RN
When I first signed up to be a nurse, I did it out of a desire to help people. I thought I was entering a noble profession, one where I could make a real difference in people’s lives. And, to be fair, I have. Nursing is a profession built on compassion and care. But what I didn’t realize was that I was also signing up to be abused — by a system that is broken and by an environment that, more often than not, is toxic.
Many of the tasks we do as nurses are uncomfortable for patients — changing dressings, inserting IVs, getting them to move after surgery. We understand these actions can be difficult for patients, but they are essential because the benefits far outweigh the temporary discomfort.
However, just as we prioritize patients’ well-being despite these challenges, we, as nurses, often find ourselves asking: Who is looking after us?
While we care for others, the healthcare system often fails to take care of its nurses. We are stretched thin, overworked, and dismissed, with little regard for our own physical and emotional well-being. In the process, we often neglect our own health and needs, further contributing to the burnout that plagues our profession.
I didn’t know that by becoming a nurse, I was signing a contract with an abusive partner: the healthcare system. No one told me I’d find myself in situations where I couldn’t do my job properly due to overwhelming demands and impossible conditions. No one warned me that I’d constantly be torn between protecting my own well-being and taking care of my patients.
The rules and guidelines that are supposed to guide us often become impossible to meet because of the environment we are placed in. Do I focus on charting to cover my back, or do I spend that time giving hands-on care? It feels like a lose-lose situation. The only time I was able to manage both was when I worked at a hospital under a union. The saying goes, “If it’s not charted, it didn’t happen.” But we simply can’t do it all — there aren’t enough hours in a shift.
One of the hardest parts of nursing is facing the ethical dilemma of balancing patient care with proper documentation. Sometimes, writing down what really happens could potentially implicate a coworker or highlight a flaw in the system.
I recall a patient whose heart rate had been at 140 for hours. Despite notifying the doctor multiple times, no action was taken. In situations like this, I often felt helpless — like we were waiting for the patient’s body to heal itself while charging him thousands of dollars. The frustration lies in knowing that while our duty is to the patient, we are sometimes left with difficult decisions about what to document and what action to push for.
What I also didn’t expect was how pervasive the toxic work environment in healthcare would be. For many of us, even asking for a simple lunch break is met with dismissal. I’ve worked more than 21 years in various settings, and breaks are a rare luxury — except for the time I spent working under a union.
There, we had a break nurse who would care for our patients while we took our breaks, making it possible to rest for a few moments during a shift. The culture of overwork is so normalized in nursing that we often forget it shouldn’t be this way. Sometimes, even your experience can work against you. You’re given the sickest patients because they trust you, but it’s just too much to manage. It’s not uncommon to work through shifts without a proper break, essentially working for free.
At one facility, the culture of overwork was so ingrained that they laughed about the fact that the medication room was where we ate lunch. This was mentioned during my orientation, and I went along with it. You get used to the idea that your needs don’t matter. When you speak up about your assignment being too much, there’s often no help offered. No redistribution of patients.
One of the most dangerous aspects of this toxic environment is how nurses are often expected to manage patients outside their scope of practice. For example, ER nurses often find themselves caring for psychiatric patients in crisis, despite having only minimal psychiatric training.
An ER nurse might be responsible for handling a patient in active psychosis — administering intramuscular injections, managing restraints, and deciding when it’s safe to remove those restraints — while still caring for other patients in the ER. All this, with only a single semester of psych training that barely scratches the surface of what’s required.
The lack of proper training in these critical areas puts both nurses and patients at risk. I’ve experienced situations where I was asked to conduct a Sexual Assault Nurse Examiner (SANE) exam, despite having zero formal training in it. I voiced my concerns, went up the chain of command, told them I wasn’t comfortable and didn’t know how to perform this sensitive procedure, and yet I was still told to do it. That was a moment where I should have said no. But the pressure is immense. You’re made to feel as if refusing could jeopardize your job or leave your coworkers in the lurch.
We are often left to “figure it out” in situations where proper training is critical to both the safety of the patient and the nurse. The healthcare system, in many ways, takes advantage of nurses’ willingness to get the job done, even if we’re not equipped for the task.
As if the demands of patient care and administrative overload weren’t enough, one of the most painful realities in nursing is how poorly we often treat each other. There’s a saying in our field: “Nurses eat their young.” Unfortunately, this isn’t just a catchy phrase — it’s a harsh truth.
