1. Gould, Kathleen Ahem PhD, MSN, RN

Article Content

Resilience is the capacity of a system, enterprise, or person to maintain its core purpose and integrity in the face of dramatically changed circumstances.


Andrew Zolli


After a year filled with fear, grief, and tragedy, we are moving forward.


The new normal cannot be easily described-ultimately, it will be defined by this transformative time. There is joy, relief, and hope as vaccines bring protection and safety, but we are forever changed.


Lessons from other eras and events such as human immunodeficiency virus, Middle East respiratory syndrome, severe acute respiratory syndrome, H1N1, terrorist attacks on US soil, and the Boston Marathon bombing, have forced us to grow and learn as each threat directed a new level of achievement in care delivery.


New norms such as universal precautions are well established. The quality and safety movement inspired safety checklist and system redesign. Evidence-based practice reshaped care and eliminated long-standing rituals and outdated practices. Throughout many hard-fought experiences in health care, resilience prevailed.


COVID-19 is a unique threat-a global pandemic that exposed every crack in our personal and professional tapestry as it united a global community that was unprepared for its wrath.


A new Swiss Cheese model emerged. The model demonstrates how errors occur and systems are infiltrated. It illustrates how defenses, barriers, and safeguards may be penetrated when a threat appears. As COVID hit, human and system factors collided. Many of our defenses were not intact; our public health system, political forces, supply chains, and knowledge about the virus were lacking. As the population faced many unknowns, nurses and all health care providers ran toward the threat.


Often, we do not know who we are until we are tested; although we staggered at first, we have come through the worst of the pandemic stronger. Improving care requires respecting human abilities by designing processes that recognize human strengths and weaknesses. Innovation, teamwork, and persistence prevailed as providers met this new challenge. Yet, a sense of tremendous loss, compounded by fear and uncertainly, will remain with us. Much of this loss is quantitative-measured by mortalities, COVID case counts, hospitalizations, economic indexes, and, now, vaccination rates. However, much of what we will carry with us is not so visible.


Many predict that we will be wearing surgical masks and goggles in the health care setting for the rest of our careers. We may look back at the pre-COVID era and wonder how we were so lax. Lessons from other eras and events informed us, but new chasms were illuminated during COVID.


Amid much loss and trauma, we move forward toward a new normal.


Take time to consider what you have gained, what you have learned, and how this experience has changed you.