The role of safety leadership in nursing management during the pandemic: A qualitative study in Indonesia

The article discusses a qualitative study on the role of safety leadership in nursing management during the pandemic in Indonesia. The study assessed safety leadership behavior of head nurses in inpatient facilities, expectations and obstacles to leadership and safety in the ward setting based on the human caring theory. Findings revealed the significance of caring values, risk perception, trust-based relationship, sharing knowledge and experience on patient safety, coaching and role modeling.

Antecedents of Nurse Managers' Work Engagement: A Cross-Sectional Study.

The responsibilities of nurse managers are complex. Their actions are crucial to providing the best possible care to patients and to the success of health care organizations. Thus, nurse managers' work engagement is essential. However, understanding of the antecedents of nurse managers' work engagement is lacking. The job demands-resources theory posits that work engagement is contingent upon job resources and demands. Therefore, the aim of this study was to explore which job demands and resources exert a major influence on nurse managers' work engagement. Considering the literature, job resources and demands potentially relevant to nurse managers' work engagement were identified. To investigate the associations between these potential antecedents and nurse managers' work engagement, the study employed a cross-sectional survey. The dataset for analyses comprised 408 nurse managers in Germany and was analyzed by multiple linear regression. The study variables accounted for 26% of the variance in nurse managers' work engagement. Positive associations were detected between the job resource of empowering leadership and nurse managers' work engagement. Regarding job demands, lack of formal rewards and work-life interferences had negative effects on work engagement. The findings suggest that the job demands-resources theory can explain nurse managers' work engagement. However, not all job resources and demands considered were determined to be influential. In conclusion, empowering leadership should be promoted in the work environment of nurse managers. Nurse managers should be provided engaging financial and nonfinancial rewards. Work-life interferences should be systematically mitigated.

Well-being in acute care nurse managers: A risk analysis of physical and mental health factors.

BACKGROUND: Nurse managers have experienced tremendous stress during the COVID-19 pandemic, contributing to negative psychological outcomes. Positive professional well-being is a construct that can be promoted to mitigate poor psychological outcomes and burnout in nurses. Little is known about the health, healthy behaviors, effects of stress on homelife, and well-being of nurse managers in the United States (U.S.). AIMS: The aims of the study were to explore nurse managers' well-being related to self-reported stress and health perceptions and habits. METHODS: A sample of 80 (41% response rate) nurse managers responded to a cross-sectional web-based survey sent via email in a southwestern U.S. 13-hospital system. Nurses answered 39 quantitative questions about demographics, well-being (9-item Well-Being Index [WBI]), perceptions of stress affecting homelife, and perceptions of health and health-related behaviors. RESULTS: Mean WBI (2.9 [2.7]) indicated risk for poor psychological outcomes. Managers (75%) reported stress from work affected their personal lives and a decline in overall health during the pandemic. Most (80%) reported burnout and emotional problems. Nurse managers had 8.1 times increased risk of poor WBI scores if stress from work affected their personal life than if they reported no spillover stress into their personal life (OR = 8.1, 95% CI [2.6, 25.0]). LINKING EVIDENCE TO ACTION: Findings from this study add a nuanced understanding of nurse managers' well-being. The strongest risk factor for poor WBI scores was stress levels affecting personal life. Interventions to improve well-being in nurse managers are needed. Limitations are the convenience sampling, limited geographic location, and response rate of <50%. Further research is needed to support nurse managers in stress reduction and development of boundaries that prohibit the spillover effect of workplace stress. Organizations may consider a combination of administrative support and changes as well as provision of on-the-job training of interventions that support individual well-being.

