In January of 2020, I had my year planned. I planned to scale my freelance writing business and step away from nursing full-time. Then, COVID-19 made its appearance, and my plans were abruptly halted and changed. My nursing job as a Staff Development Director and Infection Preventionist experienced challenges and growth I never imagined. Before the pandemic, the words resilient and flexible were synonymous with nursing. As nurses face burnout, emotional distress, and a realization that the healthcare system doesn't appreciate the value that we bring to every setting within the industry, more nurses rely on those skills to work through the unknown and manage a pandemic and forge new paths. As a nurse leader, clinical skills are important, but soft skills are essential as well. The COVID-19 pandemic forced me to grow in three areas to better serve my staff, patients, and community.
Leadership
At the beginning of the year, I had typed my resignation letter. I prepared to turn it in and walk away from my nursing job. In March, when COVID-19 surfaced in the U.S., I decided the position I held was an essential aspect of my facility's team, and I needed to be there to help my coworkers, but most of all my patients. I am the infection preventionist for a skilled nursing facility — a nursing home. Infection prevention and control programs in long-term care facilities help prevent the spread of infection to vulnerable residents. As COVID-19 hit nursing facilities hard, infection preventionist jobs became the top priority in these facilities. I not only find ways to control and prevent infectious diseases, such as the coronavirus, but I also need to educate the staff, our stakeholders, and the community. I lead the Infection Prevention Committee, and I'm an essential member of the facility's Quality Assurance Performance Improvement (QAPI) program.
COVID-19 has heightened the critical role nurses play in emergency preparedness and response. Compared to other healthcare facilities — which may have one nurse for every two to four patients — nurses in nursing homes (also known as skilled nursing facilities or long-term care facilities) can have anywhere from 20 to 60 residents under their care. This amount of responsibility and the added pressure of an unknown virus can cause staff to burn out. I have made myself available to my team. That means incontinent care, aiding in transferring a resident, feeding, or even buying lunch when it's been a hard day. It is my responsibility to ensure that staff has the resources needed to protect themselves and our residents. These resources can take form as:
- Mentorship
- Education and training
- Preceptorship
- Competency checkoffs
- PPE
- Proper usage of PPE
- Support
One thing that we implemented is annual skills fairs. In these fairs, the nurses and certified nurses' assistants are checked off on competencies and skills and introduced to new skills. This is my chance to see who needs extra attention to skills.
Communication
A significant part of any nurse's job is communication. When you step into a managerial or administrative role, you must prepare yourself to communicate on a different level. On any given day, I speak with:
- Work colleagues
- Patients
- Family members
- Physicians
- Staff
- Healthcare teams
- Other healthcare professionals
Constant interaction with different groups of people meant I had to learn to communicate effectively. Whether delivering positive or negative news or delivering written or verbal communication, I need to be clear and use language that the receiving party understands. My motto is to meet people where they are and actively listen. When speaking, nurse leaders should:
- Be mindful of their tone
- Speak slowly
- Enunciate clearly
- Use language the receiving party understands
- Respond using mirroring language
- Be aware of their facial expression
- Watch their body language
Effective communication is crucial for healthcare organizations, especially during this time. A communication breakdown can:
- Cause medical errors
- Compromise safety
- Contribute to burnout
- Lead to high staff turnover
- Contribute to poor job satisfaction
- And, in the worst cases, even lead to death
Openness
Fostering communion and making myself available and open to my staff has greatly improved the rapport. Lots of leaders say they have an open-door policy — but do they, really? I'm available to staff at any time. I make it a habit to be out and visible on the floor, so the staff feels comfortable to stop me and chat. I keep snacks in my office and have placed an inviting sign that reads, "Grab a snack, and let's chat." I've created a warm and inviting environment. We have regular meetings that we call Town Hall Meetings to update staff on changes, our facility's COVID-19 status, and any other pertinent information. Transparency is the key to openness.
The COVID-19 pandemic is new to us all. Strong nurse leaders inspire others to exceed their own personal expectations.
