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HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2025 41 Joyce Simmons, DNP, APRN, CNS-BC Professor of Nursing dissatisfaction and nursing turnover. Re- searchers identified 46% of nurses report- ed moderate to high compassion fatigue. 10 For leaders, this can be more significant since they must routinely evaluate their workforce for negative coping behaviors such as drug/alcohol abuse, increased use of sick days, increased use of paid time off, presenteeism, and absenteeism. 10 Leaders themselves can suffer from compassion fatigue toward their employees, which can compound the issue. Burnout and quality care Burnout is a challenge due to a pro- longed response to physical or emotional stressors that leads to fatigue, exhaus- tion, self-doubt, cynicism, ineffectiveness, and potentially depression. 10, 11 A Robert Wood Johnson Foundation study found that 18% of nurses experience depression, which is twice the rate of the general pub- lic, stemmed from workplace burnout. 12 During years on through five, nurses had the highest rate (20%) of burnout. 12 Burn- out can occur gradually with repeated exposure to higher workloads and unsup- portive work culture, which can lead to increased errors. 10 Leaders may see chal- lenges due to turnover, lower quality of care, and increased costs. 10 Another facet of burnout includes exposure to ethical di- lemmas that may compromise their integ- rity. 5 Caring for patients in these situations can create an internal conflict for nurs- es leading to secondary trauma. 13 These stressful events can lead to demoralization if repeated. 7 One researcher identified that two-thirds of the nurses surveyed (n=1742) felt demoralized due to a perceived lack of support from leadership. 8 For both leaders and staff, secondary trauma due to burn- out and lack of support creates feelings of misery and may manifest through anxiety, sleeplessness, depression, and lack of job satisfaction. 9 When the unit leader and multiple team members are experiencing this type of trauma, the impact on unit management, patient safety, and quality care delivery may compound. 8 Organizational dynamics Organizational dynamics such as changes in culture can cause challenges for the leader. Leaders encourage a cul- ture of belonging and emotional health in the unit to promote a more supportive environment. In a survey, nurses (38%) re- ported a sense of belonging to the organi- zation; however, some (11%) did have even lower feelings of belonging. 2 In the C-Suite, 15% of CNOs plan to leave their leadership position, and 25% plan to leave nursing be- cause work negatively affects their health (44%). 2 Leaders should be acutely aware of the emotional support provided in the unit. Administrative concerns such as this can trickle down to leaders and can cause a loss of resilience. How we face these chal- lenges in leadership can greatly impact the ability to redirect and correct without los- ing valuable employees. More to come on resiliency solutions. n REFERENCES 1 Buchan, J.; Catton, H. “Recover to rebuild: In- vesting in the Nursing Workforce for Health System Effectiveness.” International Council of Nurses, March 2023. https://www.icn.ch/sites/ default/files/2023-07/ICN_Recover-to-Rebuild_ report_EN.pdf 2 American Organization for Nursing Leadership. “AONL Longitudinal Nursing Leadership Insight Study: Nurse Leaders’ Top Challenges and Areas for Needed Support, July 2020 to November 2023.” American Hospital Association. https:// www.aonl.org/resources/nursing-leadership-sur- vey 3 Bacon, C.T. “The Nurse Leader and the Chal- lenges and Opportunities of the Intergener- ational Workforce.” Nurse Leader 21, issue 3 (June 2023): 362-365. https://doi.org/10.1016/j. mnl.2023.01.005 4 Sherman, R.O. “Communicating with Generation Z Nurses.” Emerging RN Leader, Dec. 12, 2022). https://emergingrnleader.com/communicat- ing-with-generation-Z-nurses/ 5 Haddad, L.M.; Annamaraju, P.; Toney-Butler, T.J. “Nursing Shortage.” StatPearls, last updated Feb. 13, 2023. https://www.ncbi.nlm.nih.gov/books/ NBK493175/ 6 Marselas, K. “2024 McKnight’s Mood of the Market survey: Nursing home leaders’ thoughts of quitting subside with ‘return to normality.’” McKnights Long-Term Care News, Sept. 5, 2024. https://www.mcknights.com/news/2024-mck- nights-mood-of-the-market-survey-nursing- home-leaders-thoughts-of-quitting-subside- with-return-to-normality/ 7 Kelly, L.; Lefton, C.; Fischer, S. “Nurse Leader Burnout, Satisfaction, and Work-Life Balance.” The Journal of Nursing Administration 49, no. 9 (September 2019): 404-410. DOI: 10.1097/ NNA.0000000000000784 8 Senek, M.; Robertson, S.; Ryan, T.; et al. “Deter- minants of nurse job dissatisfaction - findings from a cross-sectional survey analysis in the UK.” BMC Nursing 19, article no. 88 (Sept. 18, 2020). https://doi.org/10.1186/s12912-020-00481-3 9 Cooper, A.L.; Brown, J.A.; Rees, C.S.; Leslie, G.D. “Nurse resilience: A concept analysis.” In- ternational Journal of Mental Health Nursing 29, issue 4 (March 29, 2020): 553-575. https://doi. org/10.1111/inm.12721 10 Widjenes, K.L.; Badger, T.A.; Sheppard, K.G. “Assessing Compassion Fatigue Risk Among Nurses in a Large Urban Trauma Center. The Journal of Nursing Administration 49, no. 1 (January 2019): 19-23. https://doi.org/10.1097/ nna.0000000000000702 11 Dimino, K.; Horan, K. M.; Stephenson, C. “Lead- ing Our Frontline HEROES Through Times of Cri- sis With a Sense of Hope, Efficacy, Resilience, and Optimism.” Nurse Leader 18, no. 6 (December 2020): 592–596. DOI: 10.1016/j.mnl.2020.05.011 12 DeDiemar, A.Y. “Younger Nurse Leaders Lead- ing Older Nurses.” Nurse Leader 21, issue 2 (April 2023): 151-157. https://doi.org/10.1016/j. mnl.2022.12.002 13 Kester, K.; Wei, H. “Building nurse resilience.” Nursing Management 49, no. 6 (June 2018): 42- 45, DOI: 10.1097/01.NUMA.0000533768.28005.36 Joyce Simmons, DNP, is a professor of nursing, ad- vanced practice nurse,and isANCC board-certified. She received a BSN and anMSN at Harding Universi- ty as well as a doctorate atWalden University in 2017 with a focus on informatics and education design. Simmons currently serves as a U.S. federal grant evaluator for medical programs and she currently owns and operates a medical consulting company and is licensed inArkansas, Illinois,Minnesota,Mas- sachusetts, and Washington, D.C. Her professional memberships and leadership roles include NACNS, vice president for Arkansas; ANAmember; and the Arkansas Nurses Association, policy committee member.