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From Crisis Response to Recovery: A Two-Wave Qualitative Study of Nursing Leadership Trajectories in Italy (2020-2025).

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Title: From Crisis Response to Recovery: A Two-Wave Qualitative Study of Nursing Leadership Trajectories in Italy (2020-2025).
Authors: Podgorica N; Department of Nursing Science and Gerontology, Institute of Nursing Science, UMIT TIROL - Private University of Health Sciences and Health Technology, Hall in Tirol, Austria.; Nursing Department, Health University of Applied Sciences Tyrol, Innsbruck, Austria., Müller G; Department of Nursing Science and Gerontology, Institute of Nursing Science, UMIT TIROL - Private University of Health Sciences and Health Technology, Hall in Tirol, Austria., Ivziku D; Department of Health Professions, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.; Faculty of Medical Sciences, AAB College, Pristina, Kosovo., Tartaglini D; Department of Health Professions, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.; Research Unit in Nursing Science, Department of Medicine and Surgery, University Campus Bio-Medico, Rome, Italy., Perkhofer S; Unit for Research and Innovation, Health University of Applied Sciences Tyrol, Innsbruck, Austria.
Source: Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing [J Nurs Scholarsh] 2026 Jul; Vol. 58 (4), pp. e70117.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Wiley Country of Publication: United States NLM ID: 100911591 Publication Model: Print Cited Medium: Internet ISSN: 1547-5069 (Electronic) Linking ISSN: 15276546 NLM ISO Abbreviation: J Nurs Scholarsh Subsets: MEDLINE
Imprint Name(s): Publication: Hoboken, NJ : Wiley
Original Publication: Indianapolis, IN : Sigma Theta Tau International, 2000-
MeSH Terms: COVID-19*/nursing , COVID-19*/epidemiology , Nurse Administrators*/psychology , Leadership*, Italy/epidemiology ; Humans ; Qualitative Research ; Longitudinal Studies
Abstract: Introduction: Nursing leadership was pivotal during the acute COVID-19 response, yet less is known about how crisis-era leadership practices persisted, changed, or were replaced by new responsibilities during recovery. This study explored nursing leadership trajectories in Italy from the first pandemic wave to 5 years later.
Design: Two-wave qualitative study with a longitudinal follow-up subsample and a supplementary 2025 refreshment sample, conducted within a descriptive-interpretive orientation.
Methods: Semi-structured interviews were conducted with nurse managers and staff nurses in Italian public healthcare settings at two time points: Phase 1 (August-December 2020; n = 22) and Phase 2 (June-September 2025; n = 22). Nine participants were re-interviewed and 13 were newly recruited in 2025, yielding 44 interviews with 35 unique participants. Interviews were transcribed in Italian and analyzed using team-based thematic analysis with a hybrid deductive-inductive strategy. Deductive sensitizing domains were derived from the 2020 dataset and nursing leadership literature, while inductive analysis identified issues newly prominent in 2025. For returning participants, within-case summaries supported longitudinal comparison. Reporting followed COREQ and SRQR guidance.
Results: Findings are reported as patterns of continuity, change, and newly prominent phenomena rather than as uniform within-person change across the full sample. Six themes described leadership trajectories: (1) sustaining emotional support and compassionate leadership; (2) adaptive leadership and system learning; (3) leading digital adoption and technology-enabled care; (4) ethical challenges and moral resilience; (5) coordinating post-COVID pathways across settings; and (6) workforce stewardship, shortages, and retention efforts. Across waves, participants described leadership as shifting from immediate crisis reassurance and improvisation toward institutionalized preparedness, digital change work, cross-sector coordination, and workforce advocacy.
Conclusion: Within this sample, nursing leadership was described as moving from acute crisis containment toward a broader portfolio of organizational, ethical, digital, and workforce-oriented responsibilities in the post-pandemic period.
Clinical Relevance: Health organizations should proactively support nurse leaders' capacity for compassionate leadership and moral resilience, invest in digital competencies, and strengthen retention and preparedness strategies to sustain the nursing workforce beyond crisis periods.
(© 2026 Sigma Theta Tau International.)
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Contributed Indexing: Keywords: COVID‐19; adaptive leadership; compassionate leadership; complexity leadership; longitudinal qualitative research; nursing leadership; qualitative research; two‐wave qualitative study
Entry Date(s): Date Created: 20260726 Date Completed: 20260726 Latest Revision: 20260729
Update Code: 20260729
PubMed Central ID: PMC13402334
DOI: 10.1111/jnu.70117
PMID: 42503599
Database: MEDLINE
Description
ISSN:1547-5069
DOI:10.1111/jnu.70117