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.
Highlights
In February 2020, the World Health Organization (WHO) designated the disease caused by a novel coronavirus to be coronavirus disease 2019 (COVID-19)
This study identified the key nursing leadership elements at national, provincial and district levels as well as at the health care facility levels that were key in the contribution of nursing leadership to the challenges posed by the COVID-19 pandemic and opportunities that would enhance and strengthen nursing leadership in future pandemics in Zambia
Immediate priority for future disease outbreaks of epidemic potential and nursing should be given to early nurse leadership involvement in policy development, operational nursing planning for epidemics, well-being of the nursing professionals, continuous professional development, information communication technology uses and operational research
Summary
In February 2020, the World Health Organization (WHO) designated the disease caused by a novel coronavirus to be coronavirus disease 2019 (COVID-19). The disease was characterized as a pandemic on 11 March 2020 in order to emphasize the gravity of the situation and to urge all countries to take action in detecting infection and preventing spread (Cucinotta and Vanelli, 2020). The world continues to grapple with the COVID-19 pandemic. Zambia recorded its first cases of COVID-19 in March 2020. By August 2020, Zambia had reported 9,186 cases and 8,065 (87.7%) of them had recovered, 861 were classified as active cases, with 76 COVID-19 deaths and 182 COVID-19 associated deaths. In June 2021, there were 129,033 accumulative cases, 108,960 recovered cases, 1,004 deaths and 1,644 COVID-19 related deaths
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