Covid is Changing Care: What to Expect from Leadership

COVID-19 has been a game-changer for every perioperative nurse because patient care looks so different with new safety protocols to follow and new fears about risks for virus transmission.

“With the possibility of a strong resurgence of the virus in the Fall, planning is difficult, and many questions remain unanswered,” notes Rose Sherman, EdD, RN, NEA-BC, FAAN, a nursing leadership coach, professor emeritus at Florida Atlantic University, and editor-in-chief of Nurse Leader. “Could elective procedures and surgeries once again be canceled? Will periop nurses again be furloughed or deployed? Will supply chain issues continue?—at this point we can’t know for sure.”

As staff nurses working on the frontline forge ahead through the pandemic, she says the level of uncertainty and frequent changes around policies and practices have been exhausting. “Meanwhile, negativity and incivility in society have spilled into our healthcare environments, creating negative energy that makes team morale and engagement more challenging.”

What Nurses Need

Through these challenging times, Sherman says that nurses expect what they always have expected from their leaders—trust, stability, compassion and hope. “I need to trust my leader to do the right thing and to be transparent and I need my leader to show up as the same person each day, even though the world is uncertain. I also need my leader to feel empathy and compassion for what I am experiencing—even when they can do little to change it.”

She also emphasizes the need for hope that leaders can instill. “Napoleon said that leaders are dealers in hope. I need to know from my leader that things will get better. I don’t want a leader who is more fearful than I am.”

What Leaders Can Do

Leaders are changing their mindset and behavior about their leadership during COVID-19, Sherman notes. “Leaders tell me that they feel more vulnerable and have become better listeners.”

Because there is so much beyond a nurse leader’s control these days, “being at peace with what is within our circle of influence and what is not has become essential,” she stresses. “Leaders are spending more time talking with staff about difficult personal challenges, such as fear, the lack of child-care, and concern about their health vulnerabilities. Leaders tell me that these conversations are exhausting but necessary.”

Building Your Coaching Skills

Through it all, Sherman is seeing more coaching behavior versus a command and control approach.

That’s why she believes there has never been a better time to add coaching tools to your leadership toolbox. Here are two core elements to coaching that she says are essential leadership tools today:

1. Develop your ability to truly listen 
   Staff members want to be heard, even when little can be done to change a situation, she notes. “Leaders should spend 80% of their coaching time listening and not talking. Leaders tell me that this is quite a challenge, but it is vital.”
   
   
2. Learn how to ask great questions
   The best answers emerge from great questions. She suggests leaders ask staff members questions like these:

• What’s on your mind?
• What have you learned about yourself during this pandemic?
• When you have encountered a challenge like this before, what did you do to help yourself move through it?
• What is your biggest fear right now?
• How can we help you to reduce your anxiety level?
• Is this concern in your circle of influence or your circle of concern?
• What are you doing to promote your resilience?

Sherman believes that developing coaching skills will be time well spent through the pandemic for experienced leaders and for staff nurses working to build their leadership acumen. She is sharing her coaching skills through AORN’s virtual Nurse Leadership Seminar series this fall. Learn more.