1. Section Editor(s): Raso, Rosanne DNP, RN, NEA-BC, FAAN, FAONL

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Ernest Grant, president of the American Nurses Association, was recently quoted as saying, "Nurses are exhausted." Our clinical nurses are tired, and so are nurse leaders. It has been a miserable couple of years and the fallout from the pandemic has been huge, from health outcomes to financial impact; workplace, societal, and workforce instability; and leader and frontline worker stress. Are we expected to be "mentally tough" as our sports idols are? Probably, yes, and many are reaching their toughness limits.

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Originally, I was going to write about finding purpose and meaning by rediscovering joy at work. But it fell short for me, having to dig for meaning in our work didn't help. In the big picture, we know that our leadership has incredible meaning to patients and staff. What did help was hearing about Simone Biles' recognition of her own limits and putting her mental health above societal and professional pressure. Is it about limits, knowing when we've reached them, and then figuring out what we need to do for our own sanity?


At first, reading about mental toughness irritated me. It reminded me of resilience building. Do we really need to be more resilient or tougher? I don't think so. We've been both, repeatedly. Don't get me wrong, it's good to be able to push past failures and stay positive. However, it's also time to address the working conditions that have led to exhaustion. And we can help ourselves, too.


Simone Biles stepped back and let her team take over. We can and should take a day, a week, or an afternoon off and delegate to someone else "in charge." It could be a peer, someone who reports to you, or even your boss. Having someone to take over to give yourself a break is important. In our Wellness Survey published earlier this year, we found that you were taking less, or no, time off. This is very worrisome.


Self-care is another avenue. The respect officer at my organization sees self-care as self-respect. Brilliantly true. You know what you need to do to respect yourself, and you don't need anyone's permission, especially when you've reached your toughness limits. It's the foundation for resilience as well. Some of us find release in writing, telling stories and using narrative to reflect and learn. We're all different and should be looking deep within ourselves for what we need to do. Maybe it's yoga, or finding and expressing gratitude, or reframing. Do it.


What about the work burdens that aren't under our control? Reading about nurses' cognitive overload, and the sentiment that the front line went "from heroes to zeros," also resonates with leaders. Increasing scopes, administrative load, staffing challenges, a distressed workforce, and unrelenting outcome expectations take their toll. Work with your team to delegate as possible and your bosses to reduce work that can be done by others or not done at all. Maybe available technology can help. Negotiate deadlines and expectations. There should be no harm in asking.


Nursing Management editorial board member Rhonda Foster and I were recently texting each other at the same time about leader mental health. She was excited to write a companion editorial this month. These times are difficult, and we all have limits to our toughness on a broad continuum. I wish I had a magic wand to make the stressors ease. The courage of Simone Biles was the catalyst for our messages. Your courage is my inspiration.



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