Surviving a life-threatening crisis: Taiwan’s nurse leaders’ reflections and difficulties fighting the SARS epidemic

Authors

  • Fu-Jin Shih,

    1. Authors:Fu-Jin Shih, DNSc, RN, Professor and Dean, School of Nursing, National Yang-Ming University, Taipei, Taiwan; Sue Turale, DEd, MNSt, RN, RPN, FRCNA, FACMHN, Professor of International Nursing, Yamaguchi University Faculty of Health Sciences, Ube, Japan; Yaw-Sheng Lin, PhD, Associate Professor, Department of Clinical and Counselling Psychology, National Dong Hwa University, Hualien, Taiwan; Meei-Ling Gau, PhD, RN, Professor and Director, Graduate Institute of Nurse-Midwifery, National Taipei College of Nursing, Taipei, Taiwan; Ching-Chiu Kao, MSN, RN, Director and Lecturer, Department of Nursing, Taipei Medical University’s Wan-Fang Hospital, Taipei, Taiwan; Chyn-Yng Yang, MSN, RN, Director and Lecturer, Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan; Yen-Chi Liao, MSN, RN, PhD Student, Graduate Institute of Medical Science, College of Medicine, Taipei Medical University, Taipei, Taiwan
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  • Sue Turale,

    1. Authors:Fu-Jin Shih, DNSc, RN, Professor and Dean, School of Nursing, National Yang-Ming University, Taipei, Taiwan; Sue Turale, DEd, MNSt, RN, RPN, FRCNA, FACMHN, Professor of International Nursing, Yamaguchi University Faculty of Health Sciences, Ube, Japan; Yaw-Sheng Lin, PhD, Associate Professor, Department of Clinical and Counselling Psychology, National Dong Hwa University, Hualien, Taiwan; Meei-Ling Gau, PhD, RN, Professor and Director, Graduate Institute of Nurse-Midwifery, National Taipei College of Nursing, Taipei, Taiwan; Ching-Chiu Kao, MSN, RN, Director and Lecturer, Department of Nursing, Taipei Medical University’s Wan-Fang Hospital, Taipei, Taiwan; Chyn-Yng Yang, MSN, RN, Director and Lecturer, Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan; Yen-Chi Liao, MSN, RN, PhD Student, Graduate Institute of Medical Science, College of Medicine, Taipei Medical University, Taipei, Taiwan
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  • Yaw-Sheng Lin,

    1. Authors:Fu-Jin Shih, DNSc, RN, Professor and Dean, School of Nursing, National Yang-Ming University, Taipei, Taiwan; Sue Turale, DEd, MNSt, RN, RPN, FRCNA, FACMHN, Professor of International Nursing, Yamaguchi University Faculty of Health Sciences, Ube, Japan; Yaw-Sheng Lin, PhD, Associate Professor, Department of Clinical and Counselling Psychology, National Dong Hwa University, Hualien, Taiwan; Meei-Ling Gau, PhD, RN, Professor and Director, Graduate Institute of Nurse-Midwifery, National Taipei College of Nursing, Taipei, Taiwan; Ching-Chiu Kao, MSN, RN, Director and Lecturer, Department of Nursing, Taipei Medical University’s Wan-Fang Hospital, Taipei, Taiwan; Chyn-Yng Yang, MSN, RN, Director and Lecturer, Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan; Yen-Chi Liao, MSN, RN, PhD Student, Graduate Institute of Medical Science, College of Medicine, Taipei Medical University, Taipei, Taiwan
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  • Meei-Ling Gau,

    1. Authors:Fu-Jin Shih, DNSc, RN, Professor and Dean, School of Nursing, National Yang-Ming University, Taipei, Taiwan; Sue Turale, DEd, MNSt, RN, RPN, FRCNA, FACMHN, Professor of International Nursing, Yamaguchi University Faculty of Health Sciences, Ube, Japan; Yaw-Sheng Lin, PhD, Associate Professor, Department of Clinical and Counselling Psychology, National Dong Hwa University, Hualien, Taiwan; Meei-Ling Gau, PhD, RN, Professor and Director, Graduate Institute of Nurse-Midwifery, National Taipei College of Nursing, Taipei, Taiwan; Ching-Chiu Kao, MSN, RN, Director and Lecturer, Department of Nursing, Taipei Medical University’s Wan-Fang Hospital, Taipei, Taiwan; Chyn-Yng Yang, MSN, RN, Director and Lecturer, Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan; Yen-Chi Liao, MSN, RN, PhD Student, Graduate Institute of Medical Science, College of Medicine, Taipei Medical University, Taipei, Taiwan
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  • Ching-Chiu Kao,

