Thoughts on Leading Through the COVID-19 Pandemic

by Lynne Nakashima, BSc(Pharm), PharmD, BC Cancer Provincial Pharmacy Director and FCAPhO Task Force Chair

The COVID-19 pandemic has been an unsettling event for all of us.  It seemed to turn our world upside down in a minute and created a whole new reality.  This has been particularly difficult for the profession of Pharmacy because we are used to order and organization.  For those working in retail practice, they found themselves thrust on the front lines, with little preparation, but facing worried patients wanting advice and early refills.  For those in hospitals, they faced the uncertainty of working with patients on acute care wards and in ICU who have COVID-19.  And for those of us, specifically in cancer care, we faced the unknown of working with a high risk patient population while knowing that the care of the COVID-19 patients could have an impact on our ability to provide care to our patients.

Information seemed to change minute by minute or at least hourly, almost, especially early on.  One minute, we didn't need any personal protective equipment (PPE), and the next, we were putting up plexiglass shields at our pharmacy wickets.  All of a sudden, work from home arrangements were being made, projects canceled and our focus was directed on immediate process changes and contingency planning.  All this, while trying to sort out our family situations, caring for children with schools closed, or caring for aging parents or grandparents suddenly faced with "stay at home" directives.

So how, in all of this chaos, does one step up and provide strong leadership and support to your team?

Leadership has different meanings to different people.  I think, to most, it means setting the strategic direction, developing the vision and the mission of the team or department and making the difficult decisions that have to be made to move forward towards those goals and objectives.  The leader must have the respect and trust of their team and of those in other teams that they work with and they have to be able to communicate to a broad range of stakeholders.  All these skills seem to be ones more suited to usual environments, when you have time to think and plan.  But these and many others are needed when faced with uncertainty, like we are during this COVID-19 pandemic.

For me personally, my first instinct, at the outset, was to jump in and help.  I knew that our centres were busy as patients came for early refills and as they learned to cope with remote services and changes in services.  I wanted to be at the front lines helping patients directly.  After all, that's really one of the reasons I became a Pharmacist in the first place - to help.  But I quickly realized that my role this time, was to be more in the background, to support our centres with the tools they needed to develop new procedures, to set provincial standards, to represent the pharmacy at the emergency operations committees and to act as a resource and a spokesperson for their needs.  I needed to work hard to make sure that our centres had what they needed to care for their patients.  And I needed to be calm and a voice of strength and resolve, and a model for the staff.  It is my role to stand outside and clap for those on the front lines.

Probably one of the first things I learned about leading through this crisis is that hard work alone on my part is not enough.  I needed help.  I needed advice.  I could not do it all myself.  Fortunately, my team and the pharmacy leadership team makes this easy for me.  But it's not always easy to admit you can't be everything to everybody.   Tapping into colleagues, whether within your own department or beyond is an important skill to be able to lead through a crisis situation. 

So the second thing I learned is to surround yourself with good strong people who are willing to drop everything to help.  If you have experts within your team, rely on them.  I have never been so impressed with my team as I am now.  They, without argument, put others first.  They put our patients first.  They put our pharmacy colleagues first.  They stepped in to help, where help was needed, not because they were looking for thanks or recognition, but because they knew this is what was needed.  The team also learned that we do not have to react immediately.  We can take time to make good, evidence-based decisions.  There's an instinct to just change things.  But that's not always necessary.  And once we got into a cadence of evaluating the question and looking at the evidence, we became much better at decision-making.

My third note is that communication is a key to keeping the team on track and moving in the right direction.  Sometimes, especially through the early days, we had way too much communication.  And it changed rapidly.  I'd get off the phone having made one decision and then find myself reversing that decision just moments later.  It was hard to stay on top of it all.  But at the same time, it is important to make sure that all of the leadership team is on the same page.  We found that we needed to set provincial standards, so that we were all doing and saying the same thing.  So, finding the way to communicate in a timely way and with the best possible information is a key.  But at the same time, stay calm and logical.  It's easier for the staff and colleagues to hear you that way.

And my final note is that you are only good to your team, if you make sure that you take care of yourself too.  It's easy, as a leader to become consumed by what needs to be done, and to forget that you need a break too.  Take a walk.  Watch TV.  Play silly games on your iPAD.  Connect with family and friends.  These sorts of things keep you grounded.  And that allows you to perform at your best.

Thank you for taking a moment to read my thoughts.  Take care.  Stay safe and wash your hands!

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