Caring for Patients without Personal Protective Equipment (PPE): Material Conditions as Multidimensional Cascading Triggers for Resilience Processes.

Guided by communication theory of resilience (CTR), we analyze 453 narrative accounts by Reddit user healthcare workers (HCWs) of their experiences with COVID-19-related personal protective equipment (PPE) shortages between March and May 2020. Via thematic analysis and sensitized by CTR concepts, we examine PPE shortages as a disruptive trigger event that catalyzes the enactment of resilience processes. Findings problematize PPE shortages as material, discursive, and symbolic triggers and explore how HCWs communicatively construct resilience given PPE shortages. This study extends CTR by: (a) underscoring the multidimensional nature of disruptive trigger events, (b) distinguishing the temporal element in cascading trigger events during periods of sustained disruption, and (c) attending to the transformational processes within the adaptation-transformation dialectic with the inclusion of a sixth resilience process, critiquing and resisting the status quo. Critiquing and resisting the status quo interrelates to other resilience processes of maintaining and using communication networks, employing alternative logics, and affirming identity anchors. Practical implications are offered.