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. 2025 Jan 29;81(10):6432–6440. doi: 10.1111/jan.16786

Exploring Individual and Team Resilience Among Dutch Hospital Nurses: A Survey Study

Sharon A van Stralen 1, Caroline Schlinkert 1,✉, Linda van Eikenhorst 1, Cordula Wagner 1
PMCID: PMC12460968  PMID: 39878219

ABSTRACT

Background

Nurses confront substantial daily workloads. Coping mechanisms, including resilient behaviours at both individual and team levels, are pivotal in managing these challenges. Factors like work experience can significantly influence individual resilience. Yet, team resilience among nurses remains relatively unexplored.

Aim

Our study examined perceptions of both individual and team resilience among Dutch hospital nurses. Furthermore, we investigated the impacts of hospital type, ward type and work experience.

Methods

The Employee Resilience Scale was used to evaluate individual resilience and adapted for team contexts to assess team resilience. This study was one of three conducted under a governmental research program aimed at improving patient safety in the Netherlands. A paired t‐test and correlation analysis were conducted to compare individual resilience with team resilience. A separate t‐test assessed the impact of ward type on perceived individual and team resilience. Finally, post hoc analyses were used to examine the effects of hospital type and work experience.

Results

In total, 344 nurses from 25 different wards of 17 Dutch hospitals completed the survey. In general, nurses indicated to act more resilient on the individual level (mean = 3.77, SD = 0.61) compared to the team level (mean = 3.53, SD = 0.65; t = 7.25, p = 0.00). A correlation was found between perceived individual and team resilience (r = 0.53, p = 0.00). No effects of hospital‐ and ward type were found on both individual or team resilience. Years of work experience did not affect individual resilience but showed a significant effect on team resilience.

Conclusion

Dutch hospital nurses indicated they often act resilient on both individual and team levels. However, with increasing workloads in healthcare, being able to remain resilient will become increasingly challenging and important. Organisations should therefore support employees to maintain resilience by adapting their work environment to meet more employees' needs.

Keywords: employee resilience, hospital, nurses, quality of care, resilience engineering

