Why the ‘Strong One’ Often Burns Out in Healthcare 

Headache, anxiety or sad surgeon in meeting with doctors with burnout, stress or fatigue with medical emergency. Migraine, tired black woman or depressed nurse with depression or loss in hospital.Written by Deepika,

Who doesn’t want to thrive at their workplace, right? This process of ‘thriving’ is generally understood as a psychological state characterized by learning and vitality. 

In other words, your workplace is not about survival of the fittest, especially in the healthcare industry. Naturally, strength is one of the most valued qualities in this field. The word in itself is quite broad and may be loosely thrown around. What exactly does strength refer to in healthcare?

In an environment where people are constantly exposed to grief, uncertainty, and emotional pressures, it could simply mean the ability to remain calm and composed. However, there is a thin line, one that many do not notice. As a healthcare worker, you must stay emotionally composed, but not numb or hardened. 

A little too much to the left or the right can lead to dreadful burnout. As per recent research, burnout scores among healthcare professionals ranged from 16% to 86%, with a mean overall score of 57.4%. The same study revealed that burnout affects clinical decision-making and the ability to cope with work pressures. 

So, while being strong is a necessity, making that your entire identity is like walking on thin ice. Before it breaks, let’s understand the importance of emotional sustainability. This article will explore that by revealing why the ‘strong one’ in healthcare is particularly vulnerable to burnout. 

 

The Emotional Labor That Lives in the Shadows 

In healthcare or otherwise, emotions are shaky ground. That’s because much of the attention goes to competence, technical skills, and sound decision-making. With these covering the surface, what goes unseen is the emotional role many healthcare workers must play. 

Being on the frontline involves holding space for complex emotions like grief, fear, and even anger, both for patients and their families. It’s only a matter of time before such a role no longer remains merely empathetic. It’s commonplace to find healthcare workers who gradually become emotional fulcrums in the teeth of human suffering. 

That explains why higher-level learning routes, such as a Master’s of Science in Nursing (MSN), focus on specialized roles that require deeper emotional and psychological engagement. For instance, those pursuing psychiatric nursing tracks are trained to support patients dealing with trauma and emotional dysregulation. 

Modern online MSN programs have made this type of advanced training more accessible for working professionals already navigating complex healthcare settings. The online format ensures nurses learn counseling frameworks and care principles even as they encounter emotionally taxing situations in real time. 

As Felician University explains, the online MSN track is designed for licensed registered nurses who wish to step into an advanced practice role. As such, formal training makes nurses more competent, and it also places them in a unique position where emotional exposure is continuous. 

It is usually in the space between training and real-world experiences where emotional labor can be found. A recent meta-analytic review confirmed that higher emotional labor is associated with increased levels of burnout in healthcare. Another finding in that study was how emotional intelligence can soften this impact by improving emotional regulation. 

However, why does this emotional labor we speak of live in the shadows? Here are the main reasons:

  • In most cases, it remains unrecognized as a part of healthcare job descriptions. 
  • The industry still seems to prioritize measurable clinical outcomes over abstract emotional effort. 
  • Some form of pressure, no matter how subtle, is always there to appear emotionally composed. 
  • There is limited time and space to process emotional experiences during or after shifts. 
  • At some point, repeated exposure to distress gets normalized, making emotional strain harder to identify. 

 

The Exhaustion of Maintaining Constant Emotional Composure 

Have you ever paused to wonder whether it is humanly possible to maintain perfect emotional composure without any psychological costs? Well, that doesn’t seem to be a realistic feat, nor should it be. After all, healthcare is a people’s industry, and what could be more human than expressing emotions in a healthy way? 

According to a 2025 systematic review involving 2,425 healthcare professionals, there is a significant link between moral distress and emotional exhaustion. Although the expectation to remain strong at all times sounds noble, it is also unrealistic. Let’s look closely at how compassion fatigue and emotional suppression gradually lead to burnout. 

The Mental Strain of Keeping Emotions on Lock And Key 

Healthcare workers must witness grief, trauma, and loss, but amid it all, they cannot lose their composure. This makes many people accustomed to keeping difficult emotions on lock and key so they can continue functioning effectively. Now, this strategy works, but constant withholding of emotions is a disaster in the making. 

A 2024 study revealed that more than 20% of surveyed healthcare professionals displayed severe symptoms of stress, anxiety, and depression. Only 10.7% of the participants showed no signs of burnout. Well, that’s primarily because suppressing emotions does not make them disappear. 

