Improving Caregiver Resilience

Improving Caregiver Resilience

Medical teams function much like fire departments. The chief, or attending, is counted on to lead her troops straight towards the fire, to do the job that needs to get done. We are expected to be brave, confident, and above all, to never give up.
(Zitter, 2018)

When is it okay to quit on a patient? At what point has the patient suffered enough in spite, or perhaps because of the heroic measures implemented on the patient's behalf? One physician recognized the importance of answering this question, and has changed her approach to training residents.

Dr. Zitter begins with a question about a time the residents ever judged an attending physician for not trying hard enough to save a patient's life. After some uncomfortable silence, and then a prompt from Dr. Zitter's own experience, the residents begin to share their own stories. The process is part of a program developed in the 1990s called the Narrative Medicine movement. It is designed to change the culture in health care, and to aid in enhancing resilience among health care workers. (Zitter, 2018).

Resilience is particularly important in medicine, though it is not unique to this field. Physicians are expected to have all the answers, and the culture is typically arranged in such a way that the physician is not questioned regarding decisions they've made. This fear of contradicting the physician can lead to unsafe behaviors being allowed to continue, or as Dr. Zitter described, may lead to residents questioning (internally) a decision to stop preventative measures that will ultimately fail to save a patient. Whether through the emotional challenges relating to the loss of a patient, or through a fear of blame with a traditional healthcare organizational structure, it is important to express to residents and other care givers in training that there are limits to what they can do, and that they won't always save the day. This will be better both for the students and those they will end up serving.

The psychological effects of failure on caregivers has been increasingly studied in recent years. Storytelling, as described by Dr. Zitter is one way to address this increase in caregiver stress and improve resilience. Additional research is needed to help improve healthcare safety, and to improve the psychological wellbeing of caregivers. High Reliability Organization (HRO) theory, or programs like the Narrative Medicine movement, are among an increasing number of paths to address safety and quality in healthcare. CHNR students, faculty, and affiliates can contribute to these areas of study to contribute to improving healthcare.

As always, if you have a research idea you'd like to run past your collegues, feel free to use the CHNR forum. If you've published an article, or would like to publish an article of interest to the CHNR community, please also share in the forum, or you may contribute a blog post so others may learn from your experience.


Zitter, J. (2018). Help young doctors become more resilient. Harvard Business Review. Retrieved from

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