1. Introduction

Nurses have many tasks to perform during a typical work shift. These tasks can become disorganised or unexpected due to time restraints, personnel shortages or emergency situations. COVID‐19 magnified the workload and the complexity of the working conditions even more, due to the rapidly increased need for high‐intensity treatment in uncertain and stressful work circumstances (Van Mol et al. 2021; Hoogendoorn et al. 2021). Nurses therefore must constantly adapt to different circumstances to maintain high‐quality health care. This behaviour asks for a lot of flexibility and adaptivity from nurses. A way to deal with complex working conditions and high workloads is resilient behaviour. Resilience can manifest in various areas of life, leading to different forms such as moral, psychological and professional resilience (Anderson 2015). Despite their differences, all types of resilience share the common ability to recover from inevitable challenges in an unstable world (Anderson 2015). Resilience in the work setting refers to the ability of someone to successfully react to, adapt to and cope with constantly changing work environment (Näswall et al. 2013). Resilience can be developed over time (Näswall et al. 2013; Luthans 2002), which means that someone is able to learn from previous (unexpected) work circumstances for future events (Näswall et al. 2013; Luthans 2002). As such, it is interesting to know the status of employee resilience in an organisation to assess if the employees can navigate through adversity and the disruptions of the everyday work floor (Richardson 2002; Avey, Luthans, and Jensen 2009; Tugade and Fredrickson 2004). The current research therefore examined the resilience of Dutch nurses working in hospitals. A lot of research on individual resilience among nurses has already been conducted. The general notion hereby is that higher perceived resilience among nurses resulted in reduced drop‐out rates, less work‐related exhaustion and fewer psychological problems such as depression (Scholes 2008; Matos et al. 2010; Zander, Hutton, and King 2010; Jackson, Firtko, and Edenborough 2007; Larrabee et al. 2010; Çam 2017). Moreover, resilience has shown to increase quality of care by reducing errors, and burnout rates and enhancing efficiency and job satisfaction (Gensimore et al. 2020; Epstein and Krasner 2013; Labrague and de los Santos 2021). There are several factors that influence the resilience of nurses. For instance, work‐related factors such as challenging and constantly changing workplaces, insufficient work‐life balance, differences between personal and organisational goals, and frustrations happening in the workplace have a negative impact on nurses' resilience (Hart, Brannan, and de Chesnay 2014; Hodges, Keeley, and Troyan 2008; Glass 2009; Kornhaber and Wilson 2011). Personal factors, such as feeling hope, coping strategies, and self‐efficacy, seem to have a positive effect on nurse resilience (Hart, Brannan, and de Chesnay 2014; Hodges, Keeley, and Troyan 2008; Ablett and Jones 2007; Simoni et al. 2004; Gillespie, Chaboyer, and Wallis 2009). Effects of demographic characteristics on resilience, such as age and years of work experience are more inconsistent, demonstrating that work experience had both no effect and a positive effect on nurse resilience (Gillespie, Chaboyer, and Wallis 2009; Gillespie et al. 2007). Little is known about the effect of hospital characteristics, such as hospital type and ward type, on resilience. During and after the COVID‐19 pandemic, research on nurse resilience continued (Jo et al. 2021), highlighting the importance of resilience inverting burnout rates (Baskin and Bartlett 2021; Garcia et al. 2019). Overall, research showed a moderate resilience rate among healthcare workers around the world (Baskin and Bartlett 2021). Moreover, factors such as PTSD, anxiety and depression were shown to negatively affect resilience in healthcare workers (Awano et al. 2020; Barzilay et al. 2020; Hu et al. 2020; Labrague and de los Santos, 2021; Li, Zhou, and Xu 2020; Luceño‐Moreno et al. 2020; Pang et al. 2021; Roberts et al. 2021; Yıldırım, Arslan, and Özaslan 2020; Yörük and Güler 2020). Research on building nurse resilience through, for example, self‐care strategies, training and educational programmes evolved as well (Blackburn et al. 2020; Franco and Christie 2021; Walsh et al. 2020).

Given the multidisciplinary nature of healthcare, effective teamwork is crucial for ensuring patient safety (King et al. 2008). While much is understood about individual resilience, less is known about nurses' perceptions of their team's resilience. Team resilience can be defined as a team's ability to navigate and overcome the challenges of a constantly changing work environment in a sustainable manner (Alliger et al. 2015). Even though attempts are made to investigate team resilience (Van Der Beek and Schraagen 2015), no standards for measuring team resilience has been developed yet. The few existing studies on team resilience show some factors that increase team resilience, such as collective (positive) emotions, team connectivity and communication, and team structures (Hartmann et al. 2020; Meneghel, Martínez, and Salanova 2016). High team resilience can contribute to team attitudes, behaviours, and ultimately performance (Meneghel, Salanova, and Martínez 2016), because resilient teams can respond more flexible and adaptive to adverse events, and use these adverse events to grow (Meneghel, Martínez, and Salanova 2016). Learning more about team resilience and the factors it is affected by can therefore help to increase nursing team performance and improve quality of care. Especially since nursing depends heavily on teamwork (Kalisch and Weaver 2009) for maintaining and improving quality of care (Morey et al. 2002; Silén‐Lipponen et al. 2005).

Maintaining or improving the individual and team resilience of Dutch hospital nurses is important to improve the quality of care (Epstein and Krasner 2013; Labrague and de los Santos 2021; Gensimore et al. 2020; Morey et al. 2002; Silén‐Lipponen et al. 2005), especially with the increased workload and work complexity in hospitals (Hoogendoorn et al. 2021; Van Mol et al. 2021). However, the current levels of Dutch hospital nurses and the influence of hospital characteristics on individual and team resilience remain unknown. Additionally, evidence of the effect of demographic characteristics is shown to be inconsistent. Therefore, this survey study aimed to investigate the perceived individual and team resilience of Dutch hospital nurses with the Employee Resilience Scale (Näswall et al. 2019) and to explore the effect of work experience and hospital characteristics on resilience.

