Resilience is needed to help overcome the situations that arise daily from patients and their needs, it shouldn’t be required for dealing with issues arising from within the organisation itself. Derek Mowbray writes
It’s just possible that you’ve not heard of the term “resilience” before. There’s a lot of it about.
It’s seen, by some, as the only means by which seriously challenged staff can get through a seriously challenging number of years. Alas, resilience only goes so far, after which people can suffer the most awful condition, known as stress.
Resilience is having flexible strength of mind. Think of the wings of an aircraft flying through turbulence; they flex up and down, not completely unlike the wings of an uncoordinated bird flapping wings independently of each other.
And like birds, the wings of an aircraft cannot fall off; they have to be both very flexible and very strong. Just like resilient people.
Resilience is a choice. People choose to be resilient or not, depending on their motivation to achieve some kind of goal.
Sometimes the choice is Hobson’s choice when the only realistic option is to try to be resilient.
Much depends on the context in which a challenging situation arises
Much depends on the context in which a challenging situation arises. If the context or culture is positive, supportive, encouraging and has elements that resonate with the person’s own values, this influences individual attitude to a challenging situation, tending to provoke a positive attitude that triggers the motivation and energy required to be resilient.
Often, the culture is reflected in the behaviour of leaders and managers, and their attitude to their own teams. Leaders and managers’ attitudes and behaviours are crucial in influencing the levels of resilience in individuals.
Resilient or not
The results of 2015 NHS Staff Survey shows staff to be resilient in an organisation that is under constant intense pressure to perform at its peak. Mistakes are tragedies that must be avoided, and frequently are, due to the resilience of staff.
There are some worrying symptoms that signal the need for a closer look at what is happening each day. Twenty five per cent of the three quarters of a million staff surveyed reported feeling bullied and harassed – that’s a lot of people.
Thirty seven per cent reported feeling stressed (although they were more likely to experience strain as stress causes you to want to escape the situation) compared with 25 per cent experiencing musculoskeletal problems. This is high.
There are substantial numbers vulnerable to tension and strain
It suggests a lot of people losing mental control, and, therefore, unable to concentrate effectively. And more worrying is that 63 per cent said they have come to work, within a three month period, feeling unable to perform their duties and requirements – presenteeism, the most expensive loss of resources that many organisations face.
These figures suggest the workforce isn’t as resilient as the headlines imply. There are substantial numbers vulnerable to tension and strain, thereby having their concentration hijacked by events and other people’s behaviour.
It’s often been said that the NHS needs a cultural change, and ideas along the lines of a compassionate culture have been promoted frequently.
As I see it, the workforce isn’t genuinely at the centre of the NHS. Perhaps the main recommendation of the Francis inquiry has something to do with this.
Placing patients at the centre of the NHS is, perhaps, a more obvious thing to do, except that it forgets that the NHS is reliant on its people.
The evidence is unambiguous that the psychological wellbeing of people (combined with appropriate motivation) produces the performance needed to deliver the products of any organisation to the standards of excellence that most organisations hope and expect. Psychological wellbeing doesn’t happen by chance; it happens by design.
The WellBeing and Performance Agenda is a framework that helps organisations transform their culture to one that provokes people to feel psychologically well, and, therefore, feel in mental control. This is a pre-requisite for being resilient.
The big shift in culture comes from adopting psychological responsibility – a personal responsibility to look after yourself psychologically, and to do no harm to anyone else, either in your actions or your behaviour. The most important behaviour that is encouraged is attentiveness.
The big shift, also, comes from adopting the principle of sharing responsibility for the future success of the organisation. This principle, adopted by adaptive leaders, urges the workforce to focus on the success of the organisation and not on the success of its leaders or managers.
The organisation should be making staff feel well
Adopting this principle ends the need for whistleblowers, as everyone is expected, and encouraged, to blow the whistle all the time they have an idea of how to make the organisation (or any part of it) more successful tomorrow compared with today.
The Wellbeing and Performance Agenda is based on the recognition that individuals working effectively together, feeling psychologically well, will perform at their peak consistently. The agenda contains the actions and behaviours required to provoke psychological wellbeing, whether undertaken by leaders and managers or by the workforce as a whole.
All the actions and behaviours are designed to generate commitment, trust, kinship, motivation, concentration, leading to social engagement – the form of engagement that produces an organisation characterised by vigour, dedication and absorption. Such an organisation moves the culture to one where the workforce doesn’t need to call on its resilience against events and behaviours arising from within the organisation, as these are largely prevented.
In the NHS, the demands of its patients and their relatives, are sufficiently challenging for anyone. Resilience is needed to help overcome the situations that arise daily from patients and their needs.
It shouldn’t be required for dealing with issues arising from within the organisation itself. The organisation should be making staff feel well.
Derek Mowbray is an organisation health psychologist, director of The Management Advisory Service, and visiting professor at Northumbria and Gloucestershire Universities