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Challenges faced by nurse managers during the COVID-19 pandemic: an integrative review

Background

Nurses have crucial roles in caring for patients and preventing the spread of COVID-19. Therefore, nurse managers have a prominent role during the pandemic, being responsible for the support and training of the nursing team to ensure quality care. While performing their duties in this time of fear and uncertainty, nurse managers face several challenges.

Aim

To identify the challenges faced by nurse managers during the COVID-19 pandemic.

Methods

It is an integrative literature review whose search for articles was carried out in Medline, PubMed and Scopus. Qualitative content analysis was used.

Results

Twelve primary research studies were included. Four themes emerged: (1) Workplace demands, (2) Impacts on physical and psychological health, (3) Coping measures and resilience and (4) Recommendations to better support nurse managers in times of crisis. Nurse managers had their roles expanded or completely changed, and they experienced many pressures and stressors in the workplace. Nurse managers also faced physical and psychological health problems. Nurse managers drew on experience; management skills; social media applications; support from family, colleagues and hospital administrators; training, and continuing education to solve the problems that emerged due to the COVID-19 pandemic. Organisations should use collaborative, inclusive and participatory practices for better crisis management.

Conclusions

Knowing the experiences of nurse managers during the pandemic period may help health institutions and policymakers better prepare for emergencies.

In the Eye of the Storm: Leadership Lessons From the Front

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.

The value of human resources: Experience of critical care nurses during the COVID-19 epidemic

The COVID-19 pandemic has caused an unprecedented health crisis. Pressure on the National Health System has created unique demand particularly in certain services and care units like the critical care units.

Objective

To learn about the experience of nurses in caring for people with coronavirus in critical care units.

Method

A qualitative phenomenological study that constitutes the second phase of a mixed methodology project. We conducted interviews with 17 nurses caring for patients affected by COVID-19 in critical care units. The interviews were audio-recorded, transcribed, and analysed using thematic discourse analysis.

Results

This article shows the findings around the theme “the value of human resources” which is nuanced through sub-themes “it's not the beds, it’s the expert staff”, “shouldering the patient's burden”, and suffering because “they have not cared well”.

Discussion

Expert nurses have emerged as leading professionals in the care of the critical patient during the COVID-19 pandemic. This leadership is executed from a profile framed in an inclusive philosophy where wisdom, agility and intuition are the key elements underpinning problem identification and solving in a creative way, while adapting to the needs of the patient and healthcare team as they emerge.

Conclusions

Expert nurses have played an advanced role in the management of care and human resources by exercising effective leadership in the clinical setting. Care has been hampered due to the crisis, which causes nurses moral distress because they have been unable to meet standards of quality and excellence in care.

[The value of human resources: experience of critical care nurses during the COVID-19 epidemic]

La pandemia por COVID-19 ha supuesto una crisis sanitaria sin precedentes. La presión asistencial sobre el Sistema Nacional de Salud ha generado escenarios insólitos de demanda especialmente llamativos en algunos servicios o unidades asistenciales como las Unidades de Cuidados Críticos.

Objetivo

Conocer la experiencia de los profesionales enfermeros referida a la atención de personas infectadas por coronavirus en las Unidades de Cuidados Críticos.

Método

Estudio cualitativo de carácter fenomenológico que constituye la segunda fase de un proyecto de metodología mixta. Se realizaron entrevistas a 17 enfermeras que prestaron cuidados en Unidades de Cuidados Críticos a pacientes afectados de COVID-19. Las entrevistas fueron audiograbadas, transcritas y analizadas mediante análisis temático del discurso.

Resultados

En este artículo se muestran los hallazgos en torno al tema «el valor del recurso humano» que matiza su significado a través de los subtemas «no son las camas, es el personal experto», «llevando la carga del paciente» y sufriendo por «no haber cuidado bien».

Discusión

Los profesionales enfermeros expertos se erigen como profesionales líderes en el cuidado del paciente crítico durante la pandemia por COVID-19. Este liderazgo se ejerce desde un perfil enmarcado en una filosofía integradora donde sabiduría, agilidad e intuición son los elementos clave que dan soporte a la identificación y resolución de problemas de forma creativa adaptándose a las necesidades emergentes de los pacientes y equipo de cuidados.

Conclusiones

Los profesionales enfermeros expertos han desempeñado un rol avanzado en la gestión de cuidados y de recursos humanos mediante el ejercicio de un liderazgo eficiente en el entorno clínico. Los cuidados se han visto mermados por la situación de crisis, circunstancia que les genera sufrimiento moral por no haber podido cumplir con los estándares de calidad y excelencia en el cuidado.