Most would agree that the well-being of nurse practitioners, who increasingly take on primary care roles in their communities, is vital to cultivating a healthy society. Yet, today’s nursing environment is increasingly associated with fatigue and burnout. In the years since COVID-19 put a spotlight on frontline healthcare workers, nurses have struggled with issues such as rising violence and staffing shortages. Amid these challenges, a study published in Nurse Leader highlights that a potential path forward might be found by listening to nurse voices. Though initially geared towards RNs, the key findings have broader implications for NPs.
Read the full-text study here.
The study, titled “Nurse Well-Being Interventions: The Nurse’s Voice,” looks at how nurses experience moral injury and what kinds of workplace support they think could actually make a difference. Researchers surveyed 185 practicing nurses, who reviewed a selection of wellness initiatives and evaluated the effectiveness of each one in improving their well-being at work. An open-ended section was included for participants to share their own commentary and ideas for interventions.
The most frequently endorsed strategies included pet therapy and mindfulness reflection, but broader themes also emerged: Nurses called for manageable workloads, healthier unit cultures, and institutional support that goes beyond self-care. The findings emphasize that addressing burnout and moral injury requires not only resilience tools, but meaningful change at the organizational level. These requests seem all-too-familiar to NPs, who may feel that their voices are not being heard when it comes to change in the workplace.
Moral injury (MI) is recognized by the American Nurses Association as the psychological distress associated with having to violate your ethics. While MI is distinct from burnout, the two often go hand in hand. NPs are known to experience high rates of burnout; similarly, MI was reported at high levels among participants. NPs and other healthcare workers experience high levels of MI compared to individuals in most other professions. While self-help tools are commonly used to manage MI, these alone may fall short.
Participants pointed to workplace-based well-being programs as natural complements to self-care, targeting both emotional resilience and systemic stressors. The suggested well-being interventions fell into two key categories: supporting individual well-being and improving the work environment.
One of the key themes to emerge from the study was the importance of supporting nurses’ emotional and mental well-being through accessible, day-to-day interventions at work. Popular suggestions included pet therapy, mindfulness reflection, opportunities for exercise, and peer social groups, activities that offer emotional relief and camaraderie. Before tackling big-picture workplace issues, nurses pointed to the need for everyday support for their physical, mental, and emotional well-being.
Work environment interventions in the study fell into three major themes: manageable workloads and scheduling, unit culture and leadership, and benefits such as monetary incentives. Nurses expressed a strong need for greater scheduling flexibility, such as mental health days or voluntary sabbaticals, to recover between high-stress shifts. Many also emphasized the importance of clear communication and feeling valued by leadership. As NPs take on more roles in patient care than ever before and often feel stretched too thin, work environment interventions are sorely needed.
Some participants proposed that incentives such as vouchers for off-work activities, like massages, would be appreciated. Interestingly, compensation-related interventions were selected the least, suggesting that while fair pay matters, it’s not enough on its own. Instead, nurses pointed to supportive cultures and stronger management relationships as the foundation for a healthier work environment.
The study’s findings make clear that addressing moral injury will require more than just surface-level fixes. Real change starts within the workplace, and it must be shaped by the voices of those delivering care. From emotional support strategies to unit culture improvements, nurse practitioners know what they need to thrive.
What well-being interventions would make the greatest difference in your work?
