The Childcare Conundrum - Emerging Nurse Leader

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

We have been polling leaders during the last five months during webinars about their challenges with leading staff during COVID. Up until about 6 weeks ago, the results were pretty uniform from group to group. The top three generally included staff fear and anxiety, negativity about frequent changes, and concern about personal and family safety. More recently, we see childcare and homeschooling concerns rising quickly to the top three. The challenges are illustrated in this story from a critical-care director during a recent interview. She lives in a Midwest COVID hotspot in a medium-sized metropolitan area. The community hospital where she works is part of a larger health system. She manages two critical units, and due to COVID, they are expanding ICU beds. She painted the following picture about what is happening in her setting:

We saw some COVID in our community last spring but nothing close to what we see now. We are surging with COVID patients and expect to run out of ICU beds soon. To expand the number of beds, we need critical nurses to staff them, and we don’t have them. Many of my experienced critical care nurses have opted to retire early or seek telehealth jobs. More than half of my current staff are Millennial nurses (born 1981-1996). Most now have kids; some are school-age, but many are much younger. Some are single parents. Others have spouses or partners who also work outside the home. We have a large, well-run childcare center about two blocks from the hospital. This center is open 24/7 and has catered to healthcare workers, even providing afterschool care. Two weeks ago, the center had a COVID outbreak among their staff. Parents were notified on a Friday that the center was closed indefinitely as of that day. I heard about this on the local news. My heart sank – I knew what this meant for my staff. I started getting multiple texts from frantic nurses about not having childcare for their next shift. There were no good solutions. Given our dire situation at the hospital, we could not open a childcare center. These nurses would not contact their 60-year-old + parents to move in to care for their children when they were themselves being exposed to COVID every day. I spent the weekend setting up childcare groups for staff but knew this would not be a permanent solution. I now have young nurses at the breaking point – stressed at work and stressed at home. I had one single Mom put in her resignation after a weekend shift telling the house supervisor that she had reached her breaking point. I did not process that resignation – she had been with me for six years, and this was heartbreaking.

Even before this latest surge, there have been widespread reports about the childcare industry in the US being at the point of collapse. Many school districts that initially opened for the school year have now moved online, with parents responsible for homeschooling their kids. A significant segment of our nursing workforce, especially in acute care settings, is now in their prime childbearing years. Nurse leaders find themselves in a very challenging situation with no good answers to how to best support these Moms. Most tell me that they listen sympathetically and try to do their best to adjust schedules. Some nurses are forced into making difficult decisions about family versus work. It all comes at a time when we need them more than ever.

Don’t let nurse leaders in your organization go without development. Virtual programs include Nurse Leader Coaching, Coaching Staff to Promote Resilience and Leading Teams in Turbulent Times, or schedule your customized Nuts and Bolts of Nursing Leadership Virtual Workshop taught by experts for either new or experienced leaders. Nuts and Bolts Flyer

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