Grace under pressure: Mental health nurses' stories of resilience in practice

Abstract

Mental health nurses experience both organizational and practice‐related stressors in their work. Resilience is an interactive process of positive adaptation following stress and adversity. There is limited evidence on how personal resilience is applied to mental health nursing practice. The aim of this interpretive narrative study was to explore mental health nurses' stories of resilience in their practice for the purpose of gaining an understanding of resilience resources they draw on when dealing with challenging workplace situations. A storytelling approach was used in semistructured phone interviews with 12 mental health nurses who measured high on resilience (Workplace Resilience Inventory) and caring behaviours (Caring Behaviours Inventory). Within and across case narrative analysis produced stories of resilient practice within four themes: proactively managing the professional self; sustaining oneself through supportive relationships; engaging actively in practice, learning and self‐care; and seeking positive solutions and outcomes. Nurses displayed poise in stressful situations and grace under pressure in demanding and emotionally challenging interactions, holding dignity and respect for self and others, with the aim of achieving positive outcomes for both. Resilient practice is the responsibility of organizations as well as individuals. To develop practice and support staff retention, we recommend organizations use tailored professional development to cultivate a growth mindset in new and experienced staff, develop organizational strategies to build positive team cultures, and prioritize strategies to reduce workplace stressors and strengthen staff psychological safety and well‐being. The use of narrative techniques in reflective practice and clinical supervision may help build nurses' resilience and practice.

Mental health nurses' experience of resilience during COVID‐19: A qualitative inquiry

“…This is the first qualitative study to report the experience and impacts of the COVID‐19 pandemic on the resilience of nurses working in mental health settings. The study builds on prior knowledge of nurses' capacity for positive adaptation to workplace challenges in mental health settings (Delgado et al, 2022; Foster et al, 2023; Foster, Cuzzillo, & Furness, 2018). New understandings of how mental health nurses' resilience was challenged and maintained during COVID‐19 are useful for addressing the enduring negative impacts of the pandemic on nurses' wellbeing and clinical practice.…”

“…These findings share some similarity with those of generalist nurses, who used self‐regulation to manage anxiety and maintain a positive perspective when caring for patients with COVID‐19 (Huang et al, 2021), but the use of emotional regulation during COVID‐19 by nurses in mental health has not previously been documented. Previous qualitative studies with MHNs have reported nurses' use of emotional intelligence skills (e.g., emotional self‐regulation) to tackle workplace challenges such as emotional labour (Delgado et al, 2022) or complex interpersonal interactions (Foster et al, 2023). Wellbeing and resilience‐enhancing interventions that provide nurses with these emotional intelligence skills (Foster, Cuzzillo, & Furness, 2018; Foster, Shochet, et al, 2018) can be useful strategies to support nurses' personal wellbeing and practice against future adversities.…”

“…Personal growth has previously been identified as an outcome of the dynamic process of positive adaptation against adversity in the context of work (Gillespie et al, 2007; McLarnon & Rothstein, 2013). However, discussion on professional growth and improvements in clinical practice as an outcome of the resilience process is limited in mental health nursing apart from the work of Delgado et al (2022) and Foster et al (2023). They found that MHNs proactively engaged in professional development to improve their practice (i.e., having a growth mindset) and ability to tackle challenging practice situations (Foster et al, 2023), and to hone their self‐regulatory capacity and emotional intelligence skills to maintain internal equilibrium and wellbeing (Delgado et al, 2022).…”

“…Subsequently, nurses had to rapidly adapt to the changing landscape of care provision. Recent studies have shown that mental health nurses (MHNs) can actively build and strengthen their resilience in managing workplace stressors and challenges (Delgado et al, 2022; Foster et al, 2023). There is, however, no prior qualitative evidence on the resilience of nurses working in mental health settings during COVID‐19.…”

“…They also proactively engaged in self‐care at work (e.g., seeking support and resources for professional development) to maintain their wellbeing (Delgado et al, 2022). Foster et al's (2023) interpretive narrative study explored the resilience resources MHNs use in their practice. Findings included proactive management of emotions, thoughts and behaviours; having a growth mindset and being active in learning and self‐care; and maintaining supportive relationships with others.…”