What I Wish I’d Known About Nursing: Disillusionment, Burnout, and Boundaries
Without a doubt, I’ve always known I was meant to be a caretaker. It’s simply who God made me to be, and every difficulty and hurdle in my life has pointed me toward that truth and brought me to where I am today. I think many nurses feel something similar. Sure, some went to nursing school dreaming of becoming a SAHM one day, while others chose the major because a parent urged them to, only to question everything the moment they witnessed their first wound dressing change in clinical. But no matter how each of us arrived at this profession, I believe there had to be something deep within us—a desire to use our hands and feet to care for people in their most vulnerable moments. Or maybe we simply loved the version of ourselves that nursing drew out: the kindness, the strength, the adrenaline. Whatever it was, it pulled us here.
Nursing has a way of pulling out every emotion inside you—even the ones you didn’t know existed.
It can be anger when a doctor dismisses your instincts about a deteriorating patient. It can be tears you can’t hide while consoling a parent. It can be guilt when you feel like you didn’t do enough for a patient or their family (you did, by the way). And it can be pure joy when a patient walks out of the unit after spending a month fighting to get better.
This emotional rollercoaster is one of the many things I never saw coming when I first stepped onto my unit: big-eyed, hopeful, full of expectations… and more than a little naïve.
I recently listened to a podcast by “Real World NP” about the “Path to Overcoming Disillusionment in Healthcare,” featuring a holistic leadership coach. Disillusionment, at its core, is the disappointment that comes when you realize something isn’t quite what you believed it would be. And to be clear, I’m not saying nursing turned out to be less meaningful or less rewarding than I imagined. It’s more that, fresh out of nursing school, you see everything in black and white. You see your soon-to-be nurse friends who are your age, the fun-colored scrubs, and the promise of four days off each week. That’s all you know—because you haven’t seen the rest of it yet.
The disillusionment I’ve felt has shown up mostly in the form of learning how to compartmentalize as a nurse—something I now believe is one of the most crucial skills for having a healthy relationship with this job, especially on a pediatric hematology/oncology floor like the one I work on. For whatever reason, compartmentalizing came easily to me at first. I could leave “work at work,” stay busy on my days off, and then slip back into what sometimes feels like an alternate version of my life the moment I put on my scrubs.
I'm currently reading When Breath Becomes Air, written by a neurosurgeon who shares his path from doctor to patient after being diagnosed with stage IV lung cancer. In one chapter, he describes a moment when a patient began to code while he was on his lunch break. He left his snack on the table and ran toward the chaos, doing everything he could, but the patient did not end up surviving. He writes, “With one of the ER residents covering for me, I slipped back in, ghostlike, to save the ice cream sandwich in front of the corpse of the son I could not.”
That line stuck with me. The image of him just going back to something so ordinary, so human, while the weight of a life lost still hung in the air. It’s exactly what we do. I was never prepared, and no one could ever prepare me, for the way nurses are expected to continue on with our day and with our own separate lives after witnessing the things we witness: a new diagnosis delivered to a devastated family, the loss of a little friend. After my first experience with this kind of tragedy, I remember hating the way I was supposed to just clock out afterwards. I wanted to comfort the nurses who were in the room with me. I actually didn’t want to leave work.
We step out of tragedy and back into normalcy as if nothing has changed, even when everything inside us has.
Something I wish I’d known coming into this field is that compartmentalizing is healthy… until it isn’t. Because when do you actually let yourself feel the emotions you held in for twelve straight hours just to make it through your shift? When do you pause long enough to sit with the sadness, the frustration, the pain?
This has been my biggest challenge, because I compartmentalize too well—if that’s even a real thing. We’ll have a devastating day at work, my coworkers around me are tearful, and still not a single tear comes from me. I’m an empath to my core, yet my brain steps in to protect me, to shield my heart, to convince me that what happens within those hospital walls belongs to some separate reality I don’t have to touch right now.
I think this is something we don’t talk about enough in healthcare. There’s this unspoken pressure to be strong while we’re on the clock, but the cost of that strength catches up to you if you never let yourself feel.
The holistic leadership coach recommends taking 15 seconds at some point after a shift, even if it’s the morning after, to just sit and let yourself breakdown, process, whatever you may need. I have been practicing that ever since hearing it.
Another thing I never expected about grief in nursing is how differently each person’s “window of tolerance” looks. In other words, we all have a different capacity for how much darkness we can witness and carry before it becomes too heavy, before it affects our ability to do our job or simply exhausts us.
I am guilty of comparing myself to other nurses far too often–wondering why I am not feeling the same level of exhaustion they are, and worrying whether that means burn out is still ahead of me, or more so coming at me without me realizing.
Burnout—you hear the word in healthcare all the time. I’m always actively running from it, LOL. I take long vacations whenever I can, switch shifts to work with close friends, and soak up the small moments of joy on every shift.
What I wish had been addressed before I started nursing is the warning signs of burnout. I’m grateful I haven’t experienced it, but through conversations with other nurses and seeing stories on social media, I’ve learned that warning signs can include overall apathy at work—losing interest or enthusiasm—or emotional numbness. And in our line of work, that’s dangerous: mistakes happen when we disengage, and mistakes in nursing can be the difference between life and death.
Dissociation is different from compartmentalizing. Read that again. Pay attention to which one you lean on when the job gets hard. Compartmentalizing can protect you; dissociation can be a warning that you need to pause and care for yourself.
I wish I had known more about setting boundaries—and how personal they can be—as a new nurse. Some nurses openly share their life stories with patients and families, while others prefer to keep the non-nurse parts of themselves private. Some families might know a nurse’s own children by name, while others appreciate a nurse solely for who they are at work, without curiosity about life outside the hospital walls.
Ultimately, this comes down to each nurse’s comfort level and, more importantly, understanding their own heart. Knowing how much of yourself to give—and when to protect it—is essential when forming close bonds with patients who are incredibly sick and vulnerable.
The majority of the time, I’m the type of nurse who allows myself to connect deeply with patients and families because, once I gained some experience as an RN, I realized this was exactly why I wanted to be a pediatric oncology nurse in the first place. That being said, I’ve learned to read conversations more carefully—like the time I was casually talking to a patient who started their first year at the college I attended, and suddenly they were grilling me about my go-to bars in my old college town, lol.
For the record, I am fully convinced that nursing is the greatest job in the world. I have never once felt unfulfilled or unrewarded by the work I do—it is one of life’s deepest honors and joys to care for the most vulnerable people, who are deserving of every bit of love and attention we can give. Maybe the disillusionment, the burnout, and the challenges of setting boundaries are lessons we’re meant to discover only after stepping into the work. My hope is that by talking about these realities, I can normalize them and help you navigate them—so they don’t stop you from pursuing the work you were always called to do.
