New nurses may find themselves confronted with great human suffering, enormous technical challenges, and the norms and pressures of the nursing profession and the individual workplace.

Most eventually learn the skills and knowledge they need to succeed in the profession. But some may struggle more than others with the emotional intensity of the work. A question that seems to come up a lot when nurses write about their work goes something like this: How do you keep caring as a nurse and not get burned out? How do you develop a resilient professional persona?

This month’s Reflections essay, “How I Built a Suit of Armor (and Stayed Human),” by Jonathan Peter Robb, enumerates the challenges faced by a sensitive new nurse and the ways he found to protect himself over time. Here Robb, a district nurse for the National Health Service in London, England, describes one kind of challenge he faced:

The weight of being responsible for a person’s health wasn’t one I had prepared for. Sitting in lectures doesn’t train you for the moment when you’re standing at the end of a bed looking at a patient who is struggling to breathe, semiconscious (but who just last week was sitting up and talking), and thinking: Did I miss something? Is this my fault?

As Robb writes, “caring hurts.” […]