What Nurses Need to Know: Recognize When You’re Out of Your Resilient Zone and Take Action

“It’s been a difficult year” is an understatement. Especially for nurses.

You’re facing a completely unprecedented, deadly virus up close. Your face was bruised by long hours in protective equipment. And whenever you’re tired, you push through because a sick person needs you. And then some of you are worried about keeping your family separate and safe and some of your children are learning from home and some of your spouses were laid off…

It’s a lot.

And that’s in addition to the significant physical, emotional and moral suffering health care workers experience on a regular basis that could lead to suicide even before the COVID-19 pandemic began. Take these statistics from 2019: in the general population about eight women in 100,000 and 28 men in 100,000 die from suicide, but that’s nearly 12 in 100,000 among female nurses and 40 in 100,000 among male nurses.

“Suicide is the most extreme response to stress and despair,” says Cynda Rushton, PhD, RN, FAAN, who has published extensively on moral distress, burnout, and resilience. “We must be proactive in recognizing the signals that we need support and invest in our own well-being before we are in a crisis.”

So from Dr. Cynda Rushton, here’s what to look out for and how to take action.

Recognize the signals that you’re out of your resilient zone

Know when you’re in your resilient zone—where you can navigate peaks and valleys without too much cost to yourself—and when you’ve exceeded your limits and need attention. Some signs that you may be out of our resilient zone are if you’re becoming hyper-vigilant or irritable, or on the other end, if you’re becoming depressed, beginning to shut down, become disengaged, apathetic, or numb.

“We must be more aware of what our limits are, when we’re overwhelmed, and what patterns lead to that feeling,” says Dr. Rushton. “As health care workers, we must build our resilience muscle not to tolerate unacceptable situations but to restore our ability to choose.”

When you know you’re out of your resilient zone, it’s time to take action, now. But how do you get to get back into the resilient space? “It’s whatever nourishes you. It could be sleep, it could be time with loved ones or in nature, it could be feeling your feet on the floor but it’s not a recipe,” Dr. Rushton says.

When we realize our typical responses are not enough, we may need the support of mental health professionals to help us navigate these challenging times. Asking for help is a sign of strength; take advantage of employee assistance programs, community resources, and professionals to expand your support system when you feel depleted and despairing. If you find yourself in a situation where you are considering self-harm, reach out to someone.

The best defense is a good offense.

The new school year just began at the Johns Hopkins School of Nursing. The programs are rigorous, sometimes overwhelming. “In the first week we have new students do an assessment to figure out areas of their lives where they have resilience resources and what areas they need to invest in,” says Dr. Rushton. That way students know what resources are available when they find themselves in a distressing situation.

“Use your resources. Health care workers and students are a part of a family, and a profession with strong community,” says Dr. Rushton. “Sometimes our families and friends don’t understand. Take the opportunity to reach out, talk about, and process your stressors. Sometimes it’s easy to overlook the commitment of the community to your wellbeing.”

Self-care is not selfish.

One of the biggest barriers to taking care of ourselves is the assumption that self-care is selfish. But far from selfish, caring for our own wellbeing is a moral imperative. “Nurses have the same duty to ourselves as we do to others,” says Dr. Rushton. Building our resilience and well-being isn’t optional; it’s a requirement of the profession.

National Suicide Prevention Lifeline 1-800-273-8255

Read more:

• Health Care Suicides—We Need Cultural Change
• A new study reveals that nurses face a higher risk for suicide than the general population. Cynda Rushton, PhD, RN, FAAN, weighs in
• Heart & Minds
• We Need Nurses to Take on the Mental Health Crisis
• The Caregiver’s Mental Health is Important Too

ABOUT THE AUTHOR: SYDNEE LOGAN

Sydnee Logan, MA is the Sr. Social Media and Digital Content Specialist for Johns Hopkins School of Nursing. She connects Hopkins Nurses with the world.