Nursing & Healthcare News

Pulse on the Nation’s Nurses Survey

ANF findings confirm widespread stress and burnout. Here are our recommendations.

Nurse clasping hands and looking stressed while wearing a surgical cap, mask, and latex gloves.

The American Nurses Foundation (ANF) recently released its third annual Pulse on the Nation’s Nurses Survey, a large-scale national survey examining some of the concerns currently facing nurses.

Problems and Solutions

This latest survey, conducted in November 2022, drew a remarkable 12,581 responses from registered nurses.

The survey data reveals that stress and burnout remain serious problems for RNs across the country. Sixty-four percent of respondents said they felt stressed, and 57 percent reported feeling exhausted. Other concerns included financial worries, verbal abuse and racism, and a perceived lack of organizational support.

The good news is that the survey results also suggest some constructive steps healthcare organizations can take to address these issues, and to help recruit and retain skilled nurses. Below are some key takeaways from the latest survey, along with our recommendations for some possible solutions.

1. New nurses need more support.

Younger, less experienced RNs seem to be struggling significantly more than older veterans. Thirty-two percent of survey respondents with less than 10 years of experience described themselves as “not emotionally healthy” or “not at all emotionally healthy.”

Sixty-one percent of respondents under age 35 said they had felt anxious, and 33 percent said they had felt depressed in the past 14 days. By comparison, only 33 percent of nurses over 55 reported feeling anxious, and just 18 percent reported feeling depressed.

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WN RECOMMENDATION: When onboarding and mentoring new nurses, include resources and training to support emotional resiliency as well as clinical skills.

2. Verbal abuse is a problem.

Fifty-three percent of respondents said they have experienced increased verbal abuse from patients and families since the COVID-19 pandemic began, and one in five nurses of color said incidents of racism have also increased. However, 28 percent of nurses said their institution had no mechanism for reporting verbal abuse, while an additional 15 percent weren’t sure if there was a reporting mechanism or not.

WN RECOMMENDATION: Include verbal abuse as part of a comprehensive workplace violence program, and establish mechanisms for staff to report such incidents.

3. Nurses feel burdened by student debt.

With college tuition costs on the rise, new grads are more likely to have student loan debt, and the average size of that debt burden has increased. Thirty-eight percent of survey respondents were “concerned” or “very concerned” about managing their student loans.

WN RECOMMENDATION: Offer student loan relief options as part of nurses’ compensation packages.

4. There are disparities between staff and leadership perceptions.

The ANF survey report contrasted its findings with the results of the most recent nursing leadership survey by the American Organization for Nursing Leadership (AONL), conducted just three months earlier. Both surveys found that staff nurses often had a less optimistic view of current problems than their leadership did.

Nursing Education

In particular, staff nurses were far less confident than their leaders about preparedness for a new surge, variant, or pandemic. In the AONL survey, 65 percent of nurse leaders felt their team was better prepared; only 13 percent said they were not. By contrast, only 30 percent of ANF nurse respondents said their team was better prepared, while 41 percent felt they were not.

WN RECOMMENDATION: Emphasize open communication between frontline nurses and leadership. Encourage staffers to express concerns candidly, and expect managers to take that feedback seriously.

5. Workplace culture counts.

The survey asked nurses to identify the factors that are most important to their work satisfaction. Most (58 percent) named work-life balance, followed by compensation (41 percent), a safe environment (33 percent), a sense of doing meaningful work (30 percent), caring and trusting teammates (28 percent), and feeling valued by their organization (26 percent).

WN RECOMMENDATION: Better compensation and a positive work environment that supports nurses’ work-life balance can make a real difference.

A Team Effort

Fair compensation, adequate staffing, and workplace safety are all policy issues requiring input from many of an organization’s stakeholders.

However, other vital elements of nurses’ work satisfaction — like creating trust between teammates and responding seriously to incidents of verbal abuse or racism — can be achieved through the commitment of individual nurse leaders and staffers at all levels. Nurses, healthcare organizations, and the public will all benefit.


Catherine Rhodes is the editor and publisher of Working Nurse.


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