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Journal: Nursing administration quarterly

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The COVID-19 crisis created unique and interesting challenges for health care systems and changed how health care professionals delivered care. Evidence suggests that leadership skills remain of utmost importance during crises as it is the leader who often determines the response of the follower. A descriptive qualitative approach was used to ascertain the essence of nurse executive leadership and innovation during the COVID-19 crisis. Nurse executives were recruited via personal invitations to participate in the study. Participants were asked about their current challenges of COVID-19 on health care delivery, their leadership style, and what innovative processes their teams deployed. Using a thematic analysis approach, 3 themes emerged and resonated from the interviews: the importance of communication; the need for leadership presence; and mental toughness. With any health care crisis, leadership is essential to guide followers. As demonstrated by these findings, communication, leadership presence, and mental toughness are 3 key components to promoting and providing quality care in an austere, complex, and changing health care environment. Further understanding of the roles of these key concepts may add insight into nurse leaders and leadership development.

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This article describes how a national nursing association and a major academic medical center responded to the coronavirus disease-2019 (COVID-19) pandemic during the first wave of the outbreak in the United States (January to August 2020). The organizations share their lived experiences as they quickly found themselves at the forefront of the crisis. The article discusses how early warning signs from a world away sparked collaboration, innovation, and action that grew to a coordinated, organization-wide response. It also explores how leaders in 2 distinct but interrelated environments rose to the challenge to leverage the best their organizations had to offer, relying on the expertise of each to navigate changes that were made to almost every aspect of work. From tentative first steps to rapid implementation of innovative policies and procedures, the organizations share lessons learned and benefits reaped. The article includes practical crisis response strategies for the nursing profession and health care systems moving forward.

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During the 2020 global pandemic crisis, some health care teams pulled together while others fell apart. The teams who pulled together put aside their differences and became stronger, putting their patients first and then each other. Those teams grew stronger, but some teams completely fell apart. They spent their days nitpicking, complaining, and arguing-making decisions based on what was best for themselves, not patients or their coworkers. The common denominator in determining how well teams performed was the leader. Employees looked to their leaders to successfully lead them through crisis, whether it was on a small or global scale. Depending on leader behaviors, the leader strengthened or weakened the team; trust was built or broken. That is a heavy burden to carry knowing that employees were so dependent on them and how they showed up every day. What lessons can leaders learn from the coronavirus-2019 (COVID-19) pandemic that can help them strengthen and sustain a healthy, professional, and supportive workforce culture during a crisis and beyond?

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This article describes the implementation of an evidence-based mentoring program for new registered nurses (RNs) hired into medical-surgical units in a small community-based hospital during the unfolding of the SARS-Cov2 (COVID-19) pandemic. The hospital’s nursing leadership supported the program implementation during the COVID-19 pandemic to provide a broader support system to new RNs to improve nurse retention. During a response to the pandemic, the medical-surgical units faced numerous process changes in a short time, which further reinforced the urgency of an additional support system for the newly hired RNs.

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Responding to the coronavirus disease-2019 (COVID-19) pandemic is likely to exacerbate anxiety, burnout, fatigue, and distress already being experienced by nurses in ever greater numbers. An innovative Wellness Partner Program was developed with an aim to enhance the health and well-being of nurses on the front lines during the COVID-19 pandemic and beyond. Nurses across the country opted in to the program, and were paired with advanced practice nursing (APN) graduate students who served as the nurses' wellness partners. Areas emphasized in the program included (1) personalized support for wellness; (2) prioritizing physical activity, healthy eating, sleep, and stress management; and (3) establishment of strength-based, sustainable solutions to improve health and well-being. Partnerships were implemented for 188 nurses who were coached by 49 APN students; 104 nurses participated for 6 weeks. In the program evaluation, 98% of nurses shared that the wellness support program helped them engage in self-care and wellness, and 94.7% agreed or strongly agreed that The Wellness Partner Program helped them improve their mental and physical health. In the midst of the pandemic, nurses were supported to cope with stress, focus on self-care and wellness goals, and address challenges to their well-being.

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The impact of the global coronavirus disease-2019 (COVID-19) pandemic has triggered changes in nursing education at a pace not previously experienced in academia. Academic nursing leaders have been faced with challenges of balancing the impact of the pandemic responses in the face-to-face classroom, laboratory, and clinical learning, ensuring the safety of the college community, and supporting alternative educational delivery formats with assurance that desired learning outcomes and demanded professional competencies are attained. The challenge faced by these leaders is unprecedented. However, there is opportunity in crisis for leaders. This article details how the leadership at one institution leveraged transformational change theory to support faculty, staff, and students during this time of rapid change. Additionally, the article discusses the use of transformational change theory and the ongoing institutional commitment to meeting curricular goals and objectives while maintaining a commitment to being student focused.

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Nurses have the knowledge, skills, and expertise to bring value and leadership to a myriad of boards throughout the United States, with nursing leadership critical to the transformation of complex health care systems. The 2011 Institute of Medicine Future of Nursing report calls on nurses to lead at all levels in systems as well as in board rooms. In 2014, the Nurses on Boards Coalition (NOBC) aligned its mission with this charge, creating a goal, as stated on its Web site, to “improve the health of communities and the nation through the service of nurses on boards and other bodies.” A specific goal of NOBC was to have 10 000 nurses on boards by 2020. Through a partnership with the Robert Wood Johnson Foundation and the America Association of Retired Persons, NOBC worked strategically to achieve its goal. The accomplishments of one of its work groups, Preparation and Support, are highlighted.

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When the Institute of Medicine released its report, commonly known as the Future of Nursing report, every state was challenged to take on the work of implementing the 8 recommendations. The Texas Team Action Coalition achieved measurable results in many areas; however, sustainability of efforts was challenging due to the volunteer nature of the work. As Robert Wood Johnson Foundation’s focus shifted from Advancing Health Through Nursing to Building a Culture of Health for All, the Texas Team sought to realign its work accordingly. This article details initiatives of the Texas Team over the past 10 years and describes current efforts to position itself to champion anticipated recommendations from the 2020-2030 Future of Nursing report from the National Academy of Medicine.

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Since the introduction of the Future of Nursing report in 2011, Indiana nursing has successfully implemented many of the recommendations. This article describes these accomplishments. Notable examples include increasing the diversity of the workforce, placement of nurses on community boards and governmental appointments, promoting the advancement of nursing education, and increasing the number of nurses with baccalaureate degrees. Furthermore, Indiana supports the proliferation of new doctoral programs with a scholarship fundraising program to assist nurses with the cost of their education.

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Challenges in the nurse work environment, particularly those resulting from nurse shortages and the retirement wave, can affect the health and well-being of all Americans, not just nurses themselves or the health care organizations where they work. Many of the solutions to significantly expand the number of nurses in America will take many years to realize. However, there are some important changes that health care organizations can put into effect relatively quickly to enhance the work environment for nurses, which can improve care quality and safety, patient satisfaction, and the well-being of nurses. The biennial Survey of Registered Nurses by AMN Healthcare, which polled nearly 20 000 RNs, found that nurses are eager for many workplace changes that would create a healthier workplace while enhancing their professional and personal lives. These institutional changes also create opportunities for improving the health of the organizations themselves. Analysis of survey data found that improving professional development, flexibility and work-life balance, safety and team engagement, and organizational response to workplace violence can create a healthier workplace for nurses. These are known solutions that have yet to be fully engaged.