I recently read in an online forum that resilience is out of favour, especially in the health sector. Apparently, suggesting one should be resilient is saying we should ‘suck it up’ and get on with it, and this is not the way that things should be done in this day and age.
As remote and rural health practitioners and consumers, we need to take back this negative association with resilience, and instead make it a positive, and important characteristic that we encourage in anyone who wants to work outside of a major metropolitan area. We need to make resilience sexy.
I’m picturing a wide stance, hands on the hips, black tights and a cape, maybe a big R on the chest…
Resilience is defined as the ability to adapt successfully in the face of adversity. It’s a required characteristic in the long-term rural and remote setting. This isn’t just because of all the bad things that can happen, but because when these things do happen we often don’t have the resources to share the load. Remote and rural health practitioners need this adaptation to adversity to maintain their own mental health, so they can continue to provide excellent care to their patients.
Perhaps one of the reasons we can’t attract health practitioners to commit long-term to some of the more remote parts of the country is because we don’t encourage and teach resilience. Maybe the reason that remote/rural origin is a predictor for remote/rural practice is because they already know about being resilient.
If I could have my time over, I’d be wanting a survival course. Of course, if I’d been offered a survival course as a junior registrar, I would have said “well I don’t need that” because before you start out, you just assume you’ll be awesome and that’s the end of it. Experience now tells me we don’t know when we need to turn on our resilience switch until it’s too late. It helps to have resilient people around you, who might be able to help you develop your resilience and give you a nudge to turn your switch on.
So, how do we make our future workforce more resilient? There are no amazing new concepts on offer, but we can tweak what we already do.
The obvious solution is contextual learning – teach and train the future rural and remote doctors and other health practitioners where you want them to end up.
Select for purpose – we need to select more from those living in remote areas. We should be identifying health interested students early and providing educational support for them in their own schools and communities to maintain their interest.
Provide supported and supportive role models – ensure that teachers and supervisors of students and registrars are fit for purpose.
Foster the team-based approach – a problem shared is a problem halved – most remote practitioners work in a multidisciplinary environment; our students should learn in that environment from early on.
Finally, it’s much easier to do our job when we feel appreciated and supported. This applies to all the teams that we work in: in our own clinics with our direct professional colleagues, and multidisciplinary partnerships within our primary care teams; in our remote and rural communities with our hospital generalist colleagues; and, finally, within our wider health community with our non-primary care specialists in the tertiary hospitals.
A bit of professional respect for the work that we do goes a long way.
Sarah Chalmers is Fellow and Council member of the Australian College of Rural and Remote Medicine. As a remote GP based in East Arnhem Land, she works in hospital and general practice settings as well as in remote Indigenous communities and Homelands. She is a Senior Lecturer in Remote Medicine with Flinders University's NT Medical Program and manages the campus in Nhulunbuy. Sarah supervises medical students and GP Registrars and is currently a Supervision Liaison Officer with NTGPE.
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