Prof. Cathcart pens survival guide for nurse managers during COVID-19

Nurse managers play vital roles in health care organizations, providing clinical leadership, guiding nursing staff, liaising with hospital administrators, and more. The novel coronavirus (COVID-19) has made nurse managers’ roles more complex—and more important—than ever.

In a new article in the journal Nursing Management, Eloise Cathcart, MSN, RN, FAAN, director of the nursing administration program at NYU Rory Meyers College of Nursing, writes about how nurse managers can lead and succeed in the challenging environments created by COVID-19. 

 “The coronavirus pandemic has shown us how important good leadership is to keep us safe during this frightening time. For example, we hear the Governor of New York tell us the latest—often dire—news about how things are going in the epicenter of the pandemic. His tone is clear, firm, and compassionate; his facts are evidence-based; he doesn’t traffic in inuendo or hunches. He doesn’t talk about successes in terms of ‘I,’ but says that New Yorkers made it happen,” says Cathcart. “This is also the kind of leadership frontline nurse managers have displayed during this pandemic as they have stood in front of, beside and behind magnificent clinical nurses who displayed acts of true heroism and unbounded compassion in the care of COVID 19 patients.”

Beyond the difficulties of caring for patients with COVID-19, Cathcart describes the hurdles that nurse managers face in leading units, including working in new physical locations, overseeing new staff members redeployed from other hospital units, and having staff not accustomed to working in an ICU learning to care for ventilated patients in real time.

“No nurse manager practicing today has experienced anything like the coronavirus pandemic; this will be a formative event for all nurses as we move into an unknown future. None of us has managed this degree of chaos, complexity, and uncertainty before so, in a sense, we’re all new nurse managers trying to find our way,” she writes in Nursing Management.

Cathcart offers nurse managers four key principles to guide them through the COVID-19 pandemic.

Embrace your leadership role, even if you’re uncertain about what to do. Cathcart describes how nurse managers are the critical conduit between patients and hospital leadership, and should be visible and available to staff providing care. Nurse managers should also focus on the wellness of their staff, encouraging them to stay hydrated and take breaks to eat during busy shifts; this is especially important during the pandemic, as eating and drinking are difficult because of personal protective equipment (PPE).

The way you conduct yourself is your most important management tool. In the midst of this challenging and emotional situation, nurse managers need to stay calm and focused. “Many nurses are grieving for a world that’s irrevocably changed and feeling unsafe because they don't know what’s to come,” writes Cathcart. By connecting with your staff and enabling them to express their feelings, nurse managers can help alleviate some of this anxiety.

Have a vision for the day and acknowledge short-term wins. Cathcart notes that your goals look different during a pandemic, and should focus on getting patients and staff safely through the day—as well as celebrating small victories. “Staying focused on the present and acknowledging the small wins that come from a team working together to do their best can help bolster staff morale. Share instances when patients are extubated or discharged from the hospital to help staff remember that there are patients who survive,” Cathcart writes.

Keep the voice of the clinical nurse in the conversation. Good leaders should look to the nurses engaged in patient care for answers in challenging situations. Nurse managers may also create opportunities for nurses to share their experiences and validate the worth of the heroic work they are doing—which could be in person or through written expression like posting on social media or writing an op-ed. These outlets could help frontline nurses “lessen the tremendous burden they carry,” writes Cathcart.