Leadership Styles of Nurse Managers and Employees' Organizational Commitment during the COVID-19 Pandemic

Objective: The aim of this study was to determine the leadership styles of nurse managers and then determine the relationship of the respective styles with the organizational commitment of the nurse managers during the COVID-19 pandemic. Method(s): A quantitative correlational study design was employed in this investigation. Simple random sampling yielded 259 nurses who participated in this study. It was conducted between October and November 2021 at the government hospitals of the Hail Region, Kingdom of Saudi Arabia. Result(s): The nurses' perceived that their nurse managers employed an idealized influence leadership style (9.15). Age, years of experience, and ward assignment were found to have no statistically significant difference on organizational commitment;however, a significant difference was found with nationality. No significant difference was found regarding age with idealized influence, inspirational motivation, intellectual stimulation, or management by exception;however, it differed significantly with individualized consideration, contingent reward, and laissez-faire leadership. No significant differences were found with the years of experience to idealized influence, inspirational motivation, intellectual stimulation, individual consideration, or management by exception;however, it was found significantly different with the contingent reward and laissez-faire leadership. Concerning nationality, a significant difference was found with idealized influence and inspirational motivation. However, no significant difference was found between nationality and intellectual stimulation, individual consideration, contingent reward, management by exception, or laissez-faire leadership. With the ward assignment, no significant difference was found with idealized influence, inspirational motivation, intellectual stimulation, or contingent reward management by exception;however, a significant difference was found with individual consideration and laissez-faire leadership. Conclusion(s): During the pandemic, nurse managers employed idealized influence leadership styles. Age, years of experience, and ward assignment were found to be of no significant difference to organizational commitment, but they did have a significant difference to nationality. Age differed significantly with individualized consideration, contingent reward, and laissez-faire leadership. Years of experience was found to be significantly different with contingent reward and laissez-faire leadership. Concerning nationality, a significant difference was found with idealized influence and inspirational motivation. With the ward assignment, a significant difference was found with individual consideration and laissez-faire leadership.Copyright © 2023 The Author(s). Published by S. Karger AG, Basel. This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.

Relationships between leadership behaviour of nurse managers and nurses' levels of job satisfaction and compassion fatigue during the COVID-19 pandemic.

AIM: To reveal the relationships between the leadership behaviour of nurse managers and nurses' levels of job satisfaction and compassion fatigue during the COVID-19 pandemic. DESIGN AND METHODS: This descriptive and cross-sectional study was performed with 353 nurse professionals participating from 32 cities across Turkey. The data were collected online between August and November 2020 by using the introductory information form, Minnesota Satisfaction Questionnaire, Leadership Behaviour Questionnaire and Compassion Fatigue subdimension of the Professional Quality of Life Scale. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were followed in the study. RESULTS: Nurses mostly stated their managers as employee-oriented and change-oriented leaders. Nurses' intrinsic and overall satisfaction was high, extrinsic satisfaction was low and their compassion fatigue was at a critical level during the pandemic. According to nurses' personal and professional characteristics, there were significant differences in job satisfaction, compassion fatigue and change-oriented leadership scores. When nurse managers exhibit employee-oriented leadership behaviour, nurses' compassion fatigue decreases and job satisfaction increases.

Leaders' Role in Shaping Followers' Well-Being: Crossover in a Sample of Nurses.

The link between well-being at work and leadership has received considerable attention. Leaders have the power to influence followers not only due to formal position, but also their positive behaviors could reinforce the followers' positive working experience. Following the crossover model (Westman, 2001), this study investigates whether leaders' work-related positive psychological states (i.e., work engagement) cross over to those of the followers (i.e., work engagement and job satisfaction) through the mediation of the latter's perception of transformational leadership. We used MPlus 8 to test two multilevel mediations in a sample of 1505 nurses nested in 143 groups led by as many leaders (87.19% of nurses and 56.50% of head nurses of the entire population). Results show that while there is not a crossover of leader work engagement to nurse work engagement, manager work engagement can cross over to nurse job satisfaction, enhancing their well-being through transformational leadership behaviors. This study adds further insights both on crossover theory and on the importance of leaders in expanding and transferring resources to followers at work. Fostering work engagement at a managerial level in the healthcare sector could be the driver to facilitate the well-being of nurses at work, address negative outcomes, and promote positive ones.

