Stop Waiting to Be Understood: The Lie Nurses Are Taught About Self-Sacrifice

Nurses are taught—directly and indirectly—that self-sacrifice is part of being “good” at this work.

Work through breaks.
 Stay late.
 Carry the emotional weight.
 Don’t complain.
 Don’t ask for too much.
 Don’t be “difficult.”

But what if that story isn’t noble…
 What if it’s dangerous?

In this episode, we unpack the quiet lie many nurses have internalized — that self-sacrifice equals compassion, loyalty, or strength. We talk about how this belief shows up in burnout, moral distress, people-pleasing, and the fear of setting boundaries.

You’ll hear:
 • Why waiting to be understood keeps nurses stuck and depleted
 • The neuroscience of regulation, co-regulation, and why your presence is clinical power
 • Why boundaries are ethical — not selfish
 • How confident, clear advocacy protects patients and nurses
• How to get clear on what you want and need — and say it without apology

If you’ve ever thought:
 “Why do I have to keep proving I care by how much I can carry?”
 This episode is for you.

You are not “just a nurse.”
 You are influence, safety, wisdom, and system-level change — whether anyone names it or not.

Transcript

0:00

What? Do you need? What do you need on the surface? It's a good question. It's well intentioned, polite and even caring. But if you're a nurse, you know that feeling I'm talking about. Honestly, if you're a woman, you probably know the feeling I'm talking about. we're gonna talk about how it lands and how it feels. It's that same feeling that I get when my husband says, is there anything I can do to help? I don't want to explain it. I. Don't want to manage you, and I don't want to educate you on the obvious. I want you to know me well enough to already understand what would help, and I want you to see the load that I'm carrying. I want you to anticipate the need before I have come to name it, and I think that's what all nurses are often feeling when leadership asks, what do you need? nurses have been saying it. and that's the key here, is that if you've been saying it, then. You expect it to be known. nurses have been asking for adequate staffing, reasonable ratios, time to think resources that match acuity, fairness, clarity, respect, safety, both psychological and physical. we may not always say it in corporate language, But the message is consistent and there are strikes around the country for this very message and this very purpose. And sometimes at least show up with bagels. we had a rep not too long ago come and do an in-service and they brought bagels a couple different kinds of cream cheese and really good coffee. honestly, the break room got swarmed and I heard so much appreciation that he would think to bring something that was outta the ordinary. And what was interesting about him bringing those and his response to our gratitude was that he said, I know I was asking you to put one more thing on your plate, and so it may just be a token of appreciation and just acknowledging, I know I'm asking you to do one more thing. That was what he said to us and, um, that was very thoughtful and appreciated. and honestly. It's not a fix, but it's a signal. I see you and I know what it costs you to be here. let's just talk about pizza and all of the other little silly things that are given to nurses as if they're kindergartners. You have to be careful because so much of that has been used as a fix. instead of a fix. We'll give you pizza instead of a fix. we'll bring around candy to bribe you to do, to do some this whatever safety thing. Take us some silly safety quiz, we'll give you some candy. That's not really what I'm talking about. I don't think I need to overexplain this. You know that pizza should not be a fix. It should be a gesture. Right. So I think that's kind of the problem. really what I want to talk about is What do you do with that question? if nurses truly understood how powerful they are, healthcare would feel very different. Let's talk about how different it would feel if nurses truly understood how powerful they are. If we understood our voice. That doesn't mean louder, not more aggressive, not more combative, but more grounded, more wise. More steady nurses are already shaping outcomes every single day through assessment, advocacy, pattern recognition, presence, the thousand micro decisions that are made in one shift. This is system level influence but a lot of nurses underestimate their power because it doesn't look like authority. I would say this might be a woman problem as well. sometimes even in the community, this isn't, exclusive to nurses. if you know a nurse or you're not a nurse, you can figure out how to apply this in your situation. Because I'm pretty sure this is an exclusive to nurses, but right now I'm talking to nurses, so it looks like. Service. It looks quiet, it looks relational, and because of that, nurses are often taught implicitly or explicitly, to doubt their power. But power doesn't always announce itself. Sometimes it stabilizes a room and sometimes it slows a spiral. Sometimes it prevents harm before anyone knows it was coming. I think this comes up in some of our meetings. Sometimes a nurse will say, you have no idea how many things we prevent when we're advocating for more resources. When you're told, but it seems to work out. I think you're making this a bigger