The Healthy Disruption of Anger.

During the COVID-19 pandemic, information related to the virus changed so rapidly, and anxiety among healthcare workforce mounted exponentially. The reality of the situation was fluid; leadership had a challenging time communicating even short-term strategies. What evolved was a scared, tired, angry healthcare workforce. Association for Leadership Science in Nursing authors explore leaderships' opportunity to acknowledge, harness, and transform this anger into healthy disruption.

ALSN 2021 Conference: Nursing Science for Leadership in the New Decade.

The Association for Leadership Science in Nursing's 2021 conference provided an opportunity to further enhance professional understanding of the difficulties facing nurse leaders as the COVID-19 pandemic continues to create unimaginable challenges. Presentations provided evidence in support of courageous caring leadership interventions.

Leadership, Longevity, and Leaning In: An Interview With Mary Jo (Joey) Bulfin.

This column profiles Mary Jo Bulfin, MBA, RN, CENP, chief executive officer of St. Mary's Medical Center, West Palm Beach, Florida. Ms Bulfin began her career as a staff nurse in the organization where she is now the CEO and discusses her career path and lessons learned.

Chief Nursing Officers' Experiences With Moral Distress.

OBJECTIVE: This study explores if moral distress and its lingering residue were experienced by chief nursing officers (CNOs). BACKGROUND: Chief nursing officers, by virtue of their position and experience, are expected to uphold their professional values and act for the benefit of others. Exploration is needed to determine if the inability to do so contributes to the moral distress of these leaders. METHODS: Twenty CNOs were interviewed to determine the lived experience related to moral distress and moral residue. An interpretive phenomenological analysis approach was used. RESULTS: Six themes emerged describing CNO experience of moral distress including lacking psychological safety, feeling a sense of powerlessness, seeking to maintain moral compass, drawing strength from networking, moral residue, and living with the consequences. CONCLUSION: Moral distress is a common experience for CNOs. Although CNOs act with moral courage, they still experience moral distress. Further research and professional discussion are needed to support nurse executive leaders.

Chief Nursing Officer Sustainment: A Phenomenological Inquiry.

OBJECTIVE: The study explored factors leading to chief nursing officer (CNO) sustainment in the professional practice of nurse executive leadership. BACKGROUND: CNOs are expected to lead adaptations in care delivery in this current era of healthcare reform, requiring a multitude of new leadership skills. Exploration is needed to understand barriers to longevity, which prevent consistency of leadership and execution of vision. METHODS: Twenty CNOs were interviewed to determine the lived experience related to the phenomena of role sustainment. An interpretative phenomenological analysis approach was used. RESULTS: Six themes emerged describing sustainment. These are as follows: loving the profession, having a broader impact, reflecting on one's own work, learning to manage conflict, maintaining work/life balance, and working with supportive leaders. CONCLUSIONS: The desire and passion for nurse executive leadership must be enhanced through education and competencies that emerged in this study and include strategic processing, mindful reflection, and resiliency training.

Support for caring and resiliency among successful nurse leaders.

Health care practice settings are replete with competing priorities for nurse leaders who are responsible to the staff, the organization, and the patients and their families. In the midst of the competing priorities, there is a mandate for successful nursing leadership that is patient centered. To support the continuance of nurse leader success and avoid discouragement and attrition, a caring and resilient model for leadership may be necessary. This article considers the practices of nurse leaders that support caring, resiliency, and, ultimately, their success. Successful navigation toward patient-centered solutions through the intentional and inextricably linked living caring and resiliency was enhanced with practices of self-care, accountability, and reflection. Within each of the 3 intentional practices, a primary process emerged that revealed how nurse leaders actualize their caring and resiliency. The practices and mutually supportive processes are discussed. Useful questions are provided to guide any nurse leader who is contemplating practices of self-care, accountability, and reflection for supporting caring and resiliency.

PTSD and the COVID-19 Continuum.

The COVID-19 pandemic continues to cause chaos and confusion in health care, the outcome of which manifests itself as erratic and often incomprehensible behaviors of staff. These behaviors are symptoms of post-traumatic stress disorder (PTSD). This article explores the association of the COVID pandemic and the emergence of PTSD symptoms. A theoretical framework is presented to assist the nurse leader in gaining perspective, and suggests treatment modalities to assist at times when behaviors present in the workplace.

The Moral Obligation of Nurse Leaders:: COVID-19.

The international pandemic of COVID-19 is unprecedented. Nurse leaders play a pivotal role in balancing the needs of their staff with the needs of the patients. Maintaining one's moral compass during critical decision times is of the utmost importance. They do so to minimize the negative impact and maximize success for all key stakeholders and avoid moral distress. Transparent communication that is truthful, mindful, and relevant is only one of the competencies necessary to accomplish this. This article explores these challenges and offers some suggestions on staying resilient and upholding one's moral obligations.

The Remote Influence of Nursing Leadership.

Maintaining connection and support of staff amid the unprecedented challenges of the coronavirus pandemic (COVID-19) was difficult. One nurse leader conscientiously sent "Monday morning messages" to assure consistent inspirational communication with staff. Although remote work caused the leader to be separated from the staff, these messages helped support them through adaption, change, progress, and promotion of resiliency. The ability to inspire is an essential leadership trait, invaluable in times of crisis.

An Interdisciplinary Framework for Palliative and Hospice Education and Practice.

Leading highly functional health care teams in all practice settings is sustained through the identification of a conceptual framework to guide education and practice. This article presents an interdisciplinary framework for palliative and hospice education and practice. The framework builds on theoretical caring to convey elements of relational, holistic and compassion; articulates interprofessional tenets for guiding values; and aligns with constructs for palliative and hospice best practices. The framework invites those at the bedside and in leadership to be intentional in attending to education and the necessary activities that address the day-to-day operations of palliative and hospice care, as well as, honoring all interdisciplinary collaboration that supports quality outcomes and inspires actions that transform.

Self-Care for Nurse Leaders in Acute Care Environment Reduces Perceived Stress: A Mixed-Methods Pilot Study Merits Further Investigation.

Acute care practice settings are stressful. Nurse leaders face stressful demands of numerous competing priorities. Some nurse leaders experience unmanageable stress, but success requires self-care. This article presents a repeated measures intervention design study using mixed methods to investigate a self-care simple meditation practice for nurse leaders. Themes and subthemes emerged in association with the three data collection points: at baseline (pretest), after 6 weeks, and after 12 weeks (posttest) from introduction of the self-care simple meditation practice. An analysis of variance yielded a statistically significant drop in perceived stress at 6 weeks and again at 12 weeks. Conducting future research is merited.