All of us are responsible for the words we say and what we repeat, because the words matter. Our narratives have power. We need to be intentional about them. So here is what I say to my students. Before you repeat the words and phrases that resonate for us, we need to pause and reflect before we choose to repeat them. I like to use four filters for reflection on Is what I am about to say (1) true? (2) Is it beneficial? (3) Is it necessary? and (4) Is this the right time and place? If we are just repeating these
things out of nervous system activation, frustration, anger, fear, or outrage, we are inadvertently just spreading that negativity in the words we repeat. So, noticing the impact on us, our bodies, our hearts and minds is a good clue to determine what we should repeat or not. There is a tendency when you’re under stress, when you’re exhausted, to think, “That’s right and that’s wrong.” There’s no reflection. In a way, it’s a kind of release in the moment and it’s temporary, but the consequences can be profound. For shift report, if it’s all negative – “We had a terrible day, this happened, no one listened” – you start with your cup completely drained. There is no fuel for empathy.
There is no fuel for collaboration or listening or understanding. For me, it is people taking responsibility for choosing how you want to show up, how you want to communicate, what is important. That requires a pause before you speak. One of the words that I think has really been misapplied and misunderstood is resilience. During the pandemic, the resilience of nurses was highlighted again and again and yet it became weaponized by some and shunned by others. It is unfortunate, because the problem is not the concept of resilience, but how it’s being used. Resilience at its core is about how we face adversity, and there are decades of research that document the inherent resilient capacity of every human in their physical, psychological, social and moral dimensions. This whole narrative about “let’s not talk about resilience anymore” is interesting. Every nurse I know is resilient. It is interesting to hear people think that cultivating resilience is the sole responsibility of the individual. What we know about resilience in a social ecological framework is we are all impacted in lots of different ways with our environment all around us. Some people have cherry-picked partial definitions of the term to suggest it just means bouncing back.
The concept is much more robust than that suggests. There is no unifying definition, but one simple one is our ability to flexibly adapt to recover, even grow in response to stress and adversity. Some suggest it’s the ability to not only overcome setbacks but to move forward and go beyond the bouncing back to learning and growing and transforming it. It’s a strengths-based approach rather than a deficit focused one. Moral resilience, for example, is a protective resource to reduce the detrimental impact of both moral distress and moral injury and even some mental health outcomes. That concept has always been situated within a culture of ethical practice. We also see that the combination of moral resilience and organizational effectiveness has the greatest impact on moral suffering, so it’s really when we add the two dimensions together that we have the greatest opportunity to reduce some of the ongoing moral distress or injury.