CNO Perspective 2020


Nurses Have Stepped Up. Now It’s Time to Support Them as We Move Forward.

As I write this in mid-April, we have not quite reached the apex of the spread of COVID-19. Just yesterday, almost 700 people died from the virus in one city. I find myself overwhelmed with a sense of urgency to DO something. Every day, I contemplate the toll on nurses and physicians who are working endless hours, putting themselves in harm’s way to protect us all.

Each May, I write a CNO Perspective report on a topic that is top of mind for nurse leaders. Last year, I wrote about reducing the cognitive load for nurses and other healthcare professionals. I’ve spent the past year speaking and publishing on this topic, often by invitation.

The response I’ve continued to receive from nurse leaders tells me the theme of reducing cognitive load remains important and timely. My plan for this year’s report has been to go more deeply into how to address many of the challenges nurse leaders have expressed to me.

Since watching the toll COVID-19 has taken on healthcare workers, I now ask myself: how can I possibly talk about anything but the pandemic impacting our world? What are our next steps? How will we move forward? How do we plan for what we don’t yet fully understand?

I see nurses wearing varying degrees of personal protective equipment (PPE), often lacking essential tools and supplies, trying to safely communicate and manage patients through their entrance into and exit from the hospital. I see nurses exhausted and depleted. And I realize that cognitive burden is even more of an issue than it was before. The mental and physical burden nurses must carry in this time of need is life altering for them.

Nurse leaders will face challenges, perhaps unlike any they have faced previously. There will be financial pressures. There will be the business of making sense of a virus we have little understanding of today, but which remains a global threat. And there will be the work of mending those weary from the struggle of the fight. We must begin the hard work of looking forward and caring for those who have cared so tirelessly for patients and families.

I will begin the body of this report with a short review of cognitive capacity theory. This is a body of knowledge created by people who have studied the thresholds of the mind’s ability to think, process information, and maintain focus. It offers the foundation for a roadmap for understanding, supporting, and providing essential tools to the people whom we need to help recover.


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