2. Materials and Methods

2.1. Design and Participant Recruitment

This survey study was part of three studies within a governmental research program to enhance patient safety in the Netherlands (Langelaan et al. 2017; de Bruijne et al. 2007; De Blok et al. 2013; Warnier et al. 2022). Another publication provides a detailed description of the original study protocol for these studies (van Dijk et al. 2021). In brief, a cluster randomised stepped wedge design was applied in which every participating hospital ward received the questionnaires gradually as part of an intervention study on team resilience.

All Dutch hospitals (N = 74) were invited to participate in this study to maximise the number of participants as much as possible. In context of the intervention study, internal medicine wards, surgical wards, geriatric wards, intensive care units, orthopaedic wards and cardiology wards were eligible to participate. The participating wards enrolled from May 2020 until June 2021, during and just after the first COVID‐19 infection waves in the Netherlands. The questionnaire was sent to all nurses of the participating wards by a contact person of the ward, since it was not possible to address the questionnaire to individual nurses due to privacy legislations. This restricted us in calculating response rates. Nurses had 2 months to finish the questionnaire. Within these 2 months, multiple reminders were sent to enhance the response rate.

2.2. Employee Resilience Scale

To measure resilience, the most recent version of the Employee Resilience Scale (EmpRes; Cronbach's α = 0.91) was used in this study (Näswall et al. 2013, 2015, 2019). The EmpRes scale measures an employees' capacity to adapt to changing circumstances, and their capability to learn and adapt (Näswall et al. 2019). Theoretically, the items of the EmpRes are based on four resilience themes ‘change readiness’, ‘proactive posture’, ‘network leveraging’ and ‘adaptive capacity’ (Näswall et al. 2013, 2019; Stephenson et al. 2010). These resilience themes were previously used by Stephenson et al. (2010) in the Benchmark Resilience Survey (Stephenson et al. 2010; Näswall et al. 2019), because they were considered to be closely related to employee resilience35. The questionnaire includes nine items (Näswall et al. 2015) that are answered on a 5‐point Likert scale (1 = (almost) never, 2 = sometimes, 3 = frequently, 4 = often, 5 = (almost)) always and load on one factor (Näswall et al. 2015). An example item is: ‘I re‐evaluate my performance and continually improve the way I do my work’. To fit the Dutch hospital setting, a few changes were made to the original questionnaire. First, the questions underwent translation from English to Dutch, adhering to the recommended stages of cross‐cultural adaptation (Beaton et al. 2000). This methodology aids in addressing both linguistic nuances and cultural considerations when utilising a questionnaire in a diverse context (Beaton et al. 2000). The translation process started with two translators rendering the questions into Dutch (Stage I). Upon reaching a consensus between the two translators (Stage II), the items were subsequently translated back into English by native speakers (Stage III) to ensure accuracy in translation. The adapted questionnaire then underwent scrutiny by experts (Stage IV), followed by test interviews with nurses to gauge the interpretation of the questions (Stage V). Subsequently, the EmpRes questions were revised to encompass team resilience. For instance, one of the reformulated queries is: ‘Our team effectively collaborates with others to handle unexpected challenges at work’. These team questions were integrated into the existing questionnaire concerning individual resilience.

