Mapping Resiliency Among Dietitians

1. Mapping Resiliency Among Dietitians Jacqui Gingras, PhD, RDRyerson UniversityJennifer Atkins, BASc, MHSc (Candidate)University of Toronto

2. Little is known about how Dietitians experience workplace stress Personal experiences and backgrounds shape practice Dietitians strive to cultivate resilience in their careers Introduction

3. 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)

4. Methods • Auto/Ethnographic • Reflexive, artistic, experiential • Six female dietitian participants • Three, four-hour sessions of narrative exploration on The Resiliency Map

5. The Resiliency Map • 16’ x 16’ fabric map • Shared Values • Motivation & Commitment • Self • Emotions & Relational • Community & Social Networks • Socio-political & Marginalization

6. Findings • Themes • Disconnection • Workplace Conflict • Relational Resiliency • Subthemes • Gender • Emotionality • Burnout

7. 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).

8. 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)

9. 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)

10. 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)

11. 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)

12. 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

13. 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

14. 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)

15. 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.

16. 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.