The impact of expectations on resilience

Abstract

Introduction: Resilience is the capability of a system or individual to absorb changes and disturbances in the environment and maintain function. It includes the ability to deal with stress, rise to the occasion and make the best of things. Understanding the effects of expectations on individual and team resilience allows reframing of expectations and improvement in the resilience and team performance. Objectives/Aims: To identify the level of unrealistic expectations of clinicians in healthcare. To provide strategies for individuals and organisations to improve the individual and team resilience. Methods: Literature Review. Results: Resilience can be improved by creating a healthy work-life balance, accepting change, moving towards goals and having realistic and hopeful expectations about circumstances. Critical care clinicians demonstrate wisdom in complex pathophysiology and best practice but are often unrealistic about patient outcomes, resources, learning and people. Unrealistic expectations have been described as premeditated resentments. Clinicians become frustrated and despondent when expectations are not met. The way clinicians train with simulation focusing on rare and high-risk scenarios increases skill in those situations but widens the gap between expectations and reality of the actual event frequency and reasonable outcomes. Learners in critical care anticipate easy answers and expect learning to come through teaching, when most learning comes through experience and hard work. Critical care clinicians expect to be well resourced but are often unrealistic about what is practical and equitable in an ever-constrained healthcare environment. Conclusion: Educators need to ensure they are not perpetuating a Grey’s Anatomy effect by reinforcing unrealistic expectations of clinicians. When clinicians align expectations closer to reality, recognising the positives in their work and by bringing teams with them, the resilience of individuals and their teams may be improved, reducing staff turnover and improving patient care.