2.3. Exploratory Factors

To uncover the underlying structure of the data, the exploratory factors of hospital type and ward type were determined. In the Netherlands, three main hospital types can be identified: (1) academic hospitals, associated with a university providing complex and/or specialised care; (2) tertiary hospitals, which provide both general care and complex or specialised care, and (3) general hospitals, which are regional hospitals that provide general care and are often relatively small. Depending on the hospital, different specialisations and therefore, different wards are present. However, all wards can be grouped in two categories: surgical wards, in which the main type of treatment is surgery, and non‐surgical wards, in which specialisms are mostly exploratory and treatments can consist of for example medication, immunotherapy and endoscopies. Surgical wards consist of medical specialties such as (general) surgery, and orthopaedics. Non‐surgical specialties are among others cardiology, geriatric wards, internal medicine and intensive care. The demographic factor years of work experience was added to examine the effect on both perceived individual and team resilience. In the questionnaire, years of work experience was divided into six categories, namely < 1 year, 1–5 years, 6–10 years, 11–15 years, 16–20 years, and > 21 years. This question referred to total years of experience and was not limited to their current employment.

2.4. Data Analysis

All data were collected in Survalyser (Survalyser Nederland B.V. 2021). Frequencies and percentages were used to describe the distribution of the participants per hospital type, ward type, job function and work experience. For both individual‐ and team resilience, the average resilience was calculated. The average scores could vary between 1 (lowest resilience score) and 5 (highest resilience score). Both variables were tested on normality using the Shapiro–Wilk test (α = 0.05). After confirming normality, a paired t‐test was executed to compare individual resilience with team resilience (α = 0.05). A Pearson's correlation coefficient was used to calculate the correlation between the average perceived individual resilience and perceived team resilience (α = 0.05).

Additionally, one‐way ANOVAs were performed to determine the effects of years of work experience and hospital type on perceived individual and team resilience. When a significant effect was found, a Bonferroni post hoc test was executed to examine between‐group differences. An independent t‐test was performed to determine the effect of ward type on the perceived individual and team resilience. All analysis were performed by a researcher (SvS) in Stata/MP version 16.1 (LLC 2020).

2.5. Ethical Approval

The study was assessed by the Medical Ethics Committee of the VU University Medical Centre Amsterdam and they declared that the study was not subjected to Medical Scientific Research with humans (WMO) (number 2019.571). The data are stored in a secure database, accessible only to the research team.

3. Results

3.1. Participants

Participants for this study were employed in 25 hospital wards of 17 different Dutch hospitals. In total, 344 nurses completed the EmpRes questionnaire. No response rate was calculated since an open link was used. The majority of the respondents were registered nurses (95.1%), and a small percentage were nurses in training (4.9%; Table 1). Nurses in training were included in this study as this group performs almost all tasks registered nurses execute in Dutch hospitals albeit with extra supervision. Most nurses worked in a general hospital (40.7%) or a tertiary hospital (42.1%). Around half of the participating nurses worked in a surgical ward (53.8%). Table 1 gives an overview of all participant characteristics.

TABLE 1.

Descriptive statistics of participating nurses (n = 344).

Participants (%)
Hospital type
Academic 59 (17.2)
Tertiary 145 (42.1)
General 140 (40.7)
Ward type
Surgical 185 (53.8)
Non‐surgical 159 (46.2)
Function
Registered nurse 327 (95.1)
Nurse in training 17 (4.9)
Years of work experience
< 1 year 35 (10.2)
1 ≤ 5 years 114 (33.1)
6 ≤ 10 years 53 (15.4)
11 ≤ 15 years 38 (11.1)
16 ≤ 20 years 34 (9.9)
> 21 years 70 (20.4)
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3.2. Individual Resilience and Team Resilience

A mean score for both individual resilience (mean = 3.77, SD = 0.61) and team resilience (mean = 3.53, SD = 0.65) was calculated. Using the Shapiro–Wilk test, both individual resilience (W = 0.99, p = 0.33) and team resilience (W = 0.99, p = 0.21) were tested on normality. Additionally, both scales showed high reliability with Cronbach's α of 0.88 and 0.92 for, respectively, individual and team resilience. With the results showing both variables as normally distributed, a paired t‐test was executed, showing that the individual resilience scored significantly higher than the perceived team resilience (t = 7.25, p = 0.00).

