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Why Nurses Are Really Leaving the Bedside

Nurse turnover is often driven by moral injury, not fatigue.

Moral injury occurs when nurses know the right action but are prevented from taking it.

Burnout vs. Moral Injury

Burnout = exhaustion that improves with rest.

Moral injury = a violation of conscience that does not resolve with time off.

Common Triggers of Moral Injury

Non-beneficial or futile care.

Compromised patient dignity.

Policies and productivity metrics overriding ethical judgment.

Fear-based decision-making and lack of nurse voice.

Why Self-Care Isn’t the Solution

Mindfulness and wellness initiatives address individuals, not systems.

These approaches can feel dismissive when the root issue is ethical harm.

Moral injury cannot be “fixed” with better coping strategies alone.

What Moral Repair Looks Like

Nurses being genuinely heard.

Access to ethical and moral support.

Shared decision-making at the bedside and organizational level.

Leadership acknowledgment of harm.

Healthcare systems aligned with professional nursing values.

The Bigger Picture

Moral injury is an occupational hazard, not a personal failure.

Retaining nurses requires systemic change, not resilience training.

Protecting the moral foundation of nursing is essential for the future of healthcare.

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