It’s 3:07 AM. You’re three hours past the point of exhaustion, existing on a plane of reality fueled entirely by stale coffee and the sheer, unadulterated spite of your alarm clock.
You’re titrating a tricky pressor, charting on a COW that’s developed a personal vendetta against you, and mentally calculating if you have time to pee before your next med pass.
Suddenly, Dr. Throws-Things (you know the one) storms up to the desk, sees the lab results you paged him about at his request, and unleashes a pterodactyl screech about “incompetence” that could curdle milk in the next zip code.
You didn’t run the lab. You didn’t invent the patient’s critically high potassium. You are merely the messenger. And yet, you feel that all-too-familiar, hot-lava sensation rising in your chest.
You feel small. You feel stupid. You feel furious.
You spend the next four hours replaying the incident in your head. You draft angry, eloquent speeches you’ll never give. You mentally list the 47 other things you did perfectly that shift, all of which are now eclipsed by this one, searing moment of perceived failure.
Welcome to nursing. The only profession where you can save a life and get screamed at for the temperature of the ice water in the same 10-minute span.
If you, like me, find yourself getting frustrated, mad, and profoundly upset by the daily slings and arrows of hospital life, welcome to the club. We have jackets. (They’re made of lead, and they’re very heavy.)
But here’s the thing: We can’t carry it all. We are trained to don Personal Protective Equipment (PPE) to protect our bodies from C. diff, MRSA, and the dreaded “Code Brown” splash zone.
But nobody ever taught us how to use Emotional PPE.
This is your guide. This isn’t about growing a “thicker skin.” That’s a myth. This is about building a better system to filter the inevitable B.S. of our job so that you can protect the one thing that keeps you going: your sanity.
Part 1: Why Is My Emotional Gown Made of Tissue Paper? (Why We Take It All So Personally)
First, let’s validate your feelings. You’re not “too sensitive.” You’re not “weak.” You are a human being working in a system designed by malfunctioning robots.
We take things personally for a few very specific, nurse-centric reasons.
1. Because Nursing Isn’t a “Job,” It’s an “Identity”
For most of us, this isn’t just a 9-to-5. We didn’t just “get a job”; we “became a nurse.”
We went through a brutalizing hazing ritual called nursing school. We wear a special uniform. We have a special language (if you’ve ever said “I need to go potty” to your 40-year-old partner, you know what I mean).
Because our work is so deeply tied to our sense of self, a criticism of our work feels like a criticism of our soul. When that charge nurse sighs and says, “You missed the 08:00 dressing change,” she might as well have said, “You are a fundamental failure as a human being, and your dog doesn’t even love you.”
2. We’re Literally Trained to Be Hyper-Vigilant Paranoids
Think about your clinical training. What were you taught?
To notice the one thing that’s wrong.
You are a professional “Noticer.” You scan the room, the monitor, the chart, the patient’s skin color, their breathing pattern—all looking for the subtle deviation, the early warning sign, the impending disaster.
This makes you a fantastic nurse. It makes you a terrible houseguest.
We can’t turn this scanner off. So, when we walk into the breakroom and the conversation suddenly stops, our brain doesn’t go, “Oh, they must have been talking about something private.” Our brain goes, “THEY ARE TALKING ABOUT ME. MY BREATHING PATTERN IS WRONG. I AM THE IMPENDING DISASTER.”
3. Welcome to the “Lateral Violence” Thunderdome
Let’s just name the beast. Nursing has a well-documented, systemic problem with “lateral violence,” or “horizontal hostility.” It’s the “nurses eat their young” cliché, and it’s devastatingly true.
The American Nurses Association (ANA) has been sounding the alarm on this for years, noting that this behavior (bullying, passive-aggression, withholding information) is a massive contributor to burnout and moral distress.
We are so often disempowered from the top (by admin, by physicians, by “the system”) that we turn our frustrations on the only people left: each other.
You’re not imagining it. That passive-aggressive note left on the IV pump was passive-aggressive. The “help” that the senior nurse offered with a side of eye-roll was a power play. Taking this personally is a natural response to being in an environment that is, frankly, often hostile.
4. You’re Exhausted (No, Really)
Let’s talk biology. You’re sleep-deprived. You’re probably dehydrated. You’re running on cortisol and lukewarm caffeine.
Your amygdala—the little lizard-brain part of you that controls the “fight or flight” response—is cranked to 11 at all times. Your prefrontal cortex—the “adult supervision” part of your brain that handles emotional regulation, rational thought, and context—is asleep in the back of the car.
When you are chronically tired, you have zero emotional margin. A tiny papercut feels like a traumatic amputation. That family member’s simple question (“When is the doctor coming?”) feels like an accusation, an interrogation, and a personal attack on your time management skills.
5. The Cognitive Distortion Funhouse
In Cognitive Behavioral Therapy (CBT), there’s a concept called “cognitive distortions.” These are little lies our brain tells us. As nurses, we are masters of two specific ones:
- Personalization: The belief that everything people say or do is some kind of reaction to you. Dr. Doom didn’t say hi at the desk? He must know I contaminated that sterile field in 2018.
