It is hard to explain what it is really like to work as a nurse inside a hospital. The experience is almost impossible to understand unless you have lived it. There is no real-world equivalent to a bad shift in nursing.

Most people do not understand how working three days a week can drain a person so deeply that they spend their days off unable to function. Or why night shift nurses sleep through almost their entire stretch of days off. Or why we cannot always be fully present for our families. 

The answer is exhaustion — physical, mental and moral.

When I graduated, I knew nursing would be difficult, but I did not understand what difficult truly meant. My first medical-surgical job showed me immediately. Our ratio was eight patients to one nurse. The charge nurse, the person meant to be the extra support, also carried a full patient load.

Normal was med passes that took hours, often starting one round of medications before finishing the last. Normal meant having to push charting to the end of the shift, and hoping your documentation made sense when you were already 15 hours into a 12-hour shift. Breaks were rare. Getting to go to the bathroom was luck. There was no time to think, much less feel.

Early in my career, one of the most capable nurses I knew accidentally gave the wrong medication to a patient because she was drowning in the workload. Instead of asking what changes could prevent something like that from happening again, our manager asked me what I thought. I was a brand new nurse. I told the truth: The system set her up to fail. She has eight patients. No one can do this safely.

He looked at me and said, “If that is your opinion, you are never going to make it in nursing.”

I carried that moment with me for years. It was the first time I understood that in hospital culture, leadership said the right things about honesty and safety, but the reality did not match the words. Speaking up about real problems was treated as an inconvenience. Vulnerability was something you were expected to swallow. What mattered was endurance.

Eventually, I moved into paediatrics. The ratio was better, but it wasn’t any less intense. Children can look fine one moment and be critically unstable the next. Parents needed reassurance, explanations and someone to translate what was happening. It was a different kind of emotional work.

When the pressure mounted, communication was........

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