Front-line Nurse Leader Guilt - Emerging Nurse Leader

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

We are hearing a great deal about nurse leader stress and burnout but less about the struggles that front-line leaders are having with their own guilt during this time. Leaders experience guilt when they have a responsibility that they feel they failed to live up to. The emotion of guilt is focused on failure. The stories that front-lines tell themselves during these times impact their stress level and the amount of guilt they feel about decisions they are implementing. Many think that they should be doing more for their staff but can’t always change policies or practices. Interestingly, the best leaders often feel the most guilt. Some common areas of guilt that leaders have shared with me recently include the following:

I am guilty about…..

Still having to make excuses about a lack of PPE.
Furloughing half my staff while I kept working.
Calling a new graduate to tell her that the residency program is on indefinite hold – she wept.
Cutting hours of nurses whose spouses have lost jobs and are under significant financial stress.
Failing to effectively advocate for staff with executive leaders still in the command post mindset.
Enforcing a policy that my staff who have not seen their grandchildren in months will have to quarantine for 2 weeks (using their own leave) if they travel this summer more than 200 miles outside our geographic area.
Not having the answers to so many questions that the staff ask me today.
Telling a dedicated staff member that with budget cuts – she will not receive tuition reimbursement for her fall classes.

Some advice from the experts in dealing with this type of guilt includes asking yourself the following questions:

Am I advocating as effectively as I can within the context of my situation?
What could happen if we don’t implement some of the change that is leading to my guilt?
Am I living up to all of my position expectations in this situation?
Am I overly negative about the impact of what I feel guilty about?
Have I been too self-serving in this situation?

If you can answer these questions and recognize that you are doing your best – it is time to put the guilt aside. Many things about the current crisis will not be win-wins. Life can be unfair, but leaders should not be if it can be prevented. Sometimes it cannot, and we have to live with the knowledge that we are doing the best we can.

Read Rose Sherman’s book – The Nurse Leader Coach: Become the Boss No One Wants to Leave