Nursing Leadership
In the 1958 musical South Pacific, the character Nelly Forbush trills a song of optimism and hope amid the darkness of World War II (South Pacific Enterprises and Logan 1958). The chipper message of this fictional navy nurse might well be welcome amid the negative timbre of the pervasive political, cultural and societal upheaval that we are experiencing today – not to mention the burden of a global pandemic. The tune delivers the message of a so-called "cockeyed optimist," staying positive while many are not and being buoyed by the anticipation of brighter, sunny days ahead (South Pacific Enterprises and Logan 1958). COVID-19 has unloaded countless blows to virtually every aspect of the life we once knew; surely, this is enough to leave any cockeyed optimist reeling. Where do we find the strength of character to prevail during times like this? Somehow, good leaders do; finding creativity, courage and conviction to make the most of a bad situation, they rise above it. They show optimism in the face of fear, the unknown and circumstances beyond their control. Instilling abiding trust in their followers, they lead out of the abyss, shining light on new possibilities and opportunities.
Emergency departments around the world have developed strategies to accommodate and manage large influxes of COVID-19 patients while keeping staff and others safe. Ensuring adequate and appropriate staffing is core to launching an effective response to any critical situation, never mind one with no end in sight. In this issue, MacPhee and colleagues (2020) describe the development and implementation of an emergency staffing tool that shows promise to resolve long-standing issues, specifically staffing driven by budget versus patient acuity and needs. The demonstrated success in this approach to emergency department staffing might well be a welcome rethink in times of crisis.
Recent news has been rife with reports of violence erupting in many locales, largely in response to systemic racism but also perceived human rights infringements arising from the pandemic (for example, anti-maskers and anti-vaxxers). An increase in domestic violence has also been reported in the face of COVID-19 (Stanley 2020; Taub 2020), but regardless of the pandemic, violence is considered a rising epidemic in healthcare settings (Stephens 2019). Johnson-Howell and Derscheid (2020) describe a program implemented in the Mayo Clinic Health System to address violent situations in healthcare. Focused on the development and implementation of a violent patient preparedness program, they describe the key aspects of the program including a unique leadership approach. The pandemic has also illuminated another often forgotten segment of society's most vulnerable: the homeless. Stake-Doucet (2020) provides a review of street nurse Cathy Crowe's new book highlighting her long-standing efforts to address issues of social injustice and bringing the urgency for nursing activism and politicism to the fore.
In this issue, we also hear from our editorial team, with each member sharing their unique experience of leadership during the COVID-19 crisis. Mildon (2020) unfolds a story of positive benefits derived from the creativity and cohesion of a community-based workforce brought closer together and delivering care in novel ways despite the crisis. With the usual community care services suspended, the creation of a "care crew" is but one example of the resourcefulness of a team wanting to ensure that individuals' needs were still being met as much as possible. Along with looking out for their clients, this community organization has also paid particular attention to the needs, emotional and financial, of their staff. McAllister (2020) shines a light on some of the principles guiding her leadership within an acute care setting during the pandemic. Core to her ingredients for leading effectively is building and leveraging relationships. She describes the new role of the "pandemic practice champion," one designed to provide additional staff support, as well as a new opportunity for the incumbents. She also illustrates how the capabilities and creativity of different team members were leveraged to advantage in developing strategies and workable solutions. Her commentary exemplifies courage and authenticity in leading others but also an unwavering willingness to be vulnerable in the face of uncertainty. Almost (2020) gives us insights into the pandemic challenges faced by nurses in academia and the need for a "high-speed pivot." With pedagogical traditions thrown to the wind, she and other academics across the country have had to find new ways to teach, learn and maintain a program of research. Responding to calls for proposals related to COVID-19, many researchers have suspended or shifted their programs of research, the result of which remains to be seen. Furthermore, she describes how some of her colleagues "wrestled with guilt" associated with wanting to be helpful in clinical settings. How many of us have shared in that struggle? In sum, each of these leaders has demonstrated their unwavering commitment and courage to manage and create anew; they have held steadfast thus far and have the substance needed to prevail over the long term. I personally applaud each of them and all of you with equally compelling stories from the field.
No matter the role or setting, nursing work is central to managing a public health crisis such as the one that has consumed us in recent times. A sustained crisis demands sustained leadership characterized by courage, confidence and a healthy dose of optimism. Some may call me a cockeyed optimist, but I know there is a brighter canary yellow sky ahead. This too shall pass, and although our leaders have already demonstrated their mettle, when it's finally over, we will be a stronger force because of it.
Lynn M. Nagle, PhD, RN, FAAN
Editor-in-Chief
Adjunct Professor
University of Toronto
University of New Brunswick
Western University
References
Almost, J. 2020. The Impact of COVID-19 within Academic Settings: A High-Speed Pivot. Canadian Journal of Nursing Leadership 33(3): 15–19. doi:10.12927/cjnl.2020.26323.
Johnson-Howell, J. J. and D. J. Derscheid. 2020. Implementation of a Preparedness Program to Address Violent Situations in Healthcare. Canadian Journal of Nursing Leadership 33(3): 45–54. doi:10.12927/cjnl.2020.26320.
MacPhee, M., J. Wagner, S. A. Udod, L. Berry, G. Perchie and A. Conway. 2020. Using the Synergy Tool to Determine Regina Emergency Department Staffing Needs. Canadian Journal of Nursing Leadership 33(3): 29–44. doi:10.12927/cjnl.2020.26321.
McAllister, M. 2020. Weathering Pandemic Turbulence: It's All about Relationships. Canadian Journal of Nursing Leadership 33(3): 9–14. doi:10.12927/cjnl.2020.26324.
Mildon, B. 2020. Community Care and COVID-19: A Case Study. Canadian Journal of Nursing Leadership 33(3): 20–8. doi:10.12927/cjnl.2020.26322.
South Pacific Enterprises (Producers) and J. Logan (Director). 1958. South Pacific [motion picture]. Twentieth Century Fox.
Stake-Doucet, N. 2020. A Knapsack Full of Dreams: Memoirs of a Street Nurse [book review]. Canadian Journal of Nursing Leadership 33(3): 55–8. doi:10.12927/cjnl.2020.26319.
Stanley, M. 2020, May 9. Why the Increase in Domestic Violence during COVID-19? Psychology Today. Retrieved September 15, 2020. <https://www.psychologytoday.com/ca/blog/making-sense-chaos/202005/why-the-increase-in-domestic-violence-during-covid-19>.
Stephens, W. 2019, May 12. Violence against Healthcare Workers: A Rising Epidemic. AJMC. Retrieved September 15, 2020. <https://www.ajmc.com/view/violence-against-healthcare-workers-a-rising-epidemic>.
Taub, A. 2020, April 6. A New Covid-19 Crisis: Domestic Abuse Rises Worldwide. The New York Times. Retrieved September 15, 2020. <https://www.nytimes.com/2020/04/06/world/coronavirus-domestic-violence.html>.
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