The Compounding Effect of Compassion Fatigue 

Even if one is not experiencing pain, grief, or emotional vulnerability directly, repeated exposure to suffering can take a toll over time. This condition is often described as compassion fatigue, and it has a compounding effect. In other words, time will wear down a caregiver’s psychological reserves. 

At the same time, detachment is not an option. In a 2025 discussion on compassion fatigue among clinicians, oncologist Eric Singhi said, “Compassion and being able to empathize are so important; it’s how you gain trust.” This is where the emotional tension comes in, as the same empathy that comforts patients can become emotionally taxing for the healthcare professional. 

The Struggle to Ask for Help 

This part usually gets pushed under the rug, but many healthcare professionals find it difficult to ask for help. After all, the pressure to appear fine at all times can be intense. When being strong has become one’s identity, vulnerability can feel uncomfortable, daunting even. 

Is this pressure generated by the healthcare culture itself? Perhaps, since emotional endurance and resilience are almost always rewarded in clinical settings, acknowledging one’s struggle may be seen as a lack of professionalism. 

 

When it’s Time to Care for the Caregiver 

Burnout among the ‘strong’ healthcare workers should not only be recognized, but also addressed using meaningful support. Let’s see three effective ways this may happen:

Creating an Environment Where Vulnerability is Welcomed 

Fear of judgment and professional consequences can keep the best of healthcare workers silent about their struggles. A safe place need not come at the cost of unscrupulous emotional expression, for it to be effective. What truly matters is to ensure everybody feels safe to admit they are struggling. 

In a 2025 study conducted on 322 surgical nurses, those with higher levels of emotional exhaustion were less likely to seek professional help. Moreover, such nurses displayed more stigmatized attitudes towards mental health support. Doesn’t that sound like hurt people hurt people? Everyone needs an environment where they can voice their concerns without fear. 

Encouraging Rest Before Burnout Reaches a Saturation Point 

Rest is a lot like food; simply having it isn’t enough; the timing also matters. Hustle and resilience cultures have made rest a privilege only a few can enjoy. When something necessary to sustain emotional stability becomes a badge of honor, the results can be disastrous. 

A somber survey conducted among physicians in 2025 discovered that one in three experienced fatigue severe enough to interfere with their ability to treat patients. At least one thing is clear: fatigue can quickly cross the threshold into impaired functioning in the absence of sufficient rest. 

Implementing Burnout Prevention Methods 

It is important to be on the lookout for the early signs of burnout so it doesn’t get worse. At the same time, certain interventions should be in place to prevent burnout as far as possible. Such methods may include regular wellness screenings, confidential self-reporting tools, and other institutional channels that allow healthcare workers to report emotional burden. 

A recent review published in the Frontiers of Psychology highlighted that burnout prevention strategies were more effective when implemented at early stages, when the signs appear. Once full-blown emotional numbness has set in, it’s usually a tedious journey to recovery. Hence, early recognition of warning signs is a crucial factor in preventing progression. 

 

FAQs 

Why are healthcare workers often expected to be the strong ones?

The main reason why healthcare workers are often expected to be the strong ones has to do with how their roles place them in contact with human suffering and uncertainty. In such scenarios, being calm and composed is almost a necessity to ensure effective patient care. While emotional strength is admirable, it may create pressure to suppress vulnerability, preventing healthcare workers from seeking support. 

What is emotional labor in healthcare?

In the healthcare context, emotional labor refers to the exertion needed to manage personal emotions while responding to others’ emotional needs. This may involve maintaining composure during negative situations or regulating one’s emotional responses during work hours. Prolonged emotional labor is tied to burnout, especially when the same goes unacknowledged. 

How can healthcare workers recognize early signs of burnout?

In one’s own self, early signs of burnout often include unexplained fatigue, reduced empathy, and a feeling of detachment from work. In colleagues, the same may manifest itself as withdrawal, lower emotional engagement, or reduced communication. Early recognition of such signs allows timely support in the form of rest, open conversations, and workload changes. 

 

Recent Data on Burnout in Healthcare 

Burnout score range and mean overall among healthcare professionals, respectively  16%-86%, 57.4%
Meta-analytic review on the link between emotional labor and burnout  Directly proportional, with emotional intelligence able to reduce the impact through better regulation of emotions 
2025 systematic review involving 2,425 healthcare professionals on the link between moral distress and emotional exhaustion  Directly proportional 
Healthcare professionals displaying severe symptoms of stress, anxiety, and depression in a 2024 study  >20%, with only 10.7% showing no signs of burnout 
2025 study involving 322 surgical surgeons on the connection between emotional exhaustion and seeking professional help  Those with higher levels of emotional exhaustion were less likely to seek professional help 
Physicians experiencing fatigue severe enough to interfere with their ability to treat patients in a 2025 study  One in three 
Recent review on burnout prevention strategies Such strategies are effective when implemented at early stages, when the first signs appear

 

So, are you the ‘strong one’ at your workplace? If so, has that identity started to feel less like a role and more like a burden you must carry every day?

