Dr. Sandra Lindsay made headlines around the world (and in DailyNurse) for being the first person—and first nurse—in the US to hold out her arm for a vaccine that was regarded by many with uncertainty. How could they produce a vaccine at such a ferocious pace? (How? To paraphrase Samuel Johnson’s famous remark, when scientists fear that they or their loved ones will be killed by a virus, it concentrates their minds wonderfully). When people’s perspectives on the mRNA vaccines were clouded by fear and political biases coming from every angle, our Nurse of the Week stood up for non-immunocompromised nurses everywhere when she rolled up a sleeve and said, “I trust science.” The Jamaican-born nurse with many letters after her name is an important symbol and one that should be remembered. Nursing is about caring, but it is also about leadership, science, lots of hard work, and engaging in an endless war against ignorance.
Dr. Sandra Lindsay, DHSc, MS, MBA, RN, CCRN-K, NE-BC
So, what has Sandra Lindsay, DHSc, MS, MBA, RN, CCRN-K, NE-BC done in 2021? Well, she received her booster shot in January… We’re not certain about anything particular she did February through May, but she was probably preoccupied with her job as Director of Nursing at the Northwell Health Long Island Jewish Medical Center, waiting for the daily SARS-CoV-2 case rate to fall, and—because she really does trust science—preparing to add a Doctor of Health Sciences (DHSc) degree to her cv.
Then, this month, Dr. Lindsay responded to the request of a determined new grad, Tracey Smith, president of the Borough of Manhattan Community College (BMCC-SUNY) Nursing Students’ Association. Smith, who describes Lindsay as “the face of the Covid-19 vaccine,” was bent on getting the iconic nurse to speak at the pinning ceremony at the school, which is where she had earned her own first nursing degree in 1994 (and was valedictorian of her class, of course). “She can attest to the safety of the vaccine,” said Smith, who plans to earn a Master’s Degree in Pediatric Nursing. “She can help our new graduate nurses and the BMCC community at large to understand how this vaccine is working to protect us and the importance of mass vaccinations nationwide.”
After somehow finding time for her own new pinning, Lindsay spoke to Smith and the other BMCC nursing grads. She more than fulfilled Smith’s hopes: “It should be the natural choice for us to get vaccinated because it’s how we look out for each other. It gives us a chance to protect ourselves, our healthcare workers and our family and friends. It’s an opportunity to grab onto a much brighter future after a very dark year.”
I believe in science. As a nurse, my practice is guided by science. And so I trust that. What I don’t trust is that if I contract COVID, I don’t know how it’s going to affect me or those I come in contact with. So, I encourage everyone to take the vaccine.
Dr. Sandra Lindsay, December 14, 2020
During commencement, Dr. Lindsay was also awarded the BMCC President’s Medal for 2021, “which expresses the College’s admiration and appreciation for extraordinary service and leadership.”
At the ceremony, Lindsay said of Covid-19, “It’s not gone. I was vaccinated back in December and here I am today, feeling well, doing well. All BMCC graduates are role models. Nurses going out into the field are role models for patients who will look up to you as you model the behavior you want to see in the world.”
For more details (but not about Lindsay’s actions in February-May), see the NY Carib News story here.
I started my career as a nurse 35 years ago. Thirteen of those years I spent up in the air as a flight nurse, responding via helicopter to the most urgent calls. We responded to accidents, shootings, strokes, heart attacks, you name it.
Because we were outside the four walls of our hospital the majority of the time, hospital leaders didn’t have the same on-the-ground visibility into the work that we were doing. And while I’ve never known a nurse who got into the field for the recognition that comes along with the work, the fact that the work we were doing to save lives happened outside the hospital meant that when we pulled off something incredible, we were the only witnesses to it.
