Nursing Leadership in Turbulent Times

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

The past few weeks have been challenging for nurse leaders in healthcare settings, with the COVID-19 now officially a global pandemic. The US and the world now look to the nursing workforce to help patients fight the battle against what appears to be a very aggressive virus. Reports from nurses on the frontlines of the epidemic in China and Italy are heartbreaking, with one young Italian nurse describing her work environment as a war zone.

Nurse leaders play a critical role in providing strategic guidance to both their organization and the nursing workforce in the planning of care. With mixed messages about the availability of testing, whose guidance to follow (CDC, WHO, or State Health Departments) and supply chain shortages of drugs and protective supplies – it is not surprising that nurses feel increasingly anxious about the information that they are receiving and their own personal health risks. Nurse leaders are not always able to provide the level of certainty of knowledge that staff seeks.

What nurse leaders can do is focus on four essential leadership practices to help navigate these turbulent times:

Be transparent

In a recent article on the Harvard Business Review Blog, Amy Edmondson points out that in the early stages of a crisis – there is often bad news. In these situations, some organizations reflexively try to hide it to their detriment. The trust of both staff and the public will be earned if there are transparency and truth. Reputation should be seen as a long-term game. Staff needs to feel the psychological safety in knowing that their nurse leaders will give them the best information that they have on the issues that occur. Yes, policies and protocols will change (maybe even very frequently), but staff needs to hear the truth as you know it at the time.

Make the health of the nursing workforce a key priority in planning

It is likely during this pandemic that nurse staffing, especially in critical areas, will be a crucial issue. During times like this, nurse leaders must think about the health and well-being of their staff as they ask them to work overtime or make decisions about the use and provision of protective equipment. When nurses are fatigued, it can impact their immune system making them more likely to contract the virus. Nurse leaders need to be the guardians of the health of the staff.

Be visible

Many nurse leaders have told me that they spent hours in planning meetings last week. While planning is essential, leadership visibility during times of crisis is important to reduce rumors and communicate what is known. Without information, the staff fills the vacuum with stories and half-truths. Nurse leaders need to be visibly present on their units to support their teams.

Be empathetic

With demographic changes in the nursing workforce, it is not uncommon to now see units where more than 50% of the nursing staff have less than three years of nursing experience. This pandemic is likely to be very stressful for novice nurses who lack experience with high acuity patients and are nervous about their physical health. Many young nurses are also parents with young children whose school or daycare plans have been disrupted. Nurse leaders need to be both very empathetic and prepared to do resiliency coaching with their staff to reduce their stress and anxiety levels.

We often learn the most about ourselves and our leadership during a time of crisis. While we know that this too will pass, how we lead during the next few weeks and months in this high-stakes situation is critically important for our nursing workforce.

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