Hospital nurses need effective communication from leadership to help them cope with the long COVID-19 pandemic, according to the results of a recent study.1
Nurses also need to be part of leadership gatherings, local meetings, and decision-making to share their daily experiences and help find solutions to the unprecedented emergencies created during the past two years.
“In many ways, our research study is a time capsule, and you can put yourself in the frame of mind of these nurses when we spoke with them [in 2020],” says Shannon Simonovich, PhD, RN, lead study author and assistant professor of nursing in the College of Science and Health at DePaul University in Chicago. “The workforce was faced with a quickly evolving landscape and disease process. What we intuitively think of as a direct path for patient care was ineffective. We needed new solutions and brainstorming.”
Investigators asked nurses 13 questions about their experience during the early part of the pandemic, including:
- “How did the nursing leadership in your department prepare you to work with COVID-19 patients?”
- “Tell us about PPE [personal protective equipment] use during COVID-19. Has this changed over time?”
- “How do you feel taking care of COVID-19 patients?”
- “What implications does the COVID-19 pandemic have for nursing education?”
Nurses shared three main concerns early in the pandemic:
- Access to adequate PPE;
- Caring for COVID-19 patients;
- Ineffective communication from management.
“We heard a lot about communication, and that was what led to a lot of nurses leaving the field,” Simonovich says.
Hospital nurses reported their relationships with colleagues helped them survive the first wave of the pandemic, says Roxanne S. Spurlark, DNP, APRN, FNP-C, study co-author and assistant professor of nursing in the College of Science and Health at DePaul University. Mental health interventions and additional pay also help, although broader support is needed for a long-term crisis like the pandemic.
“In the first wave of COVID, no one knew how to manage the patients,” Spurlark says. “If you don’t know how to care for patients, how can you care for yourself as well?”
Plus, the infection prevention rules and guidance changed often. “Here come another group of rules you have to abide by that are very different than 15 minutes ago,” she says. “It became, ‘How do we have avenues of communication that are up to date?’”
In their study, Spurlark and Simonovich focused on what worked well in the first phase of COVID-19. “The focus in this paper on COVID was to create information that would be helpful,” Simonovich says. “The positive themes were wanting your leadership to be physically present, timely with up-to-date information, and provide emotional support.”
Study participants did mention some negatives, including a lack of leadership presence on the floor, nurses not receiving timely or enough education, and a lack of emotional support.
“Those three things have contributed to a lot of burnout, especially now that we’re [about two years] into the pandemic,” Simonovich says. “It’s one thing to be in a pressure cooker for a short period of time. But for nurses, especially those providing bedside care in the United States, there hasn’t been any relief.”
The nursing workforce is generous with their time and talents. They believe only their co-workers and others in healthcare can understand what they are going through.
“An overworked nursing workforce doesn’t have confidence in leaders or emotional support,” Simonovich says.
Researchers found many examples of good leadership from survey respondents. Here are a few:
- “I remember driving in at 3:00 in the morning once and my regional [nurse leader] giving me a call and saying, ‘Are you OK? I’m headed in with you. I know you’re coming in.’”
- “In the beginning, the guidelines changed almost daily because we were learning as we went. We have a daily huddle board. That whole huddle board became a COVID board. As things came from nurse education and the command center and infectious disease, I would make sure I educated all my staff, but also posted all of that on the COVID board.”
- “[We] have what’s called a ‘Zen den,’ and it’s supposed to be a room [where] you can sit and reflect. On your lunch hour, a nurse can sit down and just think or process [their] feelings.”
- “I work with a bunch of awesome nurses. We [have] good camaraderie, good teamwork, things like that. We all kind of just leaned on each other [saying], ‘Hey, we’ll see you tomorrow.’”
- “We created a wellness team [of nursing liaisons] that [go] around 24 hours a day, giving away food, snacks, but also just talking. Our nursing liaisons have a good relationship with our nurses, [and we] added our psychiatrist or psychologist on the rounds also.”
Another way nurse and case management leaders can provide support is to include staff in management planning and brainstorming.
“Have nurses in those meetings,” Simonovich says.
Case managers and nurses know their work challenges best, and it shows them leaders are taking their concerns seriously when they are included in management meetings and planning sessions.
Good leaders create a sense of “We — we’re in this together.”
“When leadership says, ‘We,’ it changes the whole perspective,” Simonovich says. “There should be more transparency. We know what good communication looks like, and it’s within our grasp to do this together — not only as professionals, but also as human beings.”
REFERENCE
- Simonovich SD, Spurlark RS, Badowski D, et al. Examining effective communication in nursing practice during COVID-19: A large-scale qualitative study. Int Nurs Rev 2021;68:512-523.
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