From staffing and supply shortages to furloughs and layoffs, few expected—let alone had a plan for managing—the COVID-19 pandemic. The crisis allowed nursing professional development to demonstrate its value like never before. This article explores the impact of the pandemic on nursing professional development practice at the micro (unit), meso (organization), and macro (national) levels of our specialty. [J Contin Educ Nurs. 2020;51(8):349–351.]
During the Ebola outbreak in 2014, we acknowledged educational emergencies, but the minor skirmish with Ebola did little to prepare us for the COVID-19 battle. This pandemic has thrust all health care workers into strange, uncharted territories. We have gone from the initial stages of the pandemic, during which we experienced staffing challenges and scarcity of personal protective equipment (PPE), to the unanticipated economic repercussions of mass cancellations of elective procedures that have necessitated organizational downsizing. Throughout the uncertainty, nursing professional development (NPD) practitioners have been challenged to meet the needs of frontline staff—including redeployment of staff to unfamiliar patient care areas—as well as to ensure the successful orientation needs of travel staff, newly hired staff, and nurse residents. NPD specialists who function at the unit, organization/system, and national levels of our specialty, experienced differing demands but identified creative ways to demonstrate the value of the specialty.
Meeting Needs at the Micro Level
Dennis Dougherty, MSN, RN, NPD-BC, Professional Development Specialist, Clinical Education, Informatics, Practice, and Quality, Boston Children's Hospital
The work of NPD practitioners continues during times of crisis. New staff need orientation. Practice gaps must be addressed. Staff competence must be validated. While this essential work moves forward, the NPD practitioner must be flexible and creative. During the COVID-19 pandemic, restrictions on face-to-face gatherings forced NPD practitioners to think outside the box. What was effective several weeks ago is no longer possible. Although this situation created new work, it opened the door to new opportunities and possibilities, especially using video conferencing technology.
Video conferencing has emerged during the pandemic as a critical tool to connect both professionally and personally. Although available for many years, few NPD practitioners used this technology routinely. However, NPD practitioners now use video conferencing to meet the needs of learners with real-time meetings that foster connection while maintaining physical distance. I have learned four keys to success when using this technology to facilitate learning: (a) attention to detailed instructions for learners, (b) working with a producer, (c) incorporating a variety of learner engagement strategies, and (d) seeking constructive feedback.
Detailing Instructions for Learners
Many learners are unfamiliar with video conferencing platforms; therefore, detailed instructions and communicating expectations are imperative. Build-in time to allow participants to become acquainted with the technology. Identify learners who need extra support and connect with them. Offer opportunities to log on and practice using the technology to ease stress and anxiety for presenters and learners alike.
Working With a Producer
Having a colleague act as a producer enhances the live virtual learning experience for both participants and facilitators. The producer allows the facilitator to focus on teaching. While the producer need not be an information technology expert, the individual should have basic knowledge of the video conference platform. The producer can support learners with technology issues, monitor the chat stream, and alert the facilitator to questions.
Learner Engagement Strategies
Quality and engagement should not suffer when using video conferencing for education. New formats for educational delivery provide an opportunity for creativity, experimentation, collaboration, and risk taking. However, reimagining effective teaching strategies requires substantial time and effort. The NPD practitioner must explore features of the video conferencing platform. Most platforms have instructional videos on their website. Additionally, collaboration with colleagues helps to identify facilitation strategies and promotes mutual learning.
Strategies for learner engagement include using “breakout rooms” for group discussions or small-group work. Quizzes, self-reflection, polling, and question-and-answer sessions also make the otherwise isolated remote learning environment interactive. Encouraging an active chat dialogue also promotes engagement.
Use program evaluation to solicit feedback from learners about the distance learning experience. Understanding what is effective and ineffective from the learner's perspective informs future distance programs. The producer and other NPD colleagues can also provide critical feedback to improve program design.
Rising to the Challenges
Although the transitions made during the pandemic have promoted creativity, adapting to the new normal has posed challenges, including continual changes, technology issues, isolation, and letting go of nonessential work.
Changes occur frequently. What seems like a good plan one day needs to be reevaluated the next. The lack of equipment and supplies has required adaptations, some of which defy known best practices. The uncertainty has created additional stress, intensifying the need for self-care.
In addition to frequent changes, use of technology creates its own challenges. Internet connections become unstable and applications crash. Learners have varying skills and comfort with technology. Anticipating these issues helps to address them.
With many NPD staff shifting to remote work, opportunities for connecting with colleagues and stakeholders has diminished. Typically, these day-to-day interactions allow NPD practitioners to learn about practice gaps, brainstorm ideas, and solicit feedback. Finding time to connect with NPD colleagues in a remote work environment is critical.
Although essential work needs to continue in a time of crisis, many aspects of work may have to be relinquished, at least for the short term. NPD practitioners need to communicate with and involve partners and stakeholders in decision making. In addition, NPD practitioners must understand how decisions affect operations for another department. On a positive note, the current situation serves as an opportunity to reevaluate aspects of work that previously seemed essential to operations. This crisis can help us identify new, more efficient ways to accomplish our work.