Factors associated with sleep quality among nurse managers during regular prevention and control of the COVID-19 in China: a cross-sectional study.

BACKGROUND: Nurse managers play a pivotal role in quality patient care and staff satisfaction and retention. An overwhelming amount of work tasks and responsibilities might result in their sleep problems which are expected to aggravate in the context of the COVID-19, thereby affecting their overall health and work quality. However, little attention has been paid to sleep quality among nurse managers. This study aimed to investigate the prevalence of sleep disorders among nurse managers and identify related factors of sleep quality during regular prevention and control of the COVID-19 pandemic in China. METHODS: This cross-sectional online survey was conducted in 14 hospitals on a sample of 327 nurse managers in China. Participants were invited to complete the general demographic questionnaire, Pittsburgh Sleep Quality Index (PSQI) and Simplified Coping Style Questionnaire (SCSQ). Multiple linear regression analysis was used to explore the influencing factors of sleep quality among nurse managers. RESULTS: In this study, 43.7% of nurse managers suffered from sleep disorders. Active coping style and frequent exercise were positive factors that could influence nurse managers' sleep quality, while passive coping style and age over 41 years old were negative predictors, collectively accounting for 52.0% of the variance of sleep quality. CONCLUSIONS: The issue of sleep disorders among nurse managers during regular epidemic prevention and control period is underscored. Coping style and demographic factors including age and frequency of exercise can significantly affect nurse managers' sleep quality. Healthcare administrators should pay more attention to nurse managers' sleep disorders and implement targeted strategies based on influencing factors to ensure their sleep quality.

Nurse managers' burnout and organizational support: The serial mediating role of leadership and resilience.

AIMS: To investigate the relationship between organizational support and nurse managers' burnout and the serial multiple mediating effects of leadership and resilience. BACKGROUND: Nurse managers are at a high risk of burnout, especially during the COVID-19 pandemic. However, no research has been done to examine the associations between nurse managers' organizational support, leadership, resilience and burnout. METHODS: This cross-sectional study recruited 458 nurse managers from 13 tertiary public hospitals in Jiangsu, China. They completed the Survey of Perceived Organizational Support, the Clinical Leadership Survey, the Resilience Scale and the Maslach Burnout Inventor-Human Service Survey. The serial mediating effect of individual leadership and resilience was estimated using the structural equation modelling method via Mplus 7.0. RESULTS: There were direct and indirect effects of organizational support on burnout, controlling for work variables. Leadership and resilience serially mediate the association between organizational support and burnout (ß = -.051, 95% confidence interval: -0.093 to -0.020). CONCLUSIONS: Among nurse managers, organizational support may be sequentially associated with improved leadership first and then resilience, which in turn is related to decreased burnout. IMPLICATIONS FOR NURSING MANAGEMENT: We recommend that hospital administrators incorporate leadership, resilience and burnout assessment in the routine psychological screening of nurse managers and creatively apply the organizational interventions to decrease nurse managers' burnout.

Virtue ethics in health care teams; its time has come: Review of the nursing virtue ethics literature.

AIM: To summarize and evaluate the nursing virtue ethics literature, examine how virtue ethics has been applied to health care teams, offer a new framework to guide understanding and development of virtuous health care teams and offer recommendations to nurse leaders. BACKGROUND: With the unprecedented levels of incivility and turnover in the post-COVID-19 world, virtue ethics may provide an innovative approach for nursing leaders working to rebuild healthy practice environments. EVALUATION: An integrative review yielded articles from eight databases using PRISMA guidelines. Level of evidence and quality were assessed using the Johns Hopkins tools. KEY ISSUES: Virtue ethics has been of interest to the health care community predominantly as a concept. Most articles focused on debating whether virtue ethics belongs in nursing. Virtue ethics offers a creative strategy for leaders to attract and retain nurses. CONCLUSION: There is a dearth of research on virtue ethics and nursing. One study empirically uncovered and validated a framework for virtue ethics in health care teams. IMPLICATIONS FOR NURSING MANAGEMENT: To rebuild strong health care teams, nurse leaders can model virtue ethics using an empirically derived framework while coaching their teams to do the same. Doing so holds the promise of reengaging staff and rebuilding healthy practice environments.

