Getting the best out of staff in a district nursing team: nurturing resilience

The NHS as an organisation is struggling to meet the demand for its services within the existing funding arrangements and associated staffing pressures. District nurse services are at the forefront of experiencing the aphorism that, while resources are finite, demand for healthcare is infinite.

Resilience 

Resilience refers to the amount of flexibility in the team—at what point does the team become so over stretched that it cannot maintain a reasonable equilibrium between:

• Capacity – funding and staff availability
• Demand – workload and both clinical and quality standards

If one (or more) of these four variables exerts pressure in excess of what the team can withstand under normal working arrangements, the equilibrium shifts and pushes normal working into the resilience buffer zone (Figure 1). The effect on the team depends on both the intensity of the pressure and the size of the buffer zone, which acts as a shock absorber. If