Then, one night, around 10 p.m., we responded to a terrible multi-vehicle wreck on a major highway. Traffic was backed up for miles on both sides while we came in and did our job – triaging patients in the dark to find the one in most emergent need (others went by ground), stabilizing him as quickly as possible with intubation, IVs, and packaging for transport before loading the patient hot (helicopter never shut down – blades still turning) into the helicopter, and transporting him to the hospital. There was nothing particularly strange about the accident itself, but as it turns out, the CEO of my hospital just happened to be caught up in that traffic, and he had a front-row seat to watch us do our job.
The next day, the CEO and my director came down to where we were and asked to see us. After seeing what we did in person, he wanted to come and personally thank us for the ‘effortless, yet life-saving’ work that he had witnessed. And now, decades later, that gesture still sticks with me. Just a simple act of recognition, especially coming from the leaders at the head of a hospital, can make a world of difference for an exhausted nurse.
And when we’re talking about our country’s nurses this year, “exhausted” is an understatement. As we mark Nurses Week amid the hopeful winding down of the worst international health crisis in memory, nurse and frontline staff recognition should be at the top of mind of every healthcare executive – not only because it’s the right thing to do, but because happy and engaged nurses reduce turnover and provide objectively better care.
So what can hospital leaders do about it? There are a few key tactics that are important not only during Nurses Week, but year-round:
Give time – and space – for self care. Nurses are often the last to take time to care for themselves. Reinforce that from the top to the bottom of your organization, staff members should take the time and resources they need to take care of their physical and mental needs. Allow them to take their well-deserved paid time off so they can recharge, and create an environment in which asking for help and asking for resources is not seen as a sign of weakness, but rather one of strength.
Give nurses the opportunity to lift each other up. By giving your nursing staff the ability to nominate each other for recognition – either for going above and beyond, for stepping in and helping whenever needed, or simply for being a positive presence in the unit – you foster a culture that celebrates achievement. Integrate the nomination process directly into ongoing staff rounding processes, making nominations quick and easy. And don’t forget how much recognition and encouragement from the ‘C Suite’ means to the staff.
Amplify good patient stories. When you receive positive feedback from a patient about the treatment they received from a member of your nursing staff, share it publicly with your entire staff. Talk about the interventions used, and how caregivers interacted with patients in a positive manner. This too can be integrated directly into patient rounding processes – build opportunities for recognition directly into rounding scripts.
Of course, Nurses Week this year will be marked by special events, meals, public displays of appreciation, nursing excellence awards, and more. But nurse recognition needs to be about so much more than a moment in time – it needs to go beyond a simple “thanks” or “good job.” When recognition is adopted as a cultural value, and when it’s codified into policies and processes, it becomes self-perpetuating and infectious, in the best sense of the word.
What a whirlwind this year has been! In just a few dramatic months, the world has changed drastically. Once upon a time, masks and scrubs were only worn by medical professionals and other individuals required to don them by rules of dress code. Nowadays, pretty much every person you see on the street is wearing a mask, or a face shield of some sort, and teachers are shopping for nursing scrubs! Just a year ago, no one would have dreamed that there wouldn’t be enough medical supplies to go around. No one could have foretold how our lives and our society would be transformed.
And here we are, at the threshold of 2021. Our society has changed, but we have, too. This year has taught us many lessons. Here are just a few to contemplate.
1: Self-Care isn’t Selfish
Caring for others is important. Who knows that better than nurses who have chosen to spend countless hours doing what they can to help people heal? But COVID-19 is showing us that sometimes, by caring for ourselves, we’re caring for others, too. One instance of this would be wearing a mask. By wearing a mask, I’m caring for myself, but I’m also protecting others. Self-care isn’t selfish. It never is. In this article from Becker’s Hospital Review, you can learn self-care tips from other nurses working on the front lines.
2: Nothing Lasts Forever
There’s a famous saying, “This too shall pass.” When we’re in the thick of something, the situation can cloud our vision, not allowing us to focus on anything else. For instance, if you remember way back in March, all people could think about was COVID-19. But with time everything passes; it’s the way of life. Nothing lasts forever. There was a time before the pandemic, and there will be time after. It’s an encouraging lesson for life: You may feel stuck, and you can’t get your mind off of something for weeks on end. And that thing can be a major force in your life at that time! But even while you’re in the thick of a crisis, always remember that there will be an end. There is always a light at the end of the tunnel.