Perceived individual resilience was positively correlated with perceived team resilience (r = 0.53, p = 0.00). This means that if an individual scored high on perceived individual resilience, the same individual also scored high on perceived team resilience.

3.3. Influences of Years of Work Experience, Hospital Type, and Ward Type on Perceived Individual and Team Resilience

3.3.1. Influence of Work Experience

No significant effect of years of work experience on the perceived individual resilience was found (F(5, 338) = 1.95, p = 0.09). Regarding the perceived team resilience, the results showed at least one significant difference between the groups (F(5, 388) = 5.54, p = 0.00). The post hoc Bonferroni tests showed that only the group with less than 1 year of work experience (M = 4.03, SD = 0.62) scored higher than all other groups in perceived team resilience, with significant differences between the 1 and 5 years (M = 3.48, SD = 0.64; t = −0.55, p = 0.00), 6–10 years (M = 3.39, SD = 0.67; t = −0.64, p = 0.00), 16–20 years (M = 3.45, SD = 0.58; t = −0.57, p = 0.00) and > 21 years groups (M = 3.44, SD = 0.62; t = −0.59, p = 0.00). No other significant differences were found between the groups. Means and SD for all groups on both individual and team resilience levels can be found in Supporting Information S1.

3.3.2. Influence of Hospital Type

We inspected the influence of hospital type on both types of resilience. The results of the one‐way ANOVA showed no significant effect of hospital types on perceived individual resilience (F(2, 341) = 0.51, p = 0.60) and perceived team resilience (F(2, 341) = 0.95, p = 0.39).

3.3.3. Influence of Ward Type

We also looked at the influence of ward type on the perceived individual and team resilience. No differences were found between non‐surgical wards and surgical wards in both individual resilience (t = 1.01, p = 0.31), and team resilience (t = −0.57, p = 0.57).

4. Discussion

This study investigated the perceived individual and team resilience among Dutch hospital nurses. Moreover, we explored whether the hospital and ward type that nurses are working at, and years of work experience affected their perception of both individual and team resilience. In both perceived individual and team resilience, nurses indicated that they frequently to often acted resiliently, scoring M = 3.77 and M = 3.53 respectively on a scale from 1 to 5. These scores indicate some room for improvement. Dutch nurses scores lower compared to other studies that used the EmpRes to examine individual resilience, with mean scores between 3.95 and 4.26 (Kuntz, Connell, and Näswall 2017; Jegatheesparan and Samaradiwakara 2022; Tonkin 2016; Bowman 2021; Nguyen et al. 2016). Nursing is a high‐intensity job, compared to the careers in the other studies, like white‐collar employees, public library staff members and tertiary education providers (Kuntz, Connell, and Näswall 2017; Jegatheesparan and Samaradiwakara 2022; Tonkin 2016; Nguyen et al. 2016). Also, the data collection of this study was performed during the height of the COVID‐19 pandemic in the Netherlands, which might have lowered the perceived individual resilience of the nurses taking part in this study. This might explain that when comparing our results with other healthcare professionals during the COVID‐19 pandemic, the difference between the groups diminishes. In 2021, a group of 844 Dutch healthcare professionals reported a mean score of 3.85 (SD = 0.75; Meekes et al. 2021). Moreover, other research on resilience among healthcare workers during the pandemic found overall outcomes in the moderate range (Baskin and Bartlett 2021), suggesting that the pandemic was a challenging period for healthcare professionals. This is consistent with reports of increased workloads, the introduction of new equipment and continuously changing guidelines (Glette et al. 2023). As a result, collaboration across wards and healthcare teams increased (Glette et al. 2023).

