The pandemic threw intensive care personnel into innumerable challenges and upheavals. A new study looks at the managers’ role and experiences during this period. The researchers behind the study conclude that the dramatic transition of intensive care came at a high organisational and personal cost, and that there are lessons to be learned.
Intensive care around the world was at the focal point during the COVID-19 pandemic. Intensive care units are staffed with highly qualified and interprofessional personnel who treat patients with severe or life-threatening conditions. During the pandemic, they were faced with an unexpected and heavy workload, and they were forced to quickly adapt to meet the increased needs for medical care. Research has looked at different aspects of intensive care during the pandemic in a number of studies. The most recently published paper describes the managers’ experiences.
Anna Nordin from Karlstad University, project leader and one of the authors behind the study, emphasises the enormous challenge.
– Nurses with different specialisations were recruited to increase the capacity and meet the medical needs of an increased number of patients. This required a new administrative structure and a coordination the likes of which we have rarely seen before.
At the start of the pandemic, Sweden had one of the lowest ICU capacities in the Western world. As a reaction to the growing crisis, the capacity was doubled by creating temporary ICUs. However, the restructuring placed immense pressure on both staff and management.
- The managers had no one to turn to, they had to motivate staff who were sad, scared and exhausted, they were expected to have solutions when there were no solutions to be found, and they worked a tremendous amount of hours, says Åsa Engström, Professor of Nursing at Luleå University of Technology and one of the researchers behind the study.
The researchers describe that one of the intensive care managers said: “The manager above me is just as exhausted and I don’t think we can support each other either. Everyone, including all managers, are just as tired.”
- This is where the unique role of leadership became most apparent. The lack of preparation and resources created a number of challenges, including over-worked and concerned staff and increased risk of infection. The leaders felt that efficient communication, on-site presence of managers, clear decision-making, structured prioritisations and mutual trust were important factors to handle the crisis in the best possible way.
Navigating through the pandemic
The study shows that the COVID-19 pandemic forced Swedish intensive care to undergo a dramatic transformation. The results clearly emphasise that the ICUs managed to handle more than anyone had thought, but that the adaptations came at a high personal and organisational cost. The tug-of-war between demands and resources meant that leaders had to work hard to meet the challenges posed by the pandemic, but that they managed to handle it.
– To quote one of the managers; “they have delivered, but it came at a very high price for the individual”, says Anna Nordin.
Lessons learned
– In order to prepare for future challenges, intensive care and the entire health care system must make use of the important lessons learned from the pandemic. The leadership role, effective resource management and the staff’s wellbeing must be prioritised to ensure that intensive care is equipped to face future crises with greater resilience and effectiveness, says Anna Nordin.
The researchers behind the study are Anna Nordin, Karlstad University, Åsa Engström, Luleå University of Technology, Maria Andersson, the Swedish Red Cross University, and Angelica Fredholm, Karlstad University.
