We are frequently encouraged in the rural and remote workforce to “build resilience”, or “be more resilient”, or even told “you’ll get used to it”, particularly when we are struggling with something. Resilience is often regarded by some as a personal virtue and is considered entirely within an individual’s control. At times, it almost seems to be a professional requirement, or even a moral obligation, for a rural or remote job.
Resilience is the ability to adapt to, recover from, or withstand adversity. Most crucially, resilience should be viewed as contextual, variable, and finite. Whilst resilience is a useful concept when talking about exposure to adverse events, the idea that the health workforce should be constantly resilient is both unrealistic and potentially harmful. The pressure to maintain this perpetual resilience can hide systemic problems, silence distress, and contribute to moral injury, burnout, and workforce attrition.
No individual can remain resilient under the often-unrelenting stressful situations we work in without adequate support, resources, and recovery. The expectation of constant resilience ignores the fundamental workings of the human nervous system, emotional processing, and the effects of cumulative stress. Health workers start to minimise or ignore their signs of distress and feel that the struggle they are experiencing is a sign of personal failure; they start pathologising and internalising normal reactions to chronic stress, such as fatigue, frustration, and cynicism. People are also less likely to seek support or supervision due to the pressure from their organisation, agency, or colleagues to appear resilient. When health workers are unable to provide the care they know is needed due to sustained exposure to high demand and insufficient resources, they may experience moral injury, especially when they feel they must endure these conditions rather than believe they can change them. Over time, the cost of the expectation of constant resilience contributes to high turnover, and, as we are hearing more and more often, people are leaving the rural and remote health workforce (if not the health profession) altogether.
Moving beyond the myth of constant resilience requires both individual and systemic shifts. Below are some strategies that can support these shifts.
Reframe resilience as responsive, not constant. The idea that we need to constantly endure stressors needs to stop now. Resilience needs to be understood as the capacity to respond to stress with adequate support and recovery. Periods of reduced capacity should not be viewed as failures, but normal and expected human responses to abnormal events.
Normalise struggle in demanding contexts. When we raise concerns, how often do we hear responses like “that’s just the way it is out here”? Acknowledge that rural and remote work is inherently challenging, and that distress is often a sign of unmet needs, not the inability of an individual to cope.
Prioritise collective and organisational responsibility. You can do all the mindful breathing and yoga to help yourself; however, wellbeing is co-created. Sustainable rural and remote work requires leadership and organisations to adopt sustainable practices such as role clarity, setting reasonable workloads, ensuring adequate leave, backfilling when someone takes leave, providing access to supervision and professional support, and fostering psychologically safe cultures and supportive leadership.
Emphasise recovery, not just coping. Essential components of sustainable functioning include time away from work, connection, genuine rest, and finding meaning outside of the health worker role. Recovery is not a luxury, so make it a priority.
Foster connection and peer support. Resilience is strongly linked to connection, so look for opportunities to incorporate this. It could be structured peer consultation, online communities of practice, or opportunities to debrief, all of which reduce isolation and share the emotional load of complex work. The Bush Support Line is also always here 24/7 if you don’t feel comfortable sharing within your workplace.
Advocate for systemic change. Rural and remote health workers are not only service providers, but also stakeholders. Advocate for such things as investment in the rural and remote workforce, realistic service models, and ethical working conditions and practices. Consider becoming a member of CRANAplus as your membership strengthens a national advocacy voice working to improve the safety, wellbeing, and sustainability of the rural and remote health workforce.
People in the rural and remote health workforce do not need to be told they need to be more resilient to cope with constant stressors; they need environments that enable resilience. Resilience is not about enduring the unbearable but responding humanely to challenges together. We need to move away from the expectation of constant resilience and towards models that value support, shared responsibility, and sustainability. Only when we create conditions that support our rural and remote workforce can both workers, and the communities they work in, truly thrive.
Be kind,
Dr Nicole Jeffery-Dawes
Senior Psychologist, Bush Support Line