While strength is praiseworthy, it also deserves to be questioned, even if we’re the first ones to do so. Discretion in this area is all about knowing when to try harder and when to let go and seek help. 

Do not take even the small signs, like unexplained fatigue or constant irritability, lightly, either in yourself or a colleague. Seeking help early or checking in with a colleague are forms of care that protect both the caregiver and the quality of care they deliver. Being the strong one only makes sense when that strength is sustainable and not tied to one’s identity. 

Author Bio

Deepika has over six years of experience as a writer and editor. Passionate about words and learning, she takes an interest in a variety of niches. Her knack for turning complex ideas into relatable narratives allows her to resonate with the reader. 

When her pen falls silent, you can find her engrossed in a novel or getting her hands messy with fine arts. By these, Deepika is committed to keeping her curiosity and creativity alive. 

References:

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https://www.nature.com/articles/s44184-024-00061-2

  1. Chen Yin-Che, Huang Zhi-Ling, et al. 2024. Relationships between emotional labor, job burnout, and emotional intelligence: an analysis combining meta-analysis and structural equation modeling. Springer Nature Link, Volume 12, 672. 

https://pmc.ncbi.nlm.nih.gov/articles/PMC11575177/

  1. Orgambidez Alejandro, et al. 2025. Moral distress and emotional exhaustion in healthcare professionals: a systematic review and meta-analysis. PubMed. 

https://pubmed.ncbi.nlm.nih.gov/39997268/

  1. Major Jutta, Palfi Krisztina, et al. 2024. Adaptive emotion regulation might prevent burnout in emergency healthcare professionals: an exploratory study. Springer Nature Link, Volume 24, 3136. 

https://link.springer.com/article/10.1186/s12889-024-20547-0

  1. Coffey Donavyn. 2025. Compassion fatigue: how oncologists can recognize the signs. Medscape

https://www.medscape.com/viewarticle/compassion-fatigue-how-oncologists-can-recognize-signs-2025a100021r

  1. Smajlovic Aljana, Budler Cilar Leona, et al. 2025. Burnout and the stigma of help-seeking in nurses: a cross-sectional study. ScienceDirect

https://www.sciencedirect.com/science/article/pii/S0001691825011059

  1. Gregory Andrew. 2025. One in three NHS doctors so tired their ability to treat patients is affected, survey finds. The Guardian.

https://www.theguardian.com/society/2025/mar/03/one-in-three-nhs-doctors-so-tired-their-ability-to-treat-patients-is-affected-survey-finds

  1. Alhassan Abdulrahman Shaden, Alhassan A. Mohammed, et al. 2025. Prevalence of burnout and its risk and protective factors among healthcare workers in the Middle East, North Africa, and Turkey: a systematic review and meta-analysis. Frontiers in Psychology. Volume 16. 

https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2025.1539105/full

 

 

Please also review AIHCP’s Stress Management Certification program and our CE courses as well, to see if they meet your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Nursing and Mental Health Careers

Nursing is sometimes only seen as a position to help others physically.  Nurses aid in surgery, recovery, elderly care, daily care and work with multiple care providers and facilities in helping individuals heal.  Beyond their physical capabilities, nurses also play a pivotal role in mental health.  There are in fact a multitude of ways nurses can play key role in mental health through a variety of careers.

Nursing is need of more competent mental health trained nurses. Please review AIHCP’s certification programs in mental health

 

Essentially, registered nurses learn a great deal about mental health in nursing school itself.  There is around 3 months dedicated to mental health studies as well as college prerequisites in basic psychology courses. Hence a nurse already has some understanding of psychology and mental health.  Those wishing to go farther have a great opportunity to focus solely on mental health if they wish through a variety of certifications, graduate programs and nurse practitioner titles.  Through these programs, nurses can serve in psychiatric wards, work with psychologists and counselors within a facility or even enter into it at a pharmacological level as a nurse practitioner specializing in psychiatric health.

