Leading through the COVID-19 pandemic: Experiences of UK Executive Nurse Directors.

AIM: To explore the challenges experienced by Executive Nurse Directors during the COVID-19 pandemic, and to inform future nursing leadership strategies. DESIGN: A qualitative research project involving interviews with 21 Executive Nurse Directors from England and Wales. METHODS: Participants were purposively sampled and recruited through Chief Nursing Officers and nursing leadership networks. Semi-structured interviews were conducted and recorded online via Teams. Braun and Clarke's approach to thematic reflexive analysis was applied to data analysis. RESULTS: Executive Nurse Directors played a critical role during the COVID-19 pandemic. Six themes are explored: tensions, and adaptive response to personal leadership styles; uncertainty and support at the board level; responding to national political decision-making; the personal and emotional impact of the role and the sources of effective support; the voice and public profile of nursing; lessons learnt and strategies for future leadership development. Enablers of decision-making included effective multidisciplinary working, freedom from normal organizational constraints, support for innovation, and the development of stronger bonds with colleagues. Barriers to decision-making included limited knowledge of the virus and its impact and lack of guidance, particularly at a national level. Priorities, strategies and actions for recovery include recognizing the emotional impact of being in a high-level decision-making role, protecting staff from burnout and understanding the long-term implications of pandemic work for nurse leaders. CONCLUSION: Future strategies for nursing leadership during public health, national and global emergencies are recommended. IMPACT: This study contributes to the literature exploring the Executive Nurse Director role and their experiences of leading through the COVID-19 pandemic, and identifies priorities, strategies and actions for recovery and learning for the future of senior leadership. REPORTING METHOD: The study adhered to the Consolidated Criteria for Reporting Qualitative Research. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Perceptions and experiences of leadership in undergraduate nurse education: A narrative inquiry.

BACKGROUND: This research explored the experiences and perceptions of leadership preparation in pre-registration nursing education. The development of leadership skills in the pre-registration period is often considered a continuous process, and evidence suggests there has been an inconsistent approach to leadership within undergraduate nurse education. Exploring perceptions of experiences in this area was deemed important to guide future leadership development for undergraduate nursing students and formed the rationale for this Doctoral study. DESIGN AND METHODS: The phenomena of interest were the expectations, experiences and perceptions of student nurses, academics, and nurses in preparation for the role of leadership. A narrative methodology to learning and contexts of learning was applied, data collection included semi structured interviews conducted early in 2020. Metaphorical associations through images are thought to support leadership development and philosophies; therefore, photographic elicitation was used to evoke association and emotions, facilitate reflection, and enable expression. The framework for narrative inquiry combined with the theoretical background was used for data analysis. RESULTS: Leadership is perceived to be an important aspect of the role of a qualified nurse and should be considered as central to learning development for undergraduate students. While all participants valued the importance of leadership in nursing, this research revealed how each narrated experience of leadership holds emotional impact on how leadership is viewed in self and others. CONCLUSIONS: Participants' experience shaped each story of perceptions of leadership, both within education and in clinical practice. Students' narratives revealed tensions between expectations of leadership, defining leadership and associating their experiences with a personal vision of self as leader in the future role, along with a perceived disconnect between the social and cultural experiences and context of learning. Tensions within the experiences of the academics also revealed a juxtaposition between aligning their experience of leadership with the educational preparation of students and the experiences from clinical leadership, within the social constructs of dual professions and learning contexts.

Nursing and values-based leadership: A literature review.

AIM: To explore literature that supports an understanding of values-based leadership in nursing. BACKGROUND: Understanding values-based leadership in nursing means understanding several leadership theories such as authentic, servant and congruent leadership. EVALUATION: Electronic databases were systematically searched to locate studies with the terms values-based, authentic, servant and congruent leadership. The literature was assessed with the Joanna Briggs Institute Critical Appraisal Tools and the Preferred Reporting Items for Systematic Reviews and meta-analysis approach and a thematic analysis. KEY ISSUES: Existing evidence focuses on specific perspectives within three dominant leadership approaches under the umbrella of values-based leadership: authentic, servant and congruent leadership. Limited literature suggests that values-based leadership can support professional collaboration, enhanced trust and voice for nurses, support for staff well-being, empowerment, job satisfaction, patient-focused outcomes and quality care. CONCLUSIONS: A dearth of empirical literature concerning values-based leadership and nursing exists. Evidence suggests that authentic, servant and congruent leadership correlate with values-based leadership theories and core nursing values. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should recognize the potential benefits of a values-based leadership approach for staff well-being, enhanced professional collaboration and the nurses voice, improved insight into clinical leadership attributes and improvements in quality patient care.

Action learning can support leadership development for undergraduate and postgraduate nurses.

Leadership skills are embedded in the undergraduate nursing curriculum and are essential for post-registration nurses. One way to support the development of these skills is to use the action learning and critical action learning approaches, which can be implemented in both the academic environment and the clinical setting. The process of action learning promotes collaborative multidisciplinary working and affords time for reflection and professional development, in turn supporting the process of applying for revalidation. Developing a nursing workforce with a high level of emotional intelligence can support decision-making, resilience and build confidence. These qualities are crucial not only for delivering safe patient care and promoting innovation in quality improvement, but are essential for personal development and individual career progression.