The experience of moral distress by chief nurse officers during the COVID-19 pandemic: A descriptive phenomenological study.

AIM: The aim of this study is to explore the moral distress experiences of nurse officers during the COVID-19 pandemic. BACKGROUND: Moral distress has emerged as a challenge for nurses ad nurse leaders, revealing the need for health professionals and health care managers to examine, understand and deal with moral distress un Nurse leaders. METHODS: It is a descriptive phenomenological study that used content analysis. RESULTS: Thirteen chief/assistant nurse officers were interviewed, and four themes were identified: being a manager in the pandemic, situations that cause moral distress, effects of moral distress and factors that reduce moral distress. CONCLUSION: Faced with various expectations, such as the management of unusual and uncertain processes, and the management of the psychological responses of both employees and themselves, chief nurse officers struggled significantly to maintain their moral integrity and experienced moral distress during the COVID-19 pandemic. IMPLICATIONS FOR NURSING MANAGEMENT: Extraordinary situations such as pandemics have factors that led to moral distress for a Chief Nursing Officer (CNO). Health care systems in which nurse managers are excluded from decision-making processes have a traditional hierarchical structure that ignores CNOs professional autonomy, contributing to the development of moral distress. Therefore, CNOs should engage in self-reflection to recognize their own moral distress experiences, examine the existing health system to identify the factors that cause moral distress and take actions to implement changes to eliminate these factors. To cope with moral distress, CNOs should also improve their communication skills, team collaboration skills and the use of scientific knowledge and take responsibility in their managerial role.

Guiding nurse managers in supporting nurses in dealing with the ethical challenge of caring.

AIM(S): This study aims to present the theory of resigning in supporting nurse managers in dealing with nurses' ethical challenge of caring. BACKGROUND: In a COVID-19 era, nurses continue to be ethically challenged in maintaining safe patient care. Nurse managers play a critical role supporting staff in responding to the complexities of working in, under resourced environments. EVALUATION: Literature suggests care delivery is compromised in times of staff shortages, lack of resources and increased demands on nurses. Examining caring behaviours through the theoretical lens of the theory of resigning enables nurse managers to understand nurses' behaviours, cultivating supportive working environments. KEY ISSUE(S): Nurses strive to provide quality, safe care but are sometimes unable to give the level or type of care they wish, due to the presence of constraints. CONCLUSION(S): This paper provides suggestions for nurse managers in dealing with nurses' daily moral distress arising from working within constraints while still trying to provide safe care. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers need to develop greater insights into the ethical dilemmas nurses experience and support them to temporarily realign beliefs and values, while continuing to work within constraints. Understanding ethical dilemmas of prioritizing care is required to address and manage this concern.

Nurse workforce scheduling: A qualitative study of Indonesian nurse managers' experiences during the COVID-19 pandemic

