There is a part of nursing we do not talk about. Not in school. Not in orientation. Not even with each other most of the time. It is the part where you learn to function in environments where violence, whether real or threatened, becomes part of the job. And over time, you start to notice something: You are not reacting to the stress the way you used to, and you …
Nursing violence causes silent and painful cumulative stress
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What happens when the nurses sent to care for your medically fragile child have never even touched the equipment keeping him alive? Patient advocate Ashley Youngdale knows firsthand. As the mother of a …
No nurse is better than a bad nurse in your child’s home [PODCAST]
In my years as an ICU nurse, I learned to recognize a pattern. The patients I cared for in trauma surgical intensive care often arrived after a cascade of preventable events. A missed medication. A symptom that went unaddressed. A follow-up appointment that never happened. By the time they reached my unit, the question was no longer how to keep them well at home. It was how to bring them …
Patients pay when Medicare care coordination codes go unused
For three months, I searched for a preceptor. I reached out to clinics, private practices, and community providers. I emailed offices, followed up, and posted in professional forums and Facebook groups. I approached the process with persistence and respect for the clinicians whose time I was requesting. Most of the time, I received no response. When I did, the answer was typically the same: not accepting students, already at capacity, …
The rising cost of clinical placements for nursing students
I am a registered nurse with 16 years of bedside experience, and I have come to understand a problem in health care that is rarely named directly: The conditions we work under shape what we are able to perceive. Care is still delivered. The chart is complete, the discharge is placed, and the bed opens. From the outside, the system appears to function, but something essential is missing, and the …
How high pressure destroys relational care in nursing
I sat up on that thin mattress in a nursing home. My earthly possessions were gone. The house I loved so much and worked so hard to buy, built in 1918, was no longer mine. I had taken a second job just to move out of the dilapidated trailer my husband had brought me to. I felt surrounded by poverty and hopelessness while he showed no ambition to leave. My …
A nurse’s final reflection on life, death, and regrets
I was recently speaking with an intensive care unit (ICU) nurse, and she described a moment that perfectly captures the weight of her profession. She was managing a post-surgical patient whose vitals were quietly deteriorating. Before the monitor alarms even registered the crisis, she had anticipated the drop, prepped the pressors, and calmly updated the attending physician. Through sheer clinical vigilance, she held the fragile line between stabilization and a …
National Nurses Week needs better nursing recognition
Nurses are constantly told that burnout can be prevented through self-care: rest, nutrition, mindfulness, and learning to assert healthy boundaries. I followed that advice. I asserted professional boundaries. I tried to maintain reasonable limits around my time and energy. I attempted to follow the guidance nurses are routinely given about protecting our well-being. Within one year, I was fired from three jobs. This is the contradiction at the center of …
Why self-care alone cannot cure systemic nursing burnout
I walked onto my small unit a few minutes before 7 a.m., nurses huddled around one elderly gentleman. A cacophony of alarm bells and call lights went unanswered as the unit’s three overnight staff members attempted to keep him in bed. He voiced his disagreement loudly while climbing over the rails meant to protect his safety. Though he was strong, he was unsteady. Exasperated, the night nurse showed me her …
Workplace violence against nurses: a crisis of systemic failure
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Retired emergency department nurse Amy Dinaburg discusses her article “Lowercase PTSD: Why emergency staff are still hypervigilant.” Amy reflects on the relentless pressure of the COVID-19 pandemic where nurses were forced to …
Emergency nurses struggle to turn off survival mode after the pandemic [PODCAST]
Oh, how I remember this well: The wicked snowstorm that paralyzed many cities, year after year. I was driving my van to work as it slid on black ice and directed me down a hill towards a large church. I had no control and could only pray that I didn’t hit that large telephone pole. When my van finally came to a stop, I realized I had missed the telephone …
Essential personnel safety: the hypocrisy of hospital snow policies
After working close to 20 years in this medical-surgical ICU, I thought I was an expert. Infallible. I could do it all.
I left my ICU comfort zone, my lifelong nurse friends, and ventured out. Nothing could stop me.
For a different hospital system, I became a critical care resource nurse.
This very large hospital system would dictate what unit I would go to and for how long. I truly thought I could …
Why I left the surgical-trauma ICU: a nurse’s story of burnout
When I told ProPublica that it was too expensive to protect us, I was naming what every number in this piece confirms. The system made a calculation about what our lives were worth, and it got the math catastrophically wrong.
I have been a nurse for almost 20 years, working in emergency departments, intensive care units, and eventually the back of a helicopter as a flight nurse. I have watched the …
The shadow ledger: Uncovering the financial cost of nursing turnover
Emergency medicine trains clinicians to recognize patterns early, anticipate deterioration, and intervene before outcomes become irreversible. We pride ourselves on seeing what others miss. Yet we are repeatedly instructed, explicitly or implicitly, to ignore the largest pattern of all. Political decisions consistently and predictably shape who arrives in our emergency departments, how sick they are, and how unsafe the environment becomes for the people expected to care for them.
If political …
Alex Pretti’s death: Why politics belongs in emergency medicine
Every day, nurses make thousands of clinical decisions that directly shape patient outcomes, safety, and recovery. Yet in many hospitals across the country, these critical choices are still guided by experience-based models rather than current evidence. For a profession that defines itself as patient-centered and science-driven, this approach contradicts the very standard of care we strive to uphold. True excellence in nursing is not defined by technology alone or by …
Why evidence-based practice in nursing is a strategic imperative
A nursing student recently told me she had decided not to apply for bedside roles after graduation. Not because of her clinical rotations. Not because of faculty advice. Because of what she sees every night on TikTok. Her feed is filled with short videos describing unsafe staffing, emotional exhaustion, hostile workplaces, and nurses counting down the days until they can leave the profession. She knows these posts reflect real experiences. …
Social media’s impact on the nursing workforce and student enrollment
I wanted to be at the top. Clinical ladder 4 was the top. You couldn’t get any higher achievement as an ICU nurse than this.
There were many requirements to obtain this:
I checked all the boxes, every year. It was hard work. And tiresome. The compensation for …
Emotional abuse recognition: a nurse’s story
As a research scientist who is devoted to ensuring that immigrant nurses have successful U.S. careers, the issue of internationally educated nurses’ (IENs’) cross-culture language competence has recently been both a sensitive and front-and-center issue pervading my work. In my more than 30 years in the health care sphere, the topic is now reaching a fever-pitch as IENs increasingly enter the U.S. health care workforce and play a critical role …
The debate on English tests for immigrant nurses
An 18-year-old was admitted to our ICU with a questionable diagnosis. The drug screen did not reveal what he had taken. Our ICU intensivist speculated he ingested bath salts. Bath salts came to the U.S. around the 2010s. It was cheap and, even better, considered a “legal high” as it was not detectable in drug tests. Josh came to the emergency room psychotic, paranoid, and hallucinating, with hypertension and SVT. …
A nurse’s story of hospital bullying
My current feeling as a nurse is more closely related to those of a line cook than to what I imagined nursing would be. Patients arrive with complex medical needs, yet we are forced to see them as checklists to be processed before the next shift arrives. Turnover feels like moving products down a line instead of treating people with care and dignity. This is not a failure of individual …
Why we need national nurse-to-patient ratios
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