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Resilience in the Face of Adversity: Experiences of Brainkind Support Staff During COVID-19

By Abbey Coleman, Rehabilitation Support Worker at Brainkind, and University of Liverpool Psychology graduate. 

Resilience-in-the-Face-of-Adversity-The-Experiences-of-Brainkind-Support-Staff-During-the-COVID-19-Pandemic.

During the COVID-19 lockdown, when the nation stood still and the majority of the labour force was either furloughed or working from home, Brainkind’s dedicated support staff continued to provide a service for the people we support.

This was indeed an unprecedented and turbulent time for both staff and the people we support alike. Aside from the physical health risk of contracting the virus, the COVID-19 pandemic has been linked with poor staff mental health in residential support settings [1, 2], and support staff working within such settings found themselves facing new challenges, such as having to adopt new roles to compensate for losses in external sources of social engagement and entertainment [3]. Despite this, studies have shown that many keyworkers were able to ‘bounce back’ and overcome these challenges – a process known as resilience [4]. 

What is resilience?

Resilience is the process where an individual can adapt to, and overcome, adversities they face, with positive outcomes. Some researchers argue that resilience is a trait or a personal characteristic that is possessed by certain individuals to varying degrees [5]. However, ecological models of resilience have been developed and tested [6] and these suggest that instead, an individual’s resilience can be facilitated or hindered both by personal characteristics and factors within their local and wider societal environment. The benefit of resilience for health and social care staff cannot be overstated, as it has been linked with lower staff turnover [7] and improved mental health [8]. It is, therefore, important to investigate and identify resources that could be used to facilitate resilience. Whilst resilience has been investigated in the context of COVID-19 in various health and social care staff populations, to our best knowledge the present study was the first to do this in a population of rehabilitation support staff. Investigating resilience specifically in this population is important as, due to the often-complex support needs of people living with brain injuries, rehabilitation support staff must possess a variety of specialist skills that are not always required for other areas of support work; therefore, this population may have a unique perspective on working throughout the pandemic period and have had access to different resources to facilitate resilience.  

The current study

We wanted to investigate the specific challenges faced by rehabilitation support staff whilst working throughout the COVID-19 pandemic, and the extent to which factors within the individuals themselves, their local community and wider societal environment, facilitated or hindered resilience. We recruited seven participants from various Brainkind services and interviewed them about their experiences of working throughout the pandemic as well as what, if anything, helped them overcome any challenges. We used a qualitative approach called Constructivist Grounded Theory [9] to analyse and identify key and re-occurring themes within the data. This approach aims to generate new theories from data rather than test existing ones. 

What did we find?

In their interviews, participants spoke about experiencing specific challenges associated with supporting individuals who experience cognitive or memory difficulties, such as finding it hard to explain the restrictions the people they supported were facing. Yet participants still demonstrated remarkable resilience by drawing upon resources within themselves and their environment. For example, on an individual level, participants spoke about how having the ability to actively take steps to cope with stressors, such as reframing situations more positively, was beneficial for them remaining resilient.  

Within participants’ local community, a major source of resilience was having access to social support from friends, family and colleagues. The support received from colleagues appeared to be particularly beneficial as there was a sense of ‘all being in it together’ with many participants reporting that their staff team grew closer and stronger during the pandemic period. However, within the societal level, participants identified gaps in resilience resources available to them, where they felt opportunities to facilitate resilience were missed. For example, participants spoke about their perceived lack of value within society and how public efforts of appreciation, albeit well intended, felt superficial to some, and therefore could hinder rather than facilitate resilience.

There was also emphasis on the importance of having support from the organisation and participants identified gaps, such as the absence of hands-on support from managerial staff due to furlough policies, where support could have been improved and therefore have facilitated resilience. Additionally, due to increased staff absences and shortages during the pandemic, participants reported working with agency staff with increased frequency, and spoke about the difficulties and challenges that working with unfamiliar colleagues brought. These included having to either train new agency staff or to take on most of the shift’s duties.

