I recently visited the Florence Nightingale Museum in London. Situated near St. Thomas Hospital, where the original Nightingale Training School was established, this surprisingly modest building houses a collection of fascinating historical artefacts (including that famous lamp).
As I wandered through the exhibition I couldn’t help thinking about Nightingale’s tenacity, indomitable strength and the many challenges she had to overcome. From the beginning her parents vehemently opposed her choice of career, viewing nursing as a job for the poorly educated working class, and not appropriate for a respectable woman. During the Crimean War Nightingale and the other army nurses worked in rat infested and overcrowded conditions, surrounded by filth, decay, disease, pain and suffering, tending thousands of wounded and dying soldiers. Over and over again Nightingale’s attempts to implement change and improve patient care were met with resistance and criticism from her medical colleagues.
Nightingale’s story is one of resilience, determination and an unwavering sense of purpose; attributes that enabled her to eventually transform both nursing education and healthcare practice. Her vision for nursing is illustrated by these words:
Nursing is an art;
and if it is to be made an art,
it requires as exclusive a devotion,
as hard a preparation,
as any painter’s or sculptor’s work;
For what is having to do with
dead canvas or cold marble,
compared with having to do with the living body – the temple of God’s spirit?
It is one of the Fine Arts;
I had almost said
the finest of the Fine Arts
~ Florence Nightingale ~
Around the world International Nurses Day is celebrated on May 12 to honour the day Florence Nightingale was born. This year’s theme, ‘Nurses: A force for change: Improving health systems’ resilience’, is an appropriate testament to Nightingale, and the many strong and determined nurses who have followed in her footsteps.
Resilience … the ability to overcome or bounce back from setback and how one learns to grow stronger from the experience. 1
Nursing is the largest healthcare workforce in the world and our combined power to enact change and improve healthcare is immense. However, a resilient health system can only be achieved if the individuals that make up that system are resilient. With the complexity, diversity, inherent challenges and dynamic nature of contemporary healthcare, resilience is as critical for nurses and nursing students today as it was for Nightingale more than a century ago.
The last decade has seen a paradigm shift with resilience now viewed less as an individual trait and increasingly as a process of learning to cope with adversity or disruptions … a process that is both progressive and modifiable through education.2
The number of google searches for the term resilience have doubled over the last decade and there is an ever increasing body of literature attesting to the importance of resilience for nurses and nursing students. However, despite the many references to the role of educators in teaching resilience, there is scarce attention to the idea of nurse educators actually being resilient. I find this intriguing as nurse educators deal with multiple and competing challenges every day, and resilience is fundamental to their success.
Teaching is emotional labour; educators care deeply about students who are struggling academically or clinically, not attending or participating, and/or who have personal issues that are impacting on their career aspirations. Tensions exist between a commitment to teaching quality and increasing pressures to be more ‘efficient’ by replacing (rather than augmenting) face-to face classes and blended delivery with online and self-directed learning. Although educators value educational outcomes, ‘student satisfaction’ and ‘progression rates’ are the metrics used by a number of universities to judge teaching effectiveness – an issue that creates an uneasy dissonance for many. Innovative, pedagogically sound, and clinically relevant curricula are sometimes undermined by people who prefer to simply ‘tick boxes’. Added to these pressures academics are also besieged by the unrelenting mantra … ‘publish or perish’, and to not do so can be career limiting. Consequently, I know very few nurse educators who work less than 40 hours a week with the majority working upwards of 50-60-70 hours.
Clinical educators, employed by both universities and clinical organisations, also encounter a range of complex challenges. Too often there is a lack of clarity about roles, educational requirements, expectations and career pathways. Inadequate preparation, support and valuing of the role of educators is also common (Sayer, DiGiacomo & Davidson, 2011). Clinical facilitators are frequently employed on a casual or sessional basis which undermines their job security; and hospital-based educators often have to contend with erosion of education budgets and resulting staffing shortages.
Despite the stressful and challenging nature of the work, the majority of nurse educators remain passionate about teaching and secure in the knowledge that they are making a real difference, both to students and to healthcare more broadly. I’ve been an academic for over a decade and a hospital-based nurse educator before that. I have always believed that these roles are a privilege. I have remained resilient, flexible and adaptable (well … most of the time…), and I’ve become pretty good at finding strategies to overcome the challenges I’ve encountered. However, I could not have done this without the friendship, encouragement, support and collegiality of the many inspirational friends, fellow educators and kindred spirits that I have met along the way:
On this path …. the path that I travel
I do not walk unaccompanied
Within the clasped hand of friendship that forms the bond of community
Where I hold the hand of one individual linked to another
I am not overcome for you are there to raise me up
And to share my burden so that I do not lose strength
My hope comes from the kindred of my fellowship with you
Come take my hand and join me on this journey
I have scaled the heights because you are with me
~ A. Paull Byatt ~
This International Nurses Day let’s make a pledge to take care of ourselves and strive to maintain a work-life balance. Let’s practice habits that sustain resilience: being compassionate, grateful, reflective, authentic and mindful. Let’s nurture each other, be kind and encouraging to our colleagues, and provide mentorship, support and guidance to novice educators. Together and steadfast, let’s remain optimistic and resilient as we continue to educate nurses and transform lives.
Read more about resilience in nursing …
- McAlister, M. and McKinnon, J. (2009). The importance of teaching and learning resilience in the health disciplines: A critical review of the literature. Nurse Education Today, 29, 371-379
- Waite, P. & Richardson, G. (2004). Determining the efficacy of resiliency training in the work site. Journal of Allied Health, 33(3),178-83.
- Sayer, J., DiGiacomo, M. & Davidson, P. (2011). The nurse educator role in the acute care setting in Australia: important but poorly described. Australian Journal of Advanced Nursing, 28(4), 44-52