One of the most common certifications is the title of Board Certified Psychiatric Nurse which is earned through the state board of nursing.  A nurse who has served at least 2 years under the guidance of a psychiatric professional can obtain this title after meeting all prerequisites and passing the state board exam.  Within this capacity, nurses can help serve in psychiatric settings.  Many of these nurses who earn this certification also have already obtained a Psychiatric Mental Health Nurse Practitioner license.  This requires not only a graduate degree in Nursing but also an emphasis within mental health.  These types of Nurse Practitioners can work within mental facilities and prescribe medication for patients.  Some states require that the NP work under the guidance of a physician or psychologist while some states allow NPs to work independent and prescribe based on their own merit.

Licensures in Psychiatric Mental Health Nurse Practitioner grant nurses the ability to focus on mental health and help fight the shortage of mental healthcare

It is not unnatural for many nurses to seek to make this transition.  In healthcare, many nurses see the need and demand of better mental healthcare.  Many physicians and surgeons are not trained in helping others deal with bad news or death.  Many physicians also push the burden upon nurses to tell the family about bad news and refuse themselves to discuss it.   Elisabeth Kubler Ross was a pioneer in identifying this weakness in healthcare.  She noted that many healthcare providers lacked any type of bed side manner and were unable to explain death and loss to families or the terminally ill.   Many in nursing were left with the problem of articulating the loss and explaining the death that had occurred.  Hence due to this, many nurses and healthcare providers turned better training in mental health.  The healthcare system at the turn of the century began to notice these needs and demands within care facilities.  Mental health became more emphasized in nursing and as seen above, certifications and licensures were designed by state nursing boards to meet these needs.

Within this became an awakening in grief counseling and thanatology.  Healthcare professionals began to learn more and more about the process of loss and how to better help others with death and dying issues.  This not only aided healthcare professionals in difficult discussions with families of the dying but also spread to dedicated practices where nurses and other healthcare professionals were granted the ability to solely help those with death and loss.

While there is still a high demand to train healthcare professionals in grief counseling, thanatology and other mental health issues, there are still many instances where such training is lacking.  There is still much to do in regards to better equipping physicians, surgeons, nurses and other healthcare professionals with the necessary knowledge to meet the needs of patients from a mental stand point.  This is why certifications are especially critical to healthcare professionals.  Certifications in grief counseling, thanatology or other venues of mental health can be easily and quickly earned by busy healthcare professionals.  These specialized certifications can also better aid them in acute knowledge and practice in how to help the mental health of their patients.

With rising mental health concerns throughout the world, the demand has never been higher to better equip healthcare professionals with certifications and licensures for healthcare purposes, whether from an acute and sole practice standpoint or as supplemental aid in a primary facility.   Some of the largest mental health concerns align with the rise in stress.  Political fissures, threats of war, technological pressures, rises in violence and broken families through divorce are all culprits for anxiety, attachment and depression disorders.  These disorders once seen as stigma are now being recognized as true health issues.

With such a rise, healthcare needs to respond to the growing problem. The healthcare industry is adding mental health specialists to primary facility teams but also opening up more practices through Nurse Practitioners due to shortages in mental health care teams.  Rural areas especially suffer from a lack of mental health accessibility so the importance of nursing to become more mental health attuned is also critical.

Due to the times and needs, nurses interested in mental hence have a unique opportunity to enter into mental health fields.  AIHCP looks to help and aid in this call for more training in mental health.  AIHCP and its American Academy of Grief Counseling offers a Grief Counseling Certification.  This certification was one of the earliest grief counseling certifications to be offered to healthcare professionals.  It provides online and independent study opportunities for nurses to enhance their knowledge in grief counseling and apply it to their career.

Please also review AIHCP’s mental health certifications in grief counseling, stress management and anger management

 

In addition to grief counseling, AIHCP also offers Pastoral Thanatology, Crisis Intervention, Stress Management, Spiritual Counseling and Anger Management Programs to help health professionals better equip themselves with the mental healthcare knowledge they need to help others.  Please review AIHCP’s Grief Counseling Certification, as well as AIHCP’s other programs to better equip your nursing career in mental health needs.  There has never been a greater opportunity and demand for nurses to enter into mental health and AIHCP offers certifications for qualified candidates.

Additional Resources

“How to Become a Mental Health Nurse”. Nurse Journal Staff. (2023). NurseJournal.  Access here

“What to know about psychiatric nurses”. Huizen, J. (2020). MedicalNewsToday.  Access here

“The Psychology of Patient Care: Why Bedside Manner Matters”. Patrick, W. (2023). Psychology Today.  Access here

“The Need Keeps Growing for Behavioral and Mental Health Nurses”. Hilton, L. (2021). Nurse.com.  Access here