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• W3128471175 abstract "One of the problems with trying to write an editorial for a publication like the IJUN is trying to pick a topic that will still be relevant by the time the Journal is published because of the gap of many months between writing the piece and the Journal coming out. This editorial is being written in November 2020, and it is really very difficult to know what the world as we know it will be like in spring 2021. One thing that will still be dominating our lives will undoubtedly be the COVID-19 pandemic. Will the pandemic be easing? Will the promised vaccines deliver? Will the vulnerable be feeling safer? Will we be back in touch with friends and family face to face, not just virtually? Will our urology services be back to normal? It is difficult to know how soon things will pan out, but one thing will not change and that is the resilience and courage of our nursing colleagues worldwide. The theme chosen for the British Association of Urological Nurses' (BAUN) 25th annual conference held in November 2020 was courage. Little did the conference organizing committee realize how prophetic this would be and how relevant in this COVID-19 world. But in reality, nurses are courageous every single day they set out to care for their patients, and this was not just triggered by the pandemic. There is no doubt that any of our colleagues who either volunteered or were redeployed to work with COVID-19 patients showed immense courage on a day-to-day basis, but that should not detract from the fact that we all show courage in our everyday interactions with patients. As urology nurses, we show our courage every time we impart bad news to patients, as we nurse them through pain and trauma, as we help rehabilitate them after life-altering surgery, help them make decisions regarding their treatment and care, and each time we see a patient in clinic or get that urgent phone call and decide what to do next. It takes courage to sit and hold someone's hand as they are given a terminal diagnosis. It takes courage to make decisions and treat and care for patients. It takes courage to sit and hold their hands as they die. The COVID-19 pandemic has caused chaos to health care across the board and hampered urological nurses in their quest to offer their patients the best service to achieve optimum outcomes and keep their patients safe. However, it is also true that the pandemic has also acted as a catalyst in many instances, challenging us and showing what can be achieved when we work together and act quickly and decisively. Most importantly, it has shown us a new way of working and that communication is key. It has also cemented the place of the internet and technology in future care. But what has been the cost to nurses' health and well-being? In the wake of the pandemic, the Royal College of Nursing Foundation (RCN Foundation) charged the King's Fund, an independent charitable organization that works to improve health and care in the United Kingdom, to research the impact on nurses. The report states that the impact of the pandemic on the nursing and midwifery workforce has been unprecedented, and its effects will be felt for a long time to come.1 This conclusion will not come as a surprise to nurses or midwives working in the United Kingdom, and one could argue that it is only stating the obvious. Neither will their recommendation, which determines that, in order to function at their best, the health and well-being of nurses are essential. The quality of the care that they provide depends on their being well and supported to ensure they retain their compassion, professionalism and effectiveness. This means nurses and midwives and health care professionals need to work in an environment where working conditions are supportive and where the work life experience is a positive one to ensure the best outcomes for patients. The King's Fund report came up with an ABC framework to help structure the elements needed to create this environment. This framework is made of three parts: autonomy (A), belonging (B) and contribution (C), and there are eight key recommendations with detailed steps to enable these to be put in place. Autonomy was described as the need to have control over one's work life and to be able to act consistently within one's values. This means nurses need to be a part of the decision-making teams that determine how care is structured and delivered, as well as being consulted and included when establishing ways of working and the culture of the organization they work for. Autonomy also reflects justice and fairness in the workplace looking at equality, psychological safety, positive diversity and universal inclusion of the workforce. It also deals with work conditions and working schedules. The report stresses that health care professionals need resources and time not only to do their work to their best potential but also to work safely, to have proper rest at work and to be able to work flexibly and effectively. The report recommends that minimum standards should be introduced across all health care organizations to ensure parity for all.1 Belonging reflects the need we all have to be connected to other people; to be cared for and to care for our colleagues; and to feel valued, respected and supported by working in effectively functioning teams with clarity of the roles and shared objectives. The report puts the onus on organizations to ensure that health care professionals should work in nurturing cultures with leaders who are compassionate and who enable high-quality, continually improving and compassionate care and staff support. Contribution emphasizes ‘the need to experience effectiveness at work and deliver valued outcomes’.1 Work conditions should be appropriate to enable the delivery of safe