The World Health Organization announced the start of the third year of the COVID-19 pandemic on March 11. This global crisis has caused suffering, economic hardship and the loss of more than 6 million lives.

Nurses continue to face relentless and long-standing challenges as leaders of the pandemic response. Healthcare leaders in every setting must maintain solutions to support and retain their caregivers. Delivering quality and equitable patient care today and after the pandemic depends on leaders’ actions now.

The American Nurses Foundation released a new survey of nearly 12,000 nurses detailing the impact of COVID-19. The big takeaway: Nurses are struggling from the stress of the pandemic. They are exhausted, overworked, and feel undervalued. Those words came from at least half of the nurses surveyed about their experiences with the pandemic. In the foundation’s survey, more than one-third of nurses chose the word “anger.” Nurses have every right to feel that way given what they’ve experienced and lost. WHO estimates that from January 2020 to May 2021, 115,000 healthcare workers died from COVID-19. When we don’t protect nurses, we dishonor the legacy of late nurses and those still dealing with COVID-19.

Nurses at all levels were disappointed. According to a new study, 75% of hospital chief nursing directors and 64% of health system directors say they are “stressed” and “dissatisfied.” While leading the way during the pandemic, the top three challenges are staffing, burnout and turnover. Nurse leaders demonstrate unwavering loyalty to nurses and a strong commitment to providing high-quality patient care. They have successfully led interprofessional teams through one of the most difficult times in the history of nursing, but they are also not immune to the entrenched impacts of COVID-19 and must have support systems from their organizations to maintain excellence in care.

Before the pandemic, nurses’ working conditions were already high-risk and unsustainable due to workplace injuries, exposure to infectious diseases, staffing issues and many other stressors. One of the most troubling issues for nurses is the increase in workplace violence, especially in intensive care units and emergency departments. This is all compounded by the tragic reality that young nurses, the future of our nursing workforce, are experiencing more negative impacts from the pandemic. Among nurses under the age of 25, 69% said they were constantly burnt out, which was significantly higher than that of nurses over the age of 25 (49%). Additionally, nurses under 25 (47%) and nurses 25-34 (46%) rated themselves emotionally unhealthy or unhealthy at all compared to nurses over 55 (19%).

Leaders must do everything in their power to retain nurses. Limiting the challenge to a “supply” or “shortage” of nurses is a narrow advantage. It’s not just a “numbers” question. Nurses are quitting their jobs due to uncontrolled work environment challenges.