We found a difference in perceived individual and team resilience, such that individual resilience scored significantly higher than team resilience. The difference between individual and team resilience may be explained by self‐report bias, which shows higher rates of socially desirable responses compared to co‐worker reports (Donaldson and Grant‐Vallone 2002). Additionally, high individual resilience may not always express itself in high team resilience, due to a lack of communication or support (Hartwig et al. 2020; Alliger et al. 2015). However, even though the difference between the perceived individual resilience and team resilience was found to be significant, the absolute difference between the scores of the perceived individual resilience (M = 3.77) and team resilience (M = 3.53) was minor Δ = 0.24.

No significant effect of work experience was observed on perceived individual resilience. However, a significant effect of work experience was identified on perceived team resilience. Upon further analysis, this effect was only significant when comparing groups to those with less than one year of work experience. Rather than indicating a decrease in perceived team resilience over time, these results may suggest that the group with less than one year of work experience rated perceived team resilience disproportionately compared to other groups. This could be because nurses in training and newly trained nurses rely heavily on their colleagues for additional guidance and oversight (Barton, Bruce, and Schreiber 2018; Johnson et al. 2011) and may still have to develop resilient capacities at work. It has been shown that it is crucial for novice nurses to be able to share their experiences with colleagues (Ten Hoeve et al. 2018). Further, receiving positive feedback from colleagues, patients, physicians and supervisors when starting to work in a complex environment. This helps building a personal and professional identity and boost self‐confidence (Ten Hoeve et al. 2018). Therefore, it might be important to pay extra attention to nurses when starting their professional career. Additionally, extra education in team skills, such as communication skills, assertiveness and adaptability, during training might be needed to smoothen the transition between nurses' training and their professional role (Johnson et al. 2011; Hezaveh, Rafii, and Seyedfatemi 2014). This enables the students to develop these skills in a safe environment without the fear of making a mistake or harming the patient (Johnson et al. 2011).

When looking at the effect of hospital type and ward type, the results of this study showed no difference in individual resilience and team resilience between the three hospital types. No differences were found in individual‐ and team resilience between surgical and non‐surgical wards either. These results indicate that the resilience of Dutch hospital nurses does not depend on hospital‐ and ward type, despite the different circumstances and care provided among hospital types, and treatment methods, such as surgery or medication among different wards. This can contribute to high quality of care among all Dutch hospitals.

Our results indicate that Dutch hospital nurses frequently need to act resiliently; however, there is still room for improvement in their ability to positively cope, adapt and thrive in response to changing work circumstances. Especially, with the increasing workload in Dutch hospitals over the next years (ABF Research 2022), being able to stay resilient will become both increasingly challenging and important. Individual resilience may not be the only type of resilience that warrants investigation, as nurses work within teams and operate within a larger organisational setting (hospital). The organisation provides the initial structure and rules. When unforeseen circumstances occur in daily practice, first the resilience of nursing teams should adapt to these circumstances to maintain quality of care. When this might not suffice, individual resilience might be necessary. Additionally, focussing on team resilience and organisational resilience can increase individual resilience as well (Näswall et al. 2013; Lengnick‐hall, Beck, and Lengnick‐hall 2011; Shin, Taylor, and Seo 2012).

In relation to the above, a sound team structure, including a shared motivation, can have a positive effect on resilience of an individual and a team (Alliger et al. 2015; McEwen and Boyd 2018). Additionally, team connectivity and clear and concise communication can help further increase team resilience (Hartmann et al. 2020; Meneghel, Martínez, and Salanova 2016). This is in line with findings on teamwork, showing it depends on willingness to cooperate, coordinate and communicate with and between team members to ensure patient safety (King et al. 2008). All this starts by psychological safety within the team, facilitating teamwork, learning behaviours and the work experience. Furthermore, the employees should be supported by their organisations to work on their resilient performance and, therefore, organisations should facilitate employees to cope, adapt, and thrive in response to changing work circumstances (Näswall et al. 2013). For example, during COVID‐19 hospitals found alternative ways of triaging, rearranged waiting rooms, and provided digital solutions for providing patient care (Alboksmaty et al. 2021; D'Alessandro et al. 2020; Damian et al. 2021; Glette et al. 2023; Sarteau et al. 2021; Szabo et al. 2021; Verhoeven et al. 2020). This not only enabled employees to successfully deal with (unexpected) change but also made them learn from the change and adapt to the new situation (Näswall et al. 2013; Lengnick‐hall, Beck, and Lengnick‐hall 2011; Baird et al. 2013; Richardson 2002). An organization’s resilience relies on the actions, skills, and teamwork of its employees. By actively contributing, employees drive changes that enable the organization to adapt and thrive (Näswall et al. 2013; Lengnick‐hall, Beck, and Lengnick‐hall 2011; Shin, Taylor, and Seo 2012). This means that as employees show resilience, the organisation's resilience also grows.

