#25

Leading in extraordinary times

Suzanne Demspsey

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Few of us could have believed that when we welcomed in 2020 we would soon face a pandemic that is affecting millions of lives and is dramatically changing the way work, we live and in all too many cases how we die. While every profession is facing unprecedented challenges, it is perhaps the medical profession that is under the most pressure.

Pressure that raises our interest in such leaders and poses the question – How do we lead in these extraordinary times? To answer this and discuss leading through adversity, I’m delighted to welcome Suzanne Dempsey, the Deputy CEO and the Director of Nursing at the Mater Misericordiae University Hospital, Dublin. The Mater Hospital is at the epicentre of Ireland’s battle against Covid 19.

Summary

2:45 Career history

• Her training as a children’s nurse at Temple Street Hospital and her post-graduate studies in adult nursing
• Subsequent leadership and management roles, including ICU Nurse Manager and Directorate Nurse Manager at  Beaumont Hospital and Director of Nursing at Temple Street Hospital
• Working in neuroscience, ICU and pediatrics
• Current position as Chief Director of Nursing with the Children’s Hospital Group

4:25 Pediatric vs non-pediatric hospitals

• Needing to be flexible to help children of different ages
• Explaining things to parents as well as knowing how to give age-appropriate explanations to children

5:35 Children’s Health Ireland

• Her role as Chief Director of Nursing:
  • Leading nursing and professional development in 3 children’s hospitals
  • Acting as the executive lead for the clinical integration of the 3 hospitals
• Moving towards a new model of care close to (or in( the home
• The challenge of unifying the different styles, environments and policies of different hospitals

8:35 Digitally-led hospitals

• The advantage of any GP having access to medical records from anywhere
• The implications of parents being able to access records and book appointments online
• How this allows to move from a paternalistic system to more of a partnership
• Accounting for lack of access to computers

11:05 A typical day in a COVID hospital

• Daily steering committee meetings to address concerns and plan for the day
• The nurses’ “safety huddle”: addressing patient safety, staffing issues, and end-of-life care
• Allowing everyone the opportunity to give feedback
• The importance of “visible leadership”: visiting the wards and being on the front line with the nurses

15:50 New challenges

• The feeling of being in it together, as part of a collective call to action
• How the hospital was managed in the early days of the crisis
• Dealing with shortages when staff started getting COVID
• The high level of fear felt by nurses

18:05 Life and death decisions

• Having a plan for when resources run out – “Thankfully we never got to that place”

19:15 Leading in crisis

• What integrity means to her
• How to cultivate trust
• The importance of listening and taking feedback

21:40 Keeping a team focused and motivated

• Having a clear governance structure and communication plan
• The importance of giving positive feedback and talking through mistakes without blame
• Special treats and fun activities
• Empowering team members by facilitating collaboration and asking them for solutions

24:20 The collapse of child care for front-line workers

• The Mater Hospital’s creche
• Allowing for flexible work hours

25:35 Patient care

• Not being able to physically comfort patients due to PPE
• Using “non-touch compassion” such as active listening
• The crucial importance of language

27:10 Post-COVID care

• The problem with patients putting off medical consultations
• Needing to get creative with technology
• Considering 6-day weeks to match peoples’ lifestyle
• Questioning the current state of primary care

30:05 Preparing for a second wave

• Current emergency room configuration
• Aiming for faster laboratory testing
• Reassessing inpatient configuration
• How to make patients feel safe

33:35 Necessary changes for the future

• Focusing on prevention and lifestyle choices
• Facilitating care in the community and offering more resources to primary care centres
• Private vs public care: “It’s about choice”
• Considering whether doctors are always the best person to see
• How being less status-driven could help the health care and education system

36:50 COVID and non-COVID patients

• How the two areas are separated
• Isolation in the single rooms of The Whitty Building

38:18 Practical patient issues

• Laundry exchange service
• Corporate donations of toiletries
• Patient liaison services that allow family members to access information
• Ways for family members to send best wishes to patients

40:40 Workforce management

• How to manage the lack of staff due to COVID or self-isolation
• Predicting needs based on other countries’ experience
• The redeployment and upskilling program

43:35 Advice to staff and nurses

• “Go back to the facts” and trust the WHO protection guidelines
• Setting up a counselling service
• The stress of seeing large numbers of end-of-life patients

45:10 Burnout

• Preparing for the long-term and remembering the importance of taking time off
• Offering free car parking at the hospital
• Supporting staff with visible leadership
• Offering financial support during sick leave
• How team spirit has been strengthened during this time

49:15 Suzanne’s own self-care

• How her family situation allows her to work long hours at the hospital
• Going for walks and watching Comedy Central
• The importance of getting positive reinforcement and feeling supported by her staff

50:32 The future of nursing

• Focusing on retention
• The 2 policies that should be fast-tracked:
  • Safe staffing policies: providing an accurate number of nurses needed to work safely
  • Boosting the numbers of advanced nurse practitioners

52:45 Advice for future nurses

• The benefits of a career in nursing: variety, constant learning opportunities, and how rewarding it is – “It is an immense privilege to care for somebody who is at their most vulnerable”

53:55 Final words

• Thanking everyone for the hard work
• “It’s not over”: why we need to remember to be compassionate, patient and avoid blame