Background: The COVID-19 pandemic placed immense strain on healthcare systems worldwide, with nurse managers worldwide shouldering significant responsibility in crisis response. The unprecedented demands of the pandemic exacerbated workload stressors and posed serious challenges for this essential workforce. Understanding the global experiences of nurse managers during this crisis is critical to informing future infectious disease preparedness and strengthening public health infrastructure.

Objectives:

1. Describe the impact of the COVID-19 pandemic on the physical and mental well-being of nurse managers and leaders worldwide.
2. Evaluate the key challenges, stressors, and support systems affecting nurse managers during the COVID-19 crisis based on findings from the systematic review.

Methods: A systematic review was registered with PROSPERO and conducted following PRISMA guidelines. Peer-reviewed literature published between January 1, 2020, and December 31, 2023, was sourced from PubMed, CINAHL, and EBSCO. Inclusion criteria consisted of original research focusing on the effects of COVID-19 on nurse managers and leaders, employing both qualitative and quantitative methodologies. Data extraction and quality assessment were performed using the Effective Public Health Practice Project (EPHPP) and Joanna Briggs Institute (JBI) appraisal tools.

Results: Findings indicate that nurse managers experienced heightened stress levels, burnout, and adverse physical and mental health outcomes due to prolonged exposure to pandemic crisis conditions. Many reported feeling unprepared for the rapidly changing healthcare environment. Key stressors experienced by nurse managers around the world included safety concerns, staffing shortages, resource constraints, ethical dilemmas and increased administrative burdens. Studies highlighted disparities in institutional support. Despite these challenges, nurse managers demonstrated resilience employing innovative problem-solving strategies to sustain operations during the COVID-19

Conclusion: The pandemic revealed significant gaps in support systems for nurse managers, emphasizing the need for targeted systems-level change needed to better prepare the clinical nursing leadership workforce for future public health crises.

Public Health Implications: This review underscores the necessity of strengthening public health infrastructure to better support nurses and other healthcare leaders in future infectious disease outbreaks and other crisis scenarios. Policy recommendations include adequate staffing and compensation, improved workforce planning, improving workforce safety, enhancing mental health resources, and ensuring leadership training programs emphasize crisis management.