Recognizing Your Resiliency
"Do not judge me by my success, judge me by how many times I fell down and got back up again."
Nelson Mandela
Psychiatric and Mental Health Nursing (NURS 411) details the concept resilience as the ability and capacity for people to secure the resources they need to support their well-being (Halter, MJ (2018). Foundations of Psychiatric-Mental Health Nursing, 8th ed. Elsevier.). There are protective factors and risk factors that lay the foundation to build resilience. Risk factors are considered to be an accumulation of unresolved stress or stressors, whereas protective factors improve a person’s ability to respond to said stress, trauma and loss. In Health Promotion Research in Human Subjects (HPEB 399), our semester project was to create and execute a research study. This included creating a research question, writing the literature review for the question, then writing the research proposal, and finally completing the research with data collection and a presentation to disseminate the information gathered. I rewrote my proposal over and over again, even after the grade was administered. This was my first within the classroom experience that taught me resiliency as a student to continue to do my best.
The note from Dr. Easley was left on top of my 5th draft of a research proposal I was working on for class. Prior to this point, I was really struggling with the concept of proposals and how to set them up. Before writing a research proposal, it is required to perform a literature review in order to be knowledgeable regarding the research you want to accomplish. When I left the 5th draft for Dr. Easley to edit, I felt more comfortable like I was finally catching on to the skillset research writing demands. Resiliency is the act of not quitting, and by continuously putting the effort in to finish this proposal demonstrated first hand my own resiliency.
A beyond the classroom experience I participated in that taught me about resilience was an internship with the Arras Foundation. During this internship, I worked with the city of Lancaster towards revitalization of the downtown area. Prior to this, I was tasked with researching other downtown areas and comparing the health benefits of increasing the walkability. Another factor of the internship was learning about community indicators. Community indicators are the main focal points that determine how well a community is functioning (its resiliency). It is commonly known that residents of rural areas tend to have lower life expectancies. Therefore, revitalizing downtown Lancaster would increase life expectancy by promoting health and wellness, stimulating the economy, encouraging young people to stay local, and providing an incentive for people to come to this area. These are just a few ways community resiliency would drastically improve.
Green spaces, clean air and water, transportation access, access to health care, and healthy living are community indicators that were especially pertinent while working towards downtown revitalization. These indicators represent a resilient and healthy community. An overall healthy community generates better patient outcomes. This can be shown when community members are visiting a community health nurse or if they have come to the hospital. A healthy community is not just physically healthy but includes mental health too. A mentally healthy community demonstrates adequate usage of protective factors. Therefore, a resilient community promotes a positive outlook which may promote individual resiliency.
It is commonly known that patients who have a positive outlook prior to a procedure or surgery typically have no complications (NURS 412; Acute Care of the Adult 1). Beyond the classroom in my nursing capstone experience, where I am gaining the opportunity to be the nurse, I find that patients with a resilient outlook on life get better quicker. This notion applies to any disease process. I once had a patient who had a long list of non-modifiable diseases, yet she was happy, kind, and overall a positive person. Most times, patients with similar health problems to her, also have a history of depression, anxiety, and other mental health issues. This patient is a prime example of how strong personal and community relationships result in greater resiliency.
I realized this was not the first time I’d learned about resilience beyond the classroom. I spent Spring 2019 in a frenzy. Outside of the five classes I was taking, I chose to spend any allotted free time doing extra-curriculars. I wrote grants, abstracts, proposals, spent a lot of time in meetings, and collected data for the IRB-approved SMART study. There were many victories, however, the defeats still hurt. Writing research prepared articles is a different type of writing; it is a learned skill not something that comes naturally. I applied for the Magellan Scholar through the University of South Carolina and was denied the grant money. I co-authored an abstract to be submitted to 2nd World Congress on Undergraduate Research (WCUR) to present in Germany and was not selected. These are two huge setbacks that could have stopped my pursuit of research altogether. Yet, I did not stop chasing the feeling of accomplishment that engaging beyond the classroom provides. Regardless of these outcomes mentioned, I continued to practice resilience by applying for and accepting an internship position with the Arras Foundation (previously known as J. Marion Sims Foundation).
