Oklahoma Nurse - May 2021

May, June, July 2021 The Oklahoma Nurse 17
Nurse Resiliency During a Pandemic
Terry Towne, MSN, RN, NPD-BC, NE-BC
Brittany Oakey, MSN, RN, CRRN
Reprinted with permission from DNA Reporter,
December 2020
Terry Towne began her nursing career as a
graduate of the Robert Packer Hospital School
of Nursing in Sayre, PA then completed her
BSN from Indiana University of Pennsylvania in
Indiana, PA. After joining the USAF Nurse Corps,
she later received her MSN from Arizona State
University. Terry is dually ANCC Board Certified
in Nursing Professional Development and as a
Nurse Executive. She is a member of the Delaware
Nurses Association, American Nurses Association,
Delaware Organization of Nurse Leaders, and the
Association for Nursing Professional Development.
Terry has served as a Clinical Educator in
Bayhealth’s Education Department for several
years. She was nominated as a Delaware Top
Nurse in 2014 and 2015. Terry received the William
H. Spurgeon III Award from National Boy Scouts
of America for outstanding service for Bayhealth’s
Explorers Program in 2015. She was Bayhealth
Nurse Educator of the Year in 2016 and 2019. Terry
currently co-facilitates a new resiliency class for
healthcare professionals at Bayhealth. Terry can be
reached at teresa_towne@bayhealth.org.
Brittany Oakey received her BSN from Wesley
College and her MSN from Wilmington University.
She is an ANCC Board Certified Rehabilitation
Registered Nurse. Brittany is a member of the
Delaware Nurses Association and the Association
for Nursing Professional Development. She received
the Educator of the Year Award and Nurse of the
Year Award in 2018 for Bayhealth Milford Memorial.
Brittany was nominated as a Delaware Top Nurse
in 2020. She currently works as a Clinical Educator
in the Education Department at Bayhealth servicing
both Kent and Sussex Campuses. Brittany
spearheaded the creation of a resiliency program for
healthcare professionals at Bayhealth. Brittany can
be contacted at Brittany_oakey@bayhealth.org.
Resilience is “the capacity to keep functioning
physically and psychologically in the face of stress,
adversity, trauma, or tragedy” (Carpenter, 2014,
p. 2). Resiliency has been studied for more than
40 years and initially was geared by psychologists
toward children (Fleming & Ledogar, 2010). Although
the term resiliency can be applied broadly across
many facets in nursing, it is vital to not only the
survival of, but to the success of nurses. Nurses
work in complex environments facing an array of
challenges while attempting to manage multiple
priorities. Depersonalization, emotional exhaustion,
and moral distress have many nurses experiencing
or struggling with compassion fatigue and burn
out. According to a recent article in Nursing 2020,
approximately 40% of nurses reported burn out
(Rajamohan et al., 2020).
In more recent times, nurses have been
called upon to care for patients plagued by the
Coronavirus Disease 2019 (COVID-19) pandemic
despite little knowledge regarding this disease. With
life’s normal challenges, the safety of nurses on the
front line was in jeopardy without relief, the only
constant being continuously changing standards
and protocols. Never before have nurses been
tested more for resiliency than during the present
most catastrophic healthcare crisis in modern
history. As pointed out by Sherman, “You need
resiliency for a long and productive nursing career….
you need to stop seeing yourself as a victim during
these downturns and become proactive in your
recovery (Sherman, 2018, p. 27).”
Nurses have made it through the tough times
- some believe nurses are now on the other
side, although there is so much uncertainty and
unrest still exist. How does nursing recover as a
profession? The answer is through resiliency.
There are a wealth of resources available to
assist nurses who are struggling with resiliency as
a result of the COVID-19 pandemic. The American
Nurses Foundation (ANF), which is a philanthropic
arm of the American Nurses Association, launched
a national well-being initiative for nurses in May
2020. This foundation partnered with the American
Nurses Association (ANA), the Emergency Nurses
Association, the American Association of Critical-
Care Nurses, and the American Psychiatric Nurses
Association. Through their combined efforts was
the development of resources to assist nurses in
managing stress and overcoming trauma associated
with COVID-19. As a result, a Well-being Initiative
was created by nurses for nurses.
The following ANF resources are available for
nurses who are struggling with resilience:
(1) Nurses Together: Connecting through
Conversations provides a virtual peer
support platform or video to give nurses an
opportunity to speak openly about self-care
and wellness, recovery and resilience, care
dilemmas, and bereavement.
(2) Narrative Expressive Writing is a five-week
program where nurses respond anonymously
to COVID-19 writing prompts and receive
feedback from a certified responder.