3. You’re Not in Control
Sometimes, we feel we have life under control. The problem with that is that as soon as something doesn’t work out, we can get extremely frustrated. COVID-19 has shown us that we’re not in control. We can do what’s within our ability, but that’s it. Once we’re aware that it’s not up to us, it’s much easier to relax, and accept reality instead of trying to fight what we can’t change.
Sometimes, it’s hard to focus on the positive when things as a whole look so bleak and bleary. But there are silver linings to everything, if we only dare to look carefully, and let ourselves focus on finding them.
This year wasn’t easy for any medical professional; no one will deny that. But finally, the vaccines are coming, hopefully heralding a happier, healthier new year!
In the Year of the Nurse and Midwife, one of the underlying themes is that of nurse leadership—and the nurse leaders of today and tomorrow have a wide range of inspiring role models! Below are profiles of six outstanding nurse leaders as described by Marion E. Broome and Elaine Sorensen Marshall in their new text Transformational Leadership in Nursing, Third Edition.
The story of modern Western nursing began with little-noted but great leaders, and it traditionally starts with Florence Nightingale, but the 20th century has also provided us with a wealth of transformational nurse leaders. Six trailblazers include…
Isabel HamptonRobb
Isabel Hampton led nurse training at Johns Hopkins in Baltimore and was the first president of what became the American Nurses Association. “Her vision of nursing … required a transformation of … accepted norms. [Her work] demonstrated her ability to effectively lead change and inspire others toward her cause” (Keeling et al., 2018).
Mary Adelaide Nutting
Mary Adelaide Nutting was Hampton’s student at Johns Hopkins and was among the first visionaries to foresee academic nursing education, rather than apprentice nurse training solely in hospitals. She led efforts to develop the first university nursing programs at the Teachers College of Columbia University and to secure funding for such programs (Gosline, 2004).
Lavinia Lloyd Dock
Lavinia Lloyd Dock was a strong woman who was involved in many “firsts” that influenced the profession for years. She firmly believed in self-governance for nurses and called for them to unite and stand together to achieve professional status. She was among the founders of the Society for Superintendents of Training Schools for Nurses, which later became the National League for Nursing (2019), and an author of one of the first textbooks for nurses and history of nursing. She encouraged nurses and all women to become educated, to engage in social issues, and to expand their views internationally (Lewenson, 1996). She was known as a “militant suffragist” and champion for a broad range of social reforms, always fighting valiantly for nurses’ right to self-governance and for women’s right to vote.
Lillian Wald
Lillian Wald, who modeled the notion of independent practice a century before it became a regulatory issue, founded the first independent public health nursing practice at Henry Street in New York. She not only devoted her life to caring for the poor people of the Henry Street tenements but also was the first to offer clinical experience in public health to nursing students. She worked for the rights of immigrants, for women’s right to vote, for ethnic minorities, and for the establishment of the federal Children’s Bureau (Brown, 2014).
Mary Elizabeth Carnegie
Mary Elizabeth Carnegie established one of the first baccalaureate programs in nursing in 1943 at Virginia’s Hampton University (American Association for the History of Nursing, 2018). She became the first African American nurse to be elected to a board of directors of a state nurses association (Florida). She was on the editorial staff of the American Journal of Nursing, was senior editor of Nursing Outlook, and the first editor of Nursing Research. Carnegie was a president of the American Academy of Nursing and was awarded eight honorary doctorates over the course of her career. Her legacy of leadership included making the contributions of African American nurses visible in the professional literature.
