Who is responsible for nurse wellbeing in a crisis? A single centre perspective

Background: Leadership during the COVID-19 pandemic often manifested as a command- and-control style of leadership which had detrimental emotional impacts on staff particularly the nursing workforce. Organisational responsibility for staff wellbeing would be necessary in another pandemic and leadership emerged as a key indicator of the overall health of an organisation and its workforce. Leadership can have detrimental effects on staff wellbeing or it can greatly boost their ability to handle a crisis. We sought to explore the interrelationship between leadership and nurses’ wellbeing in an inner-city university hospital during the initial wave of the pandemic. Methods: Secondary analysis of interview data collected during a hospital-wide evaluation of barriers and facilitators to changes implemented to support the surge of COVID-19 related admissions during wave 1. Data were collected through semi-structured video interviews between May and July 2020. Interviews were analysed using Framework analysis Results: Thirty-one nurses participated including matrons (n=7), sisters (n=8) and specialist nursing roles (n=16). Three overarching themes were identified: impact on nurses, personal factors and organisational factors. The impact on nurses manifested as distress and fatigue. Coping and help-seeking behaviours were found to be the two personal factors which underpinned nurses’ wellbeing. The organisational factors that impacted nurses’ wellbeing included decision-making, duty and teamwork. Conclusions: The wellbeing of the workforce is pivotal to the health service, and it is mutually beneficial for patients, staff, and leaders. Addressing how beliefs and misconceptions around wellbeing are communicated, and accessing psychological support is a key priority to support nurses during pandemics.