Situational crisis leadership training for nurse managers in public health emergencies: a qualitative study

Public health emergencies require nurse managers to make rapid decisions under uncertainty while protecting patient safety and supporting frontline registered nurses. Situational Leadership Theory links leadership behavior with staff readiness and task demands, but little is known about how nurse managers learn and apply this approach in crisis contexts. To explore nurse managers’ experiences of a situational leadership-based crisis training program for public health emergency response. A descriptive qualitative study. The study interviewed seventeen nurse managers who had participated in a situational crisis leadership learning program. It explored contextual assessment, risk recognition, adaptive leadership behavior, patient safety management and learning transfer. Interviews were audio-recorded, transcribed verbatim and analyzed thematically. Situational Leadership Theory guided data collection and interpretation. Data saturation was reached after 15 interviews, and two additional interviews confirmed the stability of the coding structure. Four themes and nine subthemes were identified: structuring judgment under crisis pressure, scenario training and risk recognition, adapting leadership to support safer practice, and recalibrating leadership as conditions change. Participants described greater use of structured contextual judgment in crisis response while continuing to encounter difficulties in adapting leadership responses as conditions changed. Participants described the situational leadership-based crisis training as supporting structured contextual assessment and leadership adaptation during public health emergencies. Their accounts suggest that repeated practice and reflection may support ongoing crisis leadership development and safer nursing practice.