Whether it’s senior nurses being judgmental of new grads or staff members gossiping and undermining one another, the toxicity between coworkers only adds to an already overwhelming environment.
Instead of fostering support and mentorship, many nurses face criticism for struggling to keep up or are shamed for speaking up about the workload. In some workplaces, asking for help can even lead to being labeled as incompetent or weak. Judgment comes from all sides. Not just fellow nurses but other staff members, managers, and even doctors. This culture of blame and competition only deepens the stress we feel, and it prevents us from building the solidarity we need to thrive in such a high-pressure job.
But it doesn’t have to be this way. We have the power to change how we treat each other by creating a culture of compassion and support within our units. Standing together, rather than tearing each other down, is one of the first steps toward changing the larger system.
One of the most frustrating aspects of working in healthcare is how often cost-cutting measures take priority over patient care. Suggestions from nurses that could improve quality of care are often dismissed because they might affect the bottom line. A striking example is when upper management decided to invest in customer service workshops while ignoring the need for more staff or resources to improve actual patient care. It’s disheartening to see money poured into superficial solutions, while real, meaningful change is left on the back burner.
We become stuck in a cycle of putting out fires — whether with patients, families, doctors, or coworkers. It’s never-ending, and often we, the nurses, are the ones caught in the middle. The healthcare system is often quick to point fingers at nurses when things go wrong, yet slow to offer support when we’re drowning under impossible workloads.
When we speak up about needing help, the response is often the same: “You just can’t handle it.” We’re told to work on our time management skills, as if that’s the issue. It’s easier to blame individual nurses than to admit the system is flawed. But no one person can manage this type of patient load effectively, and it’s time we stop pretending that we can.
Some of the blame does fall on us as nurses — we don’t set or enforce boundaries. We end up caretaking instead of caregiving, and sometimes we lose our voice out of fear. But more often than not, it’s the toxic environment we’re placed in. We are asked to do the impossible, and when we can’t, we’re made to feel like we’re not enough.
I recall one facility where we were told not to mention staffing shortages to patients. To me, that felt like an abusive relationship — being hit and told, “Don’t tell anyone.” But we can’t keep quiet anymore.
We need to stand up for ourselves. We need to learn to say, “No,” to stop allowing the system to take advantage of us. The first step is to get out of debt. Money often keeps us trapped in jobs that are toxic. It’s like being in an abusive relationship where you can’t leave because you don’t know how you’ll survive financially.
Once we free ourselves from the financial hold, we can begin to stand up for what’s right. We can identify our values and ask ourselves if our current job aligns with those. If it doesn’t, it’s time to have that conversation with your employer. And if they don’t listen, it might be time to walk away.
While it’s easy to identify the problems, making meaningful change can feel overwhelming. Here are some actionable steps nurses can take to improve their situation and move toward long-term solutions.
Financial insecurity often traps nurses in toxic jobs because they fear leaving without a backup plan. To break free, start by taking control of your finances:
By regaining control over your finances, you’ll reduce the hold your job has over you and open the possibility of transitioning to a more balanced role.
Nurses are notorious for neglecting their own needs in favor of patient care. But setting boundaries is essential to prevent burnout:
Setting boundaries doesn’t make you a bad nurse; it makes you a sustainable one.
While you work on long-term solutions, here are ways to protect your well-being in toxic environments:
Remember, toxic environments thrive when no one speaks up. Even if change feels slow, documenting and reporting issues is a step toward improvement.
Change won’t come overnight, but it starts with nurses advocating for themselves and others. Here’s how you can get involved:
By becoming part of a larger movement, you can influence changes that go beyond just your own situation.
Reflect on why you became a nurse and what type of care you want to give. Ask yourself if your current job allows you to honor those values:
By aligning your work with your core values, you’ll find greater fulfillment and lessen the impact of toxic environments.
As nurses, we can provide excellent care, but only if we start caring for ourselves first. The healthcare system won’t change until we stand up and demand better. We can’t continue to be martyrs for a broken system. We deserve respect, adequate staffing, fair pay, and a work environment that doesn’t push us to the brink of burnout.
The only way we can create change is if we stop accepting the unacceptable. It’s time to reclaim our power and take care of ourselves, so we can take better care of our patients.
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