deal than it really is. We don't really have these things because we prevent them, before anyone knows it's coming, you should treasure that. That's the kind of power that nurses have. That kind of power doesn't show up on dashboards, but it absolutely changes outcomes. Now let's talk about the science for a moment, because it isn't just philosophy, and this isn't just my opinion. Nurses regulate nervous systems. They do this for their patients, for families, for entire units, through the tone of voice, through pacing. Touch clinical judgment through presence. this is called co-regulation and it's not a soft skill. It's a neurobiological intervention, and nurses do this. Almost automatically without even thinking about it. When a nurse is regulated safety signals increase cognitive flexibility improves decision making gets better. Errors decrease, and outcomes improve. We don't have nurses that don't wanna learn anything anymore. We have nurses that are engaged. And invested in evidence-based practice and improving outcomes Even if they're just in it for the paycheck, they still wanna do a good job. But when nurses are rushed dismissed, morally distressed or chronically overloaded, the system isn't just strained, it's neurologically compromised, and I think this is what gets underestimated time and time again. here's where boundaries come in, because boundaries are not defiance. They're ethical signals, and this is for every human. We need to honor this. We need to be better at this. A nurse is saying, this is unsafe, or This exceeds my scope, or I need support, or I cannot carry. This alone is not being difficult. They are protecting. Their patient, their license, their nervous system, and the integrity of care. And if nurses truly trusted their power these boundaries would feel less like rebellion and more like responsibility. I feel like a rebel when I express that I'm experiencing some issues In my situation, I'm sometimes asked to take care of a patient that I don't know anything about. I don't know about their condition, I don't know about their surgery. I don't know what to look for, and when I ask questions, I feel like I'm being difficult and that needs to go away, I need to trust my own power because then those boundaries and asking those questions would feel a lot less. Like I'm a troublemaker and I walk away a lot of times from my nonstop questions feeling like I'm the difficult one. Like I'm the problem, like I am alone in this, but I know I'm not, I just want it to feel a little less like rebellion and more like responsibility and that's the way it should be. Now let's talk about leadership. Those of you who are nurse leaders or have been, let's talk about it with empathy. All right, so this might be a stretch because a lot of times nurse leaders get blamed or they are to blame for all of this. But most of our leaders did not forget the bedside. They were pulled away from it. I've asked the question before, how long does it take for a leader to forget what it's like to be at the bedside? to be on that front line? And remembering that they are pulled away from it, gradually. perspectives change. if you haven't been in leadership, you don't have the perspective that the leaders, the administrators, actually have. It would be hard to have if you've not experienced that before. So we have to acknowledge that if they were at the bedside before and some of them were not, they don't. know at all what you're going through, some of them were pulled away from that. And They have different metrics mandates, they answer to different authorities. while we use the same words patient safety staff safety staff satisfaction, we don't mean the same thing when we are, don't have a whole nother layer of metrics and mandates and pressures from every direction. many of the leaders. You have in your head right now are doing the very best they can within the systems that don't make that easy, and that's at all levels. So if you've been there, you understand that and how complicated that gets and how you can be pulled in a lot of different directions. But. In the end, you answer to your boss, you answer to the person that is above you, and you answer to your job requirements, not those that, serve underneath you. That's a problem. It creates that gap, and it's not because leaders don't care. Not all of them. let's assume, Your leaders do care but that distance has changed the perspective. here's something we know from leadership science and trauma informed systems, people don't trust leaders who always have the answer. the Gallup organization in their global leadership's report identified four primary needs that followers seek from their leaders, and that's hope, trust, compassion, and stability. That's all the people that you lead want, and that's what we want as we follow, right? So maybe we can learn to communicate those things that we are feeling. If we're feeling a little uncertain, we're feeling like. Our trust is waning. we're feeling a lack of compassion or stability to acknowledge that for ourselves is gonna be a very healthy place to be. And maybe we don't get to communicate that, with our leaders, but to know it for ourselves is gonna be really good for our overall wellbeing. that's what we want in a leader, and we trust leaders who will tolerate uncertainty, who stay regulated under pressure. Ask good questions