PMH Nurse Wellbeing Is Vital to Organizational Resilience

Nurses are often called the backbone of the healthcare system. If that is true (I believe it is), then our well-being is central to organizational resilience. This is a reciprocal relationship: When systems are dysfunctional, our well-being suffers, and when we experience impacts like burnout and secondary traumatic stress, the health of the whole system is impacted.

Organizational resilience is defined as an organization’s ability to adapt to (not only withstand) unsettling events while maintaining its purpose and feasibility (Goh, 2023). In healthcare, it is a “system’s ability to continue functioning and meet its objectives when exposed to stressful stimuli” (Ratliff et al., 2025, p. 168). Where do the nurses fit into these definitions? The answer to that is critical to the resilience of healthcare. And in the context of rising demands for substance use and mental health services (American Psychiatric Nurses Association [APNA], 2025), this is especially urgent for our mental healthcare system.

As members of the consistently ranked most trusted profession (Gallup, 2026), nurses are broadly recognized for being compassionate caregivers, nurturers, and patient advocates – all roles deeply ingrained in our professional identity. However, the toll of being a nurse is not often recognized. Factor in what we do as psychiatric-mental health (PMH) nurses, where our entire work is on a foundation of “compassion, empathy, and the therapeutic relationship, which can place complex emotional demands on practitioners” (APNA, 2025, p 2); the impact of workplace demands and stress can lead to distress and burnout.

The COVID-19 pandemic exposed a glaring dissonance in how resilience has been understood and applied to nurses: As the overall healthcare system experienced extreme “unsettling events,” nurses were navigating those same stressors while providing care, supporting families, and grieving with co-workers. When we called attention to how unsustainable this was, we were told to do more to improve our resilience. The point was, however, that there was no time or energy available to do any more than what was already being asked of us. The consequences have been profoundly troubling: an all-time high in nurses experiencing anxiety, depression, suicide, and leaving the profession in record numbers (American Nurses Foundation, 2023; Berlin et al., 2023; Nigam et al., 2023). By exposing and intensifying already existing systemic weaknesses, the pandemic showed that resilience is larger than what individual nurses can do alone. Resilience needs to be ingrained into our processes and policies on a systems level.

Until recently, the majority of research related to resilience was focused on individuals. Fortunately, within the last 10 years, organizational resilience has emerged as a topic with a growing evidence base. We now have the information needed to assist healthcare organizations in meeting us halfway by enacting initiatives that truly work in creating resilient organizations. Many of you may think, “My organization says they cannot afford to do anything else.” This American Psychiatric Nurses Association (2025) report is here to help: Addressing Key Threats to PMH Nurse Well-Being not only outlines systemic sources of harm to our well-being, it also demonstrates that these impacts are costly and shows practical ways organizations can be part of the solution.

With the need for mental healthcare at an all-time high and crossing all settings, PMH nurses are often asked to do more for patients that are sicker, cancel scheduled time off, and come to work when we are not feeling well or when we are needed at home. We are being asked to provide care in systems that do not function optimally and that are constantly changing – whether it is new technologies or large organizational mergers (Melnyk et al., 2025; Rinman et al., 2023). We also work within the near-constant regulatory or policy changes at the organization, state, or national levels (APNA, 2025). We also may experience unsafe staffing patterns – patterns that result in nurse-patient ratios that make us uncomfortable due to an environment where patients are more complex and require a higher level of care (Berlin et al., 2023; Chen et al., 2025; Dall’Ora et al., 2020). Add to this increased incivility and workplace violence; is it any wonder nurses are leaving the profession (National Nurse United, 2024)?

Is it important for PMH nurses to be resilient? Yes! And I believe we are: What other profession can care for patients and families on what is most often described as the worst days of their life, all the while making sure correct treatments occur and advocating for those in their care with insurance companies and administration. As PMH nurses, we can strive to improve our individual wellness, and I believe we do. We do need a culture change, though. I am certain many of you are guilty, like I am, of not advocating for ourselves. We see the patient’s needs before our own, and we continue to work, often ignoring the negative effects we personally experience. The more we do this, (after all, PMH nurses are indeed quite resilient!) the more is expected of us. Now we are truly at a crossroads of needing to determine how we continue to provide care for our patients and care for ourselves. How do we maintain our resilience and encourage healthcare organizations to become resilient as well?

Wiig et al. (2023) identified the solution – what is required is a reconciliation of perspectives, that of organizations and nursing, in order to advance resilience across the healthcare system, not just relying on individuals. The research is clear that systemic-level changes are required to address PMH nurse well-being (APNA, 2025). In the past, organizations have responded by telling us to use individual self-care strategies or by showing appreciation with a “pizza party,” which has become a joke among many nurses. Organizations often say they cannot do anything more. However, the American Psychiatric Nurses Association (APNA) Well-Being Report demonstrates that organizations cannot afford to avoid addressing systems-level issues. The true cost of nurse well-being affects their bottom line: “Each 1% increase in nurse turnover will cost on average $270,800 per year considering the cost of recruiting, training, and integrating new staff” (APNA, 2025, p.7). As PMH nurses experience a decrease in their well-being, absenteeism tends to rise, and productivity often drops. In addition, increasing burnout can elevate the likelihood of medical errors and lead to compromised quality of care. Therefore, there is a clear financial benefit to organizations addressing these systems-level issues.

The Addressing Key Threats to PMH Nurse Well-Being report (APNA, 2025) provides an evidence-based argument that improving PMH nurse well-being requires embedding well-being efforts throughout daily operations, leadership practices, and organizational culture. Its actionable recommendations include making clinician well-being a strategic priority. It calls for leadership accountability, addressing staffing and scheduling issues, monitoring nurse-patient ratios, and adequate coverage to allow breaks and time off for PMH nurses. Organizations can also reduce low-value administrative and electronic health record tasks to protect time for direct patient care. They can build a safe, learning-oriented environment that prevents workplace violence and promotes psychological safety. Normalizing confidential mental health support will reduce stigma around seeking help and contribute to an organizational culture of well-being. The report provides a road map, including many more practices that can be implemented, that will improve systemic issues that interfere with organizational resilience.

The bottom line is, when well-being becomes part of daily practice, when organizations make resilience a priority, and when systems include resilience benchmarking as part of the organizational goals, we all win. The organization is better prepared to meet the rising complex mental health demands, PMH nurses are supported and recognized for the care they deliver, and patients/families receive the care they seek. As APNA members, we have the opportunity to help make this change happen. After reading the APNA report, share it with leaders and the administration of your organizations. Then, bring it to the attention of your state board of nursing and community to increase awareness and shape policy. I encourage you to gather data and share successes via journal articles and conference presentations to further build the evidence and disseminate practices that foster well-being for PMH nurses. I look forward to hearing about your organization’s journey to becoming a resilient system where patients and PMH nurses thrive.