COVID-19: When Leadership Calls.

From the minute our organization received our first presumptive positive COVID-19 patient, and throughout our journey, many challenges and obstacles have been presented for health care leadership. Priorities are rapidly shifting, anxiety and fear are present, and knowing where to focus support is a challenge. As I sit and reflect on lessons learned throughout this experience, I can't help but continue to focus on frontline leadership and their important role in this entire process. 2020 by Elsevier Inc. All rights reserved.

COVID-19. This 1 little word is strong enough to stand alone as a single-word sentence. COVID-19 has caused much of the world to begin to think differently, react quickly, and for nursing leaders like myself, lead differently. COVID-19 has caused us to drastically shift focus in health care, and plan for immediate threats and rapidly work through change theory at increasing speed. The evolution of this pandemic is quickly transitioning throughout the United States, causing priority of the day to shift many times. Agility of leadership is crucial to critically function and work through the many challenges presented. For me, there is 1 priority, besides patient safety and outcomes that I can’t seem to stop thinking about. As an assistant vice president of clinical services across 3 hospitals in a large enterprise, I worry about our staff. Our support staff, our frontline nurses, and maybe most importantly, our frontline managers—the leaders that truly support our day-to-day operations on the most granular level. The demands of health care are not easy. Quality, safety, service, finance, research, education, and just for fun, lets add “pandemic” to the list of duties our nursing leaders work through every day. Emergency management is a skill, it’s maybe even a calling, and not all leaders are equipped to navigate successfully through these obstacles. Staff are frightened, they don’t know what to expect, and quite frankly, neither do I all the time; but my job is to lead them, guide them, and support them to be as successful as possible. My job is to provide exceptional care to our patients, and mentor and grow the leaders of today to be the strongest leaders of tomorrow…but how? Sure, there is research and guidance on coaching, mentoring, and leading; but practically speaking, it’s difficult to prepare for the serious challenge we are currently facing in health care. Not enough beds, not enough staff, not enough supplies, not enough communication. As I work through how I can best support our frontline leaders, I keep circling back to very basic and foundational principles I learned from my mentors throughout my career. It doesn’t have to be complicated, it just has to be effective. There are some fairly simple examples of successful tactics I can share that may help to remind leaders that authenticity and foundational concepts can help even in the most complex and complicated situations. My hope is I can help to assist other leaders, like myself, remind each other “why” we chose leadership and “how” we remain authentic to our values—even through hysteria.

Stay calm—Remind (yourself) and your leaders that frontline staff will follow our lead. Leaders are in a fish bowl: staff watch leadership and model behavior they see role modeled. It is similar to a toddler looking to their mother when they fall and get injured. Our actions will guide their reactions.

Communicate—E-mails, huddles, (zoon) meetings, 1:1, townhalls, and leader rounding, whatever you need to do make it happen, and most importantly, be consistent. Managers are looking for guidance and information to reassure them they are fully informed. If they are informed, they will most likely remain confident in their message and the next steps they need to take. Consistent and continued communication is pertinent.

Collaborate—“It takes a village.” As nursing administrators, we have to send the strong message that we need all hands on deck, while still helping the team understand resilience must be maintained. We can’t get through this without a full committed team. Managers need to lean on each other and support each other. They also need to be empowered to “tap out” when they need to hand off to the next leader to minimize any type of burnout or inefficiency in their output.

Coordinate—During a quickly evolving and challenging time coordinating work efforts is imperative for success and efficiency. Frequent coordination with key stakeholders including physician partners, support services, and operational leaders will most likely yield higher quality and a safer environment. Alignment and trust among the senior leadership team will support more efficient planning sessions, a healthier work environment, and ultimately assist in role modeling behavior for the frontline managers to follow.

Support—One of the things you might hear me say is “We have to love them through it.” Leadership is hard, and holding a team accountable is not wrong; however, loving them through transition and challenge is ok, too. Hearing the voice of the customer, even when that customer is your employee, is important. Everyone deserves a voice, and often, I don’t have the best answer to a problem. I need all levels of our nursing leadership team to feel valued and relevant to provide input and ideas to help us to be the most successful.

COVID-19 has become the number 1 priority. It has now become a part of history, and that doesn’t have to be a bad thing. We can use this moment to mold our leadership styles and learn from experience to improve the future. We can take this experience and, although challenging, can use it to reflect on lessons learned and level set with our teams on areas of opportunity. Someone once told me that winning teams trust each other, respect each other, understand each other, and enjoy each other. I have taken that with me through my career and believe that in my experience that saying is true. I have worked with many teams, but with the core values and basic foundations I shared above, I believe most of us can experience a winning team.