Now that I am in the last semester of my undergraduate career, I have started applying for Nurse Residency Programs. Due to the pandemic, hospitals are functioning in an unprecedented way. The facility where I am doing my senior practicum is no longer allowing students to precept in the Intensive Care Unit (ICU) or the Emergency Department (ED). Working in the ED is my dream, so upon finding out my placement was on Clinical Observation, I was extremely disappointed. I felt like my career plans were ruined, and for some places they were. I recently received a rejection letter from Duke University Specialty Nurse Internship Program (SNIP) in the ED. Due to my placement on the Clinical Observation unit, I was deemed unqualified for the SNIP program. I started on the Observation unit with an open mind and fell in love with the floor. I was able to be unbiased due to adequate coping mechanisms with an appropriate response to loss (protective factors). These are just a few examples of failures that helped me develop resilience in my academic and personal life. I was able to accept the failures and utilize the feelings of being inadequate to motivate myself to continue to pursue my dreams.
Stressors have the potential to cause many poor coping mechanisms. However, this is why protective factors are paramount. Mental Health Assessment Technologies Institute (ATI) describes protective factors as humor/optimism, hobbies, satisfying and strong interpersonal relationships, a strong sense of self, and religious beliefs. Protective factors are also necessary for health and wellness. Besides the mental health aspect, protective factors can be used to get through a physical diagnosis. For example, the old saying, “laughter is the best medicine” is based on this idea of protective factors. Promoting a happy and encouraging environment is crucial to health and wellness. Having a good friend to vent to, a dog to walk, or playing a fun game are healthy coping mechanisms that support these protective elements. Throughout the defeats, I have supportive friends and family to pick me up when I am down. Resilience is not a tangible subject, but everyone has a varied level of it. Resilience is critical to being a motivated and competent nurse. The ability to utilize the available resources cultivates a strong leader. Leadership skills are learned but having sufficient protective factors can set anyone up for success.
This is a picture of me and my team working on our research for the abstract we would write to submit to the 2nd World Congress on Undergraduate Research (WCUR).
(Pictured: Samantha Broome & Savannah Beckham)
Beyond the classroom artifacts
Throughout my time of research, I was constantly looking for opportunities to practice the skill of research writing. At USC-Lancaster, there are fewer opportunities available to the students on that campus. However, one grant is open to all USC campuses, and it is called the Magellan Scholar. Unfortunately, I learned about the Scholar two weeks prior to the due date. I approached Dr. Easley and Dr. Sellhorst regarding the grant, and they suggested I ask for assistance by another peer who was more familiar with research writing. This artifact is the email we received expressing rejection to our grant. We worked tirelessly on this proposal and it was painful receiving this letter. At first, the temptation to quit was very strong. Then, with the help of family and friends, I gave myself some grace and decided not to give up on research after all.
This is the first abstract I ever wrote. It was not picked for the World Congress on Undergraduate Research, however it was a great starting place to learn research writing skill and ultimately increased my resilience.
This meeting was held to update Dr. Collins (Dean of USCL) and Ms. Kelly Steen (head executive over Gregory YMCA on USCL campus). At this time, I was working with a staff member of the Arras Foundation on advancing the open community use policy. Some of our goals were to add bike racks, certify the campus as a Wildlife Habitat, and to enhance the walking paths on and through campus. This would support community indicators like healthy living, green spaces, clean air & water, and produce a new access to healthcare (The Hubb). By supporting community indicators, we can improve community resilience in Lancaster.
Within the classroom artifacts
The notes from Mental Health (NURS411) demonstrate where I first learned about protective factors. I was familiar with risk factors due to the association with physical disease process. Meaning, an unhealthy diet combined with no exercise are modifiable risk factors for heart disease or hypertension (high blood pressure). However, in mental health, risk factors are shown with adequate coping mechanisms and even perceptions of situations. Protective factors are typically seen when a person experiences stress, trauma, and/or loss due to expected or unexpected circumstance. No two people experience situations the same; one person may have more protective factors (i.e., ability to cope) compared to the other which results in varied responses.
The notes from Med Surg 1 (NURS412) show some concepts learned for patients specifically with heart failure, however are pertinent to any disease process where coping is involved.