What Are We Asking People to Be Resilient To?

There is a word that has become increasingly common in healthcare.

Resilience.

It's used in conversations about wellbeing, professional development, psychological safety and the challenges of working in healthcare.

We hear things like:

“Demonstrates resilience.”

“Building staff resilience.”

“Improving workforce resilience.”

It sounds positive.

And there is good reason for that.

Healthcare is difficult work.

Patients deteriorate. Families become distressed. Plans change. We make mistakes. We deal with uncertainty, conflict, death and situations that don't always have neat solutions.

Being able to experience something difficult, process it, learn from it and continue to function is valuable.

But I've started to wonder whether we sometimes use the word resilience without being particularly clear about what we actually mean.

And perhaps that's where things get interesting.

Resilience to what?

Whenever I hear someone talk about resilience, I find myself asking:

Resilience to what?

Resilience to a difficult clinical situation?

That makes sense.

Resilience when priorities suddenly change?

Probably.

Resilience when dealing with an emotionally difficult situation? like the first time I froze

Certainly.

But what about resilience to an environment that is consistently difficult?

That's a different question.

At what point does resilience stop meaning the ability to respond effectively to challenges and start meaning the ability to tolerate them indefinitely?

I'm not sure there is a simple answer.

And I don't think the answer is to stop talking about resilience.

I think we need to talk about it more carefully.

The individual still matters

There is an obvious individual component to resilience.

As healthcare professionals, we have responsibilities too.

We need to develop the ability to recognise our emotions and understand how they might influence our decisions.

We need to reflect on difficult experiences.

We need to ask for help when we need it.

We need to develop problem-solving skills.

We need to recognise our limitations.

We need to adapt when circumstances change.

And sometimes we need to have the difficult conversation rather than waiting for someone else to solve the problem.

That is part of professional development.

We can't reasonably expect healthcare environments to remove every difficult experience from our working lives.

Sometimes healthcare is simply difficult.

A resuscitation can be confronting.

A conversation with a distressed family can stay with you.

A mistake can be uncomfortable to reflect on.

A sudden change in a patient's condition can challenge even an experienced clinician.

Developing the ability to work through those experiences is important.

But there is a distinction between developing resilience and simply becoming better at tolerating difficulty.

Resilience isn't endurance

I think this is where we can sometimes get ourselves into trouble.

Someone who never complains, never shows emotion and keeps going can look incredibly resilient.

But what if they have stopped speaking up?

What if they have withdrawn from team discussions?

What if they no longer believe their ideas will make a difference?

What if they have simply become very good at suppressing what they're experiencing?

From the outside, that can look like resilience.

But it might be something else completely.

Endurance and resilience aren't the same thing.

Endurance can mean continuing despite difficulty.

Resilience involves how we respond to that difficulty.

There is reflection.

There is adaptation. T

here is learning.

There is self-awareness.

Sometimes there is recovery, but not always.

And that distinction matters because resilience isn't always an individual problem to solve.

There is a point where an organisation has a responsibility to recognise that asking someone to be more resilient isn't going to fix the problem.

If the workload is consistently unreasonable, staffing is inadequate, people don't feel safe speaking up, or the same problems are repeatedly raised without meaningful change, telling individuals to develop greater resilience can miss the issue entirely.

Organisations need to be able to recognise when resilience isn't the answer.

That doesn't remove the individual's responsibility to look after themselves, reflect, seek support and recognise when they are struggling.

But it does mean organisations have a responsibility to look at the environment people are being asked to work in.

This is where the distinction between resilience and endurance matters.

But the opposite isn't resilience either

There is another side to this conversation.

If we push the responsibility entirely onto the environment, we risk losing something important too.

Not every difficult situation is someone else's responsibility to fix.

A resilient healthcare professional isn't someone who identifies every problem and waits for somebody else to solve it.

They can ask:

“What part of this can I influence?”

They can look for solutions. like reporting bullying.

They can acknowledge when they have contributed to a problem.

They can ask for help.

And when an opportunity to improve something comes along, they can participate rather than simply point out what is wrong.

But that opportunity needs to be offered.

So perhaps resilience isn't about deciding whether the individual or the organisation is responsible.

It's about understanding where the responsibility sits in a particular situation.

Can someone be too resilient?

This is probably the question I find most interesting.

Not literally, perhaps.

But can someone become so good at adapting to a difficult environment that they stop recognising that the environment itself needs to change?

If someone continually absorbs additional pressure, adapts to increasing demands and finds ways to keep functioning, they may be described as resilient.

But their ability to cope doesn't necessarily mean the underlying problem has been solved.

In fact, their resilience may make the problem less visible.

That doesn't mean the person is doing anything wrong.