and compassionate care while ensuring staff are supported and given the opportunity for professional reflection, mentorship and supervision to allow them to thrive in their work. This includes access to education and learning and developmental opportunities that promote continual growth and development for all. Excessive workloads should be investigated and reorganized to ensure that nurses can deliver the care that is needed without any detriment to their health and well-being.1 IJUN editorials have often highlighted the chronic shortage of nurses in the United Kingdom, and I am sure this shortage reflects similar situations wherever nurses work in the world to a greater or lesser degree. The King's Fund report highlights the fact that, even before the COVID-19 pandemic, there were close to 50 000 nursing vacancies across the whole of the United Kingdom. The pandemic has led to a huge increase in stress, thus compounding the already high levels of stress in nurses with the resulting increase in absenteeism, staff turnover, lack of motivation and thus productivity and effectiveness while at work (presenteeism) and nurses voicing their intentions to leave, which had been registered in 2019.1 It is difficult to know if being thrust into the limelight and labelled heroes by the public has changed some of these nurses' minds or in fact had the opposite effect and compounded their intention to leave the service sooner rather than later. As the second and possibly third wave of the pandemic hits us, it is vital to question if those nurses on the frontline are ready and able to go through it all again. Organizations need to ensure they offer the same level of care and support as when the pandemic first hit. However, as things ease, and we become used to our new normal, the findings of the King's Fund report should be embraced by Trusts up and down the country to ensure we do not go back to pre-pandemic ways of working. It is vital to invest in the health and well-being of all staff if we want to make sure that patients receive the care they need from staff who are not demotivated, disillusioned and at the breaking point. It is not good enough to just have to cope with huge workloads and lack of staff and lack of resources and soldier on as has happened in the past. We need to take control and be part of the dialogue with all managers and organizations to ensure that every member of staff feels valued and feels they are working in a safe nurturing environment where they count as a person and not just a pair of hands or a number on a rota, where the educational and developmental opportunities to enhance their abilities are met and encouraged and where they could progress in their careers to reach their full potential. … with great effort, dedication and personal sacrifice, created islands of sanity where good work still got done and where people enjoyed healthy relationships in the midst of chaotic conditions, fierce opposition, heart-breaking defeats, lack of support, isolation, loneliness, and slander.2 Margaret Wheatley acknowledges that the problems in our world are not going to go away or be solved overnight, but despite this, having good leadership means that we can work effectively safely and productively amid the chaos surrounding us. In other words, you may not be able to change the whole all at once, but you can start with your team by putting people at the centre of all decisions and actions and creating ‘islands of sanity’ that really contribute to the organizations or community you serve. Good leadership means realizing everyone has potential and creating an environment where people are motivated to give their best.2 Urological nurses are no different from their fellow nurses. There is a pool of talented, professional and skilled urological nurses out there who work tirelessly to develop themselves and their colleagues with a view to expanding their practice and developing new services for their patients. But it is also true that, most of the time, this is done against the odds and without the resources they need. COVID-19 has merely precipitated the crisis we were already facing. With more and more nurses leaving the profession either through disillusionment, burnout or due to retirement, we are at a crisis point that, post-COVID, is not going to go away. Some point out that this may eventually potentially be alleviated by the upsurge in the number of people applying to do their nurse training in the wake of the pandemic. This is excellent news for the future but does not solve our immediate problems as these people will not qualify for at least another 2 to 3 years. We also have no idea of how high the attrition rate will be once the glamour of joining a profession where they are being hailed as heroes wears off and the reality of what being a nurse entails hits home. Change needs to happen now. One of the positives to emerge from the pandemic experience is the realization of the importance of both physical and mental well-being, and what the King's Fund report does is emphasize that nurses and midwives are no different from the rest of the population. In fact, their welfare is vital in order for them to be the courageous carers that the public have come to expect, respect and need. Let us hope that, in this post-COVID world, these recommendations are acted upon. Change needs to happen now if we are to have a healthy and productive nursing workforce in the future." @default.
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• W3128471175 date "2021-02-02" @default.
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• W3128471175 title "Courage and leadership in a post‐COVID world" @default.
• W3128471175 cites W2626812501 @default.
• W3128471175 doi "https://doi.org/10.1111/ijun.12261" @default.
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