Trial by Fire: Working with Media During the COVID-19 Mask Mandate

Published Sept. 1, 2023

Early in the COVID-19 pandemic, the crisis facing health care organizations elevated nurses in the media. Across the country, we saw the strife nurses faced and their bravery in caring for patients. Nurses played a prominent role in the pandemic response and became a symbol of hope and heroism. As the new chief nursing officer for my facility, I was quickly thrust into the spotlight to give news updates about what was happening with hospital staff. In addition, I was providing up-to-date information about the evolving crisis and how the community could help to mitigate the spread. In a short period of time, I learned how to respond to media requests, developing ways to engage journalists in delivering valuable messages to the public. But these news reports had detractors; dealing with critics or hostile interviewers became a necessary skill. In this article, I will share my experience engaging the media as a nurse leader, building connections and some lessons learned.

Nurses: Most trusted, least represented

Nurses have a potentially powerful platform. In 2023, The Gallup organization once again named nurses the most trusted profession for the 21st consecutive year (Brenan, 2023). Nurses’ perceived honesty and high ethical standards garnered this honor. Despite being a trusted source of information, nurses are not heavily featured in the media. In the Woodhull Study Revisited on nurses in the media, Mason et al. (2018) found nurses continue to be vastly underrepresented in health care news coverage. Furthermore, nurses in the revised study were quoted mainly on the nursing profession, not general health care topics or policy. While the COVID pandemic put nurses in the spotlight, it was rare to find nurses interviewed as experts in reports focusing on their experience caring for COVID patients. In the first wave of the COVID pandemic, I was interviewed by a local news station. The station had assigned a reporter to the health care beat, and it wanted to run a story about my turbulent first nine months as a CNO. Since becoming CNO in August 2019, I had led the nursing staff through a hospital roof fire requiring evacuation of inpatients, a mass shooting event and the pandemic. I would work with this reporter much more in the following months. Still, our first interaction highlighted that nurses can be unique and valuable sources on health care information, beyond eyewitness accounts and human interest stories.

Local crisis

In November 2020, the second wave of COVID led to record hospitalization rates in Midland, a suburban Texas city midway between Fort Worth and El Paso. Midland Memorial Hospital is the only hospital in Midland County with 290 operational beds, covering a vast service area of rural communities. At the time, the hospital relied on over 140 nurses and respiratory therapists from the Texas Department of Emergency Management and the Federal Emergency Management Agency (FEMA). The hospital saw rapidly increasing COVID hospitalizations, with more than 30% of patients testing COVID-positive and taxing all available resources. The hospital was down to its last ten ventilators and our critical care unit went from 24 beds to 60. The hospital was so far beyond capacity that we built an entire 48-bed medical unit in less than six months and a FEMA mobile hospital tent in our emergency department parking lot, all staffed with disaster response personnel. In the community, testing positivity was above 30%, with significant daily increases that included hospital staff. It was a full-scale disaster. While Texas was under an executive masking order from the governor, the city council and the mayor were resistant to requiring masking or enforcing any regulations. The mayor further stated that masking was “virtue signaling,” and he was against enforcing masks but would encourage people. Vaccines were only in development and disinformation about the virus, treatment and masking was rampant. As the health care authority for the city, Midland Memorial took the lead in setting up testing sites across the city and providing daily briefings to the public. Every morning, the CEO and I would brief reporters from all local media outlets on COVID patient counts, hospitalization rates, testing positivity (as we were doing the vast majority of testing for the city) and any updates on the virus. I served as the clinical expert while the CEO provided hospital information. I got to know many of the reporters through these briefings, which helped pave the way for more media interactions. Like many, we became more versed in virtual meeting and conference options, eventually moving to daily Facebook Live briefings where the media and general public could pose questions live that were recorded. In November, the situation became more dire and the briefings included pleas to mitigate the spread of the virus. On several occasions, I used the platform to speak to the media and the public on mitigation techniques to help ease the burden on the health care system. These messages would then be re-broadcast in local media outlets and on social media channels. These messages also were shared with state and national social media channels. I also used my social media to amplify the messaging and sent it to media outlets. These more direct messages to the community were appealing to the press. They helped me get in front of a broad audience, yet those in local government leadership continued to counter my message or fecklessly pandered. The city leadership’s inaction, combined with the overwhelming number of COVID patients and the lackadaisical attitudes of the community, motivated me to take a more direct approach to city hall.

