Healthcare workers can experience high rates of depression, anxiety, insomnia, and distress from the hardships of their profession. Having attributes such as resilience, fortitude, and perseverance during this time can allow them to bounce back rather than becoming burnt out. This fact leads us to the question, what are resilience, fortitude, and perseverance, and are they the same?
Resilience, fortitude, and perseverance have different meanings, but they are similar in that each contributes to completing something no matter what the challenges. Having at least one of these traits is great, but having all three combined means you can handle life’s challenges exceptionally well.
This article defines each of these terms, provides examples of having these traits, and shows how resilience, fortitude, and perseverance are different but related and complementary. Read on to also understand more about how each of these attributes plays an important role in helping healthcare workers do work that is emotionally, mentally, and physically challenging.
Defining Resilience, Fortitude, and Perseverance
There are numerous discussions around how the terms resilience, fortitude, and perseverance are defined and related.
Let’s start with the following basic definitions of each one:
- Resilience is recovering and moving on after dealing with difficult events quickly
- Fortitude is finding the strength to meet adversity with courage
- Perseverance is continuing a course of action no matter what— including failure or opposition
Now that we know the definitions of each term, let’s dive deeper into what each one entails.
Resilience has been defined as the ability to bounce back after something difficult or bad has happened. Resilient people are better able to withstand and adjust to an event that is challenging as well as recover more quickly than others who don’t have this trait.
In addition to holding up better under stressful situations, these individuals adapt to and recover from reoccurring adversity and stress, as stated by The Resiliency Solution. As a group, resilient people have “behaviors, actions, and thoughts” that continue to promote a sense of well-being and a healthy outlook on life.
There are three different types of resilience:
- Inherent resilience is the natural protective mechanism that helps us as we first explore the world as a child.
- Adapted resilience is acquired whenever surviving a challenging situation results in increased self-confidence gained from the fact we made it through (i.e., a person losing their job and finding that event leads to a better job).
- Learned resilience is built up over time. Successfully coping with multiple challenging situations gives us a reserve of resilience to draw upon in difficult times.
Resilient people take care of themselves to be able to help others. This has been a tremendous challenge during COVID-19— even the most experienced and resilient health care workers have experienced burnout. But in general, resilient people can manage to push ahead, overcoming almost insurmountable challenges to find ways to stay engaged in helping others.
This is where being part of a team and feeling supported is critical. Some suggestions from experts include being sure everyone on the team feels secure in asking for help and facing fear with support.
Also, teaching people how to reframe circumstances to try and find the positive, even a little bit at a time, can help. These actions can help people find emotional resilience by understanding one’s own emotional reactions and learning to accept and guide their emotions rather than having their emotions control them.
Fortitude has been defined as having the strength and having the courage to deal with danger, misfortune, or pain. Think of a runner who finishes the race regardless of excruciating pain.
Fortitude is often equated with courage— remembering that true courage doesn’t mean fearlessness. Those with courage recognize danger and feel fear, but act anyway.
St. Thomas Aquinas considered fortitude as being composed of:
- Aggression: In the sense of taking risks for the greater good, this type of aggression includes confidence and “magnificence” in the sense of a noble cause.
- Endurance: Standing firm in the face of danger, remaining resolute in spite of fear. The attributes of patience include voluntary and prolonged endurance and perseverance.
- Magnanimity: Striving to be the best you can be, regardless of what you choose. In other words, holding firm to the intention of doing great deeds.
Note that each of these components plays into what makes healthcare a fulfilling and incredibly challenging avocation. Now that we’ve read about fortitude, let’s move on to perseverance.
Perseverance has been defined as never giving up. Think of a writer who continues to send query letters, despite being rejected, until one day, after sending the 100th one, that writer secures an agent and a book contract.
If you have perseverance, you will continue to try and do or achieve something no matter how many times you fail or have to deal with difficult circumstances.
Perseverance is sometimes noted as“grit”— the passion to achieve long-term goals no matter who says you can’t and regardless of adverse circumstances. Perseverance is the determination to make it to that goal line, no matter how difficult it is or how long it may take.
Comparing Resilience, Fortitude, and Perseverance
Now that you know more about resilience, fortitude, and perseverance, let’s take a look at how these attributes are both complementary and different.