and listen without immediately correcting or defending. Being right is not what makes a good leader. Being relationally attuned does, So good leaders don't just ask, what do you need? They understand the work well enough to know what makes the burden heavier, what would make it lighter, where nurses are compensating for broken systems and what resources actually mean on that level. Because if we are having to answer the question, what do you need? And having to defend that as being A worthy goal, then it's not really about the resources anymore. it's not about our competency and It's not about a lack of, being able to figure it out. nurses can figure things out and everything is figureoutable, but where our nervous systems get all jacked up Is when we don't acknowledge that this is the problem. Is that what we want? Our leaders that understand the work well enough to know these things good leadership sounds like, tell me where this is breaking down, or what are you holding that you shouldn't have to. I shouldn't have to hold Press Ganey scores OR administration's reactions to those scores. Now, what's costing you the most energy right now? All of this is where our nervous systems get a little jacked up and where we can set ourselves straight to coming back to that circle of influence, the circle of control, the circle of concern, and start to respond appropriately so that we don't. End up in burnout and we don't end up carrying things that aren't ours to carry. Blaming people who really aren't responsible and maybe are never going to change. So systems, we blame systems that are never going to change and then we pay the price. So that's where I wanna go with this, is that acknowledging these things so that, we can validate how we feel, validate some of the thought processes and some of the things that take hold and some of the things that are weighing us down. So. Here's the shift that I want to invite us into. Advocacy does not require permission. It requires clarity, and so we have to know what is it that we really want. We have to be able to answer that question at least for ourselves. I take issue with having to answer it for my leaders. I don't wanna have to answer that question when I bring a problem. I don't want them to ask me for the solution I get when you bring a problem, think of a solution, but I also know that the solution that I bring is going to not include the perspective that they have. So I like that more to be a conversation. And I think that's lacking too sometimes when we advocate. Because we're not seeing it all the way through maybe. So that's what I mean by it requires clarity. It means knowing what you need, what you will tolerate and what you, will not normalize. we typically normalize more workload, we'll normalize taking on tasks that we know are not our tasks to take on because we've been asked to, we normalize a hurry culture, productivity over people. We will put things that are important to us on the back burner to please our leadership. or Maybe just to create a path of least resistance. Shamelessly asking for what you need is not entitlement. It's ethical self-trust, this is why we have to do this work. This is not easy to come by. Self-care is not indulgence. It's clinical responsibility. It's right in the nurse code of ethics We are ethically obligated, It's a moral imperative that we take care of ourselves. So it's not just about indulgence, it's about clinical responsibility, and boundaries are not personal. They're professional. When you don't feel safe, it's okay to say it. on the occasions that I have advocated for my safety, when my leaders have not, responded or joined in the effort to come up with a solution, then I've had to do it myself. And those solutions are not perfect and they don't always feel good, but they're professional nonetheless. So when nurses advocate from this place, not reactive, not apologetic, not burnout, but grounded and clear, then advocacy becomes less risky and more inevitable. Burnout stops being normalized downstream, and starts being addressed upstream. We start to take step into our power, and I would say this, does not only apply to nurses, This is probably just human issues, right? As we relate to the world around us, as we understand the world around us, as we unpack our worldview and how we show up in the world. This is not about doing more, and it's about remembering who you are in the system. A nurse who is regulated, self trusting and ethically grounded is not powerless. That's someone who is influential, stabilizing, and just a force. So here's what I wanna leave us with today. I wanna ask, where have I minimized my impact? Because it felt too subtle to count. Maybe we thought it didn't matter, and so I'll just be quiet because I don't think what I have to say really matters. And where have I crossed my own boundaries to keep the system running? Have you taken on that extra patient load just because that's what your leaders wanted, and you knew you were crossing a boundary when you did it, but you thought, this is just the way we do it. What would change if I treated my presence as a clinical tool, not an infinite resource, because you're not just a nurse. You are a nervous system regulator, a safety signal, a catalyst for change, whether anyone names it or not. I work with a lot of nurses in helping them find their voice, helping