Speaking up for health care staff

I was allowed to speak directly to the council at its next meeting. I reached out to my elected representative and asked to give an update to the entire council. I explained to my CEO and our public relations (PR) department what I had planned to say. In the meeting, I described how masking and other mitigation techniques work to curb the spread of COVID, the effects of non-compliance on infection rates and the devastating consequences to the hospital and community. Sharing real-life examples and my direct observations of what was happening in the hospital, I challenged the council to enforce the governor’s masking requirements. The mayor and council took no action. Recognizing the need to continue the conversation and apply pressure to act, I published my speech on social media. I shared it with several individuals who helped it reach a broader audience. Having previously built some rapport with reporters, many contacted me directly for my perspective on the crisis. In interviews after the city council meeting, the reporters pressed the mayor on not enforcing masking, despite my request. The mayor doubled down on his stance and misquoted me. The media quickly played back the recordings to him and sought clarification from me, which I happily provided and shared on social media. Unfortunately, I was also met with hostility, distrust and outright aggression online and in person. Shortly after the speech and public back and forth with the mayor, I received threatening messages on my social media, and in texts, calls and emails. While the threats and vile comments were concerning, I also received positive reactions from community members and those seeking information from a trusted source. I shared our daily conferences and any updates from our hospital’s social media pages. I also got the attention of several state and national news affiliates, and was interviewed for pieces disseminated by the Texas Nurses Association and National Public Radio, among others. Local media outlets wanted more information on COVID and actions the hospital was taking to combat the virus. Although the council received much public pressure to act, all proposals to enforce masking failed. While I did not get the outcome I sought, I was able to raise awareness and feel that it made an impact. I worked with my PR professionals at the hospital, making sure they knew the media person who contacted me, the interview request (either by the news outlet or by me) and high-level talking points. I also informed the PR team of any topics in which I needed their help. I conducted many interviews and responded to many speaking invitations to help educate the community on COVID and other health care and nursing issues.

Getting connected

In preparing to engage with the media, it is essential first to understand your employer’s policies and procedures regarding communication with the press. I continue to engage with the media frequently in conjunction with notifying the hospital PR department and my direct supervisor, the CEO. General interview requests directed to the hospital go through our PR staff, who will reach out to me for any interviews covering my areas of expertise. I also refer PR staff to other expert sources. These requests are an opportunity for me to allow other nurses to work with the media and build confidence. If I am contacting reporters, I inform my PR team before I do it and what I plan on saying. If you have an organizational PR department, it typically has local media contacts and can help you connect. If you are in an organization without a PR department, you could begin introducing yourself to local media via social media channels after receiving approval from your leadership. Typically, a journalist will frame you as a nurse with your organization to lend credibility. If your leadership is uncomfortable with your request to engage media, it may help to be more specific or write out what you want to say and why it is important. If your employer does not give you authorization to speak to the media, you must assert that your views are your own and do not reflect your employer’s. In these cases, providing alternative associations, such as your experience or leadership positions in other organizations, could be sufficient. It is imperative to define clearly whom you do or do not represent.

Many local reporters are active on social media. You can begin by tagging them on posts or sending a direct message to them with a story idea or simple introduction as a nurse willing to serve as a point of contact for health care-related stories. Mason et al. (2018) noted that journalists often need help finding nurses to interview and have limited time to track them down on their own. Journalists will be more likely to contact you for interviews or quotes if you are available, articulate and provide concise, factual information in short soundbites. In my area, reporters and journalists turn over quickly. I have worked with many reporters who are trying to make a name for themselves to get to bigger markets or decide on different career paths.

Research the media outlet you wish to contact. For example, if you know that one news outlet has a specific audience or demographic, your message may need to be crafted differently. You may provide a more informal and conversational interview on a radio morning show than you would with a national evening news broadcast. You also may craft a different approach to your message on social media platforms such as Facebook, Twitter, TikTok and LinkedIn. Having the right message on the right platform for the right audience is crucial.

Nurses play a vital role in health care delivery and are recognized for their caring and ethics. While we were lauded during the pandemic for heroism, nurses continue to be overlooked as sources on health care issues and policies. Nurses, especially nurse leaders, can promote the profession of nursing and their status as health care experts by proactively engaging the media. Knowledge of health care topics and proper interview preparation can help ensure a positive image of nursing. Building relationships with local journalists and the PR staff within your own organization can help a nurse establish credibility and lead to more opportunities for media coverage.

