Holding Both: Finding Resilience in the Highs and Lows of Healthcare

“It was the best of times, it was the worst of times…”

While Charles Dickens was writing about the French Revolution, he might as well have been describing a week in healthcare (with far fewer trips to the guillotine).

If you work in this field, you know the duality: extraordinary meaning alongside extraordinary pressure. The highs are deeply fulfilling. The lows can feel overwhelming. And when that overwhelm lingers, it becomes burnout.

Even if you aren’t feeling this currently, it is unlikely that you haven’t experienced a day, or a whole season, that feels like it is all “too much”. 

It’s great when we experience the “best” times; the times with good patient outcomes, when systems run smoothly, when our team is on point, and we move through the day with confidence and purpose. But when the bad times come, when we are overwhelmed and holding the trauma of those around us, it feels as though something has gone terribly wrong. Certainly, experiencing this type of emotional weight shouldn’t be expected, right?

But both are true. Much of what we do is so rewarding, so purposeful. Layered with this can be stress, especially in moments when problems are complex, answers are elusive and patients suffer. 

And then, of course, the day-to-day logistics of working in a business can contribute, with potential for personality conflicts, system challenges, and good old fatigue.

What if the solution to the overwhelm of this duality is not dependent on the elimination of the difficulties (which is what so many of us try to do…and end up frustrated)?

It doesn’t even require an explanation that this is not about adopting complacency; nurses are inherently not complacent. It’s about resilience.

What if we can ground ourselves in the spring of hope so as to weather the winter of despair with strength and certainty?

Resilience is the capability to experience BOTH, and we build resilience not just by expecting and preparing for the worst but by expecting and savoring the best. Resilience is the ability to experience the worst times and not get derailed. And, even in the times when derailment occurs (which it will), it is the ability to bounce back, unbloodied and with calm resolve.

This is where many articles leave it: we need to be resilient. Resilient people have better outcomes. That’s about as helpful as telling someone that people who are in shape are healthier, you should be in shape, and then not telling them how to get there. 

Resilience is a skill; it’s something we learn, not someone we are. Granted, some people learn resilience early on in life; they have an environment that is conducive to resilience growth. This is not true for everyone, and it does not have to predict future success. Like any skill, some people are more equipped to learn quickly. AND like any skill, it can be learned slowly with patience and practice. 

Here’s the best part: there are many options when it comes to building resilience, and none of them are difficult. Like any new skill or habit, the hardest part is getting started and sticking with practicing. But with many of the strategies, the benefits can be felt right away.

Let’s go back to “it was the best of times, it was the worst of times”. I had a friend ask me this week how work was going, and my immediate response was “it has been brutal”. Truthfully, this is how I felt. For some reason, this week my schedule was very heavy, traffic patterns were awful so everyone was showing up late, and my patients were more complex: new medical problems, worsening symptoms, increasing emotional struggles. It was a tough one. 

Here’s where the resilience practice comes in. It was a difficult week: true. To say it was the worst of times is a little dramatic, but it was still pretty tough. It’s Friday, and I am TIRED. But what if it is ALSO the best of times? What if the first resilience training practice is just to acknowledge the good that exists alongside the “bad”.

Here’s a list of how this week was the best of times. 

• I had multiple opportunities for collaboration this week with our physiatrists and neurologist and I learned some new and helpful diagnostic skills. I love learning new things. I love having more ways to better help my patients.

• I had a few patients in follow-up who had profound benefit from the strategies that we initiated last month. It’s so great when people get better!

• We had a new NP join our practice. YAY! Training someone new makes me a better provider. 

• I was able to provide care for about 70 patients. That’s 70 people that I was able to listen to and brainstorm with, so they can have improvements in their lives despite pain. That’s 70 people with families and friends. The work we do has ripple effects.

• Between my very dedicated medical assistant and me, we were able to finally get a drug approved for a patient who will really benefit from it in their overall health.

• I have a great team that I am honored to work with. 

  
  

These ARE the best of times. I am so happy that the work we do has such a positive impact. The first step to building resilience is to bring attention to THIS side of our work. Yes, you may need to make a list. I dare you to do it, write now and text it to yourself. 

It’s easy to dismiss an exercise like this; it seems too simple to work, too minimal. But the way to resilience is a cognitive one; it is learned through repetition of mental exercises. The way we change how we feel is by directing how we think. 

It’s okay to say the week was brutal. That was true for me. But it’s also true that it was meaningful, collaborative, impactful, and growth-filled. Both can exist at the same time.

Resilience begins when we intentionally notice that.

Before you close this app and move on to the next task, ask yourself: What made this week the best of times for you? Write it down. And if you’re willing, share one in the comments. Let’s practice building resilience together.

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If this feels familiar — if the highs are meaningful but the lows are starting to feel heavy — you don’t have to navigate that alone.

Building resilience is a skill, and it’s one we can strengthen together.

If you’re ready for practical tools and personalized support, reach out to learn more about 1:1 coaching. I’d be honored to work with you. Megan@NursingBeyondtheJob.com