Ildaura Murillo-Rohde
Ildaura Murillo-Rohde was a Panamanian American nurse, academic, and organizational administrator. She came to the United States in 1945 and studied at Columbia University. She was the first Hispanic nurse awarded a PhD from New York University. Her specialty was psychiatric–mental health nursing, and she was an outstanding advocate for mental health needs of Hispanics. Murillo-Rohde was an associate dean at the University of Washington and the first Hispanic dean at New York University. She founded the National Association of Spanish-Speaking Spanish-Surnamed Nurses in 1975 and served as its first president. She was named a living legend in the American Academy of Nursing (National Association of Hispanic Nurses, 2019).
Today’s healthcare leaders inherit courage, vision, and grit that must not be disregarded. We stand on the shoulders of valiant nursing leaders of the past who left a foundation that cries for study of its meaning and legacy for leadership today. They were visionary champions for causes that were only dreams in their time but today are essential. They dared to think beyond the habits and traditions of the time. These leaders were truly transformational. You are among the pioneer leaders to move healthcare forward to better serve society.
References
American Association for the History of Nursing. (2018). Mary Elizabeth Carnegie DPA, RN, FAAN (1916–2008). Mullica Hill, NJ: Author. Retrieved from https://www.aahn.org/carnegie.
Gosline, M. B. (2004). Leadership in nursing education: Voices from the past. Nursing Leadership Forum, 9(2), 51–59.
Keeling, A., Hehman, M. C., & Kirchgessner, J. C. (2018). History of professional nursing in the United States: Toward a culture of health. New York, NY: Springer Publishing Company.
Lewenson, S. (1996). Taking charge: Nursing, suffrage and feminism in America, 1873–1920. New York, NY: National League for Nursing Press.
National Association of Hispanic Nurses. (2019). Dr. Ildaura Murillo-Rohde, PhD, RN, FAAN. Author. Retrieved from http://nahnnet.org/NAHN/Content/Ildaura_Murillo-Rohde.aspx.
The role of nursing has evolved from its early days of taking orders from doctors and working primarily in hospitals to, today, having a leading role in directing patient care and working in an array of non-hospital settings. As we celebrate 2020 International Year of the Nurse and Midwife and National Nurses Week from May 6-12, this is a good time to recognize the ever-evolving role of nursing and the vast opportunities to serve, particularly as we face unprecedented challenges brought by COVID-19.
In just a matter of weeks, health care has gone from status quo to redesigning care delivery in nontraditional ways. Telehealth is the new normal, yet only 55 percent of hospitals fully or partially implemented telehealth systems as recently as 2014. Nurses and care teams are quickly finding new ways of meeting patient needs; developing strategies never even conceptualized before this pandemic. They’re doing this with limited supplies and in some parts of the country, without adequate personal protective equipment; having to make hard decisions such as which patients will get access to lifesaving ventilators. All while feeling the pressure of this ultimate question: how do you provide care to patients and families for a disease that has no cure, while still caring for those who can no longer visit the doctor’s office?
This pandemic has demanded expedited creative thinking, flexibility and innovation from all of us in health care, nurses included.
At my organization, there are many ways nurses have shown adaptability and creativity through this crisis. One of these includes a companion program to provide a safe way for patients with COVID-19 to say their last goodbyes to family members. Within 48 hours, Virginia Mason nurses created a protocol for family members to visit their loved ones one last time. Amid so many heartbreaking stories of people passing away alone from COVID-19, nurses took control and made a solution to a devastating reality for so many families.
Nursing teams are also leading infection prevention work among team members, including monitoring employee health and keeping our hospital’s workforce safe. Early on, nurses helped design a drive-through testing station for one of our medical centers, including templates for screening protocols and overall work to build the necessary record-keeping and team communication for such a process.
None of these activities was part of their regular duties prior to COVID-19 and that’s the beauty of this profession— nurses have an incredible ability to adapt to challenging situations even when they are dealing with the unknown.
As we look to a future past this pandemic, there are impacts of which we don’t quite yet know the ramifications. Before COVID-19, nursing was already facing a staffing shortage, and now that reality becomes even more threatened. Other areas and the full impact on the profession remains to be seen.
