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Department: Guest Editorial

The need for effective leadership

Editor(s): Kroning, Maureen EdD, RN

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doi: 10.1097/01.NME.0000717664.34007.e5
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The COVID-19 pandemic has forever changed us. When the patient surge occurred at my hospital, it was such a glaring eye-opener that my colleagues and I continue to talk about how scary it was not to have the needed resources and to see so many patients critically ill and dying from the virus. Most of us continue to fear experiencing another surge and having to relive what we just lived through only months ago. One of the saddest results of the pandemic is that many nurses are discussing quitting for this reason. It's likely that most hospital workers continue to worry if they'll have enough vital supplies and adequate staffing to provide safe, quality care for patients, as well as worrying about protecting themselves and their families from contracting the virus.

Healthcare workers look to their leaders for support and guidance, especially in times like this. As a healthcare leader, a recent incident reminded me just how essential the leadership skills of effective communication, empathy, compassion, and education are.

On a busy Sunday afternoon during the COVID-19 surge, a 68-year-old female patient was admitted to my hospital. She was immunocompromised, being treated for metastatic lung cancer, and presented with shortness of breath and 3 consecutive days of chills and fever. The patient's sister was the only family member granted permission to sit at her bedside. After several hours, the patient told her nurse she was worried that she and her sister would be exposed to COVID-19 while in the hospital. The nurse reassured her that the hospital was taking all precautions to avoid exposure; however, her sister had witnessed a nurse in the next room donning personal protective equipment (PPE) to enter the room and then saw the nurse doffing the PPE when exiting the room. They asked to speak to someone in charge.

The person in charge in most acute care hospitals when administrators aren't present is the nursing supervisor. Once on the unit, I assessed the situation by using effective communication techniques. Having a clear, concise message was vital when communicating with staff. Speaking to both the patient's nurse and the nurse caring for the patient in the next room was necessary to gather as much information as possible. I noted that the patient in the next room was positive for COVID-19 and in recovery. The nurse caring for the patient with COVID-19 was also caring for the immunocompromised patient's roommate. Through active listening and eliciting feedback, I discovered that the patient and her sister were deeply sad and worried about not only the cancer metastasis and treatment, but also the possibility of contracting COVID-19 while in the hospital. This was a known fear expressed by many patients in the hospital during the surge. Understanding the fear surrounding the pandemic, it was also important to show empathy and compassion.

Providing education about the Health Insurance Portability and Accountability Act was necessary because the patient and her sister wanted to know the diagnosis of the patient in the next room. I explained that the hospital uses strict standard precautions for all patients and strict isolation guidelines for anyone with suspected or confirmed COVID-19. This reassured both the patient and her sister. I also offered to relocate the patient to a private room because one had just become available. Both the patient and sister thanked me for listening to and addressing their concerns.

In my 20 years in a leadership position, I've learned that what we say matters. Our words have consequences and impact those receiving our message. And it isn't only what we say, but also how we say it. Emotional intelligence—the ability to monitor our own feelings and emotions—is especially important during highly stressful times. It's essential for leaders to demonstrate humility, reaching out to others who have expertise when needed, and be trustworthy so that when messages are communicated, people can make informed decisions about their own health and the health and safety of others. Leaders need to act as role models, leading by example and being cognizant of the messages they send. In the midst of this deadly pandemic, I can't say enough about the need for effective leadership.

Wolters Kluwer Health, Inc. All rights reserved.