Recently, the resilient capacity of Dutch hospitals was examined with the Benchmark Resilience Tool (BRT) (Whitman et al. 2013) and interviews with board members of Dutch hospitals (Schlinkert et al. 2024). The results showed that the board members scored the resilience of their hospitals as generally high. However, according to the board members, hospitals are mostly trained on short‐term crises. Longer crises, such as seen now with the COVID‐19 pandemic, pose different challenges that were unseen before (Schlinkert et al. 2024). These findings highlight an aspect of organizational resilience in hospitals that can be strengthened. Enhancing this area can also support individual resilience by providing better support to employees during prolonged crises.

The shortage of research on team resilience suggests it should be given more attention, especially in the healthcare setting. Day‐to‐day jobs in healthcare will become more complex in the future (Sturm et al. 2019), and to successfully manage this increase in complexity another way of working has to be established. The employees, however, motivated, will not be able to solve this individually. Therefore, future research should focus more on team resilience and organisation resilience to (1) investigate the current state of resilience on these levels, (2) find what factors influence the resilience on these levels, and 3) see in what areas the resilience can be improved to further increase individual resilience as well.

4.1. Strengths and Limitations

This research was about the perceived individual and team resilience among Dutch hospital nurses and explored what factors might influence the perceived resilience. The strength of this study lies in the sample, showing an appropriate representation of the Dutch hospitals and (non‐)surgical wards. Additionally, the scored perceived individual and team resilience is relatively high, and no differences were found between hospital types and ward types. Since resilience can contribute to quality of care, this shows the quality of the Dutch healthcare system does not show major differences between hospital types and ward types (van Schoten et al. 2022). A limitation of this study is that the EmpRes has not been validated for measuring team resilience. No other suitable tool was found for measuring team resilience, and therefore the EmpRes was reformulated to encompass team resilience as well. However, this could lead to an insufficient measurement, due to the complexity of team resilience in regard of among other things, communication and support (Hartwig et al. 2020). Furthermore, the questionnaire did not ask for other demographics, such as age, ethnicity or age, to ensure the anonymity of all participating nurses. The results were shared with the participating wards. Therefore, no analyses on resilience could have been made based on these demographics. Additionally, when looking closer at the nine items of the EmpRes, they look closely related to the theory of perceived self‐efficacy. Perceived self‐efficacy is defined as: ‘People's beliefs about their capabilities to produce effects’ (Bandura 1994). However, self‐efficacy is a part of resilience, and the nine items of the EmpRes still encompass the theory of (Seville 2016).

Another limitation of this study is not exploring the extent of variation in team resilience across wards. Due to the participation of small hospital wards, the number of participants from some wards were too small to investigate further. Lastly, the EmpRes was distributed to the hospitals from March 2020 to June 2021, which during and in between the first COVID‐19 waves in the Netherlands. This could have affected the resilience of nurses, since the workload of nurses was even higher during this period. However, the results are in line with other studies on healthcare professional resilience during the pandemic. In addition, the results of this study still showed relatively high levels of resilience among participating nurses, and additionally, gives insight into the resilient capacity of nurses during the COVID‐19 pandemic in the Netherlands.

