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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.

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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.

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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 .

Lori Armstrong, DNP, RN, NEA-BC
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