Nurse Leaders’ Challenges Fighting the COVID-19 Pandemic: A Qualitative Study

Freitas, Juliana Santana de; Queiroz, Ana L.; Bortotti, Isabelle M.; Laselva, Cláudia Regina; Leão, Eliseth Ribeiro

doi:10.4236/ojn.2021.115024

Cited by 7 publications

(23 citation statements)

References 23 publications

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“…Drawing on their specialist expertise and experience, nurse executives in the current study were leading changes and improvements, re‐engineering the workforce and physical environment, and ensuring that barriers did not get in the way of what was required to be done. Recent research in one hospital ( n = 6 nurse leaders, Brazil) also reported substantial workforce and environmental changes undertaken by nursing (Freitas et al, 2021 ). For our participants, these changes occurred internally and externally to the home hospital, including working with other health services (as part of a hub) further extending their work environments, working remotely from the hospital or team members.…”

Section: Discussionmentioning

confidence: 97%

“…In the face of such uncertainty, personal and professional qualities merged, with leadership comprising courageous decision‐making, taking calculated risks and being agile and constantly re‐inventing clinical, management and communication practices (Aquilia et al, 2020 ). Nurse leaders in the United States have also reported significant decision‐making with limited information (Aquilia et al, 2020 ), with another reporting nurse leaders demonstrating significant adaptability and innovation while overworked and stressed (Freitas et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

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The context, contribution and consequences of addressing the COVID‐19 pandemic: A qualitative exploration of executive nurses' perspectives

Riddell

Bignell

Bourne

et al. 2022

Journal of Advanced Nursing

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Aims To explore (1) the context in which nursing executives were working, (2) nursing's contribution to the healthcare response and (3) the impact from delivering healthcare in response to the pandemic. Design Retrospective, constructivist qualitative study. Methods Individual interviews using a semi‐structured interview guide were conducted between 12 February and 29 March 2021. Participants were purposively sampled from the Victorian Metropolitan Executive Directors of Nursing and Midwifery Group, based in Melbourne, Victoria the epi‐centre of COVID‐19 in Australia during 2020. All members were invited; 14/16 executive‐level nurse leaders were participated. Individual interviews were recorded with participant consent, transcribed and analysed using thematic analysis. Results Four inter‐related themes (with sub‐themes) were identified: (1) rapid, relentless action required (preparation insufficient, extensive information and communication flow, expanded working relationships, constant change, organizational barriers removed); (2) multi‐faceted contribution (leadership activities, flexible work approach, knowledge development and dissemination, new models of care, workforce numbers); (3) unintended consequences (negative experiences, mix of emotions, difficult conditions, negative outcomes for executives and workforce) and (4) silver linings (expanded ways of working, new opportunities, strengthened clinical practice, deepened working relationships). Conclusion Responding to the COIVD‐19 health crisis required substantial effort, but historical and industrial limits on nursing practice were removed. With minimal information and constantly changing circumstances, nursing executives spearheaded change with leadership skills including a flexible approach, courageous decision‐making and taking calculated risks. Opportunities for innovative work practices were taken, with nursing leading policy development and delivery of care models in new and established healthcare settings, supporting patient and staff safety. Impact Nursing comprises the majority of the healthcare workforce, placing executive nurse leaders in a key role for healthcare responses to the COVID‐19 pandemic. Nursing's contribution was multi‐faceted, and advantages gained for nursing practice must be maintained and leveraged. Recommendations for how nursing can contribute to current and future widespread health emergencies are provided.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

The context, contribution and consequences of addressing the COVID‐19 pandemic: A qualitative exploration of executive nurses' perspectives

Riddell

Bignell

Bourne

et al. 2022

Journal of Advanced Nursing

View full text Add to dashboard Cite

show abstract

“…A self‐administered electronic survey was created by the research team based on data from a previous qualitative study, in which tactical nurse leaders from the same institution were interviewed and detailed the solutions they designed to fight the pandemic (Freitas et al, 2021 ). Considering the singularity of the aim of this work, it was not feasible to use a pre‐existing scale.…”

Section: Methodsmentioning

confidence: 99%

“…This work was based on a previous assessment study with nurse leaders (Freitas et al, 2021 ). Nurse leaders have proposed solutions for the best management of the challenges posed by the pandemic on health care.…”

Section: Introductionmentioning

confidence: 99%

Nurses' perception of solutions proposed by nurse leaders in face of COVID‐19 pandemic: A cross‐sectional study