(3) Happy App is a smart phone app that
connects nurses one-on-one to a supportive
team member 24/7.
(4) Moodfit Mobile App is intended for nurses
to identify wellness goals and activities. It
gives them the ability to track goals for sleep,
nutrition, exercise, mindfulness and other
activities.
(5) The Self-assessment Tool is an evidencebased
tool which helps nurses identify
symptoms, understand if they need help, and
directs them to the appropriate resources.
(6) Hotlines and provider resources are available
that include instructions to find a mental
health provider, to obtain a referral, and to
look for the best provider match.
The ANF also partnered with Nurses House, Inc.
This is a nurse-managed, non-profit organization
designed to help nurses in financial need. Through
this combined effort was the development of a
COVID-19 fund offering a one-time $1,000 grant for
qualified nurses who are ill from COVID-19, care for
a family member with COVID-19, or who are under
employer-mandated quarantine due to the virus
(ANF, May 2020).
The ANA created a Self-Care Webinar as part of
their most recent Covid Webinar series. In addition,
the ANA created a Healthy Nurse Health Risk
Appraisal which surveyed nurses to better focus
on strengthening physical and emotional health
(www.anahra.org). This tool played an integral role
in the formation of ANA’s Healthy Nurse Health
Nation (HNHN) initiative in 2017 to create a healthier
work force among nurses in the USA. Goals of
this initiative were to make self-care a priority for
all nurses to help them serve as role models. The
health areas addressed with the HNHN included
activity, rest, nutrition, quality of life, and safety.
There are many interventions to assist with stress
reduction in our daily lives. First and foremost,
nurses must be self-aware of their strengths and
weaknesses. Self-reflection gives nurses the ability
to hone in on past experiences when moving
forward. One strategy to de-stress is by designing
a respite room or Zen Den which is “a space set
aside specifically… to take time away and sit quietly”
(Leverance, 2015, p.29). Another method is to
practice mindfulness where individuals are able to
accept themselves and live in the moment. Keeping
a positive attitude is vital to resilience. The ability
to show gratitude and incorporate humor can also
help individuals to feel better. At a time when there
is social distancing, nurses still need to consider
creative, yet safe ways to network and socialize to
nurture interpersonal connections. Music therapy,
art therapy, and journaling can assist with stress
reduction. Other considerations include fulfilling
spiritual and religious needs in an effort to feel
whole. When practicing these interventions, stress
levels reduce resulting in the ability to cope better
with life’s obstacles.
Summary
Nurse resilience is dependent upon many factors.
“A healthy nurse is one who actively focuses on
creating and maintaining a balance and synergy of
physical, intellectual, emotional, social, spiritual,
personal, and professional wellbeing” (ANA
Enterprise, 2020). Despite life’s stressors, nurses
need to take time for themselves to bridge this
gap. Take a break, get the proper amount of sleep,
eat nutritionally, and “acknowledge the emotional
toll of the situation by seeking support” when
needed (Webster & Wocial, 2020). Nurses all make
a difference and are appreciated for their sacrifices
during the COVID-19 pandemic. We are in this
together and can help each other as we return to the
new “norm.”
References
American Nurses Association. (2017). Health risk
assessment. www.anahra.org.
American Nurses Foundation, (2020, May 19). American
Nurses Foundation launches national well-being
initiative for nurses. http:/www.nursingworld.org/
news-releases/2020/American-nurse-foundationlaunches-national-well-being-initiatve-for-nurses/
ANA Enterprise. (2020). About the healthy nurse
healthy nation grand challenge. https://www.
healthynursehealthynation.org/en/about/about-thehnhn-gc/
Carpenter, H. (2014, July 28). Resilience. My American
Nurse. https://www.myamericannurse.com/healthsafety-wellness-10/#
Centers for Disease Control and Prevention. (2020,
September 28). COVID-19 death and resources.
https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.
htm
Fleming, J., & Ledogar, R. J. (2010). Resilience, an
evolving concept: A review of literature relevant to
Aboriginal research. Canadian Institutes of Health
Research. 6(2), 7-23.
Leverance, K. (2015). Become a more resilient nurse
- reduced burnout, prevent compassion fatigue,
and take better care of patients, Oncology Nursing
Society, 30(4) 24-30.
Rajamohan, S., Davis, C. R., & Ader, M. (2020). REST:
Break through to resilience. Nursing 2020, 53-56.
Sherman, R.O. (2018). Building your resiliency. American
Nurse Today. 13(9), 26-28.
Webster, L., & Wocial, L. (2020, September). Ethics in a
pandemic. American Nurse. 15 (9), 18-23.
To access electronic copies of
The Oklahoma Nurse, please visit
http://www.NursingALD.com/publications