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Lev Zhuravsky, MHealSc 2013

Abstract

An Intensive Care Unit is a geographically distinct area of a hospital where critically ill and injured patients undergo continuous monitoring and support of failing organ systems. The importance of leadership in the ICU both in the routine environment and crisis situations has been acknowledged by the Australian and New Zealand clinical governing bodies.

On Tuesday February 22, at 12:51 pm local time, a 6.3 magnitude earthquake struck Christchurch. A combination of high peak ground acceleration, the time of the day, and the collapse of the buildings resulted in injury and loss of life. The health response to the Christchurch earthquake was unique because this city with an urban population of about 400,000 people has only one hospital with an emergency department and Intensive Care Unit.

The main purpose of this study was to investigate if shared leadership is possible and warranted during a crisis engendered by a natural disaster, through an exploration of the nature of both specialists and nursing leadership in the Intensive Care Unit of Christchurch Hospital within the first seventy two hours of the earthquake. This qualitative study explores the Intensive Care's staff experiences and adopted leadership approaches to manage large scale crisis resulting from the city-wide disaster.

In-depth interviews were conducted with ten members of the ICU team. Thematic analysis of the verbatim transcriptions revealed three main global themes- core formal leadership competencies, a role of informal leadership in crisis and, a contribution of shared leadership approach to an overall management of a crisis. This research highlighted the importance of main formal leadership competencies such as decision making abilities, ability to remain calm and effective communication. A contribution of an informal leadership focussed on motivation to lead, autonomy and emotional support. Shared leadership played an important role in managing complex critical situation triggered by a natural disaster.

The results of this research could potentially add value to the research field of crisis leadership and contribute to the development of professional and personal capacity building programmes and interventions aiming to assist existing and future leaders in managing complex crises.

Supervisor: Gillian Abel

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