Freitas

Savieto

Queiroz

et al. 2022

J Nursing Management

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Aim: To evaluate the perception of bedside nurses regarding the implementation of solutions proposed by nurse leaders for patient and employee care during the COVID-19 pandemic.Background: Nurse leaders have proposed solutions to better manage the challenges of the pandemic. However, multiple factors influence the transposal of actions from the tactical to the operational levels.Method: This cross-sectional study was carried out in a 620-bed non-profit institution. Participants were bedside nurses who completed an online survey.Results: One hundred sixty-eight nurses participated in the study. Most of the proposed solutions were very effective and easily identified by the nurses. These solutions included adaptations of the physical structure, availability of medical supplies and adequacy of institutional protocols. The actions that stood out with low perception were adequate integration of new employees and the availability of remote work, hotel accommodations for frontline health care workers and day care for children whose parents worked at the hospital. Conclusion:Bedside nurses were able to recognize most of the solutions proposed by their nurse leaders during the COVID-19 pandemic.Implications for nursing management: Tactical-level nurse leaders need constant proximity to bedside nurses and continuous elucidation of the objectives to be achieved by the strategies adopted.

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“…Nursing leaders, administrators, and nurse managers faced the organizational pressures and issues that precipitated CF. Recent findings published by Freitas et al 25 suggest that majority of nurse administrators and leaders cited three significant challenges: nurse staff safety and infection risk, stress, worry, and anxiety, and work-overload.…”

Section: Psychosocial Strugglesmentioning

confidence: 99%

Compassion Fatigue among Nurses Assigned to COVID-19 Facilities: A Constructivist Grounded Theory

2022

Acta Med Philipp

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Background. The Coronavirus Disease (COVID-19) pandemic significantly disrupted regular health care services, mainly in the hospitals. Nurses soldiering on the battlefront of care of disaster response in the Philippines during the disease outbreak are at high risk of developing rapid-onset compassion fatigue. Notably, research is still needed to investigate the impact of compassion fatigue on various clinical areas and further develop a theory of compassion fatigue within the nursing context.Objectives. The study explored the concept of compassion as experienced by nurses directly caring for COVID-19 patients. The study further explored the experiences of nurses on compassion fatigue.Methods. This study employed qualitative methodology, specifically the constructivist grounded theory.Results. Thirty-four participants were included in the study. The narratives and voices of the nurses unfolded the following themes: (1) Acts of Compassion, (2) COVID-19 Pandemic: Nursing Challenges and Detours, (3) Nurses' Compassion Fatigue, (4) Narratives of Opportunities: Thriving at the outset of COVID-19. All four concepts are linked to the multidimensional concept of compassion fatigue. A substantive theory, "Remon's CF Theory in Nursing," is proposed based on the grounded experiences of nurses caring for COVID-19 patients related to compassion fatigue. Conclusion. Compassion Fatigue (CF) is a psycho-social phenomenon and occupational hazard affecting nurses directly caring for or in contact with COVID-19 patients. CF is a process that develops over time brought by prolonged enactment of compassion, the experience of empathic distress, and concurrence of organizational, contextual, and psychosocial factors. Nurses' CF can potentially affect safety and lead to poor nursing care, compromised work relations, and burnout. Nurse leaders' organizational and leadership commitment and support through up-to-date policies and continuous research on the topic are necessary to regain compassion among nurses. Likewise, reframing nurse compassion fatigue as an organizational and collective problem provides the larger perspective to further improve clinical practice and nurses' welfare.Recommendations. Nurse leaders, hospital and COVID-19 facility administrators must ensure specific policies and priorities that address issues causing and fueling nurse compassion fatigue, including frequency of exposure to traumatic events, lack of resources, and inadequate support system. The study further suggests conducting quantitative research to test the proposed theory and explore the relationship between organizational, psychosocial, and environmental context, compassion fatigue, and compassion-driven factors.

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Nurse Leaders’ Challenges Fighting the COVID-19 Pandemic: A Qualitative Study

Cited by 7 publications

References 23 publications

The context, contribution and consequences of addressing the COVID‐19 pandemic: A qualitative exploration of executive nurses' perspectives

The context, contribution and consequences of addressing the COVID‐19 pandemic: A qualitative exploration of executive nurses' perspectives

Nurses' perception of solutions proposed by nurse leaders in face of COVID‐19 pandemic: A cross‐sectional study

Compassion Fatigue among Nurses Assigned to COVID-19 Facilities: A Constructivist Grounded Theory

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