Never Again - Emerging Nurse Leader

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

Winston Churchill is often quoted as telling the English population during World War II that “when you are going through hell – keep going.” That is what nurse leaders are doing today as they lead through this COVID-19 crisis. Yet at some point, it will be over. As one nurse leader recently said during an AORN virtual leader to leader town hall – “every day is one day closer to the end.” We will reach the other side of this crisis – the unknown unknown at this point is when. It is then that the real lessons learned can be reflected on.

The American Journal of Nursing and Johns Hopkins School of Nursing are co-sponsoring a frontine nurses wikiwisdom forum. I was reading the stories and comments of nurses in this forum. One comment caught my attention. A staff nurse noted that she hoped as a country and profession, we would never be so unprepared and let this happen again. As I thought about this, it reminded me of my first trip to Germany in the early 1980s. Each town we visited had an exhibit of what had happened to that town during World War II (many were completely bombed out) and also pictures of the holocaust. It was a national initiative titled Never Again initially coined by remembrance of the holocaust. It arose out of concern that people were denying what had happened and in some cases their role in it. Behavioral experts warned the German government that unless there was transparency about the War and the holocaust that it could indeed happen again. Over time,people can forget and minimize experiences.

Reflections about the COVID-19 pandemic need to fall into at least two buckets. The first bucket will be what Cole Edmondson has aptly called Holding the Gains. In this bucket, we will place all of the wonderful innovations and barriers that we were able to break down and need to maintain. We will talk about things such as:

The explosive growth of telehealth with acceptance from both the public and payers.
The successful management of a patient surge through staff redeployment to areas outside their expertise.
The minimization of unnecessary documentation.
The incredible level of teamwork and collaboration both across and within disciplines.
The just in time conversions to ICU beds.
Breaking down scope of practice barriers and promoting across state license endorsement.
Community coordination of an emergency response.

But in addition to this Holding the Gains Bucket, we need a second bucket – The Never Again Bucket. In this bucket, we need to talk about and plan action around things that should never happen again such as:

Placing the nursing workforce in a situation where they are fearful for their own lives and the safety of their families.
Having inadequate virus testing for both the healthcare workforce and the public.
Having patients die alone in isolation causing moral distress for families and nurses.
Seeing a health crisis in another developed country and believing that it could not happen here.
Health systems that are unable to purchase the right amount of PPE, ventilators and some types of medication.
The price gouging of medical supplies.
Lack of a coherent national plan or adequate federal stockpile to effectively manage the crisis.

Many Americans including nurses will lose their lives in this pandemic. As a tribute to them, we owe it to ourselves and to the nursing profession to make sure that this does not happen again. Nursing will emerge from this crisis with an unusually powerful voice. Within the last two weeks, we have seen a critical care nurse (Simone Hannah-Clark) write a wonderful piece in the NY Times – An ICU Nurse’s Coronavirus Diary. We have also seen James Falise, an ICU nurse manager at the University of Miami Health System, give an incredibly articulate interview with the PBS Newshour about the physical and mental efforts required of healthcare workers right now. We can’t lose this opportunity to be not only a professional voice but also a public voice to make sure this does not happen again.

Read Rose Sherman’s book – The Nurse Leader Coach: Become the Boss No One Wants to Leave