Fortitude vs. Resilience
Fortitude and resilience are different, but similar at the same time.
According to Wiki Diff the difference between fortitude and resilience is that “fortitude is the mental or emotional strength that enables you to find courage in the face of adversity, while resilience is the mental ability to recover quickly from depression, illness or misfortune.”
A stressful situation can cause many people to reach deep within to try and find the fortitude to carry on with their lives instead of halting their progress. For example, the COVID-19 pandemic has caused the vast majority of healthcare workers to reach deep to find the courage, or fortitude, to keep going in the face of almost unbearable circumstances.
After 2020, almost all healthcare workers have shown examples of fortitude perhaps best described by the Finnish word “sisu.” This word means ‘the extraordinary courage and determination that can surface in times of extreme hardship,’ and its definition relates to fortitude in that sense.
“Sisu” also illustrates the ability to tap inner sources of strength and move beyond what we think we are capable of physically, mentally, and emotionally. As this happens, day by day, it’s possible to become increasingly resilient in the face of even the most daunting circumstances— like working day in and day out in a COVID-19 critical care unit.
A recent article by Nursing Outlook adds the following five care team principles to mitigate fear, stress, and burnout by developing resilience while using fortitude and courage when working through hard times:
- Good communication ensures care team members understand and respect each other. This is also essential to ensure coordinated and successful treatment.
- Collaboration is essential and, again, respectful— traditional medical hierarchy must give way to a team approach, bringing everyone’s respective knowledge and experience together.
- Listening to each other is key to rapid adjustments in care.
- Catch and address developing problems as much as possible— albeit difficult in a pandemic critical care environment.
We now know the differences between fortitude and resilience, and that these two attributes can work together to prevent burnout. Now, let’s look at the differences and similarities between resilience and perseverance.
Resilience vs. Perseverance
Resilience and perseverance are different but similar at the same time.
According to Wiki Diff, “resilience is the mental ability to recover quickly from depression, illness, or misfortune, while perseverance is when you continue in a course of action without regard to discouragement, opposition, or your previous failures.”
Perseverance has been equated with “grit” and, when paired with resilience, these traits are important predictors of success in healthcare professionals.
“Grit” is known as “perseverance with passion for a long-term goal is a necessity for getting through medical training. As is resilience— healthcare workers face unexpected outcomes and death daily. Being resilient and continuing despite risks defines healthcare professionals today.
The National Center for Biotechnology (NCBI) notes that “Non-cognitive traits, defined as those skills associated with motivation, attitude, and temperament rather than intellect, are increasingly recognized as important skills to identify and develop in medical professionals.”
Grit and perseverance are included in these non-cognitive traits. The NCBI article continues by noting that both of these are of increasing interest in healthcare literature. Resilience has been recognized to predict well-being, while grit is associated with both academic and professional success despite one’s intelligence.
Fortitude vs. Perseverance
Fortitude and perseverance are different but similar at the same time.
According to Wiki Diff, the difference between fortitude and perseverance is, “Fortitude is the mental or emotional strength that enables courage in the face of adversity, while perseverance is the continuation in a course of action without regard to discouragement, opposition or previous failure.”
In the book Everybody Matters by Bob Chapman, the script mentions the quality of “courageous patience.” This term is an excellent characterization of how fortitude and perseverance work together to accomplish a goal. Especially in the healthcare setting – holding an end goal of patient improvement while maintaining fortitude despite setbacks.
Here’s a quick look at how resilience, fortitude, and perseverance can work together:
- Resilience and fortitude: Courage to continue, with quick recovery from setbacks
- Perseverance and resilience: Determination to complete the task, recovering quickly from setbacks
- Fortitude and perseverance: Courage and emotional strength to continue and complete the task no matter what
In the following section, we’ll take a deeper dive into the role of resilience in healthcare work. Because not only do fortitude and perseverance play into the ability to be resilient, the topic of resilience in health professionals has received great attention during the pandemic.
Healthcare Worker Burnout
The COVID-19 pandemic continues to significantly stress healthcare workers to a greater extent than many have ever experienced.
Feelings of being overwhelmed and powerless bring healthcare workers’ levels of frustration and anxiety beyond what is normally encountered. All of this can lead to burnout, causing many to leave a profession they once felt was their calling.
