book

Nursing, COVID and the End of Resilience

I’ve been wanting to add a post about this book for a while. Its finished and its recently published by Routledge.

It was nearly ten years ago that I first stumbled on two pieces of writing about resilience. One was a critical article by economist Mark Neocleous, Resisting Resilience. Published in 2013, the author describes how a turn to resilience has embedded itself across military support systems, responses to threats of terrorism, urban planning and self-help advice.
‘Resilience’ [he says] has in the last decade become one of the key political categories of our time. It falls easily from the mouths of politicians, a variety of state departments are funding research into it, urban planners are now obliged to take it into consideration, and academics are falling over themselves to conduct research on it.’

The second piece that I read that morning ten years ago was an editorial in Nursing Standard by Jean Gray, Building Resilience in the Nursing Workforce. At the time I read it as a more or less uncritical encouragement to nurses to become more resilient in the face of a range of workplace pressures but a more careful re-reading shows that Jean was well aware of the combination of ‘adversities’ that nurses face, those inherent in the work itself and those that are the effect of policy and funding decisions. But for Jean’s cautious article, there are probably a hundred that enthusiastically promote resilience training as a solution a host of entrenched workplace problems. Their message, to put it bluntly, is that systems are far too difficult to change, so nurses should change the way they think instead. Despite the claims that evaluations show that an afternoon of resilience training can reduce intention to leave among nurses, I suggest that this approach adds to many nurses’ sense that their managers are not serious, or do not have the power, regarding improving working conditions. The imperative for nurses to learn to be more resilient is often received by nurses as insulting.

Neocleous, and many others, describe system resilience initiatives and concerns alongside the way that the concept of resilience has emerged within positive psychology and self-help. Despite the optimistic twist that politicians have found attractive and useful, I find the positive psychology movement problematic. Perhaps the main reason is its disregard for material conditions and there are strong elements of this thinking in resilience research. For instance, one study of resilience among nurses working in the Philippines during COVID found that they were highly anxious about the poor provision of protective equipment and of becoming infected. The researchers recommended not that the supply of PPE be urgently improved but that managers support nurses to not feel so anxious and to develop positive coping strategies (Labrague and de Los Santos, 2020).

My book lists some of the nurses that died after contracting COVID in the UK – and of course many more died worldwide. I suggest that resilience is of no use to these nurses. In the book I also report on signs that in policy and professional communities there is now a fundamental scepticism about this individualised version of resilience and an acknowledgement that it is a totally inadequate concept if we want to understand and improve health systems.

You can find more details about the book, Nursing, COVID and the End of Resilience here:

Labrague LJ and Santos JAA (2020) COVID‐19 anxiety among front‐line nurses: Predictive role of organisational support, personal resilience and social support. Journal of Nursing Management 28(7): 1653-1661.

Researching Racism in Nursing: book launch at the RCN

Last night saw the launch of a multi-contributor book, Researching Racism in Nursing, published recently by Routledge. Here’s what the publisher’s website says about the book:

Research shows that racism affects the working lives of nurses and nurse academics, as well as healthcare service delivery and outcomes. This book looks at the impact of racism, from experiences of microaggression to discrimination and structural and institutionalised racism.

Focusing on the work of six doctoral researchers and practitioners who have chosen to address and investigate the racism they experience, witness or observe in the UK’s National Health Service and Universities, this book includes personal reflections on their findings. The substantive chapters are framed by a discussion of policy and research on racism, thoughts on research supervision within this field and a drawing together of the key themes developed through this book.

Giving voice to nurses’ and lecturers’ responses to racism in nursing education and practice, this is an important contribution for students, researchers and practitioners with an interest in health inequalities, healthcare organisations, research methods and workforce development.

Thanks to all of the contributors/speakers and to the RCN for organising and hosting this event. Thank you to Wendy Irwin for introducing the event and chairing proceedings.

Here’s the book’s Table of Contents

Foreword by Sheilabye Sobrany

1        Introduction: Researching racism in nursing Helen Allan

2        Doctoral research – the personal is academic Michael Traynor

3        On listening to Migrant Women         Ann Mitchell

4        Experiences of perinatal British mental health services: reflections on conducting research with migrant women from Sub-Saharan Africa       Gabriel Ngalomba

5        An ethnography of Islamophobia      Dave Ring

6        The Nursing and Midwifery Council’s role in Integrating Internationally Educated Nurses in the UK healthcare       Monday Ugiagbe

7        An exploration of the experience of Black and Minority Ethnic nurse educators in UK universities Donna Scholefield

8        Racism in nursing: the more things change, the more they stay the same      Petula Gordon

Another Centre book launch: Critical Resilience for Nurses

We seem to be making a habit of launching our books at the Royal College of Nursing annual research conference. This year we launched Critical Resilience for Nurses: an evidence-based guide to survival and change in the modern NHS, by Michael Traynor and published by Routledge. Its available from the publisher’s website here.

book_launch

Photograph courtesy of Mike O’Driscoll

The argument of the book is that often the promotion of resilience perpetuates an individualising drive in contemporary politics. To urge nurses to go on resilience-building courses can amount to a refusal to engage in actions aimed at bringing about changes to the structures that create much of the need for resilience in the first place. The promoters of resilience among nurses often fail to distinguish between the difficulties of nursing work that are due to the nature of the job – dealing closely with the sick and dying and those that are a result of government or managerial policies, making the job more difficult than it need be. The book sets out an alternative – critical resilience – which is about joining together with colleagues and companions to understand the political forces that are lying behind day to day experience. It is about critique rather than complaint.

I (MT) have great ambitions for this book. My heart is in it and I hope many people read it and are affected by it.