Safeguarding and Inspiring: In-Patient Nurse Managers' Dual Roles during COVID-19.

In Canada, and internationally, in-patient nurse managers' leadership roles during the current COVID-19 pandemic have not been recognized. Yet these nurse managers play critical roles in safeguarding both staff and patients, and inspiring staff to provide complex patient care. This paper describes how 13 acute-care nurse managers enacted and experienced transformational and complexity leadership during COVID-19. This case study of leadership at one multi-site, academic health sciences centre, examined how the first phase of the pandemic impacted the first-line manager's role, the strategies used to navigate organizational and patient care challenges, supports available and overall key learnings about leadership during a pandemic. Results reveal the dual roles assumed by nurse managers during the COVID-19 crisis. Nurse managers in this organization safeguarded patients, families and staff while ensuring 24-hour unit operations. Through leader-staff relationships, managers inspired staff to keep going despite the constant uncertainty and ambiguity. Nurse leaders in this case study exemplified characteristics of transformational and complexity leadership as their roles intensified in the context of COVID-19. Recommendations for nursing and healthcare leaders regarding the ongoing and future pandemics are discussed.