Background: The increase in COVID-19 cases in Indonesia has resulted in changes in the hospital workflow, including the staffing process and scheduling, especially in the isolation units. Nurse managers are working hard in the scheduling system to ensure high-quality care is provided with the best human resources. Objective: This study aimed to explore the experiences of nurse managers in managing staff nurses' work schedules during the COVID-19 pandemic. Methods: A qualitative descriptive design was used in this study. Eleven nurse managers from three COVID-19 referral hospitals were selected using purposive sampling. Data were collected using online semi-structured interviews. Thematic analysis was used for data analysis, and data were presented using a thematic tree. Consolidated criteria for reporting qualitative research (COREQ) checklist was used as a reporting guideline of the study. Results: Four themes were developed: (i) Nurse shortage, (ii) Strategically looking for ways to fulfill the workforce, (iii) Change of shift schedule, and (iv) Expecting guidance from superiors and compliance from staff. Conclusion: The lack of nurse staff is a problem during a pandemic. Thus, managing personnel effectively, mobilizing and rotating, and recruiting volunteers are strategies to fulfill the workforce during the pandemic. Using a sedentary shift pattern and sufficient holidays could prevent nurses from falling ill and increase compliance with scheduling. In addition, a staffing calculation formula is needed, and top nursing managers are suggested to provide guidance or direction to the head nurses to reduce confusion in managing the work schedule during the pandemic. © The Author(s) 2022

The effect of a nurse manager's authentic leadership intervention on nurses' well-being: A single unit QI project.

INTRODUCTION: Nurse well-being is at the forefront of nursing leadership's focus, particularly with the impact of the ongoing COVID-19 pandemic. Nurse managers, as authentic leaders, should understand their role in supporting the spectrum of nurse well-being. At the negative end of well-being, leaders must address staff burnout as it increases nurse turnover, shortage of nurses, and poor patient outcomes. PURPOSE: The specific aim for this quality improvement (QI) project was to implement a program that could guide a nurse manager of a single inpatient unit on how to improve well-being in their nursing staff as measured by: (a) improved well-being scores to a composite score of 3.5 or greater as indicated by follow-up Culture Pulse surveys distributed in 2021; and (b) reduced absenteeism among nursing staff by 18%. RESULTS: Five surveys identical to the organization's work culture survey, that measures well-being, were sent to staff each month starting in January 2021 and ending in May 2021. The average composite score from all five surveys was 2.8, indicating an overall improvement. Absenteeism was reduced during implementation by 39%. DISCUSSION: This QI project guides nurse managers in the evidence-based interventions that can promote well-being in their staff.

Experiences of Nurse Managers during the COVID-19 Outbreak in a Selected District Hospital in Limpopo Province, South Africa.

The South African health care system was hard hit by the second wave of Coronavirus disease (COVID-19), which affected nurse managers as healthcare facilities became overwhelmed due to an increased workload emanating from the overflow of admissions. Therefore, this study sought to explore and describe the nurse managers' experiences during COVID-19 in order to identify gaps and lessons learnt. A descriptive phenomenological research approach was used to explore the experiences of ten nurse managers who were purposively selected from different units of a selected district hospital. Data was collected through telephonic unstructured individual interviews and analysed using Colaizzi's seven steps method. The study revealed that nurse managers experienced human resource related challenges during COVID-19, worsened by the fact that vacant posts were frozen. It also emerged that there was a shortage of material resources that affected patient care. Nurse managers also indicated that COVID-19 brought a lot of administrative duties plus an additional duty of patient care. Also, nurse managers who had previously contracted COVID-19 experienced stigma and discrimination. The government needs to address resource related challenges in rural public hospitals and provide continuous support to nurse managers, particularly during a pandemic like COVID-19.

Experiences of first-line nurse managers during COVID-19: A Jordanian qualitative study.

AIM: The aim of this study is to explore the experiences of Jordanian first-line nurse managers during COVID-19. BACKGROUND: Nurses are exposed to life-threatening occupational risks during COVID-19. Exploring the first-line nurse managers' experiences will help in designing health policies to better deal with such emerging crises. METHODS: A descriptive phenomenological study was conducted. A purposive sample was used to recruit 16 first-line nurse managers from Jordanian hospitals. Semistructured interviews were conducted. Phenomenological data analysis method was used to analyse the data. RESULTS: Four major themes emerged: (a) unprecedented pressure (first-line nurse managers revealed their suffering with the unprecedented demanding situations during COVID-19 pandemic); (b) strengthening system and resilience (nurse managers employed several strategies to strengthen the health system and enhance resilience); (c) building a supportive team (the presence of a robust supportive system is vital to deal with the pandemic); and (d) maturity during the crisis (exposure to a new experience developed nurse managers management skills and self-awareness). CONCLUSIONS: The unprecedented pressure associated with COVID-19 drained first-line nurse managers physically and psychosocially. Providing adequately trained staff and medical equipment is important to better deal with crises. IMPLICATIONS FOR NURSING MANAGEMENT: Strengthening emergency training and improving emergency response plans of hospitals are essential.