References

Brenan, M. (2023, January 10). Nurses retain top ethics rating in U.S., but below 2020 high. Gallup. https://news.gallup.com/poll/467804/nurses-retain-top-ethics-rating-below-2020-
high.aspx

Mason, D. J., Nixon, L., Glickstein, B., Han, S., Westphaln, K., & Carter, L. (2018). The Woodhull Study Revisited: Nurses’ representation in health news media 20 years later. Journal of Nursing Scholarship, 50(6), 695–704. https://doi.org/10.1111/jnu.12429

ABOUT THE AUTHORS

Kit Bredimus

Kit Bredimus, DNP, RN, CENP, FAONL, is the chief nursing officer and vice president of nursing at Midland Memorial Hospital in Midland, Texas.

In the years following my first COVID-19 interview, I picked up a few pointers to help anyone looking to engage with the news media.

Craft your message. Know what topics you want to cover before an interview. Sometimes journalists will come with an agenda and want to get some soundbites that help push the story they want to tell. If the discussion is straying away from the topic you came to discuss, bring it back to your talking points.
Practice. Becoming a polished speaker does not just happen, it takes practice. While some individuals are naturally gifted speakers, it is never wasted time to prepare for an interview and rehearse your talking points. Practice your key points and how you want to deliver them. Record yourself on your computer or audio to see how your cadence, tone and overall performance looks and sounds to help tune up your interview.

Prepare for on-camera interviews. It is more common now to be interviewed via webcam in the post-COVID era. In these interviews, it is essential to use measures you would for meetings (light in front of you, eye level with the camera, your background clean and non-distracting, a silenced phone, etc.). For in-person interviews, the interviewer will typically have you speak to them and not look directly at the camera. Be sure that any tops or ties don’t have tight checks or stripes, as these patterns can become distorted on camera.

Get comfortable. Slow down and breathe. When you get nervous, it shows. Remember when heading into the interview that you are the expert and are simply educating the interviewer on the topic. If you mess up on a recorded interview, you can ask to start over on a line of thought or answer to a question. If you get tripped up in a live interview, move on to the next topic and keep going. If you are stammering or going on too long, it is ok to pause, collect your thoughts, and close. In most situations, the interviewer is not out to make you look bad and wants you both to be successful. Before responding to an interview question, you have time to pause and think about your answer before speaking. You may feel like you need to jump into answering quickly, but taking your time to collect your thoughts helps you come off more polished and professional.

Beware of “gotcha interviews.” In preparation for interviews, you should know with whom you are speaking and what organization they represent. Prepare for interview questions they may ask, including answers to the tough questions on a hot topic. Sometimes interviewers may want to get you to parrot back a question that was asked, or they pose a leading question to get you to answer a certain way. It is acceptable to pivot away from the question and provide some soundbite talking points to the topics you came to discuss. If you find yourself in a situation where you feel the interviewer is becoming overly aggressive or hostile, you can politely end the interview and thank them for their time. Maintaining your composure and not becoming defensive is critical.

Foster local connections. You may work with local journalists for more than one story. You can foster these connections through social media or email. A word of caution in sharing your personal number, as a journalist also may share a source with other journalists, and you can receive some unsolicited calls. It is preferable to keep things in writing. While you may not get responses to your social media or emails, they will likely see the messages and respond when there is another opportunity for an interview. Like politicians, they also like positive feedback and are more likely to respond if you comment positively (and sincerely) on a recent story they produced. Don’t become discouraged if you don’t hear back from reporters right away.

“Off the record” information may be shared. Always be aware that information you share may be attributed to you even if you ask to keep something “off the record” or “on background.” In trying to become comfortable with an interviewer, you may let your guard down and make some comments in jest that are then used in a segment or article. Assume that whatever you say to a journalist will be quoted and you can avoid costly mistakes.

Wrap up the experience. Thank the journalist for the opportunity. It is appropriate to ask when the piece will run and if you will have the ability to preview it. Receiving a preview of what will run is rare. Some outlets use fact-checkers to validate that your information and content are correct, so be aware that someone from the outlet may contact you to verify. Turnaround times can vary wildly from a few hours to several weeks or months later. Your interview may not make it to publication, and you usually won’t be notified.