By the time nurses decide to strike, the reasons have likely been building for quite some time.
There have already been twenty health care strikes reported in 2026, many of which are nurses pushing for more than just better pay. Every strike has its own circumstances, but leaders shouldn’t wait for a walkout to ask what nurses need.
I’ve spent enough time in nursing to know that nurses will keep showing up and doing everything they can for their patients, even when the job asks too much of them. Many are speaking up about conditions in the industry that have accelerated burnout and made them rethink their career paths. Some of the biggest complaints have been about workplace violence, lack of infrastructure to manage workloads, and the overall psychological load inherent to the profession.
Health care systems need to respond quickly to support a stable workforce, especially when workforce instability directly contributes to the quality of care patients receive. Nurses who are overloaded with patients, worried about their personal safety during a shift, or running on empty emotionally and physically aren’t able to provide care as effectively, which can lead to patient issues falling through the cracks.
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The data shows how fragile retention is
A national survey of more than 500 nurses published this year revealed that 55 percent said they are open to new job opportunities. Nearly one in four reported they are considering leaving nursing altogether.
The possibility of losing almost a fourth of nurses from the profession is jarring, and not just from a recruitment or retention standpoint. The clinical judgment and knowledge from having experienced nurses on your staff are some of the most valuable assets an administration has when it comes to ensuring quality care.
Nurses often spend the most time with patients out of everyone on the care team, and often notice changes before they become problematic. This can protect patients even when a team is short-staffed.
The same study found that 83 percent of nurses had experienced verbal abuse from their patients or patients’ family members, an increase from 64 percent in 2024. And 35 percent reported physical abuse, up from 23 percent.
No one can be expected to focus solely on a patient’s care when they’re also worrying about their own well-being. This is when preventative catches start to fall through the cracks, and it’s something that can be avoided with the proper infrastructure and oversight from hospital administrations.
Why a raise is not enough
Pay is still part of the conversation, but increased wages alone don’t make unsafe working conditions manageable. The survey also found that despite the median annual salary rising by $7,000 from 2024, 53 percent of respondents still felt burnout at least a few times each month. No matter how much you’re getting paid, an unmanageable workload still isn’t going to be safe for nurses and patients.
Being paid more isn’t going to suddenly make you capable of handling seven patients at a time, flipping someone on your own, or charting after a high-pressure shift. Health care isn’t a field where corners can be cut, and getting a pay increase doesn’t suddenly increase efficiency when there aren’t systems in place to set nurses up for success.
Nurses need a properly staffed hospital system so patient loads are evenly and realistically dispersed. This isn’t just a workforce issue; this is a patient safety issue. Without enough people who are properly trained to take care of patients, those who are qualified are spread thin, which can lead to delayed care and a greater risk that an emerging problem gets missed.
Tech can help nurses handle their workloads, but a lot of them want AI safeguards in place before it’s widely applied. While health care organizations are investing in AI and other tools to help support workers, 61 percent of nurses in the survey reported having limited knowledge on how AI is being used in their organizations. Technology designed without the people who will use it simply adds more barriers to letting nurses do their jobs effectively, inadvertently putting patients at risk as well.
When trauma is treated as just “part of the job”
Burnout among nurses is often described as exhaustion, but much of it is better understood as moral injury: the distress of being unable to do the job you trained for, and to do it safely. Part of that injury comes from how we handle traumatic moments, or rather, how we don’t.
Think about a common scenario. A nurse’s patient dies. She prepares the body, takes it to the morgue, and returns to the unit, where a new admission is already waiting. There is no pause, no debrief, no check-in. The unspoken message is: You deal with life and death every day. That’s the job. Process it on your own time.
Other high-risk professions don’t work this way. In many police departments, an officer who fires their weapon or goes through a critical incident is covered by a defined protocol. That can include mandatory counseling, and often, time away from the field.
I’m not suggesting nursing copy that model exactly. But the principle matters: Trauma is expected, so the response to it should be planned too.
Health care already has models to learn from. Here are concrete steps any facility can take:
- Make a post-event debrief standard practice: After a death, a failed code, or a violent incident, hold a brief, structured huddle, even ten minutes, as a routine expectation rather than an optional extra.