- Mind-Reading: Assuming you know what people are thinking, and it’s always bad. The patient’s daughter is staring at you? She thinks I’m an idiot and is composing a Yelp review of my failures in her head.
When you combine a high-stakes identity, a hyper-vigilant brain, a toxic work culture, and chronic exhaustion, you get the perfect storm. You get a raw, exposed nerve ending wearing scrubs.
So, how do we fix it? We don’s our Emotional PPE.
Part 2: Your Emotional PPE Kit (A Step-by-Step Guide for the Floor)
This isn’t about “positive vibes only.” This is about tactical, practical, battlefield-tested mental armor. We’ll build our kit in three layers.
Layer 1: The “In-the-Moment” N95 Respirator (Immediate Triage)
This is for when the emotional projectile is flying at your face, and you have 30 seconds to react.
Technique 1: The Mantra: “It’s Not About Me.”
Say it in your head. Write it on a piece of tape on your stethoscope. Tattoo it on your eyelids.
99% of the time, the negativity you receive is not about you. It is a reflection of the other person’s fear, ego, stress, pain, or terrible childhood.
- That surgeon yelling? He’s not mad at you. He’s mad that his case is going poorly, he’s behind schedule, his kid failed a test, and he’s probably hangry. You are just a convenient, non-litigious target for his emotional shrapnel.
- That patient’s family member being rude? They are not attacking you. They are terrified. They are grieving. They are helpless. And in that moment, you are the face of “The System” that is failing them.
- That charge nurse being short with you? She’s got 12 admissions in the ER, three call-outs, and her unit is on divert.
It. Is. Not. About. You. It’s just landing on you. Let it land and then let it roll off.
Technique 2: The 4-Second “Tactical” Breath
Before you snap back. Before you cry. Before you do anything… stop.
Inhale for a 4-count. Hold for a 4-count. Exhale for a 4-count. Hold for a 4-count.
This is a simplified “box breathing” used by Navy SEALs, and it is a physiological cheat code. It short-circuits the amygdala’s panic response and forces your prefrontal cortex (the adult) to get back in the driver’s seat. It gives you the one thing you need most: a pause.
In that pause, you can choose your response instead of just reacting.
Technique 3: Get Curious, Not Furious
This is a mental judo-flip. When someone is being an absolute monster, replace your internal monologue of “What a complete [expletive]!” with:
“I wonder what’s going on with them today to make them act this way?”
This one little question magically shifts you from being the victim of their attack to being a neutral observer of their behavior. It’s a “clinical assessment” of their emotional state.
- Observation: Dr. Doom is yelling, face is red, pupils dilated.
- Analysis: Possible stressors: low blood sugar, high ego, poor coping mechanisms.
- Conclusion: This is a their problem, not a me problem.
This reframing gives you all the power. You are no longer a participant in their drama; you are a scientist studying it from a safe distance.
Layer 2: The “Post-Shift” Decontamination Shower (The Debrief)
You’ve made it through the shift. You’re in your car, the “new car” smell long replaced by the faint, haunting aroma of C. diff and cafeteria tater tots. Now the real work begins: leaving the shift’s emotional gunk at the hospital.
Technique 1: The “Brain Dump” Ritual
You can’t just “not think about it.” Your brain is a dog with a bone. You have to process it.
You need a “container” for the day’s awfulness. This can be:
- A “Vent Buddy”: One trusted colleague (or partner, if they can handle it) who you can tell the story to once. You get 10 minutes. You tell the whole, ugly, angry story. Then, you must move on.
- A “Crap Journal”: A 50-cent notebook you keep in your car. Before you drive home, you write down the 3-5 worst things about the day. All the gory details. Then, you close the notebook and leave it in the car. It’s physically “contained.”
- The “Scream in Your Car” Method: Highly effective. One good, solid, primal scream (at a red light, preferably) to get the adrenaline out.
The goal is not to dwell; it’s to dump.
Technique 2: The “Evidence Review”
Your brain is telling you, “That was the worst shift ever. I’m a terrible nurse. Everyone hates me.”
Your brain is a liar. It’s a dramatic, storytelling liar.
Challenge it. As the great researcher Brené Brown says, “The story I’m telling myself is…”
- “The story I’m telling myself is that the charge nurse thinks I’m incompetent.”
- Okay, what’s the data?
- Data: “She sighed at my dressing change.”
- Counter-Data: “She also sighed at the phone, the printer, and her coffee. She then asked me to help the new grad with a difficult IV, which she wouldn’t do if she thought I was incompetent.”
- New Story: “The charge nurse was stressed, and I’m a competent nurse.”
Interrogate your own assumptions. 9 times out of 10, they fall apart under cross-examination.
Layer 3: The “At-Home” Kevlar Vest (Long-Term Resilience)
This is the stuff you do on your days off that makes you stronger for the days you’re on. This is how you build your emotional core.
