key: cord-0831199-g081iwff
authors: Leaver, Rachel Busuttil
title: Courage and leadership in a post‐COVID world
date: 2021-02-02
journal: Int J Urol Nurs
DOI: 10.1111/ijun.12261
sha: 3d5f25a28ee84165859b9f27e1686c57f0c86490
doc_id: 831199
cord_uid: g081iwff

nan

change and that is the resilience and courage of our nursing colleagues worldwide.

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 val- 

The King's Fund. The Courage of Compassion: Supporting Nurses and Midwives to Deliver High-Quality Care

Who Do You Choose to Be: An Invitation to the Nobility of Leaderships