- Build in a protected pause: Practices like “The Pause,” a moment of silence after a death, show respect for the patient and give staff a breath before moving on.
- Don’t reassign right away: Where staffing allows, give the nurse a short buffer before assigning a new admission, with charge nurses empowered to arrange coverage.
- Set up trained peer support: Programs like Johns Hopkins’ RISE pair affected clinicians with trained peers within hours, not weeks.
- Offer confidential follow-up: Make it easy and stigma-free to use employee assistance program (EAP) or counseling services, with proactive outreach after a critical event.
- Write it into policy: Define what counts as a critical incident, who triggers the response, and how it’s documented, so support doesn’t depend on whether a given manager happens to think of it.
None of this is a luxury. Nurses who carry unprocessed trauma from shift to shift are more likely to leave, and turnover is itself a patient safety risk. Protecting the people who provide care is part of protecting patients.
Violence is also not “part of the job”
Somewhere along the way, we began seeing workplace violence and verbal abuse as an unfortunate part of working in health care. When an organization doesn’t properly address violence, it sends a message that employee safety isn’t a priority. That’s not an environment people want to stay in.
This has an outsized impact on morale and patient care. A nurse worried about getting physically abused has one more dire concern competing for their attention. Consistently being yelled at or berated by patients and their families can harm self-esteem and motivation, and nurses sent on medical leave from being the target of physical abuse leave a hole in a team where every person counts.
Every instance of workplace violence should be treated seriously, as both an employee safety event and a potential patient safety signal. Leaders need to know when and where these incidents are happening, and if staffing, training, or facility design are contributing to this risk.
The ripple effects of nurse burnout
Burnout is often treated as something that happens to health care workers that can be fixed with access to a mental health app and a few free yoga sessions. But burnout is more complex than that, with effects that can be measured beyond the nurses and clinicians directly experiencing it.
One of the best ways to think about nursing is to look at it like surveillance. Nurses are the ones who usually spot something before it has a chance to become a code, and that catch depends on time and attention. Nurses need to feel safe and confident when they’re working, but it’s hard to do so in an environment where threats are common and being overworked feels unavoidable.
An exhausted nurse doesn’t usually have time to investigate every small concern as much as they’d like, and a nurse who has reported burnout and has been repeatedly dismissed isn’t likely to speak up again. The impact of this doesn’t show up on test results or labs, but instead on the number of readmissions or patients that weren’t able to receive the care they needed.
Listen before concerns become a crisis
The most strategic first step organizations can take is to bring frontline nurses and workers into the decision-making process, especially when it comes to staffing models and new technology that directly affect their work.
Even if you don’t agree with every recommendation, following up and letting them know how their feedback was considered and what changes it influenced is just as important. This step is crucial because if employees feel like their feedback isn’t being heard, they’re going to continue to be frustrated with the lack of change. Explaining how their input made a difference, or why it didn’t, helps them better understand why administrations came to the conclusions they did. This helps employees feel seen and heard, when many currently feel ignored.
Violence also needs to be treated as a risk that the organization is actively working to reduce. Reporting should be quick and easy, ideally under two minutes, and incidents should be tracked by unit and shift type to help find patterns. Administrations should also measure workload, not headcount. A unit might look fully staffed on paper, but there could be three nurses drowning because half the floor turned over at 7 a.m.
The nurses on strike know leaders are not going to say yes to everything. What they want is a health care system that takes accountability and is transparent about the steps it is taking to mitigate their concerns. They want to know their administration is committed to making nursing the fulfilling profession they know it can be.
A strike may bring these concerns into public view, but nurses’ experiences can help leaders see where support is needed long before they reach that point.
Cara Lunsford is a nurse and vice president of health care policy and clinical solutions at Relias. She has eighteen years of nursing experience, including over a decade in pediatric oncology, and has also worked in home health and hospice care, serving as a director of nursing.
As the founder of HOLLIBLU, she established a supportive network for nurses that Relias acquired in 2022. With a passion for empowering her peers, she focuses on building resources and partnerships to enhance nursing careers and address the burnout that is pervasive within the industry.
