Nurses Leading the Way: A Qualitative Study of Nursing Leadership, Innovation and Opportunity in Primary Care During a Public Health Crisis.

Introduction: Nurses in primary care play critical roles during public health crises; however, nursing leadership was underutilized during the COVID-19 response. This study explores nurses' leadership roles during the pandemic and their perspectives on the value of nursing leadership in primary care. Methodology: We conducted qualitative interviews with 76 nurses across four Canadian regions. Participants described their roles and the barriers and facilitators encountered during the COVID-19 pandemic. We used thematic analysis and examined themes relevant to leadership. Results: Three themes emerged: actualizing leadership, leveraging leadership experience and the value of nursing leadership. Nurses demonstrated leadership competencies, including educating teams and developing care delivery strategies. Participants emphasized the importance of involving nursing leadership in decision making and policy development. Conclusion: Sustaining and leveraging nursing leadership post-pandemic is essential to enhance collaboration and strengthen healthcare systems. Involving nurses in decision making can address system challenges and improve responses to future public health crises.