Dear Nursing Administration

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(Disclaimer:  the post “Dear Nursing Administration” does not represent my views about my current administration, nor does it pertain to any independent person that has acted in any administrative role in any of my past nursing endeavors. This is a broad synopsis of opinions held and voiced by many floor nurses I have worked with.  It is written in the hopes of shining a light on an “elephant in the room”; namely, the way the peons feel they are being treated by those in “power”.)

Dear nursing administration

Dear Nursing Administration,

I feel like most of the nursing profession has felt or currently feels a certain way about the state of healthcare these days.  There are many (more than I believe you realize) that are looking for avenues out of medicine all together.

I feel like something needs to be said about it, because I feel nursing administration has NO IDEA this is happening.  Being the vocal entity that I am, I feel like I should enlighten you to the thoughts of the people that you so frequently abuse, either intentionally or unintentionally. 

So, I have written down some highlights that I hope make you aware of what you are doing to bring about the destruction of healthcare as we know it.  Because regardless of your realization, YOU are a large part of why seasoned professionals are leaving healthcare.


You are abusive to some of your most important employees.  For whatever reason, you add more and more patients to our load.  You give more and more reasons why things need to be done RIGHT NOW.  You add more and more onto the pile of those in the trenches. Nevermind the fact that it’s rarely ever an emergency. We have a license which you threaten every time you do these things.

You up our nursing;patient ratios to UNSAFE numbers.  You work us SHORTSTAFFED. You ask (or worse yet, mandate) us to come in on our days off or to stay late.  Let’s also not forget the fact that you DON’T work the floor with us. You HAVE NO IDEA what our day is like or any clue just how dangerous you make it.  

You may care, you may not.  When you add patients without an ear for your staff, you don’t care about us.  You care about money.


When you come at an already overworked nurse and add more to their plate, you are doing several things.

First off, you are stressing us out and making us unable to do the job you hired us to do in the first place.  If we was hired to be nurses, LET US BE NURSES. Most of us don’t care to lend the occasional hand with whatever is asked of us. It is a completely different arena when you ask us to do someone else’s ENTIRE JOB.  

We cannot adequately do our job when we have to do someone else’s job.  This is ESPECIALLY TRUE when we know nothing about the job and get thrown into it at the last minute and are expected to do it perfectly from the get go.

What happens when we make a mistake?  You come at us with write ups, incident reports to fill out. You ask “how could you” and “what did you do” instead of “how did this happen” and “how can we make it right”?

Secondly, You make us resentful.  You make us not want to be a part of the organization or  healthcare in general because you work us to death without regard for our physical and emotional wellbeing.

You have no regard for us in any sense, other than the fact that we are bodies to do a job.  A HUGE job. A job that gets bigger every day because of your ineptitude or indifference.

Thirdly, you make us unmotivated underachievers. 

You give us no motivation to go above and beyond, because you’ve proven to us that all you’ll do is work us harder.  If we volunteer to stay late, you’ll then expect it. We never call in sick or take a personal day, so you’re offended when we ask for one.  If we empty a trash can, you’ll fire housekeeping and ask us to clean rooms when we get done doing compressions.

Lastly, you make us unwilling to help.  If you work us to death during our regularly scheduled hours, why would we sign up to work extra?  There is nothing in it for us to kill ourselves harder than you already make us.

If we sign up for overtime, it’s NOT you that we are doing it for. It’s for our coworkers, who would be even more overworked and understaffed if we didn’t.  It’s for the patients, who deserve nurses that has the time to devote it to them and only them instead of having to worry about losing their job because of unsafe conditions.  


When you overload us with patients, we work ourselves to death trying to do the job you have hired us to do plus the orders you give and mandate us to do outside of that job.  

Do you know what happens when we are thrown into a brand new job, a job that isn’t the one we were hired for nor is it one we are prepared for, and we make a mistake?  Who’s going to have our back?

Not you. Not nursing administration.

You’re going to sit in your office and say ,”he/she did it wrong.”

For as long as nurses have been nursing, this has been the case.  Ask any nurse currently working in their field if they feel administration has their back.  Can you guess the answer?

I have worked in healthcare for 15 years. I am genuinely curious if some of my previous administrators would have had my back if the need had arisen. Worse yet, I have seen administration actively punish someone for things that only happened because of the circumstances they were in. Unsafe nursing conditions have ruined so many nursing careers.

The future of healthcare is forever changing.  There are more patients. The patients have more acute and chronic illness. There is more patient non compliance resulting in increased appointments with providers and increased ER and hospital visits.  All the while we are dealing with less and less nurses. So what does healthcare administration do? 

They give more patients to understaffed departments, increasing the patient:staff to far beyond dangerous numbers.  

There are more expectations of those fewer nurses and more jobs to place on those nurses to make up for the shortage.

Everyday they show that they either do not care or do not hear our complaints about the dangers and suggestions for how to make it better, easier.

We as nurses cannot keep up with the demand, yet you expect us to without help and with no explanation as to why there is no help or why you allow this to continue happening. 


There are countless articles floating around about the differences between bosses and leaders.  Members of healthcare administrations are bosses.

