Nursing Leadership Challenges and Opportunities During COVID-19 (SARS-CoV-2) Pandemic Response in Zambia

Abstract

A nurse leader has the capacity to influence, coordinate and integrate nursing care for patients and families and advocate for the nursing profession to achieve positive health outcomes. In Zambia, nurse leaders operate at all levels of the health system and can contribute significantly to alleviating the negative outcomes of diseases of epidemic potential. The COVID-19 pandemic has provided an opportunity to strengthen nursing leadership efforts towards the reduction of morbidity and mortality from this outbreak. A cross-sectional survey of nurse leaders in six provinces of Zambia was conducted. The data was collected through telephone interviews and self-administered questionnaires on roles and responsibilities, nursing leadership, involvement in policy advice and overall experience with the COVID-19 outbreak. Quantitative variables were analyzed for descriptive statistics while qualitative data were summarized into emerging themes. Nurse leaders played a key role in motivating nurses despite response hesitancy due to risk of infection. Ensuring compliance to infection prevention and control standards was a key responsibility for all nurse leaders. Challenges included their late involvement in planning for service delivery, lack of dedicated resources for performing supervisory functions and the absence of a nursing operational plan for COVID-19. The inability to provide for psychological needs of nurses and unclear incentives policy were important factors for the lack of motivation. Enhanced interprofessional collaboration, professional development in critical care nursing, change management and expanded partnerships with community organizations were among opportunities identified. The role of nurse leaders can be maximized by ensuring their early involvement in strategic planning. A funded operational plan inclusive of dedicated resources for monitoring and supervisory functions of the nurse leaders is indispensable. To sustain motivation, facilities for psychological support, medical care, mentoring and a clear policy on incentives are required, as well as, a continuous professional development programme that addresses competences in nursing leadership and critical care.