95,000 Nurses, 8 Warning Signs: The Hidden Signs of Nurse Burnout

A 2025 report released by Laudio and the American Organization for Nursing Leadership (AONL) introduces a set of eight operational metrics designed to help healthcare organizations identify early signs of nurse burnout. Drawing from data representing nearly 100,000 nurses across more than 150 hospitals, the report marks a shift from traditional, reactive burnout management toward a model that leverages objective data for early intervention. According to AONL CEO Claire Zangerle, DNP, RN, “Leaders who address these invisible stressors can create truly supportive and sustainable work environments that better support nurses and the patients they serve."

Operational Metrics Reveal Hidden Stressors

Despite hospitals reporting improvements in staffing overall, the research found that nurses are struggling more than ever to take breaks, leave on time, or use their paid time off (PTO). These patterns of overwork often remain invisible in standard staffing analyses, yet they are now clearly linked to decreased nurse retention and well-being.​

Four Most Powerful Burnout Indicators

Among the eight predictors identified, four stood out as the most powerful warning signs:

• PTO Threshold: If half the nurses on a team haven’t used PTO in six months, turnover among newer nurses rises sharply, signaling chronic stress and lack of recovery time.
• Extended Hours: Nurses frequently leaving work late is the strongest indicator of burnout, tied to a consistent 2-6% jump in overall nurse turnover.
• Break Patterns: Units where nurses regularly skip breaks see annual retention declines of 15% or more among new hires, exposing cultures where breaks aren’t protected.
• Unscheduled Absences: Frequent callouts create staffing gaps, piling more pressure on remaining team members and escalating burnout risks across the unit.​

Moving from Reactive to Proactive Burnout Prevention

This research marks a clear shift for the profession: from responding to burnout after the fact to proactively managing it with operational data. “Leaders who address these invisible stressors can create truly supportive and sustainable work environments that better support nurses and the patients they serve,” said AONL CEO Claire Zangerle, DNP, RN.​

Recommendations for Nursing Leaders

The report goes further by outlining over 30 practical interventions for executives and nurse managers. For hospital leaders, the focus is on integrating data systems and redesigning roles for sustainability. For frontline managers, recommendations highlight understanding team dynamics and sharing responsibility for well-being, ensuring preventative support can be tailored at every level.​

A New Evidence-Based Framework

By leveraging these data-driven indicators, health systems are better equipped to support nursing staff and prevent burnout-related turnover. Continued adoption of proactive, evidence-based approaches will be critical to building more resilient and sustainable nursing workforces in the evolving healthcare landscape.

 

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