Participants suggested that they would prefer to work with agency staff who were hired regularly by their service and for each new agency staff to receive a full induction prior to starting. This could be a good system for services to incorporate when using agencies to hire temporary support staff, however due to the need to often hire agency staff on urgent or short notice, this understandably might not always be possible.  

Conclusion

The findings of our study are in support of an ecological model of resilience, as a number of factors were identified that influence resilience, not just within the rehabilitation support staff themselves, but also their environment. Whilst our results may only be able to offer a snapshot into the experience of resilience in rehabilitation support staff due to the limited number of participants, our findings can hopefully pave the way for future studies investigating resilience in rehabilitation support staff.  

On a personal level, both the process of conducting this study and our findings have allowed me to reflect on my own experience as a support worker within Brainkind, and listening to the experiences of others has inspired me to take steps to improve my own resilience in my work.

However, as the results of the current and previous studies have suggested, the responsibility to improve resilience does not solely fall upon an individual, but instead there are steps that employers, government policy makers, and society can take to promote resilience in support staff.

Finding new ways to help the support staff of organisations like Brainkind foster resilience could be hugely beneficial, not only by potentially reducing staff turnover and improving employee wellbeing, but also by indirectly improving the quality of support received by the people served. 

References

  1. Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Zhao, J., Wu, J., Du, H., Chen, T., Yang, J., Tan, H., Kang, L., Yao, L., Huang, M., Wang, H., Wang, G., Liu, Z., & Hu, S. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Network Open, 3(3), e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976 
  2. Vanhaecht, K., Seys, D., Bruyneel, L., Cox, B., Kaesemans, G., Cloet, M., Van Den Broeck, K., Cools, O., De Witte, A., Lowet, K., Hellings, J., Bilsen, J., Lemmens, G., & Claes, S. (2021). COVID-19 is having a destructive impact on health-care workers’ mental well-being. International Journal for Quality in Health Care, 33(1). https://doi.org/10.1093/intqhc/mzaa158 
  3. Hanna, K., Giebel, C., Cannon, J., Shenton, J., Mason, S., Tetlow, H., Marlow, P., Rajagopal, M., & Gabbay, M. (2022). Working in a care home during the COVID-19 pandemic: How has the pandemic changed working practices? A qualitative study. BMC Geriatrics, 22(1). https://doi.org/10.1186/s12877-022-02822-0 
  4. Donnellan, W., Hirons, A., Clarke, K., Muinos, C., & McCabe, L. (2022). Exploring resilience in UK-based domiciliary care workers before and during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 19(23), 16128. https://doi.org/10.3390/ijerph192316128 
  5. Fletcher, D., & Sarkar, M. (2013). Psychological resilience. European Psychologist, 18(1), 12–23. https://doi.org/10.1027/1016-9040/a000124 
  6. Windle, G., & Bennett, K. M. (2012). Caring relationships: How to promote resilience in challenging times. In M. Ungar (Ed.), The Social Ecology of Resilience: A Handbook of Theory and Practice (pp. 219–231). Springer Science + Business Media. https://doi.org/10.1007/978-1-4614-0586-3_18 
  7. Johnston, L., Malcolm, C., Rambabu, L., Hockley, J., & Witham, M. D. (2020). Supporting the resilience and retention of frontline care workers in care homes for older people: A scoping review and thematic synthesis. MedRxiv, 2020-09. https://doi.org/10.1101/2020.09.05.20188847 
  8. Labrague, L. J. (2021). Psychological resilience, coping behaviours and social support among health care workers during the COVID19 pandemic: A systematic review of quantitative studies. Journal of Nursing Management, 29(7), 1893–1905. https://doi.org/10.1111/jonm.13336. 
  9. Charmaz, K. (2003). Grounded theory: objectivist and constructivist methods. In N. K. Denzin & Y. S. Lincoln, Strategies of Qualitative Inquiry (2nd ed., pp. 249–291). Sage. 
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