Technique 1: Cultivate Your “Non-Nurse” Identity (This is CRITICAL)
I’m gonna say this loud for the people in the back: YOU ARE NOT JUST A NURSE.
If your entire sense of self-worth is tied to your job, you are building your house on an active volcano.
You must have a life outside the hospital. You must be “Daughter,” “Friend,” “Partner,” “Hiker,” “Baker,” “Parent,” “Video Gamer,” “Person Who Is Really Good at Napping.”
This “identity portfolio” is your protection. When you have a terrible day at work and feel like a “bad nurse,” you can clock out and go be a “great gardener” or a “mediocre but enthusiastic kickboxer.” Your job is what you do, it is not who you are.
Technique 2: Practice Actual Self-Compassion (Not Just “Self-Care”)
“Self-care” has become a buzzword for “buy a bath bomb.” That’s not what we’re talking about.
We need self-compassion.
Dr. Kristin Neff, a leading researcher on this, defines it with three components:
- Self-Kindness: Talking to yourself the way you would talk to a new grad you’re precepting—with patience, encouragement, and understanding. (Not, as we often do, like a drill sergeant who hates us).
- Common Humanity: Recognizing that you are not alone. Everyone struggles. Everyone makes mistakes. Everyone feels like an imposter. This isn’t a “you” problem; it’s a “human” problem.
- Mindfulness: Noticing your feelings without judging them. “I’m feeling really angry and small right now.” (Not “I’m a terrible person for being so angry”).
The next time you mess up, instead of “I’m such an idiot,” try: “Wow, that was a really tough situation, and I feel awful. It’s human to make mistakes. What can I learn from this?” It feels weird at first. Do it anyway.
Technique 3: Get a Little Stoic
The ancient Stoic philosophers were basically the original burnout-proof nurses. Their entire philosophy is the ultimate Emotional PPE.
The core idea, from the philosopher Epictetus, is this: Some things are up to us, and some things are not.
- Not up to you: The surgeon’s temper. The patient load. The family’s complaints. The hospital’s policies. The fact that the cafeteria still doesn’t have good salsa.
- Up to you: Your response. Your actions. Your integrity. Where you put your focus.
The Roman emperor Marcus Aurelius wrote in his Meditations (basically his post-shift debrief journal), “You have power over your mind – not outside events. Realize this, and you will find strength.”
When you find yourself spinning out about something you can’t control (like Dr. Doom’s personality), reel yourself back in. Focus only on what you can control.
- Can’t control: Dr. Doom’s yelling.
- Can control: My charting. My patient care. My “tactical breathing.” My choice to not engage.
Conclusion: Doffing Your Emotional PPE
Look, this isn’t easy. You work in an impossible system, and you are a good person who cares. That’s why it hurts.
But you cannot pour from an empty cup. And you definitely can’t pour from a cup that’s been riddled with bullet holes by 12 hours of negativity.
Protecting your mind is not a “nice to have”; it is a core clinical skill. It is just as important as knowing your pressors. You can’t be a good nurse if you’re a walking, crying, rage-filled ball of sentient stress.
Your sanity is your most valuable piece of equipment. Protect it.
🧠 Read More From the NurseThoughts.com Brain Trust
Listen, protecting your sanity is a team sport. Now that you’ve got your Emotional PPE on lock, why stop there? Your brain is (mostly) intact, so let’s keep the good vibes rolling.
If you liked this, you’ll love these:
- Finally Reclaim Your Days Off: The Ultimate Nurse’s Recovery Guide
- For when you’re on Day 1 of your “weekend” and you’re so tired you tried to unlock your front door with your hospital badge. Again. Learn how to actually recover so you don’t spend your entire “off” time staring at a wall.
- 10 Self-Care Rituals Every Nurse Needs After Your Shift
- No, “chugging a cold cup of coffee you forgot you made 8 hours ago” is not on this list. This is the real-deal, post-shift decontamination protocol for your soul. (And yes, it’s better than a bath bomb. Maybe.)
- Nurse Motivation Tips
- Feeling that pre-shift dread? Is your “get up and go” broken? Here’s how to find your motivation when it’s seemingly clocked out, left the building, and is halfway to Mexico with your last good pen.
- The Nurse’s Guide to Setting (and Keeping) Boundaries
- Ah, “boundaries.” That magical word. This is your official permission slip to finally say “NO” (or “That’s not my job,” or “Please don’t eat my lunch”). Learn how to build a verbal forcefield to protect your time, energy, and last donut.
About the Author
This post was written by a real, currently-practicing, slightly-crispy Registered Nurse who is definitely not hiding in a supply closet right now.
After years on the floor, they’ve seen… things. Things that would make you laugh. Things that would make you cry. Things that would make you question the structural integrity of the human body.
Our author remains anonymous, mostly because they are 100% certain “Dr. Throws-Things” reads this blog, and they would prefer not to be on the receiving end of a “gently” tossed hemostat during the next code. All opinions are their own, usually formed around 3 AM while cleaning up something unidentifiable and questioning their life choices.
