Nurses’ mental health

Nurses often hold their own feelings back to comfort others. You might smile for a frightened child minutes after a patient died in the next room. Over time, that constant switching can leave you drained or numb.

Small ways to let it out

• A few slow breaths in the supply room or stairwell
• A short debrief with a coworker at the end of the shift
• Naming the feeling to yourself: “That was sad.”
• Writing it down after work, then closing the notebook

In one hour a nurse may assess a patient, teach a family, chase a missing result, calm an angry visitor and train a new grad. Each task makes sense on its own. Together, with no pause between them, they add up to a heavy mental load.

Worldwide, 85% of nurses are women, according to the World Health Organization. Many nurses go from a full shift to caring for children or aging parents, with little time to recover in between.

On short-staffed shifts, nurses have to choose what gets done and what waits. Going home with tasks undone can bring guilt, worry and replaying the shift at night.

Try this

• Hand off clearly what is still pending, so it is not only in your head
• Remind yourself: “I prioritized safety with what I had.”
• Separate what was in your control from what the staffing allowed
• Use the “After a short-staffed shift” worksheet to put it down on paper

Raising a concern about an unsafe assignment is part of protecting patients and yourself. Learn your workplace’s process for raising staffing concerns before you need it.

Ways to make your voice count

• Bring facts: patient numbers, acuity and what could not be done
• Join a staffing or shared-governance committee if your workplace has one
• Raise concerns in writing through the proper channel, and keep your own notes
• Speak up together with coworkers, not alone

When the unit is busy, breaks are the first thing to go. But a few minutes to eat, drink water and sit down helps your focus and mood for the rest of the shift.

Ideas that help

• Ask the charge nurse to plan break coverage at the start of the shift
• Keep water and a snack where you can reach them
• Offer to cover a coworker’s break, and ask them to cover yours
• Take even five minutes away from the unit if a full break is impossible

When you are short on sleep, patience runs thin, worries feel bigger and hard moments stick. Many nurses notice they cry more easily, snap more quickly or feel flat after a run of nights.

When the unit is short, there is pressure to pick up “just one more.” Some extra shifts may be fine for you. A steady pattern of them, with no time to recover, wears you down.

Before you say yes

• Ask: “When will I next have a full day off?”
• Check how you slept this week
• Decide your limit ahead of time, so you are not deciding while tired
• Practice a kind no: “I can’t this time. I need the rest.”

Ideas that help

• Carpool or use transit after a run of nights if you can
• Pull over somewhere safe if you are nodding off
• Take a short rest before driving if you feel very sleepy
• Tell someone when you are heading home

Many nurses brush off verbal abuse because “no one was hurt.” But being sworn at, threatened or insulted shift after shift can leave you on edge, dreading work or feeling less safe with patients.

Try this

• Get checked for injuries, even small ones
• Notice if you feel jumpy, shaky or numb, which are common reactions
• Report it, and write down what happened while it is fresh
• Take a short break off the unit if you can
• Talk it through with a coworker, peer supporter or counselor

OSHA notes that violence in healthcare is likely underreported. Reports, even of “small” incidents, show leaders where safety changes are needed.

Things to ask your workplace for

• A clear, simple way to report
• Follow-up support and time to recover after an incident
• Not working alone with a patient known to be high-risk
• Training on calming tense situations

Examples

• Being given unfair assignments again and again
• Criticism in front of patients or coworkers
• Gossip, eye-rolling or the silent treatment
• Not being helped when you ask
• Questions met with sighs or put-downs

The ANA statement also counts failing to act, like standing by while someone is mistreated, as part of the problem.

Steps that can help

• Find one ally on the unit you can trust
• Keep notes: dates, what was said, who saw it
• Name the behavior calmly if you feel safe: “Please don’t speak to me that way in front of the patient.”
• Raise it with your manager, HR or employee assistance program

New nurses are still learning, and a harsh welcome can push people out of the profession. Experienced nurses have real power to change the culture.

Ideas for experienced nurses

• Ask new nurses how they are doing, not just what they have done
• Correct in private and praise in public
• Say “good question” and mean it
• Step in when you see someone being put down

Examples

• Caring for a patient whose treatment seems to be causing more suffering than good
• Not having time to comfort a dying patient or their family
• Seeing a concern dismissed by someone with more power
• Too few staff to give the care you were trained to give

• Lean on coworkers, friends and family, and tell them when you are struggling
• Learn the signs of moral distress in yourself
• Listen to your inner voice when something feels wrong
• Seek a trusted mentor, your employee assistance program or a counselor
• Use the codes of ethics, your ethics committee or a moral distress consult

Your first year can bring fear of making mistakes, feeling slow, and wondering whether you chose the right path. Those feelings are common, and they usually ease with time and good support.

