Nurses' perceptions of leadership in Brazilian hospitals during COVID-19 through Kotter's conception.

ABSTRACT

OBJECTIVE: to understand nurses' leadership perceptions during the COVID-19 pandemic in Brazilian university hospitals, through the lens of John Kotter's concepts and his eight-step change model. METHOD: a multicenter qualitative research with an analytical design. The sample comprised 139 nurses working in COVID-19 settings, interviewed using a semi-structured interview guide. Data were categorized through Bardin's content analysis based on John Kotter's concepts and his eight-step change model. RESULTS: the findings yielded significant insights into nurses' perceptions of leadership during the COVID-19 response, which exhibited characteristics consistent with Kotter's principles. There is evidence of leadership based on the pursuit of knowledge, grounded in polished communication, facilitating teamwork through a relationship of trust and respect. The recognition of the complexity and difficulty of exercising nursing leadership, particularly in crisis contexts, is apparent. CONCLUSION: nurses' perceptions reinforce essential elements for leadership practice, such as the importance of seeking diverse knowledge, polished communication, relationships based on trust and respect, and recognition of the complexity of leadership, thus presenting characteristics in line with Kotter's principles. HIGHLIGHTS (1) Nurses' perceptions of leadership during COVID-19 were highlighted. (2) COVID-19 intensified the complexity in nurses' leadership roles. (3) Nurses' leadership was consolidated in knowledge, communication, trust. (4) Working in the COVID-19 response as a nurse-leader has become challenging. (5) Kotter's principles assist in reflections on nurses' leadership.