“Every minute of every day a nurse touches a life, and a life touches a nurse.” …Unknown
COVID-19 is an incredible learning experience filled with genuine heroism, courage and love at the front line and numerous examples of stewardship within the governance and operational leadership of both the public service and private sector.
To illustrate caring, coping and leading, let’s take a bird eye view and observe what it is like to work in a hospital Intensive Care Unit (ICU). It is an intense and frenzy-paced environment, where the provider stress levels can mirror that of the trauma patients in some situations; an experience that is difficult to put into words, but we will try.
You do not want to be a COVID-19 patient in the ICU unit. If you are, that means you’re really sick. If you end up there you will get stellar care from a team of health care providers.
You hear a nurse singing a song out loud as she hung that IV medicine, huh? You were a little bewildered, and thought, ‘is that from The Sound of Music? Why is the nurse so inappropriately jolly considering the elderly COVID-19 patient has a tube down his throat? What you don’t realise is the singing is to calm nerves, to keep relaxed. The COVID-19 patient who is a grandfather and dad almost died. The nurse is concerned for him but does not want anyone to see that on her face.
I know you just heard us laughing and cracking a joke in the hall. I get it. You don’t see anything funny with the mom confined to that bed, attached to all those monitors. We understand. We do. Please understand that while you were observing the elderly person and the singing, we saved the young woman next door. She could not breathe. Now she can. We didn’t think we’d get a breathing tube down in time. We also restarted the heart of the man across the hall. We were unsure if his heart would restart, but it did. The COVID-19 patient next door to him wasn’t so lucky. We tried. We begged God, but she went anyway. We contacted her daughter and let her cry into our ear.
With COVID-19, sometimes we have to laugh. It’s the only thing we know to do in these moments. If we cry, we are afraid we won’t be able to stop. We are really sorry if at times we seem short. We won’t get a break today; once again, we are short-staffed. We are not trying to be rude. We are focused on the change we just noticed on an EKG. We are trying to figure out what we can try next when the blood pressure plummets again. You see, we are giving the maximum amount of all those drugs you see hanging. We know you’re not ready to say goodbye. We are not ready to give up. That distracts us at times and impacts our ability to converse.
We want you to know that when we see your loved one in this condition, we feel your pain. We think of our own loved ones who have passed away. When their conditions mirror each other, so similar in presentation, it feels like peeling the scab off our grief. We don’t let you see that, but we choke back our own tears while you cry.
Oh, dear mom, as you try to maintain your composure while your child remains unresponsive, we have to fight to keep from sobbing. Your plight is a very real confrontation of the frailty of our children. We don’t like it as a mother or a father. We will sweat blood to fight for your baby’s life, no matter the age. We know it could be ours just as easily.
At home you cry over your ailing spouse, we are sorry we can’t be stronger for you. For a moment, we place ourselves in your shoes. We imagine our spouse lying there, and we silently grieve with you. Then we get back on the horse and we fight for your loved one. We just wanted you to know that.
Our singing, dancing, laughing behavior might make you think we are indifferent. Or my distraction and firmly set expression might make you think we don’t care. But we do. What you don’t see is when we pull into our home driveways at the end of a very long shift. Often times, we put our car into park, and we cry. All the stress of fighting for them, all the grief pushed away, all the emotions finally have time to catch up with us. We don’t sing or laugh. We weep. Then we wipe our eyes and go inside; then go to bed early so we can come back in the morning to care, to listen and to ask.
As we saw during COVID-19, healthcare providers serve as leaders in their relationships with patients. Patients seek their leadership for diagnosis, assessment, advice, and treatment. Trust is an essential component of the relationship. In addition, healthcare providers assume a leadership role beyond their relationship with patients, they are members of a high performing multi-disciplinary team.
- Reflecting on your personal COVID-19 learning, to what degree do you share what you want and what you feel?
- When was the last time you examined your attributions and your judgments?
- Is empathy and caring part of your leadership?
- How can you alter mindset, communications, and listening skills to generate different interactions?
- What assumptions about others are you making? Are they correct? How do you know?