and isolated the tactics they use to cope with stress and build up their resilience. Here are a few fundamentals that can help you manage your energy and protect your well-being for the long haul.

Regularly add to your personal emotional and relationship energy reserves. Store up positive experiences like playing with your child, going on a backyard picnic date with your partner, or watching a funny movie on your day off. That way, the “withdrawals” that come with the constant or emergent stress you are facing won’t “break” your coping abilities.

Recognize and harvest daily uplifts. Even in the most dismal of circumstances you can find “uplifts”—happy, reaffirming, exhilarating, peace-restoring events—at work. Notice, savor, and celebrate them. Examples might be when your patient turns a corner, when an anonymous donor buys lunch or dinner for the staff, or when a shipment of home-sewn masks arrives just in time.

Daily uplifts are always there even when everything seems bleak. The more you look for them, the easier they will be to spot.

Control your physiological stress reactions, learning to execute “steady state” activation. It’s important to learn that fine art of managing “fire fights” of life-and-death crisis by remaining active enough to be at the top of our game but “calm” enough to be able to sustain clear thinking and endurance. This is a teachable and learnable skillset.
Practice attitudes that foster resilience. A positive attitude can make a difference in how you feel. Incorporate these resilience boosters into your own day-to-day medical experience:

* Realistic optimism: This is really hard. But we are going to get through this.

* Wonderment (a.k.a. learning to see the familiar in unfamiliar ways): Healthy babies are being born even in this pandemic. How miraculous that life finds a way.

* Meaning: I am here to help others, and my work really does matter.

Learn to counter stress-generating thought patterns. You may find yourself imagining worst-case scenarios or indulging in catastrophic thoughts, exaggerating, and shaming or blaming yourself or others. This is normal, but such thought patterns can spiral. Check in with yourself frequently. When you catch yourself thinking damaging thoughts, gently stop yourself and choose a healthier thought instead.

Take good care of your physical health. Do everything you can to keep your body strong. Try to eat healthfully, focusing on plenty of fruits, vegetables, and whole grains. Get as much sleep as possible. Hydrate with water. Yes, you’re tired, but try to get in a walk on your day off. Our physical and mental health are interconnected—and keeping your immune system strong is more important than ever these days.

Regularly debrief the effects of daily “battle.” Instead of putting on a tough face and soldiering on, be open about how you are affected by the painful experiences you’re having every day. Find a trusted colleague, friend, or family member to help you process the feelings of shock, despair, outrage, anger, or guilt that you feel.

Develop and share a vision for the future. With close colleagues, teammates, or loved ones, articulate your vision of a desired future. If you can remember that good things are in store for you personally and professionally, it will be easier to persevere through the difficult times. We all need to remember that the pandemic will not last forever.

Remind yourself that you have coped with difficult times, losses, and setbacks before. Think of how you handled and ultimately made it through previous challenges. Tell yourself that you will make it through this time as well. This practice stirs your awareness of self-efficacy—task-specific self-confidence—for coping with even novel circumstances.

Find (and embrace) a philosophy that helps you cope for the long haul. We all need to find a way to put what’s happening in perspective, one that allows us to persevere in the face of ever-worsening news. One example might be: “There are no perfect people/families/organizations, but we are all learning as we deal with this.”

Appeal to a higher ideology that offers hope. If you believe in a nurturing Higher Power, you really need to lean on that belief system right now. Make time for prayer or meditation. If not, then put your full faith behind your organization, team, or human resilience and innovativeness in general. Or reaffirm your commitment to enduring for the sake of something or someone other than yourself, such as your partner and children, your parents, or your friends.

This pandemic is revealing our industry’s desperate need for resilience training. It is time to start treating yourself like the high performer you already are. If you give your body and spirit what they need now, you will grow from this experience and emerge stronger than ever.

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