5. Conclusions

The results indicate that Dutch hospital nurses frequently demonstrate resilience at both the individual and team levels, with no significant influence from hospital or ward type. No significant effect of work experience was found on individual resilience. Years of work experience did show a significant effect on perceived team resilience, but only in the group with < 1 year of work experience. No continuous decrease was found with increasing work experience. Compared to other fields, resilience among nurses may have room for improvement. Enhancing resilience is essential to support and maintain high‐quality care, particularly given the growing workload and complexity of working conditions. However, maintaining resilience cannot rest on nurses alone; nursing teams, hospital management and organisational structure also play key roles. Strengthening team and organisational resilience can, in turn, enhance individual resilience. Therefore, future research should explore the impact of boosting team and organisational resilience to further support individual resilience.

Author Contributions

C.S., S.A.v.S., L.v.E. and C.W.: made substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; S.A.v.S., C.S. and C.W.: involved in drafting the manuscript or revising it critically for important intellectual content; C.S., S.A.v.S., L.v.E. and C.W.: given final approval of the version to be published. Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content; C.S., S.A.v.S., L.v.E. and C.W.: agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Conflicts of Interest

The authors declare no conflicts of interest.

Peer Review

The peer review history for this article is available at https://www.webofscience.com/api/gateway/wos/peer‐review/10.1111/jan.16786.

Supporting information

Supporting Information S1.

JAN-81-6432-s001.docx (17.3KB, docx)

Acknowledgements

We would like express our gratitude to all participating hospitals, wards, and contact persons for their cooperation. Furthermore, we would like to thank the nurses who participated in this study. Finally, we thank Liselotte van Dijk, Meggie Meulman, and Bernadette Schutijser for their contribution to the data collection.

Funding: This study was funded by VWS, the Dutch Ministry of Health, Welfare and Sport.

Linda van Eikenhorst and Caroline Schlinkert contributed equally to this study.

Contributor Information

Caroline Schlinkert, Email: c.schlinkert@nivel.nl.

Linda van Eikenhorst, Email: l.vaneikenhorst@nivel.nl.

Data Availability Statement

The Nivel subscribes to the FAIR data management principles, which stand for findable (findable), accessible (accessible), interoperable (interchangeable) and reusable (reusable). This data can be reused for research under certain conditions. Nivel applies the following principles when requesting data to be used for further research: The data request is in line with the purpose for which the data was previously obtained—conducting scientific research—and does not interfere with Nivel's ongoing research. The data requester publishes publicly about the results known from research in which the data has been used with the data request. The data request meets the requirements laid down in the General Data Protection Regulation (GDPR), the Dutch Code of Conduct for Scientific Integrity (2018) and the Code of Conduct for Health Research (2022). Processing the data request is feasible for Nivel in a practical sense. Each data request is assessed according to the procedure of the relevant data collection (more information can be found with each panel and each registration) by the management of Nivel.

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Supplementary Materials

Supporting Information S1.

JAN-81-6432-s001.docx (17.3KB, docx)

Data Availability Statement

The Nivel subscribes to the FAIR data management principles, which stand for findable (findable), accessible (accessible), interoperable (interchangeable) and reusable (reusable). This data can be reused for research under certain conditions. Nivel applies the following principles when requesting data to be used for further research: The data request is in line with the purpose for which the data was previously obtained—conducting scientific research—and does not interfere with Nivel's ongoing research. The data requester publishes publicly about the results known from research in which the data has been used with the data request. The data request meets the requirements laid down in the General Data Protection Regulation (GDPR), the Dutch Code of Conduct for Scientific Integrity (2018) and the Code of Conduct for Health Research (2022). Processing the data request is feasible for Nivel in a practical sense. Each data request is assessed according to the procedure of the relevant data collection (more information can be found with each panel and each registration) by the management of Nivel.

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