Resilience Is Not a Strategy
When the Data Becomes a Story
I’ve spent much of my career analyzing data that reveals how people think, feel, and stay connected. From consumer perception and patient experience data to workforce analytics. When I worked with NRC Health as part of their Market Insights team, I saw firsthand how patient loyalty is shaped by trust, safety, and human connection. Over time, that same question began to shift for me: what about the loyalty and trust of the people delivering the care?
That curiosity followed me into my work at AMN Healthcare, where my focus has been on understanding the human side of workforce strategy. Over the past year, I’ve written about how loyalty is earned not through incentives, but through environments where people feel seen, supported, and aligned with their purpose.
It was during that work that I came across the KARE Trauma & Resilience Study, which examined how long-term toxic stress affects caregivers in post-acute and long-term care environments, settings where emotional endurance often defines daily work. Around the same time, our own 2025 AMN RN Survey – Nursing in Transition: Workplace Changes, Challenges and Solutions – revealed national insights into the daily realities of nurses today. Viewed separately, each study is compelling. Viewed together, they tell a story that shouldn’t be ignored.
As someone who lives in numbers, I can’t dismiss what they’re showing us. Nurses aren’t short on resilience; the data proves that. What’s missing in the system design is the support for the weight nurses carry.
The Weight Nurses Carry
The KARE Trauma & Resilience Series found that caregivers are twice as likely as the general population to have lived through four or more Adverse Childhood Experiences (ACEs), events like neglect, abuse, or family instability that leave lasting marks on health and coping. Nearly half (48%) say those experiences still affect their physical health, and three in four (74%) say they influence their mental health.
That kind of history doesn’t make people weak. It builds an instinct to survive. Many nurses have spent their lives practicing resilience before they ever put on scrubs. They are drawn to care because they understand pain. They show up because they know what it means to keep going.
And then they walk into workplaces where that same resilience is required just to make it through a shift:
- 73% report intermediate or high toxic stress before their day even starts
- 38% endure verbal abuse on the job
- 15% experience physical assault
- More than half report burnout (57%) or compassion fatigue (64%)
- Nearly one in four worry about losing housing within two months or not having enough food at home
Pause there.
Read those numbers again.
It can feel easy to move past a statistic, to file it under “the nature of the work,” to reassure ourselves that nurses are strong enough to handle it. And they are. But that strength comes at a cost we rarely name.
Behind every percentage point is a person who has learned to keep functioning through exhaustion, who absorbs more than anyone should have to, and who does it again tomorrow.
This is not about admiration or blame. It’s about recognition. Once you see the full picture, that person stops being a statistic you can move past.
When Resilience Becomes the System
No one designed a system to depend on resiliency. It just happened slowly.
Each year brought new pressures, new documentation, new expectations and nurses adapted. They always do. Their ability to absorb change became part of the system’s strength and it also created problems.
The data shows what that endurance has cost. More than half of nurses (57%) now report burnout, and 64% say compassion fatigue has affected their health. Nearly three in four (73%) start their day already carrying intermediate or high toxic stress. And still, 72% say they find fulfillment in their work.
That contradiction tells a story of its own. Nurses continue to draw meaning from what they do, even as the environment around them drains it away. They stay connected to purpose and, at the same time, do not feel protected. Only a workforce built on resilience could hold that kind of paradox, to be fulfilled and fractured at the same time.
The KARE Trauma & Resilience Series adds another layer to this story. Nurses who reported high early-life adversity also reported higher toxic stress, poorer health, and greater emotional strain today. The KARE Trauma & Resilience Series found that resilience doesn’t erase trauma, it often conceals it. Many nurses have learned to function through pain long before they ever stepped into their careers. When a workplace that depends on that strength, we stop seeing how close people are to breaking.
The numbers show the risk of a breaking point:
- 49% of nurses say they feel valued by their employer
- 39% plan to stay with their current organization this year
- The leading reasons for leaving are burnout, workload, and lack of flexibility
What began as adaptation has quietly turned into acceptance. The more resilient nurses became, the more the system asked of them. Over time, that unspoken expectation, they’ll find a way, has become the foundation of how healthcare works.