During a time of crisis, it takes all hands on deck to meet patient and organizational needs. NPD practitioners may be asked to assume roles or perform tasks that are not aligned with their typical responsibilities. Although being asked to perform new or different tasks may be frustrating, the NPD practitioner needs to keep the bigger picture in mind. Approaching these circumstances as an opportunity to demonstrate leadership, build new relationships, and increase visibility can demonstrate the value of NPD practice.
Leading from the Meso Level
M. Greta Price, MSN-ED, RN, NPDBC, NEA-BC, Director of Clinical Professional Development and Patient Education, Riley Children's Hospital, Indiana University Health
As an NPD leader in a new organization, I had hardly completed orientation when the pandemic struck. Fortunately, I had aggressively immersed myself in my new role and organization—pre-work that contributed to my department's success in this unprecedented situation. During this crisis, I found six key NPD leadership strategies that helped our team to thrive.
Envisioning the Future
Environmental scanning is an input of the NPD Practice Model (Harper & Maloney, 2016). As the coronavirus emerged, I scoured valid and reliable resources, including my organization's infection preventionist, leadership, and national health organizations, to prepare NPD staff and demonstrate our value.
Staying in Your Lane
As an NPD leader, I must know and teach NPD staff our “lane.” The boundaries of our lane are established by the “Big 6” (Price, 2017) responsibilities from the Nursing Professional Development: Scope and Standards of Practice (Harper & Maloney, 2016):
- Competency management
- Practice/quality improvement
- Role development
- Collaborative partnerships
If we cannot categorize an activity into one of the Big 6, then it needs to go. Our team's strengths during COVID-19 were competency, education, role development, and collaborative partnerships. We were responsible for training, and our operations partners were responsible for deployment.
Although we knew our organization would adjust staffing, we were unsure of what changes would be needed. As a result, we prepared for a variety of scenarios of shifting staff: pediatrics to adult, adult to pediatrics, perioperative to acute care, ambulatory to acute care, acute care to critical care, and so on. By forecasting different scenarios, we were ready when executive leadership requested a cross-training plan.
Regardless of staffing model, I knew redeployed staff needed confidence and competence to practice safely. In addition, we needed to follow social distancing guidelines, conservation of personal protective equipment, and hand hygiene. The sense of urgency was palpable. I wanted to minimize leaders' worries by anticipating their needs within our scope of practice. As I practiced environmental scanning to foresee their needs, I became the leader who made their jobs easier. Our department became valuable.
Aligning with Leadership
Because of my thorough assessment in the first several months of my tenure, I knew the culture and the key players. I studied the organization's strategy, values, and key performance indicators. I directed my team to act within these guidelines. Knowing the organization's culture, we could align with our leaders.
Giving Credit to the Team
During the pandemic, our NPD team created a “upskilling” plan, an employee wellness program, a rapid-fire interprofessional simulation to decrease exposure during intubation, and other meaningful projects. They are publishing and presenting their work, and I am their biggest cheerleader. My role is to coach my team to excellence, and then let them take the victory lap.
As an NPD leader, I believe in our practice specialty and what we offer the profession. Through envisioning, knowing our responsibilities, forecasting, anticipating, and aligning, we can better equip our teams to demonstrate their value. I am confident that my organization's executives can describe what our team does. How about you?
Supporting from the Macro Level
Mary G. Harper, PhD, RN, NPD-BC, Director of Professional Development, Association for Nursing Professional Development
The Association for Nursing Professional Development (ANPD) is the recognized specialty organization for NPD practitioners. One of the ANPD's goals is to be the “leading resource for nursing professional development practice” (ANPD, n.d.-a, para. 3). With COVID-19, the NPD practice team at ANPD quickly realized that our members needed our organization's support more than ever. ANPD's support was focused on providing resources to help members move their practice to virtual formats, directing NPD practitioners to best practice clinical resources and redeployment strategies, and promoting self-care. These initiatives were achieved through live and recorded webinars; pod-casts; partnering with other nursing associations, including Sigma and the American Association of Critical Care Nurses (AACN) to promote our collective resources and provide them at no charge; discussion forums on the ANPD website where individuals shared creative strategies for addressing educational needs during the pandemic; and “high-five” e-cards and Facebook profile picture frames acknowledging NPD practitioners' roles in supporting the front lines. These complimentary resources are conveniently aggregated on a COVID-19 resource page on the ANPD website (ANPD, n.d.-b).
The COVID-19 pandemic has created leadership challenges and opportunities at the micro, meso, and macro levels of NPD practice that demonstrate the critical contributions of the specialty to health care.
- Association for Nursing Professional Development. (n.d.-a) About ANPD. https://www.anpd.org/page/about
- Association for Nursing Professional Development. (n.d.-b). COVID-19 resources for NPD practitioners. https://www.anpd.org/page/covid-19-resources
- Harper, M.G. & Maloney, P (Eds.). (2016). Nursing professional development: Scope and standards of practice (3rd ed.). Association for Nursing Professional Development. doi:10.1097/NND.0000000000000255 [CrossRef]
- Price, M. G. (2017). Scope it out: What's in and what's out. Journal for Nurses in Professional Development, 33(3), 156–158 doi:10.1097/NND.0000000000000350 [CrossRef]