Organizational learning during COVID-19: A qualitative study of nurses' experiences.

AIM: The aim of this study is to test the validity of the Organizational Learning in Hospitals model in the context of the COVID-19 pandemic. BACKGROUND: Organizational learning is especially crucial in circumstances of intense, complex, enduring change, as with the COVID-19 pandemic. Nurse managers need additional guidance for fostering organizational learning under such circumstances. The Organizational Learning in Hospitals model may be a helpful resource but requires additional validation. METHODS: Semi-structured interviews were conducted to gather 19 nurses' first-hand experiences of organizational learning during the COVID-19 pandemic. Data were analysed using deductive thematic analysis. RESULTS: Nurses' experiences of organizational learning generally aligned with the tenets of the model. Specifically, effective organizational learning occurred when the contextual factors and mechanisms portrayed in the model converged. Model and contrary cases illustrate this phenomenon. CONCLUSIONS: This study validates and adds context to the model. It offers practical examples of the contextual factors and mechanisms of organizational learning. Leaders can use the model to guide their efforts to foster organizational learning. IMPLICATIONS FOR NURSING MANAGEMENT: This study reaffirms the importance of nurse leaders' central role in organizational learning. Nurse leaders can use the Organizational Learning in Hospitals model, and the practical examples provided, to foster organizational learning during challenging times.

The organisational and managerial challenges experienced by nurses recovered from COVID-19: A phenomenological study.

AIM: This study was conducted to discover the organisational and managerial challenges of nurses recovered from COVID-19. BACKGROUND: Nurses, who are at the front line of fighting against COVID-19, face numerous organisational and managerial challenges that impose a burden on their already heavy burden of infection. Working in challenging situations can affect the quality of nursing care. METHODS: This qualitative study was conducted through an interpretive phenomenological approach. To collect the data, 18 semistructured interviews were held with 15 recovered nurses, which were then analysed using van Manen's method. RESULTS: The data analysis led to the extraction of four themes: nurses as victims of organisational prejudice, a profession surrounded by problems, insufficient sources for dealing with COVID-19 and post-COVID-19 development. CONCLUSION: This study showed the organisational and managerial challenges of recovered nurses from COVID-19. Although these nurses had positive experiences, they needed eliminating organisational prejudice, minimizing concerns and sufficient resources to deal with the crisis. IMPLICATIONS FOR NURSING MANAGEMENT: It is believed that these results can be used as a guide to nurse managers to improve the experience of recovered nurses from COVID-19 by treating all employees with equal kindness, considering to their problems and minimizing burden by actively providing resources.

A Mixed-Methods Study of Nurse Managers' Managerial and Clinical Challenges in Mental Health Centers During the COVID-19 Pandemic.