However, in all the fear and unknown, this pandemic allows us to see the unique attributes of nursing more clearly, and all of the opportunities within — to lead in health care, care for patients and make a difference in our communities. The opportunities within nursing are limitless, and without nurses, we could not provide the necessary lifesaving, compassionate care that so many in our country need now and in the future.
Ventilators are in short supply for COVID-19
patients, but nurse leaders need a safe way to vent, too.
Continually fighting COVID-19 at work and home is creating unsustainable levels of stress for nurse leaders. Providing a safe place for them to debrief and process their feelings (to vent their frustrations and conflicting emotions) can help them persevere through this ongoing crisis.
Leaders expect to be lonely when making tough choices, but that has never been more true than for nurse leaders during the COVID-19 crisis. Our courageous nurse leaders are in the unenviable position of having to implement previously unthinkable policies and compromises that make them and their bedside nurses feel extremely exposed and vulnerable. These difficult decisions are born out of necessity — like having to use the same mask all day or substituting garbage bags for non-existent protective gowns. But the moral distress these ad-hoc, but unavoidable, measures create is sapping the strength and emotional reserves of even the most confident and committed professional caregivers.
For nurses, there is no escaping the mental strain of COVID-19. Severe stressors surround nurse leaders and their teams, both professionally and personally. When they’re at work, they feel guilty for not helping at home. When they’re at home (however briefly), they feel like they should be at work. And having to decontaminate their clothes and their bodies upon arriving home is exhausting after working yet another 12- to 16-hour day — only to have to distance themselves from their family members once they get inside. Some worry what would happen if, heaven forbid, both they and their spouse were to contract and succumb to COVID-19 leaving their children parentless.
Many nurse leaders are around COVID-19 patients all day every day. The fear of being exposed and not being careful enough at work never leaves their minds. They must be healthy for their families, they must remain resilient for their patients, and they must stay strong for their teams. This relentless mantra repeats itself every day.
Nurses need to talk about what they are seeing and have a safe place to vent. Some of them are the only ones who can hold the hands of patients when they take their last breath. Others are having to facilitate FaceTime calls with family members so patients can give their final good-byes. No one should die alone. But COVID-19 is making this a common occurrence. The effects are dramatic and traumatic on nurses and nurse leaders who confront heart-wrenching moments like these all too often. Creating a safe space for nurse leaders to regularly talk about their COVID-19 experiences can help them clear their mental cache.
With this goal in mind, Lori Gunther and Melissa Gell, partners and co-owners at Synova Associates, are offering crisis debriefings on Facebook for nurse leaders who need to vent. They have invited me to co-facilitate these meetings with them from a clinician’s perspective. We’re calling the group Nurse Leaders One to remind nurse leaders that we are in this together and that they are not alone. Nurse Leaders One is here to help nurse leaders get the confidential emotional support they need to get throughout the COVID-19 crisis. Our daily crisis debriefings last for just 45 minutes to an hour. We meet in the evening, Monday through Saturday. And only 10-15 people participate in each group so everyone can participate.
We are enlisting other facilitators and nurse
executives to help so we can make more of these groups available. Hosting these
groups is important work because, when we take better care of our nurse
leaders, they can take better care of their nurses and patients.
I have never been more proud to be a nurse than I am at this moment. Ironically, we are celebrating The Year of the Nurse in 2020. And, true to form, the nursing community is rallying like never before in the fight against COVID-19. It’s heartwarming to see the recognition nurses are receiving in the media for their dedicated, often heroic service. The voluntary surge in staffing—from even retired nurses—brings tears to my eyes. But if we want to see this level of commitment continue, we’ve got to provide our nurse leaders with the emotional support they need now and throughout this crisis.
We know better than to think sheer willpower will be enough to see us through. We know better, so we’ve got to do better. Please let me know if you are interested in helping us offer more Facebook groups through Nurse Leader One. Contact me on LinkedIn at https://www.linkedin.com/in/armstronglori.