Resilience has kept the system running, but it was never meant to be the system itself. The question now isn’t whether nurses can keep adapting. It’s whether we can adapt the system to lessen the weight they carry with every shift.
What Nurses Are Actually Asking For
The 2025 AMN RN Survey shows that nurses are already telling us what would help, and they aren’t asking for anything abstract. They’re describing the architecture of a healthier workplace.
The survey asked nurses what would most improve their work environment. Their top responses were remarkably consistent across every generation, specialty, and setting:
- Better patient ratios (82%)
- More flexible scheduling (81%)
- Less documentation (78%)
- Stronger leadership support (73%)
- More recognition and value (69%)
The KARE Trauma & Resilience Series echoed this in a different way, caregivers described relief not as rest, but as predictability. Stability itself was healing.
These aren’t requests for self-care apps or resilience workshops. They’re blueprints for redesign; tangible ways to reduce friction, restore balance, and rebuild trust. Each one points to an area where system design can either relieve pressure or compound it.
The data also shows what happens when those needs go unmet. Nurses who report feeling supported by leadership are twice as likely to say they plan to stay with their organization. Those who don’t are overwhelmingly the ones planning to leave. And while 72 percent of nurses find fulfillment in their work, only 49 percent feel valued by their employer. An indication of how disconnect transforms purpose into fatigue.
This isn’t about making the job easy. Nursing will always carry weight. But weight can be distributed differently. Workflows can be rebuilt, schedules can flex with life, documentation can give back minutes, instead of taking them.
What nurses are asking for isn’t comfort, it’s alignment; between what they give, what they value, and what the system returns.
When Leadership Runs Out of Margin
It can feel like the finger is being pointed at leadership. But the truth is, most leaders are trying to hold everything together.
No one sets out to build a system that runs on exhaustion. But that’s what happened, slowly, piece by piece. It’s not about fault; it’s about what we choose to do next.
Across the industry, health system leaders are managing a reality defined by competing pressures: budget constraints, staffing shortages, turnover, shifting reimbursement models, and rising patient expectations. Every decision comes with a trade-off, between safety and efficiency, all focused on surviving another day, month, or year to serve the communities they’re in.
Recent studies show the scope of that strain. Health care executives and nurse leaders report spending most of their time on budget management, recruitment, and retention, while also being held accountable for patient outcomes and staff well-being — an impossible equation when resources keep shrinking. In that kind of environment, resilience isn’t just expected from nurses; it’s required of everyone.
The downstream impact of that survival mindset is catching up. The same challenges leadership is trying to solve, turnover, burnout, and staffing instability, are now being compounded by the environment itself. As resilience becomes the fallback, the system’s fragility deepens. Burnout leads to attrition, attrition worsens shortages, and shortages add more weight to those who remain.
This is not negligence; it’s a structure that evolved faster than anyone could rebuild it. The opportunity ahead doesn’t start with blame. It starts with letting go of the bias that shapes how we assign it, and opening ourselves to awareness that can guide small, meaningful change.
From Resilience to Redesign
The data tells a story that’s difficult to unsee. Nurses are carrying a weight they were never meant to carry alone, and leaders are managing systems stretched to their limits. Both are exhausted and resilient, facing the same challenges from different perspectives.
But the answer isn’t more resilience, it’s redesign.
The 2025 AMN RN Survey and the KARE Trauma & Resilience Series make that clear. Nurses have outlined what would make their work more sustainable: safe ratios, flexibility, documentation relief, recognition, and leadership support. These aren’t luxuries. They’re infrastructure. When those needs are met, the data shows turnover drops, engagement rises, and patient outcomes improve.
The path forward starts not with a sweeping overhaul, but with small, intentional acts of redesign. Asking: Where is the system depending on people to compensate for what’s broken? And then committing to one small change at a time, whether it’s staffing models, scheduling autonomy, or space for recovery between shifts.
For leadership, that means not having a posture of endurance, but one of curiosity, being willing to look at the data, listen to the voices behind it, and test new ways of working even when the solution isn’t perfect. Progress won’t come from proving certainty. It will come from learning in motion.
The work ahead is heavy, but it’s not hopeless. We’ve already seen what happens when people carry systems. Imagine what could happen when systems finally start carrying people.
Because resilience was never the strategy.
