Clinician burnout from chronic job stress is widespread. Research continues to show that nurses experience high rates of depression and anxiety, and a much publicized 2019 analysis in the Archives of Psychiatric Nursing by Davidson and colleagues found that suicides were significantly higher among nurses than in the general population. Organizations have responded to this epidemic of burnout by providing wellness programs and resilience training, including counseling and stress-reduction exercises. But such interventions focus on individuals, neglecting to address the broader context and failing to acknowledge the shared nature of burnout among clinicians in an institution or profession. The National Academy of Medicine and the American Academy of Nursing, along with other professional organizations, have urged more methodologically robust studies and dedicated funding to help foster the well-being of clinicians. However, the profession cannot wait the years it could take to translate research into practice.
The term vicarious resilience, first used by Hernandez and colleagues in 2007, describes the growth that helping professionals experience through witnessing the experiences and triumphs of victims under adverse circumstances. This strength-focused concept originated with therapists helping trauma victims, yet it also applies to nurses, who often learn about the traumas of patients while cultivating relationships with them and their families.
By extension, the concept may have some application to the ongoing process of witnessing the suffering and resilience of colleagues under highly stressful conditions. Nursing is deeply rooted in human connections, characterized by empathic concern for and an intuitive awareness of the emotions of one's colleagues. Connection with colleagues is an especially salient area of exploration when speaking of resilience and burnout-a 2005 study by Bakker and colleagues in the Journal of Advanced Nursing found that burnout complaints among coworkers were the most important and significant predictor of burnout among critical care nurses at the individual and unit levels. With this in mind, ways to address burnout should include fostering the shared emotions of and relationships among the nursing team.
Recognizing the ways in which nurses already develop vicarious resilience is an important and necessary approach. Today's nurses face ever-increasing professional demands owing to systemic changes in health care, rapidly changing technologies, and increasingly complex care, but they are also more isolated than their predecessors because of electronic documentation demands and decentralized nursing stations. Initiatives to promote teamwork, facilitating vicarious resilience among colleagues, and recognizing the ways resilience is already being supported are therefore more important than ever. Debriefing sessions, for example, could afford nurses the opportunity to bond with and learn from one another. So, too, could sharing stories-a more creative manner of debriefing-to increase solidarity and affective ties, allowing colleagues to reflect on their surroundings and draw strength from acknowledging mutual experiences.
Vicarious resilience does not ignore the important phenomenon of compassion fatigue or burnout; instead, it offers a counterbalance, a positive resource to be attended to and nurtured. Whether we speak of encouraging vicarious resilience or team-building activities, these initiatives alone cannot replace the organizational efforts needed to improve nursing work environments, such as support for staffing ratios. Nurses already foster resilience through external support structures and relationships. The thrust of resilience, the strength that drives and protects us as individuals, is one's internal power and responsibility; nonetheless, the cultivation of resilience is a collective, mutual, and inherently other-regarding endeavor-which nursing itself embodies.