Reflecting on my mother’s decade-long nursing career, I often wonder why so many nurses leave the profession after just a few years.
In the UK, the shortage of nurses has reached alarming levels. Fewer students are enrolling in nursing programmes, and nearly half of newly registered nurses leave within five to ten years.
Meanwhile, the demand for healthcare continues to grow, as outlined in England’s NHS Long-Term Workforce Plan, which sets out how the NHS will ensure there are enough nurses and doctors to support patients.
The problem is not confined to the UK: nursing faces a global crisis. The high turnover of skilled professionals has serious implications for healthcare systems worldwide.
The Netherlands is also experiencing troubling trends, with predictions of a significant healthcare staffing shortfall in the coming decades.
Burnout is one of the most pressing reasons behind this exodus of nurses from the profession.
I interviewed nurses in the Netherlands about their workplace experiences including burnout for my research.
And I found that one of the main reasons nurses leave is because of the profession’s culture of self-sacrifice. While empathy, compassion, and dedication are hallmarks of nursing, these qualities can lead to them working too hard. Nurses often push themselves so hard to meet their patients’ needs that they neglect their own health. Nursing often reinforces the culture of self-sacrifice, with an unspoken expectation that nurses should prioritise patients’ needs.
My research shows that nurses are actively seeking employment to avoid burnout, but this often involves changing employers – a decision that is personally and organisationally intense and costly. I argue that, to ensure they remain in the workforce long term, nurses should be trained in setting boundaries and prioritising self-care.
Nurses, particularly in long-term care, frequently form strong emotional bonds with their patients, which makes it challenging to draw boundaries between professional responsibilities and personal attachment. Interviews with nurses highlight the emotional toll of this. Several nurses mentioned feeling guilt when calling in sick, knowing their patients and colleagues depend on them. Some described how increased workloads, due to colleagues’ absences, eventually left them too overworked to continue. Others reported being constantly contacted to work extra shifts, even on their days off, due to staffing shortages caused by absenteeism and turnover.
These stories reflect the relentless pressure nurses face. For many, the instinct to help others is both a source of pride and a path to burnout. When nurses don’t to set boundaries, their bodies often force them to stop – through illness and exhaustion.
Although nurses are the backbone of healthcare systems, the profession is undervalued and often viewed as less professional compared to other medical roles. This perception disrespects the complexity of nursing and discourages young people from entering the field.
To address these issues, nurses need more support from employers and colleagues, including doctors and HR teams. Public campaigns must celebrate nursing as a highly skilled and indispensable profession, challenging outdated stereotypes.
Burnout prevention also requires systemic changes. Nursing education must teach self-care and boundary setting as essential skills. Research indicates that nurses often report improved mental health and job satisfaction after switching employers, suggesting that organisational culture is pivotal in retaining staff – and that some workplaces are already leading the way.
Self-sacrifice culture is a double-edged sword. While it reflects the compassion and dedication that define nursing, it poses a serious threat to the sustainability of the profession. To retain nurses, they need to be viewed as true professionals and be acknowledged for the value they deliver to the overall care processes. By fostering a culture that values personal boundaries, supports wellbeing, and elevates the professional identity of nursing, we can ensure that nurses are cared for just as much as they care for others.
Failure to act will have far reaching consequences not just for nurses but for patients and healthcare systems around the world.
Ester Ellen Trees Bolt does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
