Nurse-endorsed strategies to repair nurse-employer relationships, alleviate burnout, boost retention, and rebuild trust in the post-pandemic era

Background: Burnout, turnover, and eroded trust between nurses and healthcare organizations worsened during the COVID-19 pandemic and continue to threaten workforce stability. Addressing these issues requires understanding both individual and system-level contributors to nurse distress. Purpose: This study sought to identify nurse-endorsed strategies for reducing burnout and improving organizational resilience through analysis of pandemic-era survey data. Methods: A qualitative content analysis was conducted using responses from two organizational surveys completed during the pandemic. Trauma-informed analytic methods were applied. The SEIPS 2.0 framework guided deductive coding of work-system domains, while Foli's Middle Range Theory of Nurses’ Psychological Trauma informed inductive analysis of trauma-related themes. Discussion: Nurses described persistent challenges across all SEIPS 2.0 domains, including insufficient resources, system-induced and secondary trauma, workplace violence, and perceptions of institutional betrayal. They emphasized transparent communication, equitable treatment, fair pay, safe environments, adequate staffing, and meaningful recognition. Most recommendations reflected low-cost cultural and structural reforms that could be readily implemented. Conclusion: Findings underscore the importance of trauma-informed, system-level strategies—such as reliable staffing, visible leadership, and genuine recognition—to reduce burnout, rebuild trust, strengthen workforce resilience, and enhance nurse retention.