If you think about it, even the terms boss and leader inflict certain internal responses.  When you hear the word boss, it automatically has a negative connotation to it. It makes you think about someone who gives demands while not participating, someone who sits in an office and barks orders while having no idea what is going in.

When you hear the work leader, you think of someone on the front lines, doing the work side by side with others, encouraging them to be better and do better.

Bosses give orders and seek control.  Leaders inspire and support individuals and work continuously on the achievement of goals. You don’t inspire or support me.  You tell me what to do and how to do it.

Bosses are profit oriented, but leaders are people oriented. You only care about how many patients we can squeeze in to make money and not about how the people (your staff) can adequately care for patients.

A boss knows how work is done but a leader shows how work is done.  When’s the last time you were on the frontlines, seeing how your staff works and in what conditions?

Bosses place blame and show who is wrong.  Leaders show what is wrong. When something goes wrong, you are quick to say, “What did you do wrong?’ and not ,”How did this happen and how can we avoid it?”  

Be leaders.

It’s time for a leadership overhaul in healthcare.  Members of administration need to realize that THEY are a part of the nursing shortage. 

It’s time for them to realize that THEY need to have the backs of the people that work their asses off for the organizations.

The time has come for them to get THEIR hands dirty, to get down in the trenches with those of us fighting the healthcare war.

Because it is war.  It’s an open and declared conflict.  It is brutal and ugly and thankless. It is the worst day of our life sometimes.  There are days when we as healthcare employees wonder if we are doing the right thing, if this is the path we want to continue down.

It is YOUR job as nursing administration to lift us up, show us that we are needed and wanted and protected.  It is YOUR job to be a voice for us. It’s time for you to LEAD us. 

So LEAD, damn it.

If you’d like to read about the day I no longer had the passion for nursing that I once did, click here.

Nursing tools I use every day

Dear administration (one nurse puts a voice to the complaints of many in the healthcare war.

8 thoughts on “Dear Nursing Administration”

  1. This totally sums up everything I feel about the system being broken and how it affects us as nurses. We sacrificed too much and work too hard to get too little back from the broken system. I feel Liberated to say I look forward to retiring next year from the toxic environment I work in and how that environment has created toxicity within the nursing personnel. I still love the concept of nursing as an art and profession taking care of those who need care. But I will be doing it in a different venue. One where I am receiving as well as giving. I say a prayer nightly for all my sister nurses that are enduring. May God give you strength to do what is best for you and not feel guilty.

  2. You, my fellow nurse, have hit the nail so hard and so accurately on the head. I’ve been with my organization, no…business, for 7 years now and though there was once a time where I truly believed I was making an intentional and positive difference in the lives of my patients, I no longer feel my work or my passion matters. I’ve lost the spark I once had to stay at the bedside, even with my MSN degree under my belt. I dreamed of going on and educating future nurses how to grasp and perfect their critical thinking and personal compassion towards OTHERS, but I no longer crave the dream. It’s just so damn easy for these administrative pencil pushers to look at a situation, but never actually see it. Their decisions and POLICY/process changes carry no merit or understanding of what those actually in the trenches are experiencing, FEELING, seeing, and doing. Things that keep us up all night, or all day, WORRYING or stressing about and it not only affects us as caregivers, it eventually affects us as mother’s, fathers, husband’s, and wives. We become cynical and unimpressed with things that once brought us joy and it’s a disgrace. Our facility on average is 6 dollars per hour behind the market for non exempt nursing staff and our own cno is hardly bothered by this when it’s brought up to her during weekly phone conferences with other mid-level and bedside staff. To be HONEST, she sounded bored as if we were keeping her from some lavish luncheon with the other executive team. It’s this mindset that is killing our once loved and praised position of holistic healing towards others and ourselves. this selfish and uncaring atmosphere is then only trickled down the ladder until we, the actual difference between life and death at the bedside, also start to not care about the patient and only focus on compliance in order to keep our jobs. We could leave, of course, BUT those like me continue to stay because we still hold true to our convictions no matter how much we suffocate through them. Those of us that have put in the years, 15 for me so far and many more for many others, and love the specific population we work with, pediatrics. This relationship with our jobs is as unhealthy as an abusive married couple where one wants out but knows they will hit rock bottom without the life they have grown so accustomed to, they just don’t know how to live any other way. If only florence could be here now and see what had become of the movement she started all those years AGO; I would suspect she would be utterly ashamed.
    Thank you for a very honest and brave post. I pray all nurses in the world who have just about had enough have a chance to read it.

    • Q for your kind words. I too am ashamed at how far down nursing has fallen. You are correct, Florence Nightingale would be devastated by the current state of nursing. I don’t feel like it will ever get better, and like you, I feel like the pencil pushers that make all of the rules will never understand it because they are no longer on the floor.

  3. Reading this forum and the before Really made me realize that i Am feeling the same way. Ive given so much to nursing and no longer can give anym of myself

    • It’s a shame that so many nurses feel this way.

  4. Ditto. 44 years as an ED nurse. I did not quit the job. I quit the NUrse manager !

    • Yup!!! It’s sad how quickly a bad manager can bring the entire department down.


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