Resilience – a term used so widely in the medical literature at present; have we become resistant to its meaning?
Looking up the definition of resilience in a dictionary, you will find “the capacity to recover quickly from difficulties; toughness”. You also get “the capability of a strained body to recover its size and shape after deformation caused especially by compressive stress.”
This term particularly evokes the image of multiple hardships causing the eventual casualty, otherwise known colloquially as ‘the straw that broke the camel’s back’.
So, how do we recover our shape after multiple knockdowns?
Recent events have affected the hope & morale of our profession. The Bawa-Garba case has particularly resonated with paediatric trainees. Many of us identify with the scenario of holding multiple bleeps and being inundated with jobs seemingly out of our control. Recruitment for paediatrics is struggling given that increasing numbers of foundation year 2 doctors are opting to take time out before choosing their specialty, with the additional strain of more paediatric trainees leaving before CCT for various reasons. As per the 2017 State of Child Health Report, general paediatric and neonatal rotas are currently experiencing an average vacancy rate of 14%. Community paediatrics trainees are starting to identify as the new ‘Lost Tribe’ of this decade, with vacancies variable across the country, but widely, ours is the least filled subspecialty across the board.
I look to categorize factors affecting resilience as fixed and flexible; some contributors are debatable. For example, rota gaps and winter pressures for those who cover the acute medical rotas are a fixed inevitability which become increasingly profound year on year. Exams tend to be another fixed factor; postgraduate studies, along with fulfilling clinical duties, reclaiming social life and other commitments can often take their toll on the hardiest of professionals. I view flexible factors as those that are fluid and dependent on the individual – sometimes change of personal circumstances including pregnancy, a house move, a bereavement, a difficult commute. Often, the ability to show resilience is determined by the ratio of fixed to flexible factors, along with other influences such as general wellbeing. It is important to improve personal health to address flexible factors, and to work as a team to try and address fixed factors that affect so many of us.
One of the ways that we can help to improve resilience in addressing flexible factors is by talking to each other and providing peer support. As one of the new BACCH National Trainee Reps, we encourage networking and discussion; at our Trainees Day, we will be holding a workshop on ‘surviving and thriving’ as led by the wonderful Dr Ellie Nash, GP registrar.
One of the recurring comments by trainees in community paediatrics is that they can sometimes feel disconnected from their peers. We can feel alone and alienated from those often going through similar experiences. Some deaneries have already established close connections for their community trainees; for those who don’t ‘know their neighbour’, we propose that you take a moment to think about how you interact with your peers. We will be actively instigating this to encourage networking on a personal level. Instead of offering a cupful of sugar, perhaps we could start by meeting to discuss not just the usual woes of ePortfolio and ARCP – but, maybe start with – how are you doing…can we help each other?