A recent survey from the organization Mental Health America showed the following statistics of what emotions were felt during working from a sample of 1119 healthcare workers:
- Stress: 93%
- Anxiety: 86%
- Frustration: 77%
- Exhaustion: 76%
- Overwhelmed: 75%
These emotions can all contribute to burnout, at which 54% of the healthcare workers who participated in this study were experiencing burnout.
The overall result was that almost half of respondents had considered quitting their job. How can resilience, fortitude, and perseverance change all of this? To better understand the role of these attributes in healthcare professionals, we need to first define and then explore how these three things are interrelated and important as applied to healthcare.
Healthcare Workers and Resilience
Some people are much more resilient than others. In general, people fall into one of three groups:
- Low resilience: Those who completely fall apart after stressful events, to the point of deep depression.
- Medium resilience: Those who have challenges coping, but do bounce back after trauma.
- High resilience: People who grow even stronger because of adversity and bounce back stronger with a deeper understanding.
A New York Times article notes that individual differences in resilience come from a combination of “genetics, personal history, environment, and situational context.” How much an individual felt loved as a child is the biggest predictor of how well an individual can cope with trauma. But, factors such as situational context are especially pertinent to healthcare workers.
Understanding the roots of resilience and helping healthcare workers learn how to be more resilient has become even more critical during the COVID-19 pandemic. Healthcare professionals focus on the well-being of their patients, often to the detriment of their own self-care. These workers should also feel as if their well-being matters.
Nurses are at a particularly high risk of burnout because they truly are frontline, with enormous demands on how quickly they work to treat patients, and they are most often the caregiver present during a patient’s struggles— particularly with COVID-19. Having resilience is important for this profession so you can bounce back despite these demands.
Doctors also need to cultivate resilience. They too are facing constant exposure to patient illness and death. Doctors must cope with the constant pressure of making the best decision, which can often involve ethical and moral challenges as well as technical.
Fortunately and to a great extent, resilience is a learned skill that can be acquired by healthcare workers.
Resilience Can Be Acquired
It’s clear that during stressful periods, being resilient can help protect against adverse effects of stress. Knowing how resilience can be acquired over time, there are some ways suggested by experts to work on building resilience in a proactive way.
Changing something about your lifestyle by doing any of the following can help promote resilience:
- Let go of people who drain your energy and reach out to new friends.
- Try new experiences to find fun in something different.
- Be physically active and seek out mental stimulation to experience the feeling of accomplishment and confidence that comes from completing something new.
- Be gentle on yourself, there is truth to the sayings around realizing the difference and being at peace with what you can and cannot change.
The Resiliency Solution has developed resiliency programs to help healthcare professionals better cope with job stresses and develop resilience.
What they recommend is equally applicable to anyone wanting to develop more capacity for resilience:
- Talk to your coworkers to find support and gain other perspectives
- Take time to process your feelings
- Practice acceptance
- Apply an optimistic point of view to difficulties
- Laugh as much as you can
- Enjoy your spare time
- Focus on being flexible.
- Give yourself some treats from time to time
- Get a good night’s sleep
Now that you know how healthcare workers use resilience in their field of work and some ways you can develop resilience if yours is low, let’s move onto healthcare workers using resilience, fortitude, and perseverance combined to be stronger.
Healthcare Workers, Resilience, Fortitude, and Perseverance
Healthcare professionals are one of the best examples of how individuals can move forward with determination and courage, pursue a goal no matter what the obstacles, and come back stronger on a demanding and difficult journey.
The following are traits of highly resilient healthcare workers, who also embody fortitude and perseverance:
- Dwells on the positive, looking for solutions even in seemingly hopeless situations
- Have a solid sense of what is right and wrong
- Believe in something greater than themselves
- Are altruistic
- Accept what they can change and focus energy on what they can
- Commitment to a mission promotes courage and strength
- Have a good social support system, from their family to their healthcare team
You have learned everything there is to know about resilience, fortitude, and perseverance, including how it can help prevent healthcare workers from experiencing burnout.
Resilience, Fortitude, and Perseverance – A Powerful Team
This article has explained how resilience, fortitude, and perseverance may be different attributes, but each one can work together as a powerful team to sustain effort regardless of challenges and bounce back even after adversity. Healthcare workers are an example that epitomize what it means for resilience, fortitude, and perseverance to work together.
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