Quite the opposite.

They may be doing exactly what they need to do to get through the day.

But it raises an interesting question for organisations:

Are we measuring resilience by how well people tolerate difficulty, or by how well people are able to respond to it?

Those aren't necessarily the same thing.

Resilience and psychological safety

This is where resilience and psychological safety become particularly interesting.

Psychological safety is about creating an environment where people can ask questions, raise concerns, admit mistakes and challenge ideas without fear of humiliation or punishment.

Resilience is about an individual's ability to respond to difficulty.

They are different things.

But I don't think they should be viewed as competing ideas.

In fact, they can support each other.

Resilience can give someone the confidence and self-awareness to speak up.

Psychological safety gives them somewhere safe to speak up.

You need both.

A resilient person might recognise that something isn't right and have the skills to raise it constructively.

But if the environment makes speaking up unsafe, individual resilience can only take them so far.

Equally, creating a psychologically safe environment doesn't remove the need for individuals to develop the skills to communicate effectively, manage emotion and participate constructively in difficult conversations.

The individual and the environment are connected.

What does a resilient workforce actually look like?

This is where I think we could perhaps change the question.

Rather than simply asking:

“How do we improve staff resilience?”

perhaps we should ask:

“What would a resilient workforce actually look like?”

Would it be a workforce that never complains?

One that absorbs pressure without making a fuss?

One that keeps going regardless of circumstances?

I'm not sure.

I would probably expect something different.

I'd expect people to remain engaged with their work.

I'd expect people to participate in decisions that affect them.

I'd expect people to feel able to ask questions.

I'd expect people to raise concerns.

I'd expect people to reflect on difficult experiences.

I'd expect people to seek help when they need it.

I'd expect people to contribute to solutions.

And I'd want to know whether people are actually staying.

That makes things like staff retention, engagement and participation in decision-making interesting measures.

Not because they provide a perfect measurement of resilience — they don't — but because they may tell us something about the environment in which resilience is being developed.

Shared decision-making changes the conversation

This is one area where I think resilience can become particularly useful.

Imagine a problem affecting a team.

There are two very different approaches.

The first is:

“This is the problem. How do we get staff to cope with it?”

The second is:

“This is the problem. Who understands it, what can we influence, and how can we work together to improve it?”

The second approach gives people agency.

It allows staff to understand the problem rather than simply experience it.

It gives them an opportunity to contribute.

And it creates the possibility that resilience becomes something more than an individual trait.

It becomes part of how a team responds to difficulty.

Perhaps one sign of a resilient workforce isn't that people complain less.

Perhaps it's that people participate more.

What about the really difficult stuff?

There will always be things that individuals cannot change.

Healthcare involves uncertainty.

There will be resource limitations.

There will be competing priorities.

There will be difficult decisions.

There will be days when everything seems to happen at once.

Resilience doesn't mean pretending those things aren't difficult.

It means developing the ability to recognise what is happening and respond appropriately.

Sometimes that response will be personal.

I need to take a break.

I need some support.

I need to reflect on what happened.

Sometimes it will be interpersonal.

I need to have a conversation.

I need to ask for help.

I need to explain why I'm concerned.

And sometimes it will be organisational.

This keeps happening.

There might be a better way of doing this.

We need to understand why.

What can we change?

Those are all legitimate responses to difficulty.

Maybe the question is bigger than resilience

I don't think we should abandon the word.

I think we should be more precise about what we mean.

Resilience isn't being emotionally muted.

It isn't never struggling.

It isn't putting up with bullying or poor behaviour.

It isn't silently carrying every difficult situation.

But it also isn't expecting someone else to solve every problem.

For me, resilience is increasingly about self-awareness, reflection, adaptation and participation.

It's being able to recognise difficulty, understand your own response, seek support when you need it, learn from the experience and work with others to improve what you can.

Sometimes that means coping.

Sometimes it means stepping away.

Sometimes it means asking for help.

Sometimes it means accepting that you need to change something about yourself.

And sometimes it means having the confidence to say:

“This isn't working. What can we do about it?”

Perhaps the question we should ask isn't simply:

“How do we make our staff more resilient?”

Perhaps we should also ask:

“What are we asking people to be resilient to?”

That question doesn't remove individual responsibility.

It adds context.

And perhaps that's where resilience becomes most useful — not as a measure of how much difficulty someone can tolerate, but as the capacity of individuals, teams and organisations to recognise difficulty, respond to it and learn from it.

Maybe genuine resilience isn't about being able to withstand anything.

Maybe it's about knowing what you can change, what you need help with, and when something needs to change around you.

Further Reading: Reflective Practice For Nurses

The Time I Stayed Silent

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