    1. Authors:Fu-Jin Shih, DNSc, RN, Professor and Dean, School of Nursing, National Yang-Ming University, Taipei, Taiwan; Sue Turale, DEd, MNSt, RN, RPN, FRCNA, FACMHN, Professor of International Nursing, Yamaguchi University Faculty of Health Sciences, Ube, Japan; Yaw-Sheng Lin, PhD, Associate Professor, Department of Clinical and Counselling Psychology, National Dong Hwa University, Hualien, Taiwan; Meei-Ling Gau, PhD, RN, Professor and Director, Graduate Institute of Nurse-Midwifery, National Taipei College of Nursing, Taipei, Taiwan; Ching-Chiu Kao, MSN, RN, Director and Lecturer, Department of Nursing, Taipei Medical University’s Wan-Fang Hospital, Taipei, Taiwan; Chyn-Yng Yang, MSN, RN, Director and Lecturer, Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan; Yen-Chi Liao, MSN, RN, PhD Student, Graduate Institute of Medical Science, College of Medicine, Taipei Medical University, Taipei, Taiwan
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  • Chyn-Yng Yang,

    1. Authors:Fu-Jin Shih, DNSc, RN, Professor and Dean, School of Nursing, National Yang-Ming University, Taipei, Taiwan; Sue Turale, DEd, MNSt, RN, RPN, FRCNA, FACMHN, Professor of International Nursing, Yamaguchi University Faculty of Health Sciences, Ube, Japan; Yaw-Sheng Lin, PhD, Associate Professor, Department of Clinical and Counselling Psychology, National Dong Hwa University, Hualien, Taiwan; Meei-Ling Gau, PhD, RN, Professor and Director, Graduate Institute of Nurse-Midwifery, National Taipei College of Nursing, Taipei, Taiwan; Ching-Chiu Kao, MSN, RN, Director and Lecturer, Department of Nursing, Taipei Medical University’s Wan-Fang Hospital, Taipei, Taiwan; Chyn-Yng Yang, MSN, RN, Director and Lecturer, Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan; Yen-Chi Liao, MSN, RN, PhD Student, Graduate Institute of Medical Science, College of Medicine, Taipei Medical University, Taipei, Taiwan
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  • Yen-Chi Liao

    1. Authors:Fu-Jin Shih, DNSc, RN, Professor and Dean, School of Nursing, National Yang-Ming University, Taipei, Taiwan; Sue Turale, DEd, MNSt, RN, RPN, FRCNA, FACMHN, Professor of International Nursing, Yamaguchi University Faculty of Health Sciences, Ube, Japan; Yaw-Sheng Lin, PhD, Associate Professor, Department of Clinical and Counselling Psychology, National Dong Hwa University, Hualien, Taiwan; Meei-Ling Gau, PhD, RN, Professor and Director, Graduate Institute of Nurse-Midwifery, National Taipei College of Nursing, Taipei, Taiwan; Ching-Chiu Kao, MSN, RN, Director and Lecturer, Department of Nursing, Taipei Medical University’s Wan-Fang Hospital, Taipei, Taiwan; Chyn-Yng Yang, MSN, RN, Director and Lecturer, Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan; Yen-Chi Liao, MSN, RN, PhD Student, Graduate Institute of Medical Science, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Yen-Chi Liao, Director of Finance Department, Shin-Kong Wu-Hon Shih Memorial Hospital and PhD student of Graduate Institute of Medical Science, College of Medicine, Taipei Medical University, 95 Wen-Chang Rd (Shih-Lin), Taipei, Taiwan 11221, Taiwan. Telephone: +886 2 2833-2211.
E-mail:fjshih@ym.edu.tw

Abstract

Aim.  This study explored Taiwan’s nurse leaders’ reflections and experiences of the difficulties they encountered and survival strategies they employed fighting the severe acute respiratory syndrome epidemic and the background context framing these phenomena.

Background.  On several continents in 2002–2003, the highly infectious severe acute respiratory syndrome overwhelmed health care systems and health professionals who had to provide care in situations involving high personal risk and stress, some becoming infected and dying. Nurse leaders in Taiwan had to develop new strategies and support systems for nursing care.

Design.  A two-step within-method qualitative triangulation research design.

Methods.  Focus group in-depth interviews held with 70 nurse leaders from four Northern Taiwan hospitals involved in the severe acute respiratory syndrome epidemic. Participants then completed an open ended questionnaire. Content analysis was undertaken with data and stages and themes generated. Data were then analysed using Hobfall’s concepts of conservation of resources to further discuss participants’ reactions and actions in the severe acute respiratory syndrome crisis.

Results.  Participants worked under incredible stress to lead the profession through a period of crisis. Five stages arose in the participants’ involvement against severe acute respiratory syndrome over 12 weeks: facing shock and chaos; searching for reliable sources to clarify myths; developing and adjusting nursing care; supporting nurses and their clients; and rewarding nurses.

Conclusion.  Nurse leaders become important executors of intervention in this health disaster, requiring emotional intelligence to manage their internal conflicts and interpersonal relationships effectively. They developed sociopolitical and analytical abilities and crucial requirements for planning and implementing strategies in areas where none previously existed. Building support systems was an important resource for managing conflicts between familial and professional roles.

Relevance to clinical practice.  Findings will assist nurse leaders to prepare themselves and the profession to better deal with disaster management in similar infectious outbreaks in the future.

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