Managing health care under heavy stress: Effects of the COVID-19 pandemic on care unit managers' ability to support the nurses-A mixed-methods approach.

Aim(s): This study aims to investigate care unit managers' perceptions of how the COVID-19 pandemic influenced their ability to support the nurses.

Background: The COVID-19 pandemic placed extreme pressure on health care organizations. More knowledge regarding how the pandemic influenced care unit managers' ability to support nurses is central to ensuring high-quality health care in future crises.

Method(s): A mixed-methods study in Swedish hospitals with a survey (n = 128) and interviews (n = 20) with care unit managers.

Results: Approximately half of the managers reported having spent more time available to and supporting the nurses. Availability was positively predicted by their perceived organizational support while negatively by their job demands. These job demands concerned meeting staff anxiety and managing organizational restructuring. Full focus on direct patient care and strong professional and social support were important job resources.

Conclusion(s): For care unit managers to effectively support the nurses during a crisis, they need proficient job resources and moderate job demands. Managers' perceived organizational support positively affects the quality of their crisis leadership. Creating arenas in which staff collegiality can form and develop is beneficial for the ability to meet future crises.

Implications For Nursing Management: This study specifies important job resources that should be acknowledged and reinforced to strengthen the ability of care unit managers to actively support the nurses during a crisis.