By Lauren Powers, RN, CCRN

I write this letter with a heavy heart. Our story began during my sophomore year in college, but after a decade with you, I can’t help but feel our dynamic has changed. Intrusive thoughts of leaving you have etched their way to the forefront of my mind. The harder I try to quiet them, the louder they declare themselves. They’ve grown from whispers to screams, and I can’t ignore them anymore. It’s time for me to put myself first. This is the hardest letter I’ve ever had to write.

Our honeymoon phase was beautiful. My love for you poured over. You pushed me to work hard, spending sleepless nights submerged in pathophysiology and nursing theory. You nurtured me, holding my hand as we endured new experiences and navigated a world that felt so foreign. As I stood in white with a candle in hand reciting the Nightingale pledge, you were the crowd that cheered as I was pinned. You watched me grow from being unsure of myself to a confident nurse, and I am forever grateful for that.

Our reciprocal relationship kept me coming back even after the most impossible days. You comforted me after my first patient passed away as I attempted to keep my composure futilely. You taught me to heal through the heavy stuff—the messy, unfair aspects of life that few can grasp. You were there when I made my first mistake, reminding me that our humanity is a gift and a curse; that by being human, I would make mistakes, but that same humanity allowed me to touch others in a profound way. Our relationship taught me how to be a team player, a coworker, and a friend—How to uplift those around me the way you supported me. You bore witness as I became a part of something so much bigger than myself. That camaraderie is irreplaceable and something I will always cherish.

You’ve brought out the best in me and at times the worst. You facilitated my journey through self-discovery, leaving your mark subtly yet intimately on my identity.

Then “unprecedented” times struck, showcasing your faults and cryptic nature. I became wary of your character as you watched us scramble to care for innumerable patients with a pandemic running ramped. I felt like the foundation that raised us crumbled at our feet with the highest stakes at hand. You watched me give endlessly, only to be met with death, defeat, dwindling supplies, and patients lying alienated as they take their last breath. You sat silently as I pondered the last words exchanged between my patient and their loved one. You let me harden myself, refusing to interject as I felt who I was as a nurse slip away.

As months became years, my reflection didn’t look the same. Deep wrinkles traced my forehead from unanswered questions. My expressions are no longer eager and youthful but worn and deflated. The pep in my step became dragging my feet as I walked through the hospital entrance, wondering, “Will I have the resources necessary to care for my patients?”

Will I be the nurse my patients deserve today or just a shell of the one I was before?

I can’t place all the blame on you—After all, it takes two to tango. Maybe I saw a bit of honor in playing the martyr, speaking more to my ego than my soul. Perhaps if I advocated for myself with the same determination that I’ve given my patients or if I gave myself the same grace that I’ve poured out for others, there would be a different narrative. Maybe I should’ve invested in “mindfulness” or practiced more yoga. I am not too naive or vain to acknowledge my fault in this mess; truthfully, that hurts the deepest. The moral injury of facing lives lost, mistakes made, and patients uncared for while trying to function in an incredibly fractured system inevitably takes its toll.

I refused to look my patient’s new widow in the eye and explained that he was collateral damage from a broken system. Instead, I wept with her, as I did with so many others just like her, apologetic and remorseful. Perhaps this is the aftermath, and I am collateral damage too. Regardless of the perspective, the loss follows us home, and we internalize it as we’re told, “just do your best,” as if that would ever be enough to console us.

If my humanity is the catalyst of my demise in this profession, then so be it.

So here I stand with a bitter taste in my mouth and the paradoxical feeling of resentment and gratitude. The question then becomes: What do you do when your passion and morality no longer align? You are hailed as the most trusted profession, so why have I lost so much trust in you?

If you love something, set it free—I love you bedside nursing, so I must set you free with an aching heart and a heavy chest.

Lauren Powers is a critical care nurse.