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Abstract | AONL COVID-19 Longitudinal Study Finds Top Challenges for Nurse Leaders



The American Organization for Nursing Leadership (AONL) and Joslin Marketing, Richmond, Va., partnered to conduct a longitudinal study on the impact of COVID-19 on nursing leadership in July 2020 and February 2021. The recent findings indicate changes to primary challenges and levels of support, with new findings on mental health and advocacy concerns. The February 2021 Longitudinal Study identifies critical changes that have occurred in health care since July 2020. This article features highlights from the February survey; the full report can be viewed at

Since the initial survey, evidence has emerged indicating access to personal protective equipment (PPE) has improved while the challenge of mental health and staffing have worsened. As stated by one nurse leader: “We have seen nurses leaving the profession due to moral distress, burnout and fatigue. I believe if we can address the root cause of this problem, we will retain more nurses and begin to stabilize the numbers in the workforce.”

The February 2021 survey is part of an ongoing longitudinal study designed to track several areas over time. The initial survey was completed in July 16-26, 2020, with 1,824 leaders responding. Findings from the first survey were published in the December 2020 issue of Nurse Leader. Nearly one out of three respondents in the second survey recalled completing the initial survey. The second survey was sent to 23,515 nurse leaders and completed or partially completed by 2,471. The margin of error for the second survey was +/- 2.45% with a 99% confidence level.

Of the respondents from the February 2021 survey, 87% were either chief nursing officers (CNOs), chief nursing executives (CNEs), vice presidents, directors or managers. Overall, 34% of the respondents were directors, 32% managers and 17% CNOs or CNEs.

The majority of respondents came from acute care hospitals (52%) or health system facilities (14%). Only 4% came from long-term acute care or post-acute care facilities. Of all the respondents, 51% were urban, 29% suburban and 20% rural.

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