The Nursing Lens

Category: Nursing Workplace Culture

  • The Hidden Cost of Caring: How Modern Healthcare Desensitizes Nurses

    When nurses have no time to grieve or recover, what happens to the people who care for everyone else?

    By Lesline Rostick, RN, BSN

    We often call nurses heroes, angels, and the backbone of healthcare. We praise their empathy and resilience. But there is a quieter reality behind that praise: many nurses feel they must set their emotions aside to get through a shift.

    A patient dies. We support the family, complete the care that follows, and prepare the room. Once it is cleaned, another admission may be waiting. The next patient deserves our attention, so we steady ourselves and walk in.

    The grief does not disappear when the room is ready. We may remember the family’s faces on the drive home or find ourselves thinking about the patient days later. Yet there is often no time on the unit to acknowledge the loss before the work moves forward.

    Are nurses becoming desensitized? Or are we learning to hide what we feel because we have so little opportunity to process it?

    What a Nurse Carries

    Patient loss is one part of the strain. Alarms sound, medications are due, call lights ring, documentation needs to be completed, and admissions arrive. When every task feels urgent, it can be difficult to give patients the time and attention we wanted to give them.

    Nurses may also face hostility from patients or visitors, bullying from coworkers, and concerns that leaders leave unanswered. The CDC has identified harassment from patients and coworkers as a working condition associated with symptoms of poor mental health among health workers.

    The shift ends, but our responsibilities do not. Some nurses are raising children alone. Some care for children with special needs or aging parents. Others are managing their own health, relationship difficulties, or financial pressure. A nurse can leave a difficult shift and go straight home to people who need them, with little time to rest before returning to work.

    These pressures build together. During a difficult period in my career, my anxiety began before my shifts. My stomach hurt when I arrived on the unit. I called out more often than I wanted to, and eventually I took a leave of absence to care for my mental health.

    I had worked hard to become an RN. I cared deeply about nursing and my patients. I needed care myself.

    Give Nurses Time to Recover

    Checking on a colleague after a patient death matters. So does having a manager who listens when a nurse says an assignment is unsafe or reports bullying. Hospitals need to provide support after difficult events and address the working conditions that add to nurses’ distress.

    They should also provide paid mental health days as a required benefit for nurses. These days should be separate from time needed for physical illness, available without disciplinary attendance points, and usable without disclosing a diagnosis to coworkers. Hospitals must plan coverage so that taking a mental health day does not leave other nurses with unsafe assignments.

    A day away will not resolve every problem. A nurse returning to bullying or an unsafe workload needs more than permission to rest. Leaders must respond to those concerns directly.

    A U.S. study published in JAMA Psychiatry found that, in 2017–2018, female nurses died by suicide at nearly twice the rate of women in the general population. The study cannot explain any individual death. It does underscore the importance of making it easier for nurses to seek help before a crisis.

    Reclaiming the Heart of Healthcare

    Expecting nurses to remain deeply empathetic without fixing the structural issues that exhaust them is unrealistic. Empathy is a renewable resource, but only if the person giving it is allowed the environment, time, and safety to recharge.

    If we want nurses to keep caring for us, we have to build a healthcare system that cares for them, too. It’s time to dismantle the forces that cause desensitization and bring humanity back to both sides of the hospital bed.

    To my fellow nurses and healthcare professionals: What happens on your unit after a difficult patient loss? Are staff given time and support to process it, or are they expected to move straight to the next admission? Have you ever felt you had to set your feelings aside just to get through a shift? I’d welcome your perspective in the comments.

  • When Bullying Creates a Hostile Work Environment in Nursing

    Rumors, unequal scrutiny, and unanswered concerns can make nurses feel unsafe in the place where they are expected to care for others.

    I worked hard to become a nurse. Earning my RN was one of my proudest accomplishments, and I entered the profession ready to learn and care for people. I never imagined that I would begin to dread walking onto my unit.

    The anxiety did not always wait for my shift to start. Some days, my stomach hurt as I arrived at work. I wondered what I would be accused of, whether my report would be accepted, and who might already have heard a story about me that was not true.

    Nursing is demanding. Patients can deteriorate quickly. Assignments can change. We depend on one another to communicate clearly and respond when someone needs help. When a nurse cannot count on fair treatment from coworkers and leaders, the strain reaches into every part of the shift.

