Bergman, A., Nelson, K., et al. (2024).
Nursing Management, 55(12), 16–26.
Nurse leaders are a heterogeneous group encompassing a variety of roles, settings, and specialties. What ties these diverse professionals together is a common code of ethics. Nurse leaders apply the provisions of their code of ethics not only to patient scenarios, but also to their interactions with nursing colleagues who rely on their leaders as advocates for ethical nursing practice. Successful nurse leaders embody principles of professionalism, utilize effective communication and interpersonal skills, have a broad familiarity with the healthcare system and its nuances and complexity, and demonstrate skillful business acumen.
Despite their extensive training, nurse leaders have long been an underappreciated and largely unseen force maintaining the health of the healthcare systems and functioning as a safety net for both patients and nursing staff. However, nurse leaders are under more scrutiny and subject to extraordinary stressors related to the COVID-19 pandemic. Some of these stressors occurred due to the ethical challenges placed on leaders navigating an unprecedented pandemic. Others reflect long-standing patterns within healthcare and nursing that were exacerbated during the pandemic.
Unresolved ethical issues combined with unrelenting stress can lead to escalating degrees of moral suffering that undermines integrity and well-being. Moral injury (MI) occurs when an individual compromises personal or professional values, violating the individual's sense of right and wrong and causing this person to question their ability to navigate ethical concerns with integrity. Conversely, moral resilience (MR) is the capacity to restore or sustain integrity in response to ethical or moral adversity. MR includes six pillars: personal integrity, relational integrity, buoyancy, self-regulation/self-awareness, moral efficacy, and self-stewardship.
This research substudy aimed to explore the experiences and scenarios that exposed nurse leaders to MI during the COVID-19 pandemic and the strategies and solutions that nurse leaders employ to bolster their MR and integrity. This research strives to amplify their stories in the hopes of developing practical solutions to organizational, professional, and individual concerns rooted in their ethical values as nurse leaders.
The article is linked above.
This qualitative study examines the moral injury (MI) and moral resilience (MR) of nurse leaders during the COVID-19 pandemic. Researchers surveyed US nurse leaders, analyzing both quantitative MI and MR scores and qualitative responses exploring their experiences. Five key themes emerged: absent nursing voice, unsustainable workload, lack of leadership support, need for leadership capacity building, and prioritization of finances over patient care. The Reina Trust & Betrayal Model framed the analysis, revealing widespread broken trust impacting all three dimensions of trust: communication, character, and capability. The study concludes with recommendations to rebuild trust and address nurse leader well-being.
