Jacqui Gingras, PhD, RDRyerson University

Jennifer Atkins, BASc, MHSc (Candidate)University of Toronto

IntroductionIntroduction

Little is known about how

• Dietitians experience workplace stress

• Personal experiences and backgrounds shape practice

• Dietitians strive to cultivate resilience in their careers

Background

Science-based vs. experiential types of knowledge (Liquori, 2001)

Professionalization – dietitian identity constituted through professional discourse (Butler, 1999)

Isolation & suppression of emotions (DeVault, 1999)

Reality of practice vs. expectations and melancholia/loss/grieving (Gingras, 2009)

Methods

Auto/Ethnographic

Reflexive, artistic, experiential

Six female dietitian participants

Three, four-hour sessions of narrative exploration on The Resiliency Map

The Resiliency Map

16’ x 16’ fabric map

• Shared Values

• Motivation & Commitment

Self

Emotions & Relational

Community & Social Networks

Socio-political & Marginalization

Findings

Themes• Disconnection

• Workplace Conflict

• Relational Resiliency

Subthemes• Gender

• Emotionality

• Burnout

Disconnection

Disembodiment • [You’re] always trying to, trying to, to, to bend and be,

you know the way you’re supposed to be (Emily)

• There’s a lot [of]… expectations… about body size. [It’s] just feeling kind of exposed all the time and having lots of comments about my size…” (Kathy)

Family• I’m teaching people what to do with their babies and

how to be with their kids and everything and my kids are being totally ignored… I’m feeling really guilty (Heather)

Moral Strain• It seems like we don’t all agree on what contributes to

health… you know what’s actually important (Pamela).

Workplace Conflict

Inter-professional• Clinical hierarchies (Kelly, 2006) &

Dietetics as a profession unknown

Intra-professional• I …moved from the hospital into the

community…. .which is not as respected, absolutely not as respected You know being told, “it won’t be as challenging but that’s nice work out there in community’. (Kathy)

• When you’re working on a project… and one [dietitian, with a Master’s degree] is paid more and what they say is respected … the imbalance… erodes your sense of worth…it’s very demeaning. (Dawn)

Workplace Conflict

Emotionality

• “Women, more than men, are reluctant to engaged in conflict as they feel they may be dismissed as ‘emotional women’” (Kelly, 2004, p.24).

• “People who make it into positions of power don’t show their emotions, they don’t get emotional”. (Pamela)

• “The social negotiation of position, authority and status is very much an emotional and sometimes passionate process” (Fineman & Sturdy, 1999, p. 659)

Relational Resiliency

No Longer Alone

• “I always think “it’s just me”, and really, being, talking to this group I think “maybe it’s not just me”. (Pamela)

Reconnecting

• “It comes back to this (moves to “shared values” on the map) shared values as well for me … the connections with other people are what keeps me here”. (Emily)

Relational Resiliency

Realizing Resiliency

• “Flying under the radar” (Heather)

• Research, education, creativity, teaching, mentoring, always trying something new

Speaking truth to power

• “Some of those things that we’ve talked about I haven’t spoken as openly about before, and then once you have, you start, then, it becomes like a truth”. (Kathy)

Discussion

Maslach’s Burnout Inventory (MBI) begins with Emotional Exhaustion

Cornerstone five points of resiliency (Denz-Penhey, & Murdoch, 2008)

• Social support networks

• Family

• Experiential inner wisdom

• Physical environment

• Psychological self

Implications for Practice

Resilience can be learned (Waite, & Richardson, 2004)

Given reports of isolation in dietetics, relational resilience is especially relevant

Further research warranted

Acknowledge the unique challenges and discourses that constitute dietetic work

Acknowledgements and Thanks

Our participants Collaborators at Fife House for their

expertise and meeting spaces AIDS Bereavement Project of Ontario for

sharing their Resiliency Map Cindy Weeds for her community

development skills and Anna Demetrakopoulus for facilitation of The Resiliency Map process

Funding was provided by the Office of Research Services and the Faculty of Community Services (Ryerson University)

References

Adams, L. T. Inter-professional conflict and professionalization: dentistry and dental hygiene in Ontario. Social Science & Medicine, 2004, 58, 2243-2252.

AIDS Bereavement Project of Ontario’s (ABPO, 2004). Reproduced with permission. Available at: http://www.abpo.org/index.php/resiliency_initiative/

Butler, J. Gender trouble: feminism and the subversion of identity. New York: Routledge , 1999.

Denz-Penhey, H. & Murdoch, C. Personal resiliency: serious diagnosis and prognosis with unexpected quality outcomes. Qualitative Health Research, 2008, 18(3), 391-404.

DeVault, M. Whose science of food and health: narratives of profession and activism from public-health nutrition. In: Clarke AE, Olesen VL, editors. Revisioning women, health, and healing: feminist, cultural, and technoscience perspectives. New York: Routledge; 1999. p. 166-83.

References

Fineman, S. & Sturdy, A. The emotions of control: A qualitative exploration of environmental regulation. Human Relations, 1999, 52(5), 631-663.

Gingras, J. Longing for recognition: the joys, complexities, and contradictions of practicing dietetics. York, England: Raw Nerve Books, 2009.

Kelly J. An overview of conflict. Dimensions of critical care nursing, 2006, 25(1), 22-28.

Liquori T. Food matters: changing dimensions of science and practice in the nutrition profession. J Nutr Educ. 2001;33:234-46.

Waite, J. P. & Richardson, E. G. Determining the efficacy of resiliency training in the work site. Journal of Allied Health, 2004, 33(3), 178-183.