What Is Resilience and How Do We Strengthen It?

Tonia Hale

Tonia Hale

By Tonia W. Hale, DNP, MAOM, BSN, RN

Resilience is discussed often now, especially as we reflect on enduring the many challenges that the COVID-19 pandemic has presented over the last nine months. Our ability to creatively cope with challenges and even crises that emerge with little to no warning in our lives — like the pandemic — is fortunately a skill we can work to develop at any time in our lives. In other words, resilience is not something you’re born with, it is something you build.

It is easy to face life when everything is going smoothly, but when we encounter a major bump in the road, how can we react and adapt in a way that supports our mental and physical health? As I have watched our Blue Ridge Regional Hospital [1] (BRRH) healthcare providers and team members this past year, I’ve seen countless instances of selfless acts as they care for our patients and each other.

Our providers face unique challenges when it comes to resilience. As people who devote their lives to caring for others, and get much fulfillment and joy from this calling, they can, ironically, shortchange themselves in the self-care department. Couple this with the exhaustion brought on by the never-ending nature of the pandemic and fear for their families’ safety, and it is no surprise that they are more at risk for compassion fatigue — becoming so physically and emotionally depleted that empathy becomes harder to muster — and burnout.

Micah Krempasky, MD, psychiatrist and Senior Patient Safety Officer for Mission Health/HCA Healthcare, thinks that it may help us more to focus on actions we need to engage in to develop resilience rather than trying to define it. “Someone once told me that accepting care, even as a healthcare worker, is a gift we give to someone else as well as ourselves, and it’s true. I think many caregivers instinctively hold back from asking for help or welcoming care from others, and flipping just that one switch can do a lot to build resilience. Since providers are called to care for others, it’s hard for them to create boundaries around when to stop giving and determine at what point they need to stop and care for themselves,” she explains.

Dr. Krempasky adds that fortunately, resilience-building self-care habits run along a broad spectrum. “Self-care might be going to bed early for one person and getting outside for a walk for another, or slowing down for a cup of tea, spending time with a friend. Simply pausing like this and doing something good for ourselves allows our brains to slow down, which brings peace and quiets our worries,” she shares.

PJ Mears, MA, Senior Consultant with Leadership & Organizational Development at Mission Health/HCA Healthcare, recently focused on resilience as part of a leadership development series with the BRRH leadership team. He uses the analogy of keeping our batteries charged in order to stay resilient, noting that we must remember that the brain is constantly anticipating what our bodies need. “The body doesn’t lie,” he says, noting that our brain’s ancient purpose isn’t purely emotional, it exists to keep our organs and systems running efficiently. “We’re constantly assessing whether situations we’re faced with are safe or not, how to react to them, how much control we feel we have in our environment, and our level of connection with others,” he says. He adds that in times like these, if we spend too much time in a fight or flight state, as opposed to one where we effectively process our emotions, we’re robbed of energy that’s needed to stay resilient.

Mears references the “six P’s,” a series of actions and mental practices that enhance our resilience: presence, positivity, purpose, perspective, proactivity, and partnership. “We need to be present in our lives, meaning neither trapped in the past nor excessively worried about the future, foster positivity and gratitude, and maintain a strong sense of why we’re here and what our work is in the world,” Mears says. “It’s also essential to feel you have some control in your life, and even in times like these we have the power to make decisions that nurture our health for example, including setting healthy boundaries and creating space for self-care. Finally, connection to others is critical because our brains are social organs.”

Dr. Krempasky recognizes that the financial instability that many are suffering due to the pandemic, as well as our inability to connect with others, are profound blows to our resilience, but she emphasizes that, along with every challenging storm, there is a cloud with a silver lining. “What if we were to look at, with regard to the pandemic, what it has given us in addition to all it has taken away? I sometimes see it as a reset button that has forced us to let go of what doesn’t matter and a reminder of what’s truly important, like our relationships, our health, and our purpose,” she says. “It is especially important now to recognize that we are all living with a high level of stress, and to extend grace whenever we can — to ourselves and others.”

Staying strong through this time means reaching out to others and remaining conscious of our health. Our emotional state is heavily determined by physical realities, such as adequate nourishment, sufficient hydration, and high-quality rest. I’m encouraging the BRRH team and our community members to do all they can to build resilience, as we live with uncertainties around when we can go back to living life less than six feet apart at all times. An important part of this is to continue practicing the three Ws, which are critical to avoiding a virus spike similar to what we’ve seen after Thanksgiving: washing your hands frequently, waiting six feet apart, and wearing your mask.

I encourage our extraordinary BRRH team and our community members to continue focusing on the positive aspects of life, allowing yourselves to do things you enjoy regularly, and counting your blessings. I want to wish everyone Happy Holidays, and let’s be good to others, and ourselves in 2021.

As you may know, Mission Health received its first shipment of the Pfizer vaccine on Thursday and began vaccinating our employees Friday morning in accordance with the CDC tiering system. This guidance from the CDC prioritizes healthcare workers most at risk for contracting COVID-19 and includes staff at Mission Hospital in Asheville, along with staff at the five regional hospital locations. The staff health team has worked through the weekend to administer the vaccine quickly to our frontline workers. Vaccinations are continuing and we have been told to expect doses of the Moderna and more of Pfizer vaccine within the next week, but we don’t have firm dates at this time. For additional information regarding the availability of COVID 19 vaccinations as well as the phased approach to administering the vaccination, please access the NC DHHS COVID 19 website [2] and Mission Health. [3]

Blue Ridge Regional Hospital


Tonia W. Hale, DNP, MAOM, BSN, RN, is Chief Executive Officer and Chief Nursing Officer of Blue Ridge Regional Hospital in Spruce Pine.

Blue Ridge Regional Hospital, a member of Mission Health, an operating division of HCA Healthcare, is a community hospital serving Mitchell, Yancey, lower Avery and upper McDowell counties. Located in Spruce Pine, North Carolina, Blue Ridge Regional Hospital is a Critical Access Hospital operating 25 beds. Blue Ridge Regional Hospital offers medical specialties including emergency services, prenatal and postnatal obstetrical care, wound clinic, cardiac stress testing, cardiac and pulmonary rehabilitation programs, nuclear medicine, 3D mammography, endoscopy services, critical care, rehabilitation services and fitness center, cancer services, orthopedics, general surgical services, pediatrics and family medicine, and walk-in, non-emergency care at Mission My Care Now Spruce Pine. For more information, visit missionhealth.org/blueridge [1].