Nursing executives' response to COVID-19 in Spain. An ethnographic study

Area of Science:

• Nursing Leadership
• Healthcare Management
• Public Health Crises

Background:

• The COVID-19 pandemic presented unprecedented challenges to healthcare systems globally.
• Executive Nurse Leaders (ENLs) are crucial in navigating complex health crises.
• Understanding ENL roles in pandemic response is essential for preparedness.

Purpose of the Study:

• To delineate the multifaceted role of Executive Nurse Leaders (ENLs) during the COVID-19 pandemic response in Spain.
• To analyze the scope and impact of ENL involvement across different management areas.

Main Methods:

• A qualitative descriptive study employing an ethnographic approach.
• Direct qualitative content analysis of 25 semi-structured interviews with ENLs in senior management positions.
• Inclusion of diverse executive roles across autonomous health policy and healthcare organizations in Spain.

Main Results:

• Four key themes emerged: the health crisis context, ENL involvement in autonomous policy and healthcare organization management, patient care considerations amidst visitation restrictions, and communication strategies.
• Identified ENL engagement in autonomous policy, healthcare organization, and shared management domains.
• Highlighted criticism of visitation bans and nurses' adaptive responses, alongside communication strategies for staff and public.

Conclusions:

• ENLs played an indispensable role in managing the pandemic response, with varying participation levels across Spanish autonomous communities.
• Enhanced understanding of ENL roles can improve healthcare challenge management, leadership visibility, and social recognition.
• Advocating for ENL integration at executive levels is vital for strengthening national preparedness for future health emergencies.