Master's thesis: Nurse managers of four COVID-19 care sites tell of their early experiences

Mari Nevala conducted interviews with nurse managers for her master’s thesis.

News19.4.2022

The nurse managers of the four primary health care COVID-19 care sites in the capital area of Finland were interviewed about their early COVID-19 crisis management experiences. The nurse managers of COVID-19 care sites have been on the frontline of the crisis and have led their staff with resilience and spirit. Experiences shared reflected upon the state of flux that capacity development created within primary health care, the importance of infection prevention in COVID-19 crisis response work, and the challenges of managing frontline nursing staff. The results can be used to better understand the contribution of primary health care organizations to COVID-19 crisis management. It serves as an in-action review of the COVID-19 care site model within primary health care. The new information can be used to better both current crisis response and recovery efforts, as well as future crisis preparedness.

The nurse managers spoke unanimously of how capacity development for the dedication of COVID-19 care sites within primary health care had created a state of flux within their clinics. This state of change had lasted for almost a year at the time of the interviews and had brought changes to the way in which they serve their communities. The respondents were all worried about how these changes might affect continuation of care for the non-essential and non-COVID-19 related health care needs of their regular clients. The role of nurses changed as well, of which experiences were varied. Two nurse managers said that their nurses were not involved with direct patient care in the COVID-19 care sites but were mostly responsible for supportive tasks and need-for-care assessments through telecommunication. The other two described a model of operation in which nurses continued to see patients on-site with low-threshold physician consultation. Most respondents were of the opinion that communication between stakeholders had improved due to the crisis. All respondents said that digital solutions for the health care needs of their communities were developed very quickly, to which two said that telemedicine would continue to be used in the future with crisis recovery efforts as well.

Infection prevention was a significant topic of discussion throughout both interviews, as the purpose of COVID-19 care sites was to reduce transmission. The respondents spoke of how there were different stakeholders involved in preventing infection, in which their nurses played significant roles. Each respondent told stories of how their COVID-19 care site was born and an important aspect of preparing for the crisis response work was in considering and planning for infection prevention. Protocols for infection prevention varied between respondents’ experiences, as did the equipment used. Though discrepancies could be attributed to the nature of the study and the depth of the interviews, they show that global efforts to standardize and increase infection prevention and control measures should begin within our local communities.

The nurse managers shared that the need for effective leadership was accentuated within the COVID-19 care sites. They have had to adjust their leadership styles to accommodate for the new situation and have also had to be vigilant in keeping up with the current information. They each have had to recruit and motivate their staff to work on the frontline of the crisis, for which they have had limited resources. Respondents said that they have had to rely on their own leadership abilities and the power of their nursing teams’ fighting spirit. Most respondents said that their single biggest concern now is in keeping their staff motivated. While the work has been challenging, two respondents said they were honoured to have had the experience of leading their staff on the frontline of an unprecedented global health care crisis.

Nurse managers from the four COVID-19 care sites in the capital area of Finland were interviewed using thematic pair interviews. The interviews included discussion on five themes, capacity development, managing staff, infection prevention, emerging issues, and overall experiences. The interviews were conducted through telecommunication and recorded for analysis purposes. The data were analyzed inductively using thematic analysis.

The author is a Finnish nurse with primary health care experience. She conducted the interviews of the four nurse managers as a project for her master’s thesis for the degree program in Global Health and Crisis Management. The two interviews took place in November 2020 and February 2021. The thesis report was published in December 2021.

Early Nurse Management Experiences from Finnish Primary Health Care Clinics Functioning as COVID-19 Care Sites (Theseus)