It is no secret by now that the pandemic has dealt blows to morale in nurses like never before. The issues are being voiced everywhere—nurses find themselves overworked, understaffed, underpaid, disrespected by both the health care system and many in the general public, in sometimes deeply startling ways.

As professionals who come to work every day looking to help, restore, and heal, we found ourselves losing our idealism about our profession. On top of our ongoing grief over our patients—both COVID and non-COVID related—we’ve also felt the loss of watching increasing numbers of beloved colleagues either leave the profession or leave our units, often because of preexisting issues highlighted by the stresses of the pandemic.

This is not at all to say that their reasons for leaving are wrong. It’s only to say that those of us who stay feel the grief of seeing them leave and wonder anew about our own longevity in this work, even as we support their decisions and wish them well.

Four motivations that have kept me in nursing.

This has left me inevitably asking myself why I still stay. My motivations for staying in this work and in my current workplace are:

  1. To provide meaningful, helpful care to my patients and families.
  2. To work in a supportive environment that is life-giving and not demoralizing.
  3. To earn decent wages that support my family and allow us to pursue goals and support others in ways that are meaningful to us as a family.
  4. To serve the general public with my expertise, particular gifts, and skill set.

But the reality is that I’ve lost my idealism about all these motivations in certain ways. Some of that is just a natural byproduct of experiencing the hard realities of nursing over time.

Much of that loss, however, has been exacerbated or brought to light anew because of the pandemic. My work doesn’t always feel meaningful when family members berate us even as we work day and night to save their loved ones from diseases that were easily preventable. I feel demoralized when we can’t provide the quality of care we want to because of dire staffing shortages. It is hard to live in a city with exorbitant costs of living when wages for me as a longtime local resident and employee are a fraction of those for temporary travel nurses just passing through. I don’t know how to serve a public that now violently insists they are the experts with their bunk research and rampant misinformation.

Out of the pain of lost ideals, a new strength in realism.

There is a deep grieving I am doing as I let go of my ideals, while still seeking to work towards the preservation of meaning, a healthy work environment, decent and fair compensation, and a personal sense of valuable service towards the general public.

Isn’t this the lesson we nurses begin to grasp over time with our patients?

With experience, we come to recognize we can’t fix everything for our patients—but as we are pressed to define or redefine ‘best outcomes,’ we take whatever steps are possible in those directions, often still grieving, still constantly reorienting.

Is there a possible insight to be found here? Maybe the ways we grieve ideal outcomes for and with our patients, but still work towards ‘best outcomes’ in light of the reality of painful diagnoses, has some relevance to our perspective on our profession at this precarious point in history. This insight may help those of us who stay in nursing maintain some real hope for best outcomes for this profession (and/or for our individual workplaces), even as we deeply grieve the loss of the ideal.

This is painful, and hard, and also in some ways nudges us towards new definitions of what hope looks like in the midst of these realities. I think again about the reasons I still stay in nursing. Lately, I’m grieving many gaps and losses in all four of these ideals. We’ve all lost a lot of our ideals, and in this kind of work, that hurts.

Even still, I find myself staying, still curious about where new hope and new pursuits in the redefining of ‘best outcomes’ can show up in all four of these reasons to stay.

(An earlier version of this post appeared on the author’s blog, The Heart of Nursing.)