The impact of leadership on the nursing workforce during the COVID-10 pandemic

Abstract

Aims: To determine how the learning about protective factors from previous pandemics were implemented and the impact of this on nurses experience. Background: The COVID-19 pandemic led to systemic change within healthcare settings and demands placed on frontline nurses has been overwhelming. Lessons learned from previous pandemics indicate that clear communication and strong visible leadership can mitigate the impact stressful events may have on nurses. Conversely, a lack of clear leadership and regulatory protocols in times of crisis can lead to an increase in psychological distress for nurses. Design: Secondary analysis of semi-structured interview transcripts. Methods: Secondary data analysis was conducted on data collected during a hospital-wide evaluation of barriers and facilitators to changes implemented to support the surge of COVID-19 related admissions in wave one of the pandemic. Participants represented three-levels of leadership: whole trust (n=17), division (n=7), ward/department-level (n=8), and individual nurses (n=16). Data were collected through semi-structured video interviews between May and July 2020. Interviews were analysed using Framework analysis. Results: Key changes that were implemented in wave one reported at whole trust level included: a new acute staffing level, redeploying nurses, increasing the visibility of nursing leadership, new staff wellbeing initiatives, new roles created to support families and various training initiatives. Two main themes emerged from the interviews at division, ward/department and individual nurse level: impact of leadership, and impact on the delivery of nursing care. Conclusions: Leadership through a crisis is essential for the protective effect of nurses emotional wellbeing. While nursing leadership was made more visible during wave one of the pandemic and processes were in place to increase communication, system-level challenges resulting in negative experiences existed. By identifying these challenges, it has been possible to overcome them during wave two by employing different leadership styles, to support nurse wellbeing.

Who is responsible for nurse wellbeing in a crisis? A single centre perspective

“…For those who felt they lacked leadership, or were redeployed to unwelcoming teams, the situation was framed much more negatively and morosely. Previously our research has shown how much an impact leadership across all levels can have on nurses, positively and negatively 16 . Similar themes surrounding the importance of team cohesion and reflective practice informing future protocols has been found in other samples of the COVID workforce as examples of strong leadership 15 .…”

“…Leadership emerged as a key indicator as to the overall health of an organisation and its workforce. Covid-19 has shown us that leadership can have detrimental effects on staff wellbeing or it can greatly boost their ability to handle a crisis 16 . The wellbeing of the workforce is pivotal to the health service, and it is mutually beneficial for patients, staff, and leaders 14 .…”

“…This acceptance and compassion to self is not the responsibility of the individual rather something which needs to be hardwired into organisational practices 14,19 . The cornerstone of this practise is compassionate leadership, rather than command-and-control style 14,16,20 .…”

“…Placing this burden on staff who are already emotionally depleted is likely to result in compassion fatigue, which is likely to affect the standard of care staff are able to provide 14 . We have previously shown the importance of nursing leadership during the pandemic and the way the command-and-control style of leadership impacted on nurses at each level of the hierarchy 16 . At the heart of this was the subsequent emotional impact.…”

Psychometric properties and latent profile analysis of the Nursing Brand Image Scale: a methodological study in the Chinese context

“…The convergent validity presented suitable values for most of the factors, except for the Influential Leaders subscale and the Lack Authority/Professional Identity subscale, which showed levels below those recommended AVE. Future studies might examine if these two dimensions represent two different brand images of nursing, the traditional and the new. The inconsistency in perceptions of brand image is responsible for the low convergent validity of the two subscales [48,49]. Regarding the discriminant validity evaluation, there was interpretable identity between Valued By Society subscale and Influential Leaders subscale, as well as Strong Interpersonal Skills and Advanced Nursing Practice.…”