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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Leading through a pandemic

Sue Matthews A *
+ Author Affiliations
- Author Affiliations

A Administration, The Royal Women’s Hospital, Locked Bag 300, Cnr Grattan Street and Flemington Road, Parkville, Vic. 3052, Australia.

* Correspondence to: sue.matthews@thewomens.org.au

Australian Health Review 46(3) 255-255 https://doi.org/10.1071/AH22124
Submitted: 17 May 2022  Accepted: 17 May 2022   Published: 2 June 2022

© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Leading in a crisis has been studied and written about in the past. But, leading in a crisis the scale and length of the pandemic has very few publications. Implications for leaders are to lead with confidence and transparency.

As a Chief Nurse in Toronto during the outbreak of severe acute respiratory syndrome (SARS), I thought that would be the biggest leadership challenge I would ever experience. Over 4months, Toronto was the epicentre of two waves of the epidemic that saw 438 cases in Canada, 8000 worldwide and 48 deaths across 23 countries. Little did I know that almost 20 years later, I would be leading in a pandemic the scale of COVID-19.

My experience with SARS, however, did help in understanding how to lead through this crisis. Knowing how staff and patients would respond, knowing the anxiety they would have because much was unknown, helped me to move quickly to take protective actions, and most importantly communicate with confidence and transparency.

In a time of immense stress and pressure on all levels of the organisation it was most important to ensure that staff knew what we knew – and did not know – and that they saw the confidence we had in our ability to manage this crisis. Middle managers particularly needed this support. These are the most difficult roles in healthcare, sandwiched between staff and patient care and organisational priorities. Keeping them informed was crucial, as without information, people fill the void with misinformation and rumours. Middle managers were most effective when they had key messages, knew how to respond to questions and knew where to get information when they did not know the answer. Assuring them that ‘we’ve got this’ was crucial. The hardest part was that often, there was nowhere to find the answers, because the answers were unknown. Being honest about this was a key part of every leader’s toolkit.

What kept me up at night, was the need to ensure that staff and patients were protected. Personal protective equipment was in high demand and staff needed to know they would always have access to it. But, wearing it at all times is draining. When I walk to the units even now, I wear it for 1 or 2 h, and I am drained, but it is important to role model what we ask of our staff.

Staff frustration was palpable, and still is. Staff share their moral distress at not being able to provide the care they want and need to. Healthcare professionals are passionate about making a difference in people’s lives and want to support the whole patient on their journey, and that is hard to do under this relentless pressure. Healthcare workers are exhausted, and their mental health is suffering. As a leader, it has been particularly hard not to have a response to many of their needs. They know I do not have more staff, and I can not stop the pandemic. But leadership in this environment is not having all the answers, but rather it is shown though being present and transparent. Leaders must show staff that they hear them and must give them confidence that ‘we’ve got this’.