COVID-19 One Year Later: Now What?

Nurse executives begin post-pandemic action

Preparing for post-pandemic nursing

By Meredith Foxx, MSN, MBA, APRN, NEA-BC, Executive Chief Nursing Officer.

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It’s been just over one year since the COVID-19 pandemic introduced overwhelming challenge and uncertainty to healthcare, and there is finally light at the end of the tunnel. Across the globe, nursing leaders are beginning a process of healing and action in preparation for a post-pandemic world.

This month, Cleveland Clinic’s executive nurse leaders safely gathered to reflect on the past year, outline post-pandemic action planning and take a closer look at the health system’s state of readiness for future crisis situations.

As we began the meeting, I outlined our objectives and guiding principles, explaining the importance of developing a nursing structure that is flexible and capable enough to respond to a future crisis. Examples included infrastructure/information technology (IT) outages, patient surges, mass caregiver absences, the necessity of teaching new ways of care, mass casualties and, of course, global health pandemics.

Kristine Adams, MSN, CNP, Associate Chief Nursing Officer for Care Management and Ambulatory Services, began the group discussion by encouraging our fellow executive nurses to consider the young nurses who will be in their shoes 30 years from now. She said: “What wisdom can you impart on those future nurse leaders? What would you tell them? What did we do right or wrong? What lessons did you learn?”

Start, stop, continue

Throughout the meeting, the executive nurses gave their open and honest responses to these questions, focusing on important topics such as IT, supply chain, staffing, floating, communication and more.

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They participated in a start, stop, continue exercise, which prompted the group to reflect on how Cleveland Clinic’s nursing leaders and caregivers worked together during the pandemic and how they might improve or change that work in the future.

Each executive nurse was asked to answer the following question by writing one item on a post-it note and placing it on the corresponding start, stop or continue board.

What are key things we should have in place or do to be ready for the next major disruption?

  • Continue: What are we thankful we had?
  • Start: What do we wish we had?
  • Stop: What actions did we take that we shouldn’t in the future?

The executive nurses then divided into three groups, one for each board, and began to plot idea themes, analyzing potential value of the theme against its complexity or effort required to implement. Each start, stop and continue group determined two or three top idea themes, which they presented to the other nurse leaders.

Learning from experience

The executive nurses will continue collaborating within their working teams. In the next meeting, they will collectively decide on the start, stop and continue idea themes that will guide their work moving forward.

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The idea themes will fall within the following key initiatives, identified by the executive nursing team.

  • Develop a team nursing model that is ready for surges and major staffing issues. This will include the upskilling of caregivers currently working in settings such as medical-surgical nursing.
  • Develop a plan to increase the ready supply of current Cleveland Clinic licensed and non-licensed caregivers who are not in a care setting, to assist with crisis staffing.
  • Develop a nursing-specific crisis communication protocol/channel. This will include communication devices and platforms, topics, and standardized communication processes.

A positive road ahead

As a nursing community, we’ve all faced so much throughout the past year. The COVID-19 pandemic undoubtedly stressed our resources, exposed the many social disparities that were percolating in our communities and more.

But with everything that came our way, nurses were viewed as the primary problem solvers and solutions providers by our colleagues and varying government structures. Through the courageous leadership of nursing professionals, we’ve learned many lessons over the past 12 months. I encourage all nurse leaders to share lessons with fellow nursing and healthcare colleagues. We are all better together!