Managing the COVID-19 Pandemic: Experience of Managers in Healthcare: A Narrative Inquiry
Abstract
:1. Introduction
- to understand the experience of managers during the pandemic
- to identify the difficulties and strategies used to face challenges within the managerial role during the pandemic
- to describe factors perceived as helpful for managers in facing this critical period and proposals how to better manage a crisis situation
2. Materials and Methods
3. Results
3.1. Participants
3.2. Narratives
3.2.1. Personal Level “The Emergency Has Engulfed Us”
3.2.2. Practical/Professional Level: “Managing the Pandemic”
3.2.3. Social Level: The Strength of the Team and the People
3.3. Responses to Guiding Questions
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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n = 36 (%) | |
---|---|
Gender | 36 |
Male/Female | 18 (50.0%)/18 (50.0%) |
Working directly with patients affected by COVID-19 | |
Yes | 11 (30.6%) |
No | 25 (69.4%) |
Years in managerial role | |
<5 | 13 (36.1%) |
6–20 | 19 (52.8%) |
21–35 | 1 (2.8%) |
>36 | 3 (8.3%) |
Living status | |
lives alone | 6 (16.7%) |
lives with others | 30 (83.3%) |
Narrative Threads | |||
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Level of Justification | Theme | Direct-Care Managers (n = 26) (Nurses/Doctors) | Non Direct-Care Managers (n = 10) (Administrative, Technical and Hospitality Service) |
Personal | The emergency has engulfed us |
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Practical/professional | Managing the pandemic |
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Social | The strength of the team and people |
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Level of Justification Theme | Micro–Story Extracts |
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Personal The emergency has engulfed us | Micro-story n. 1 “go to the front” (extracts) “But the most surprising thing was when I asked who would have wanted to go to the front…, as we call it. Yes the front,.. because for us it’s a war, war against an invisible enemy that not only kills but takes away feelings, kills memories…” (Nurse Manager) “…I remember very well the emotion of the last goodbye to the nursing team the day before they left for six weeks to work in the Covid hospital, we thanked them for their sacrifice, for their willingness, for the risk they were running… The news we received from the front was dramatic, with an unknown and very aggressive virus, with patients intubated for 3-4 weeks and in the worst cases they died without even being able to have their loved ones near them… I remember that it was said that this was an inhumane disease…” (Administrative Manager) Micro-story 2 “The war of the worlds” (extracts) “It’s collective hysteria”... he said without thinking much about it. I saw he was very busy and with lot’s of worries that took him far away from me. I was talking to him and I was actually interested in something else entirely. I needed to know what fate awaited my unit. So this problem captured all the attention of the person, but I would have liked him to have been interested in my problem instead. And well that’s how it was, this damn bug was taking over everything, like in the war of the worlds. Everything you touched, every person you met, it could lead you to disaster. And then I’d start to get out of breath and dizzy. And even though I wasn’t sick, I felt like it. Of course I’m rational and I’ve always been active and present at work, but in a corner of my mind there was always that voice saying, eh, no, this time we won’t get out of it… Instead out there, in the field, there were people who were really ill and people who really cared for them. And the knowledge of that made me find the oxygen” (Medical Manager) |
Practical/professional Managing the pandemic | Micro-story n. 3 “Things you wouldn’t want to do” (extracts) “…given the impossibility to visit patients, family members would stand under the terraces of the hospital to see and communicate with their loved ones, it was moving, and my job was to have to tell them to leave…” (Administrative Manager) Micro-story n. 4 “Changing ways of thinking to face something new” (extracts) “Aware… I don’t want to forget the suffering that the pandemic created in patients, relatives, caregivers, and all of society in more or less intense ways. Personally, I found the lockdown period interesting. I find the experiences related to the crises a source of growth; the change of routine, having to face dramatic situations, changing our ways of thinking to face something new has left us to live and share moments never experienced before. During the most critical period I totally changed role, I left an outpatient department for the intensive care unit, an environment I’d left more than 20 years ago. The tension related to the new environment, the feeling of being insecure and not professionally ready for any situation led me to dedicate myself to study again. The welcome from the intensive care colleagues was fantastic. Their guidance during the first days and their constant support made sure that I never felt alone but always supported. The collaboration created was fundamental, so that in a short time I went from a state of tension to one of well-being, where the professional gaps became points of exchange (especially between colleagues on temporary loan) and to increase my professional knowledge. (Nurse Manager) |