them, show up in the world in the way they really want to. And here's the thing about being a nurse, you are already an influencer. Whether you chose it or not, people are watching. People are asking you for advice. They're looking for how you're responding. you kinda chose it when you chose to be a nurse. if leaders really listened to what nurses have been saying all along, healthcare would feel very different. And you know that to be true. It wouldn't be louder, maybe not more aggressive. It means more grounded, more wise, more human. we've all seen protests and we can see a protest that looks like this is gonna make a difference. There's a lot of people, and they're promoting, they're standing for something instead of standing against something. It's more grounded and more wise and more human. sometimes we need to be louder, but hopefully we come from that place of being grounded, wise and just being a good human when we recognize that it is time to be louder. You know, when your kid walks across the street and you see a car coming you can't just. Stay silent You have to scream, right? So there are times when we have to scream. But for the most part, if we get really good at this, we will address these things upstream so we don't have to react to them downstream. what that means is that if people are falling in the river at a certain place and you're having to pull them out downstream, maybe we need to go upstream and find out where they're falling in, and prevent that. This is a whole lesson for healthcare in general. and life in general. and yes, sometimes it really does start with bagels and good coffee. All right. Let's bring it back to that question. What do you want and what do you need? If we're honest, part of us wants the people around us, our leaders, our partners, our families to just know, right. yeah, of course. because what we want is for. For them to see us clearly enough to anticipate the need and to understand the weight without us having to translate it. And sometimes they will, but They're also carrying their own responsibilities and pressures and perspectives. So this is where our power lies. Let's get clear and let's know our own answers to those questions. What do I want? What do I need? What would make this sustainable? What would make this ethical? What would make this feel like respect? And maybe in the moment we might ask for a pause and then step into it with courage and then say it to your boss, our coworkers, our families, our spouses, clearly, directly and unapologetically. This is a muscle to build. Not from anger or shut down or, but from a place of grounded self-trust. And if we discover that we're missing perspective along the way, which is sometimes my fear is that I'm gonna say it and it's gonna be, it's just gonna fall on deaf ears because it's missing a point of missing some kind of perspective that's important. So I will stay silent or I will say, I don't know. But if we discover that we're missing a perspective along the way, we can just be open to learning that too. Power and humility can exist in that same space because imagine how that might feel to know yourself well enough to speak your needs, to trust yourself enough to say them out loud and to stay open. Enough to grow. Grow when that new. Insight shows up. That feels like regulation, that feels like steadiness, and that feels like power. That doesn't need to prove itself. And again, that's a skill that we grow in. That's a confidence that we grow in. And we only do it by stepping out there and saying the words and seeing how they land and trying it again and again to Learn to trust ourselves. with the power and the responsibility that we've been given. I think a lot of us are ready for that, Just imagine how that might feel. Now, if you need more support on this, I would be happy to connect with you. every week I try to remind you that there's a link below in the show notes a link to schedule a discovery session, and we can maybe get you pointed in the right direction. I can give you some resources. Maybe we can formulate a little bit of a, a first step because none of this happens overnight. None of this happens perfectly. Even when you're good at it, even when you're confident. It's not perfect because we're still dealing with a lot of variables, but that's okay. Again, I think a lot of us are ready for this. All right. If this episode resonated with you, if you feel seen and understood and quiet or quietly were nodding along, stay connected. You can join the Regulated Nurse Newsletter for reflections practical tools, regulation, boundaries, and honest conversations about what it really means to care and stay whole. You'll find that link below. You don't have to be a nurse to join if this is supportive, it's for anyone. Now, if you're craving community, I'd like also to welcome you to the Regulated Nurse Facebook group. This is a space for nurses who value truth, nervous system awareness, ethical boundaries, and support without fixing or minimizing, that link is below too. If this episode made you think of another nurse, someone carrying a lot, or someone who might benefit from a little understanding and support, Share this episode with them. sometimes the most powerful advocacy is simply in saying, you're not alone. There's a place for you. As you go out every day and default to yes, your extraordinary self.