Kentucky Nursing Leadership During a Pandemic, USA

Case Study Submitted by: Dr Janie Heath, Dean of the University of Kentucky College of Nursing, Warwick Professor of Nursing & President of the Kentucky Nurses Action Coalition; Dr Ruth Carrico, Professor of Medicine, University of Louisville Division of Infectious Disease & Immediate Past President of the Kentucky Nurses Association; and Delanor Manson, Chief Executive Officer, Kentucky Nurses Association, Kentucky Nurses Action Coalition, and Kentucky Nurses Foundation
Country: United States of America (USA)

On the occasion of World Leadership Day on 20 March, ICN brings you a story of strong nursing leaders who – like so many others around the world – are fighting on the frontlines of the battle against the COVID-19 pandemic and providing quality nursing education to the next generation of nurses.

USA Kentucky Nursing Leadership during a pandemic

When the World Health Organization declared 2020 as “The Year of the Nurse and Midwife,” no one imagined it would look like this. That declaration will be in our hearts forever as nurses throughout the world continue to march through the COVID-19 pandemic storm.

Just like Florence Nightingale, mother of modern nursing, and Mary Jane Seacole, British-Jamaican nurse and businesswoman, did in the Crimean war, nurses today are sacrificing to put others above themselves. From 9/11 to Ebola to Hurricane Sandy— nurses in the USA have met each challenge with courage and compassion. The COVID-19 crisis has not been any different and, in Kentucky, a nursing collaborative was established to shepherd the commonwealth, its citizens, nurses and students through the crisis.

Efforts have been around the clock, regardless if serving on the frontlines of care delivery, conducting virtual research experiences, providing innovative telehealth alternatives or converting educational environments to online learning. Over 80,000 nurses have been supported by the Kentucky Nurses Association (KNA) to help maintain safety and wellness.

Other nursing organisations, the Kentucky Organization of Nurse Leaders and the Kentucky Board of Nursing, stepped up too. Every day, they advocated for nurses’ safety and protection as they faced supply chain shortages of Personal Protective Equipment (PPE), infectious patient surges and new evidence on COVID-19 treatment and containment.

Academic nurse leaders throughout Kentucky also stepped up to support students’ success notwithstanding tremendous pressures with state budget cuts. Faculty found creative solutions to help students’ complete required clinical hours despite many healthcare facilities limiting student access. In Kentucky alone, 3,000 undergraduate nursing students graduated by the end of 2020.

In addition to everything Kentucky nurse leaders did, they remembered nurses are human too. They recognised “emotional” PPE (e-PPE) was critically needed to address the mental health tsunami that nurses faced personally and for their patients, families and communities. Perhaps that is the single most important impact they made as, sadly, nurse suicide rates are now higher than in the general population in the United States and we cannot afford to lose one more life to suicide in the nursing workforce.

Kentucky nurses felt the stress of their circumstances, on the job and at home. In the middle of one crisis after another, they provided comfort and care to patients as well as their own families and friends—some of whom faced hardships due to lack of childcare, job loss, active COVID symptoms, and a divided country.

Generous Kentuckians donated time and money for statewide distribution of PPE, including masks and hand sanitizers, and e-PPE, including the KNA Apricot Ribbon and Sign Campaign. Over 1000 ribbons and 600 thank you signs were distributed and prominently placed throughout Kentucky’s 120 counties. Nurses were publicly recognised for their tireless dedication for care delivery during the pandemic.

The color of apricot was chosen for the ribbon campaign because it is the “academic color for nursing” and the orange palette represents “warmth, optimism and hope”. The ribbons wrapped around trees, lamp posts, and other landmarks to lift the spirits of frontline providers.

Dr Camille Burnett helped launch a statewide public letter-writing campaign called Heart-2-Heart, a partnership between the University of Kentucky Colleges of Nursing and Agriculture, Food and Environment. The, now a national initiative, included a network of young members of Kentucky’s 4-H Youth Development Program of Fayette County, encouraging them to make cards, draw pictures and write letters supporting healthcare workers in COVID-19 hotspots. To date, over 3000 nurses in Kentucky have received Heart-2-Heart cards.

Building multiple platforms for widespread distribution Heart-2-Heart campaign such as social media, educational conferences and academic environments, Kentucky nurse leaders continue to dedicate resources to advance e-PPE efforts. Crisis management research has repeatedly demonstrated that adversity, such as a pandemic, in the middle of racial unrest and a presidential election does not have to hold us back from reaching our greatest potential. Collectively, the Kentucky nursing community has stayed resilient and strong though challenging times. By working together, staying connected and communicating intentional strategies, such as below, they have emerged stronger and healthier.

  1. Staying focused on what we can control – stopping COVID-19 single handedly is out of our hands but you can control how you react to the challenges by following CDC recommendations for handwashing, social distancing and disinfecting surfaces.
  2. Taking time to breathe and reflect – thinking about how our new world with COVID-19 brings opportunities for creative adjustments and family connections by returning to simpler times in our lives with walking outdoors, eating dinners together and playing board games.
  3. Practicing gratitude – finding something positive every day and being grateful for simple things like beautiful days of sunshine or spending more time with pets is vital to health and mental wellness.
  4. Taking care of ourselves – prioritizing “me time” in the middle of a crisis is challenging but critical if you are going to come out healthy on the other side. You must get adequate sleep, exercise and eat healthy so you can take better care of others and your communities. Kentucky nurses—along with thousands of health care professionals and service industry workers—are keeping their state and nation afloat right now.

Kentucky nurse leaders are grateful for the relentless efforts of so many to continue building a culture of health and strengthening the nursing workforce during unprecedented times. #TogetherKY #KYNursingStrong

For questions about the Heart-2-Heart campaign or for information on how to get involved, contact

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