Social The strength of the team and people | Micro-story n. 5 “We are all in the same boat” (extracts) “during the COVID emergency this Spring, the positive aspect for me was the great collaboration that existed among healthcare professionals across the board, at times even moving given the very dramatic context…. the people with whom I work every day perceived, as I did, the difficult moment we had to overcome, and we immediately stood together to support each other and do everything possible… I repeat once again that the most important thing during this period was solidarity and standing together” (Nurse Manager) Micro-story n. 6 “Unity amongst all and at all levels” “our team responded magnificently to this enormous challenge. Having a common goal “managing this pandemic wave in the best way possible with as little damage as possible”, united not only our team but the whole organisation ” (Administrative manager) Micro-story n. 7 “The strength of the team” (extracts) “Leading a team and being even more of a leader in a crisis phase like we hadn’t experienced in decades, gave me and us a great buzz. The fact of having a great team really reassured me and made me confident that we would be able to handle this acute phase and that things would get better.” (Administrative Manager) Micro-story n. 8 “Everyone did their best” “I had a unique experience, for which no one was prepared. I was able to count on the contribution—support of my hierarchical and functional superiors first and foremost and my staff. I was able to benefit from the support of the other departments… I was able to see collaboration at all levels: from senior managers to hospitality services; from the technical service to IT. Everyone did their best to help us, the soldiers from Civil Protection and staff on loan at the tent. The dearest people were my loved ones “ (Nurse Manager) Micro-story n. 9 “Desire to feel useful and part of it all” (extracts) “…I was lucky enough to have a team that compares to no other, everyone has given and is giving their best to cope with the thousands of requests and the daily evolution of the scenarios… each department head has shown a very high sense of responsibility towards their staff and the organization, but above all, not forgetting a strong attachment to the profession. We were able to move the outpatient unit in 2 days, bringing together two teams that had never worked together before, but with a spirit that distinguished nurses, commendable, all ready to do their part, all with the fantastic desire to feel useful and part of it all. The staff have responded with a willingness to be there, many have proposed to go to work in a Covid ward, so we have done our part, yes, because it was important to be there, to understand that the unity of nurses doesn’t only come from what they teach us in universities, but from that sense of belonging that is unique in the world, we are nurses.” (Nurse Manager) Micro-story n. 10 “Often the barriers are ourselves” (extracts) “…it’s interesting how in these occasions people’s creativity is productive and used to the maximum, decisions are quick, teamwork is optimal… it’s incredible what the (hospital name) was able to do in a short time… it’s normal to wonder why it can’t do the same in normal conditions… the explanation I gave myself is that in this phase we all had one common goal (to treat COVID patients with as little damage as possible)… the lives and the deaths of so many people were at stake… At that point it was easy to bring all stakeholders together under one roof… in ‘normal’ everyday life we often have lots of goals to achieve, some of which are divergent or even conflicting… the sense of urgency varies according to the leader and the situation, leadership is not always clear and direct, norms and habits often clog up the organization… I think that from a business and leadership point of view, COVID has taught us a lot. Also the fact that often the barriers are ourselves… “ (Administrative Manager) |
Theme | Sub-Themes | Direct-Care Managers (n = 26) (Nurses/Doctors) | Non Direct-Care Managers (n = 10) (Administrative, Technical and Hospitality Service) |
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Emotions |
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The managers role during the pandemic |
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Communication flow and adapting to the situation |
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Theme | Direct-Care Managers (n = 26) (Nurses/Doctors) | Non Direct-Care Managers (n = 9) (Administrative, Technical and Hospitality Service) |
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Personal characteristics, knowledge and competency |
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Support from inside and outside of the organisation |
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We’re all in the same boat |
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Theme | Direct-Care Managers (n = 23) (Nurses/Doctors) | Non Direct-Care Managers (n = 8) (Administrative, Technical and Hospitality Service) |
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Provide support |
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Improving information and communication |
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Having an emergency plan in place |
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Awareness of resources |
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Attention to care |
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Avoiding bellic language |
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Value the role of professionals |
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Don’t create false expectations |
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Respecting the rules |
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© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Tolotti, A.; Liptrott, S.J.; Bonetti, L.; Cavatorti, S.; Sari, D.; Caoduro, L.; Biegger, A.; Bressan, A.; Valcarenghi, D. Managing the COVID-19 Pandemic: Experience of Managers in Healthcare: A Narrative Inquiry. Healthcare 2024, 12, 447. https://doi.org/10.3390/healthcare12040447
Tolotti A, Liptrott SJ, Bonetti L, Cavatorti S, Sari D, Caoduro L, Biegger A, Bressan A, Valcarenghi D. Managing the COVID-19 Pandemic: Experience of Managers in Healthcare: A Narrative Inquiry. Healthcare. 2024; 12(4):447. https://doi.org/10.3390/healthcare12040447
Chicago/Turabian StyleTolotti, Angela, Sarah Jayne Liptrott, Loris Bonetti, Shaila Cavatorti, Davide Sari, Luigi Caoduro, Annette Biegger, Alessandro Bressan, and Dario Valcarenghi. 2024. "Managing the COVID-19 Pandemic: Experience of Managers in Healthcare: A Narrative Inquiry" Healthcare 12, no. 4: 447. https://doi.org/10.3390/healthcare12040447