What can help

• Ask questions early, even “small” ones
• Find a mentor outside your direct chain of command
• Join a new-grad or residency group if your workplace has one
• Track what you have learned each month, not just what went wrong

ICU and emergency nurses see sudden deaths, traumatic injuries and hard end-of-life choices more often than most. Critical care nurses have been a focus of moral distress research for this reason.

What can help

• A pause or moment of silence after a death
• Debriefs after hard cases, led by someone trained
• Mixing in time away from the highest-intensity work when possible
• Time with people outside healthcare who help you feel normal

Nurses in homes, schools and clinics often make decisions without a team nearby. That independence can be rewarding, and also isolating.

What can help

• A buddy you text before and after higher-risk home visits
• A clear plan for what to do if a visit feels unsafe
• A regular call or meeting with other nurses in similar roles
• Your own wind-down routine at the end of the day

In the 2024 national workforce study, 41.3% of LPN/LVNs said they intended to leave or retire within five years, a little higher than RNs.

Many LPNs in long-term care get to know residents for months or years. Losing them is real grief.

Travel nursing can mean good pay and adventure. It can also mean starting over every few months, missing family and sometimes feeling like an outsider on the unit.

What can help

• A regular video call with people back home
• A small routine you bring to every assignment
• Finding one friendly face on each new unit
• Online or local groups for travel nurses

Nurse leaders often carry the stress of their team and the demands of the organization at the same time. They may feel they cannot show strain because others are counting on them.

What can help

• A peer group of other nurse leaders
• Being honest with your team about what you can and cannot change
• Protecting your own days off, so your team sees it is OK
• Using the same support you would recommend to your staff

The American Nurses Foundation’s free Nurse Well-Being program is built on the Stress First Aid model. It gives nurses a shared, color-coded way to talk about stress levels. In its pilot, nurses who took part for six months reported 28% less burnout.

A simple version to try

• Green: coping well, sleeping OK, enjoying some things
• Yellow: more tired, irritable or worried than usual
• Orange: struggling to cope, sleep or switch off
• Red: feeling hopeless, numb or unsafe: reach out today

Ideas to try

• Change out of your scrubs as soon as you can
• Name one thing that went well today
• Play music or a podcast on the way home
• Wash your hands slowly and take three deep breaths before leaving

Ideas that help

• Movement you enjoy, like a walk, dance class or swim
• One plan each week that has nothing to do with healthcare
• Time outdoors, even briefly
• Time with people who make you laugh

Nurses are often the last to admit they are struggling. Treat your own stress the way you would treat a patient’s: notice it, take it seriously and get support early.

Ways to look out for each other

1. Check in after a hard patient or a death: “That was a lot. How are you doing?”
2. Offer practical help, like covering a call light or grabbing water.
3. Notice changes, like someone going quiet or snapping more.
4. Point gently to support, like a peer program or employee assistance.
5. Check in again a few days later.

What helps nurses most

• Act on reports of violence and bullying, and say what changed
• Make it safe to raise staffing concerns
• Plan break coverage and protect days off
• Share your own experience of getting support

The American Nurses Foundation’s Nurse Well-Being program includes a training guide to help nurse leaders start conversations about mental health and build healthier teams. It is free.

Ideas that help

• Ask “Do you want to talk, or do you want quiet?”
• Help guard their sleep after nights
• Plan time together that work cannot take
• Skip “I could never do your job,” which can make them feel alone

Ideas

• Being patient and kind with nurses when you or a loved one is in care
• Local events that honor nurses during Nurses Week
• Meals or thank-you notes for a local unit
• Supporting nursing students in your community

Broad questions about past mental health care on licensing and job forms can keep health workers from seeking help. The Dr. Lorna Breen Heroes’ Foundation works with boards and hospitals to remove them. As of September 2026, it had verified changes by 11 nursing boards and over a thousand hospitals.

Ask before you start

• Is this service separate from my employer?
• What, if anything, would ever be shared, and when?
• Who will see my records?

Many states have alternative-to-discipline programs for nurses with a substance use problem. According to the National Council of State Boards of Nursing, these let nurses show recovery to their board in a non-disciplinary, non-public way while keeping their license. Details vary by state.

Therapy can help with work stress, low mood, sleep, grief and memories that will not let go. You can ask a therapist, “Have you worked with nurses before?” For anything medical, consult with your clinical provider.