In the Eye of the Storm

Abstract

New York City (NYC) was in the eye of the COVID-19 pandemic storm in the spring of 2020. Since that time, the country has seen wave after wave of outbreaks and concurrent psychosocial crises. Clinical nurses and nurse leaders delivered extraordinary care with grit, innovation, agility, and resilience. When in the eye of the storm, staff have to feel safe and have a voice even in command-control, adaptive modes. Nurses and nurse leaders have been resilient, and organizations have to play their part in decreasing work burden and creating positive work environments. Non–value-added work as well as barriers to practice should be eliminated permanently. This article describes the many challenges including intensive care unit capacity, staffing, well-being, and lack of visitation, as well as leadership lessons such as the importance of presence, based on the NYC experience of a chief nursing officer in a large academic medical center. These lessons and their implications for our workforce, for public health, and for leadership development and competencies and have taught us how to lead into the future.

Analyzing the Effects of Family Presence and Visitation Restrictions During the COVID-19 Pandemic Among Nurse Leaders and Non–Nurse Leaders

“…During the pandemic, much of the power to make decisions or enforce policies was very autocratic, as is often the case during a disaster when nontraditional power structures (eg, Incident Command System) are utilized. 2,[9][10][11] These policy changes included visitor restrictions and intense infection control practices for patients hospitalized with COVID-19. The autocratic management environment used by many organizations during the pandemic, as opposed to the typical shared governance environment, could have been an additional source of stress for nurses at any level of the organizational hierarchy.…”

“…Although many studies have identified sources of distress among nurses, few have examined them comparing the effects between direct care nurses and nurse leaders. During the pandemic, much of the power to make decisions or enforce policies was very autocratic, as is often the case during a disaster when nontraditional power structures (eg, Incident Command System) are utilized 2,9-11 . These policy changes included visitor restrictions and intense infection control practices for patients hospitalized with COVID-19.…”

Developing and Evaluating the Effectiveness of a Nursing Leadership Mentoring Pilot Program

“…Multiple sources have identified many challenges in the profession with high reports of turnover and attrition in leaders and staff. [13][14][15][16][17][18] Challenges within health care affect all nursing at all levels ranging from staff nurses to nurse leaders. These challenges highlight the need to examine the concepts of nursing leadership, nursing support, and nurse leader mentoring to help stabilize the nurse leader workforce.…”

“…Villanueva12 asserts that skills acquired during mentorship improve individual job satisfaction and professional commitment among the mentees and mentors. Multiple sources have identified many challenges in the profession with high reports of turnover and attrition in leaders and staff 13–18…”

Understanding the Impact of Span of Control on Nurse Managers and Hospital Outcomes

“…Emerging evidence suggests that the psychosocial impact of the COVID-19 pandemic has perpetuated burnout among healthcare workers (Coco et al, 2021). During the height of the pandemic, nurses reported insomnia and feelings of posttraumatic stress (Sagherian et al, 2020), while their managers faced diminished staff well-being and excessive workloads (Raso, 2022).…”