Title page

Below are the headings to be used for this assignment.

Introduction: Explain the type of work setting you are discussing and whether interprofessional teams are currently present. If interprofessional teams are present, indicate a team function that could be improved. If interprofessional teams are NOT present, indicate what type of team you think might be possible in the setting.

Describe a nursing action item for each component below that could contribute to: interprofessional team support; how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Compassion

Advocacy

Resilience

Evidence-Based Practice

Summary: Include a summary statement of how the article (Promoting Resilience in nursing) components can support interprofessional teams and patient outcomes. Address how you may be able to influence this process of support for interprofessional teams overall in your unit or organization.

References: List any references used in APA format.

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Title

Name

Your title here

This paragraph(s) is to introduce the paper. Explain the type of work setting you are

discussing and whether interprofessional teams are present. If present, indicate a team function

that could be improved. If not present, indicate what type of team you think might work well in

this setting and how it might function. Remember, this is an APA scholarly paper. REMINDER:

Remember to keep the headings bolded and remove these directions beneath each heading when

you start your paper.

Compassion

In this paragraph, describe a nursing action that could contribute to compassion through interprofessional team support; describe how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Advocacy

In this paragraph, describe a nursing action that could contribute to advocacy through interprofessional team support; describe how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Resilience

In this paragraph, describe a nursing action that could contribute to resilience through interprofessional team support; describe how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Evidence-Based Practice

In this paragraph, describe a nursing action that could contribute to evidence-based practice through interprofessional team support; how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Summary

Provide a clear and concise summary. Include a summary statement of how iCARE components can support interprofessional teams and patient outcomes through nursing actions. Address how you may be able to influence this process of support for interprofessional teams on your unit or in your organization.

References

Please use at least one scholarly source from the CINAHL database in the Chamberlain Library.

Other scholarly sources may be used, but are optional.

T
his month, I attended the awards
ceremony of eleven senior nurses
who had all successfully completed
their Aspiring Nurse Director

development programme at London South
Bank University with NHS Improvement
(NHSi). The programme aims to talent spot
and equip aspiring nurse leaders into chief
nurse posts. It was a great afternoon, full of
personal reflections from those who had
undertaken the course. These were people with
ambition and there was a drive to progress
into board-level nursing posts from many,
but not all of the scholars. During the open
debate that afternoon, the scholars reflected
that undertaking the programme had enabled
them to consider ‘the right chief nurse job for
them, rather than the next one advertised’ as
key in their future decision making, with some
individuals reflecting that the programme had
enabled them to conclude that they did not
wish to progress onto a board-level post.

Concerns have been reported recently
in the nursing press surrounding the high
turnover levels of nurse directors. Jones-Berry
(2016) reported an analysis of 230 English
NHS trusts, 14 Scottish and 7 Welsh Health
Boards and revealed that 132 (53%) of chief
nurses had only been in post since 2014. Of
this figure, 33 chief nurses had only taken up
post in the last year.

Following the awards ceremony, Professor
Kelly, Chair of Nursing Research and Director
of Research and Innovation at the Royal
College of Nursing shared his research findings
(Kelly et al, 2015). Semi-structured telephone
interviews with chief nurses were conducted.
The aim of these interviews was to explore

Promoting resilience in nursing
Sam Foster, Chief Nurse at Heart of England NHS Foundation Trust, considers recent research into role
stressors and coping strategies for executive nurse directors

role stressors experienced by executive nurse
directors and the strategies that they used to
maintain resilience.

The drivers behind the study were
multifaceted and included:

■ The recent financial pressures on the NHS.
Dame Professor Donna Kinnair recognised
that organisational failures are all too often
blamed on the chief nurse, despite having
no budgetary responsibility for improving
care, making the role even more difficult
(Jones-Berry, 2016)

■ A number of well-publicised care quality
scandals in the UK. This was well debated
in Allan et al (2016): with headlines
depicting how under fire nursing has
become in recent times: ‘too posh to wash’,
‘too clever to care’, ‘complicit in cruelty’ and
the list goes on

■ The short length of tenure and the high
number of vacancies for chief nurse posts.
The researchers raised questions about not

only the demands of the role, but also the
support mechanisms in place.

Professor Kelly presented us with three key
theoretical positions to consider in the context
of the issues facing board-level nurses:

■ Failures of foresight—disasters preceded
by long incubation periods typified by
signals of potential danger being ignored or
misinterpreted (Weick, 1998)

■ Normalisation of deviance—incremental
process involving a gradual erosion of
normal procedure and standards that would
never be tolerated if proposed in one single
abrupt leap (Vaughan, 1997)

■ Deaf effect—when a decision maker doesn’t
hear, ignores or overrules a report of bad
news to continue a failing course of actions
(Jones and Kelly 2014)
The results of the study found both chronic

and acute stressors. Chronic stressors included
overall workload, a feeling of a lack of shared
corporate responsibility for quality, and tensions
between financial solvency and care quality that
engendered a feeling of personal vulnerability.
Acute stressors included dealing with the
immediate such as complaints and incidents.

The resilience strategies that were reported
by the chief nurses included the support of
fellow board members, peers, family and
mentors, along with a degree of self-discipline
regarding work–life balance, good preparation
for the post and ongoing coaching.

Kelly et al (2016) found that the current
fiscal austerity and recent care scandals have
increased pressure on chief nurses and this,
coupled with larger organisations to lead,
limited resources devoted to quality, and
repetitive demands for data by oversight
organisations, could be detracting from more
important quality assurance strategies. Clear
strategies are required to maintain resilience
in the face of these major stressors. As a chief
nurse, the study resonated with me. I was
pleased to hear Ruth May, executive director
of nursing at NHSi, speak at the event,
detailing the strategies in place to support
those thinking about becoming a chief nurse
or those already in post. These include the
development programme for aspiring nurse
directors, a programme to support new nurse
directors to help plan for the first 100 days,
and a buddy programme for people new in
post and those in difficult circumstances.

While I have largely focused on the
struggles of the role, I would like to add that,
for me, the chief nurse role is a privilege.
It is a role that has opportunities for huge
personal and professional pride in leading
an amazing profession, as well as daily
opportunities to make a significant difference
for our patients. BJN

Allan H, Traynor M, Kelly D, Smith P (2016) Exploring
Sociology in Nursing. Sage Publications, London

Jones A, Kelly D (2014) Deafening silence? Time to
reconsider whether organisations are silent or deaf
when things go wrong. BMJ Quality & Safety 23(9):
709–13

Jones-Berry S (2016) Trusts are struggling to retain chief
nurses. Nurs Standard 31(4): 12-3

Kelly D, Lankshear A, Jones A (2016) Stress and resilience
in a post-Francis world—a qualitative study of
executive nurse directors. J Adv Nurs 3. doi: 10.1111/
jan.13086 [Epub ahead of print]

Vaughan D (1997) The Challenger launch decision: risky
technology, culture, and deviance at NASA. University of
Chicago Press,Chicago

Weick KE (1998) Foresights in failure-an appreciation
of Barry Turner. Journal of Contigencies and Crisis
Management 6(2): 72-5

FOSTER’S PHILOSOPHY

British Journal of Nursing, 2016, Vol 25, No 20 1155

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