Nurses have become fluent in the language of “burnout.” We use the word to describe a range of internal states such as exhaustion, disengagement, frustration, and compassion fatigue, states that are often attributed to staffing shortages and other systemic pressures. The term has become so embedded in our professional vernacular that it risks lumping distinctly different experiences into a single narrative.

Identity erosion as a framing device for understanding burnout.

In my coaching work with nurses, I have found that framing these experiences through the lens of professional identity adds a layer of clarity that is often missing from burnout conversations. Many nurses are beginning to see that their professional identity has been shaped over time by the environments in which they work, sometimes in ways that have lessened their sense of self.

Naming this as identity erosion does not separate it from burnout, but instead helps explain the deeper impact while opening the door to a greater sense of control. This shift in thinking explains why some nurses are asking deeper questions about their values, purpose, and how their work reflects who they are.

To be clear, health care systems deserve scrutiny. Nurses are working within environments that often demand increased productivity while constraining time, autonomy, and human connection. But in my work coaching nurses across career stages and practice settings, I rarely encounter people who simply fail to understand that the system is dysfunctional. Most already know.

What I hear instead are quieter and more complicated questions. How do I continue practicing in a system that no longer reflects my values? How do I remain compassionate without becoming consumed? When did I stop feeling connected to the work I once loved? Why do I feel guilty for wanting something different.

These are not merely symptoms of exhaustion. They reflect something more existential: a gradual erosion of professional identity and agency.

When nursing identity is at cross-purposes with institutional expectations.

Nursing is often framed as a calling, and is regarded by many as an identity, rather than a profession alone. It is rooted in service, competence, advocacy, and human connection. Over time, however, nurses find themselves adapting to environments that instead emphasize efficiency, compliance, and endurance.

In such environments, the very sense of purpose that many nurses start with can become a constraint on personal growth and change. Adaptation and persistence are essential in many jobs, but identity erosion can happen when they are accepted as a moral expectation rather than a professional choice. The adaptation itself is often subtle. A nurse avoids mentoring students because she no longer feels hopeful about the profession. A leader becomes emotionally detached as a way to survive impossible operational demands.

These subtle changes accumulate over time, shaping how nurses relate to themselves, their patients, and their profession. Many nurses learn to shrink themselves in order to survive. This is where coaching has changed how I think about burnout conversations.

A structured space to examine identity, values, and agency.

Coaching is not a solution because it reduces stress, but because it creates structured space for nurses to examine identity, values, and agency—something rarely supported within clinical environments. In coaching spaces, nurses often disclose feelings they have never voiced in performance evaluations, staff meetings, or workplace surveys, such as guilt for wanting boundaries, ambition they feel uncomfortable naming, emotional numbness. What often emerges are questions of identity.

In one coaching conversation, a nurse who had become increasingly disengaged from team discussions reflected, “I didn’t realize how much I had pulled back until I started talking about it.” Through coaching, she recognized a pattern of self-silencing after being repeatedly dismissed during patient rounds. Rather than remaining in a posture of withdrawal, she identified a core value of advocacy and began to reengage by speaking up in rounds, little by little. Over time, the nurse described feeling more aligned with the kind of professional she wanted to be. Her self-awareness and response came from her own efforts to keep showing up in a system that wasn’t changing.

Naming moral distress and systemic dysfunction are essential steps. But nurses also need intentional space to think critically about who they are becoming in the midst of these pressures. Many need permission to reflect honestly on how their work is shaping them and whether the version of professionalism they have adopted is sustainable.

The work to fix broken systems must continue. But we also need to help nurses determine ways to preserve meaning, identity, and intentionality while practicing within imperfect systems. That work cannot be accomplished through wellness campaigns alone. Health care organizations must invest in structures that support reflection and professional identity development, including coaching and other facilitated spaces. At the same time, nurses may need to actively seek out their own opportunities to engage in intentional reflection, asking themselves how they want to show up within their environments and what that requires of them. Reclaiming agency begins with this question.

Staci A. Simmons, DNP, APRN, CPNP-AC, CNE, is an associate professor and DNP Program coordinator at the University of Alabama. She is a board-certified acute care pediatric nurse practitioner with clinical expertise in pediatric critical care. She has completed an International Coaching Federation (ICF)–accredited coach training program and is currently pursuing certification as an associate certified coach (ACC). Her scholarship explores professional identity formation, leadership development, and the use of coaching to advance and support nurses.