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Patients, visitors, staff and healthcare providers can find the latest COVID-19 updates here.

COVID-19: Resilience Support Toolkit

People who work in health care are already resilient and resourceful. We do challenging work and are exposed to suffering and loss on a daily basis. During times of crisis our resilience is tested. The pandemic has us all worried about ourselves and our loved ones. It also presents us with the specter of a surge of very sick patients that will challenge our capacity to provide care. This is the time when we most need to be resilient, but because of the disruption to our routines, our workflow and our social connections, our resilience may already feel depleted. But through practice and intention, our resilience can grow, even through times of crisis.

Resilience is like a muscle. The more you work it, the stronger it gets. This Resilience Support Toolkit is meant to help us all strengthen our resilience by working resilience-building practices into our daily routines and workflow, using the framework of PAUSE, RESET, NOURISH or PRN. These practices are based on solid neuroscience and the idea of “neuroplasticity”, that our brains are constantly changing based on how we think and what we choose to focus on. These tools help to calm our nervous system and enhance our focus and well-being.

PRN means “as needed.” The PRN framework reminds us to engage in small practices, numerous times a day, in the flow of our work, to steady ourselves, replenish and stay connected with our team. These practices will complement the other strategies you already use to take care of yourself and manage your stress. They can be used on your own, or with others, including your teams at work.

Please feel free to contact us with comments, questions, ideas and inspirations: resilience@hhsc.ca

The Resilience Support Toolkit

We invite you to listen to the following videos that describe the Framework as well as some of the science that informs the Framework:

Quick Neuro Physiology Facts that Inform the PRN Framework

PRN general framework

The Costs of Caring, the Rewards of Resilience: Creating an Organizational Culture of Compassion and Well-being

Assessing Your Stress Level

In order to build our resilience “muscles” through challenging times it is important to check in with ourselves throughout our days, to notice how we feel and determine how we can best support our resilience in the moment.  Here are a couple of tools you can use to quickly check-in with yourself:

The Window of Tolerance Framework
Mental Health Continuum
COVID- Normal vs. Excessive Stress

PRN Resources

PRN Poster, PRN Name Tag Insert and PRN Small Graphic: These can be printed and posted throughout the unit as reminders to PAUSE, RESET, NOURISH. The small graphic could be attached onto all sanitization dispensers as an example.

HHS PRN Graphic Badge
HHS PRN Details Poster – Letter Size
Mindfulness Audio Practices

Transition Checklist Posters

These checklists can be posted on the unit, in the department, in your car or somewhere at home as a way to transition from home to work and work to home, even when physically working at home.

HHS Checklist – Start-of-Day
HHS Checklist – End-of-Day

Grounding Ourselves through PRN

The following PRN strategies are all designed to help us shift out of a stress response that is either pushing us into overdrive, or causing us to start to shutdown. These strategies both calm our stress response and help us to connect with positivity; they get us grounded. When we are grounded, we are anchored in our bodies, and we are present and focused. We are less impacted by the stress around us because we are rooted in our individual and collective sense of purpose. In the Working Mind model of mental health, this is called being in “the green zone.” These grounding practices use a variety of strategies, for example by shifting our thinking, connecting to and releasing tension in the body, connecting to others or our sense of meaning, and expressing gratitude and compassion.

Grounding-Worksheet

PRN Body Strategies

Our stress response is integrated throughout the body and is therefore the body is a good barometer for our stress level. We only need to pause, notice and then engage in a body- based strategy to help use feel a little more grounded and centered. By using body-based grounding strategies we can regulate the nervous system to bring us closer into a steady state (or the “green zone”). links to all body strategies below:

PRN Diaphragmatic Breathing
PRN 4, 7, 8 Breathing
PRN 54321 short
PRN 54321 standard version
PRN balancing the nervous system
PRN feet on the floor
PRN TIPP Skill
PRN PLEASE Focus on the Basics

PRN Connection Strategies

The research overwhelmingly indicates that the number one mitigating factor for workplace stress is the support of our team. Research also shows that a sense of meaning and purpose is protective. Cultivating gratitude and compassion for self and others have also been shown to rewire the negativity bias and reduce one’s experience of stress. The following strategies will help build connection to each other, ourselves and what is truly important in our lives.

PRN OMDP
PRN collective grounding
PRN connecting to calm
PRN pro social distancing
PRN Self-appreciation
PRN self compassion break
PRN resourcing
Compassion vs Empathy
PRN Grief
PRN Activate to Motivate

PRN Mind Strategies

Our ability to think is a powerful thing that can help us to do many wonderful things. But it can also amplify our stress level when we get caught in the negativity bias and rumination. Shifting our thoughts away from excessive worry and negativity helps us to establish a mindset of “realistic optimism”. This means that we don’t get stuck thinking only about what is wrong or the scary things that might happen. Nor do we retreat to “Pollyanna” thinking by being overly optimistic or denying the reality of the challenges we are facing. These PRN Mind Strategies help us to find a balance by keeping us anchored in the reality that times are tough, but not everything is bad. They help us to focus on what is in our control, and the steps we can take to support ourselves and others. The following sailing analogy helps to illustrate:

The pessimist worries about the wind.
The optimist hopes it will change.
The realist changes the sails.

PRN Limiting Negative Inputs
PRN Managing Thoughts
PRN power of visualization
PRN Switching Focus
PRN Resiliency Slogan

Physician Resources

Health care work is challenging work. We know that those who work in health care are resourceful and resilient yet during times of crisis and uncertainty everyone’s coping is challenged including those of physicians. Physicians also have unique pressures due to the very nature of their roles in treating patients as part of the health care team. Please find below some resources directed to physicians but anyone on the health care team may find these helpful.

Pacing Ourselves in a Pandemic
Resilience and Stress Inoculation during COVID-19
Supporting Physicians during COVID
Women Physician’s Drop In Support Group

Family Resources

This has been a period of stress and uncertainty for families. All the unknowns, interruptions in routines, activities, and education, has made this time very difficult. Here are a variety of resources to support families during the pandemic and beyond.

Fun in the Sun
Taking Care Of Yourself
Resilience Building
Positive Parenting
Parenting Video Resources: #caringthroughcovid
Listen Tips Child
Assisting Children with the COVID Pandemic