    When a Rumor Becomes the Story

    One morning, I was giving handoff before I had finished all my documentation. I explained that I had the clinical information needed for the report and would complete the charting. The oncoming nurse refused to take the report. Later, I learned that she had told the shift director I had not given it.

    I wrote out the report and left it at the charge station. Before leaving, I returned to photograph what I had written because I wanted a record that I had provided the information. When a coworker asked why, I said that, as a person of color, I felt a need to protect myself. A rumor then circulated that I had called the nurse racist. I had not.

    That rumor stayed with me for months. I felt people watching me, whispering, and drawing conclusions before speaking to me. It was isolating to come to work knowing that my own explanation might carry less weight than something I had never said.

    My handoffs also seemed to receive more scrutiny than those of other nurses. I was aware of how readily new nurses could become targets of criticism, and I was especially troubled by what I observed as unequal treatment of nurses of color. I had already emailed my manager about workplace concerns. When she finally called me to a meeting, the focus was the rumor. I left feeling that the concerns I had raised still had not been addressed.

    I cannot tell another person what they intended. I can say what I experienced: my account was harder to believe, while the rumor was treated as grounds to question me.

    The Harm Does Not Stay at Work

    The longer it continued, the harder it became to walk onto the unit. I called out more often. At times I arrived and felt so anxious and physically unwell that I struggled to stay. Eventually, I took a leave of absence because my mental health was suffering.

    An absence appears on a schedule. It does not show the dread that came before it or how painful it was to wonder whether the career I had dreamed about was the wrong choice for me. I still wanted to be a nurse. I needed a workplace where I could do that work without feeling isolated and constantly on guard.

    My experience is personal, but the effects of bullying on nurses are documented. A 2025 study conducted across three hospitals identified gossip and rumors among the behaviors nurses reported. Participants also described strained working relationships and feelings of powerlessness. Those findings come from a specific group of hospitals and should be understood in that context. They give language to a harm that is easy to dismiss when it happens quietly, between shifts and conversations.

    Speaking Up Must Be Safe

    A hostile work environment can also change how a nurse approaches a clinical concern. As a newer nurse, I sometimes felt that admissions were assigned to me without enough attention to the patients already in my care. On one shift, I was caring for patients with significant needs, including confusion and fall risk. I raised a concern about taking another admission because I did not believe I could do so safely without more support. The shift director became involved, and I was directed to take the admission. A sitter was ultimately provided for one of my patients.

    I am glad that patient received additional support. I also remember the pressure of having to defend why I asked for it.

    In a 2023 survey of 867 hospital nurses in the United States, greater psychological safety was associated with more open communication, higher job satisfaction, lower intention to leave, and more favorable patient safety ratings. Because it was a survey conducted at one point in time, it cannot prove that psychological safety caused those outcomes. It does show why leaders should pay attention to what happens after a nurse asks a question or raises a concern.

    If nurses expect ridicule, unequal scrutiny, or retaliation, speaking up becomes harder. That matters during handoff. It matters when an assignment feels unsafe. It matters when a nurse needs to say, “I need help.”

    What Leadership Allows Becomes Unit Culture

    I heard people explain away a coworker’s conduct by saying, “That’s just how she is.” That answer leaves the next nurse to deal with the same behavior. It also tells everyone watching which concerns are likely to be taken seriously.

    I eventually brought my concerns to HR. I was told that the investigation supported my account and found that my manager had been unresponsive. I had hesitated to pursue it because I feared what might happen if I did. By then, the experience had already affected my health and my trust in the workplace.

    Managers have a responsibility to examine concerns without favoritism. That means looking at patterns: whose handoffs are questioned, whose assignments are reconsidered, who receives an answer after raising a concern, and whose account is believed. When a nurse reports bullying or unequal treatment, a leader’s response can either restore trust or deepen the harm.

    Nurses need to feel safe with the people beside them as well as with the patients in front of them. We cannot expect open communication while allowing rumors to define a colleague, dismissing harmful conduct as a personality trait, or making nurses fear the consequences of asking for help.

    I took leave to care for my health. I remain proud to have become a nurse. Both things are true. What happened should not be accepted as part of learning to survive in this profession. A nursing unit is safer when concerns are heard early, examined fairly, and acted on before a nurse has to leave to recover from the place where they work.