PURPOSE: The worldwide outbreak of the COVID-19 pandemic has posed challenges for nurses. The aim of this study was to examine the managerial and clinical challenges of nurse managers in mental health centers during the current COVID-19 pandemic. DESIGN: A mixed-methods study based on an analysis of data obtained in focus groups with 25 nurse managers from two mental health centers in Israel. METHODS: The quantitative phase was conducted prior to the group sessions using a structured self-administered questionnaire that examined the nurse managers' (a) background data, (b) communication with the staff nurses, (c) perceptions of nurses' functioning, (d) perceptions of their own functioning, and (e) management as impacted by the pandemic. The qualitative phase included three sessions of focus groups in which the nurse managers discussed both their challenging and positive issues during the pandemic. FINDINGS: The most important challenges were related to the need to protect patients from infection and communicating with families and primary caregivers. Work policies and procedures were less well adapted to pandemic conditions; nevertheless, nurse managers felt a sense of purpose, duty, and pride in their work. Three themes emerged: (a) "management complexity" included the change from a familiar routine to a new reality, working in capsules, protecting against infection, functional confusion, and insights into future epidemics; (b) "challenging communication" included communication with patients through glass walls and communication with staff through screens and (c) "bright spots" referred to staff cohesion and the provision of respectful care. CONCLUSIONS: Mental health nurse managers have experienced during the pandemic a change in their roles from being less managerial to focusing more on clinical work. Communication between nurse managers and staff nurses and between mental health patients and staff were the main challenges. Nurse managers favorably noted the uniformity and humanity of the staff, sense of cohesion, and shared responsibility. CLINICAL RELEVANCE: In the first wave of the pandemic, there was confusion as to the functional role of ward nurse managers, as the focus of their activities became more clinical and less managerial. During and after the pandemic, preventive interventions should be carried out in order to assist patients, staff nurses, and nurse managers in mental health centers.

Challenges facing nurse managers during and beyond COVID-19 pandemic in relation to perceived organizational support.

AIM: To explore challenges facing nurse managers during and beyond coronavirus disease, 2019 (COVID-19) pandemic and its relation to perceived organizational support. BACKGROUND: When faced with high-pressure situations like the COVID-19 pandemic, it is critical that nurse managers be equipped with the support they need to successfully surpass these hard times. METHODS: Descriptive correlational design was utilized. The study was conduct at different health care settings across Egypt. Convenience sampling technique was employed to recruit (214) nurse managers. Two instruments were used; questionnaire of challenges faced by nurse managers and survey of perceived organizational support. Mann-Whitney test, Kruskal-Wallis test, Spearman's correlation, and regression analysis were utilized. RESULTS: The highest percentage of managers reported being faced with high level of challenges. There was a highly statistically significant negative correlation between challenges currently faced by managers and their perception of organizational support. CONCLUSION: The COVID-19 pandemic had placed additional challenges on nurse managers and these challenges are expected to persist in the future. Higher perception of organizational support minimizes managers' perception of being challenged in times of pandemics. IMPLICATIONS FOR NURSING MANAGEMENT: Better training focused on disaster management, ethical decision making, leading in times of uncertainty, and maintaining well-being will help nurse managers lead better their teams.

A Phenomenological Study of Nurse Managers' and Assistant Nurse Managers' Experiences during the COVID-19 Pandemic in the United States.

AIM: To understand the experiences of hospital nurse managers and assistant nurse managers during the COVID-19 pandemic in the United States. BACKGROUND: Little research has been published about the experiences of nurse managers during the COVID-19 pandemic. Experiences of front-line nurses have been well documented. This is the first phenomenological study to date in the United States on experiences of hospital nurse managers during the COVID-19 pandemic. DESIGN: Phenomenological qualitative approach. METHODS: Thirteen managers, seven nurse managers and six assistant nurse managers were interviewed about their experiences using audio-video teleconferencing and a semi-structured interview guide. Consolidated Criteria for Reporting Qualitative Research criteria for reporting qualitative research were used. RESULTS: The four major themes that emerged were as follows: being there for everyone; leadership challenges; struggles, support and coping; and strengthening my role. There were 11 subthemes. CONCLUSIONS: A major focus of nurse managers during the pandemic was psychosocial support of front-line nurses while at the same time experiencing stress and exhaustion themselves. IMPLICATIONS FOR NURSING MANAGEMENT: More attention on the psychosocial needs of nurse managers, interventions to allay their exhaustion and provisions for readily available support are warranted.