I Thought Stepping Away From Nursing Meant I Didn’t Belong

Image source: Jenn Walsh

Disclosure: The author is an Ambassador for the Dr. Lorna Breen Foundation and is organizing an independent fundraiser benefiting the Foundation. This essay was not commissioned, sponsored, or reviewed by the Foundation.

I didn’t want to die, but I certainly didn’t want to live.

By the time I finally stepped away, I had gradually lost myself and nearly all of my zest for life. I felt like I was floating through my own existence, somehow both present and invisible. I couldn’t be present for myself. I struggled to get out of bed, couldn’t eat, and slept constantly without ever feeling rested. Basic acts of caring for myself became increasingly difficult. My hair became so badly matted that eventually parts of it had to be cut out. I was alive, but I was barely participating in my own life.

I believed that my existence did not matter, down to my bones. The belief was visceral. I physically carried it with me everywhere I went: in my shoulders and my stomach. If I disappeared from the world, very few people would notice and even fewer would care. I spent countless nights alone on the 21st floor of my apartment, my dog at my feet, staring blankly out the window while the record player filled the silence, wistfully wishing I could quiet my own mind long enough to forget what I was feeling. I hung by my fingernails to the few threads connecting me to a person I recognized. I was a cardiac surgery ICU nurse. I was an endurance athlete training for an Ironman. Those identities mattered enormously to me. They represented discipline, capability, purpose, and the ability to do difficult things. As other parts of my life became increasingly unrecognizable, I held onto them as evidence that some version of me was still there. Eventually, those threads began falling apart too. If I had not stepped away when I did, I cannot confidently say that I would still be sitting here to write this essay.

Taking a step back from nursing never felt courageous. It felt like failure. Someone said to me, “This job isn’t for everyone,” and maybe I should “do something less intense.” I don’t know that either comment was intended to hurt me, but they did, because I took those statements as evidence I didn’t belong. My mental health battles were character flaws and lack of discipline. It reinforced the loud and intrusive thoughts I had when I was alone.

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Some circumstances were outside of my control and some weren’t. There are decisions I regret. I am responsible for that. I also know that experiences over the preceding years had reinforced those beliefs. I did not matter. It rang through my head day in and day out. My bed had taken shape to my body. The isolation that came from the bad relationships I had been in and the compounding effects of depression and anxiety took an insurmountable toll. My world became smaller. The few relationships I believed I had left deteriorated. My confidence was gone. Eventually, I began interpreting nearly everything happening around me as confirmation of what depression had already convinced me was true.

I wasn’t merely struggling. In my mind, I had become the problem. I believed I was a burden. I believed I wasn’t a good person. I believed I was ineffective at work and that my presence did not matter. In every way that mattered to the person I had once believed myself to be, I thought I had failed.

There is an irony in being a nurse and reaching that place. I had spent my career learning that deterioration was something to respond to, not something to judge. If a patient couldn’t eat, couldn’t get out of bed, slept constantly, stopped caring for herself, withdrew from the people around her, and believed her existence didn’t matter, I would have recognized those things for what they were. When the deteriorating person was me, I interpreted those same symptoms as character flaws. I saw weakness where I would have recognized illness in someone else.

Resilience is a funny word when we use it in healthcare because oftentimes, we distort the very foundation of what it means. You cannot be resilient without flexibility. Resilience cannot mean becoming so rigid in our identity as the person who can handle anything that we lose the ability to recognize the damage we are doing to ourselves. It cannot mean continuing indefinitely simply because we have always managed to continue before.

Healthcare workers are not superhuman. We are human beings who work in extraordinary circumstances. Many of us feel deeply called to difficult work. I do. We develop extraordinary capabilities because the work sometimes requires them, but being made for difficult work does not make us immune to difficult lives. Taking a step back because circumstances in your life have become more than you can safely carry does not erase your education, your clinical judgment, your experience, or your skill. It does not erase the thousands of moments when you showed up for someone who needed you, and it does not mean you no longer belong in the room.

I wish I had understood that sooner. I interpreted my need to step away as evidence that I was failing at being a nurse. Looking back, recognizing that I could no longer safely continue living the way I was may have been one of the most responsible decisions I made. If resilience requires adaptation, then perhaps stepping away was not the absence of resilience. For me, it was resilience finally becoming flexible enough to keep me alive.

There was no dramatic transformation. I didn’t wake up one morning knowing exactly who I was again or what my future would look like. Instead, I began noticing very ordinary things. I could feel my feet underneath me again. I could breathe without feeling suffocated by my own life. I could rest, actually rest, rather than disappear into sleep. I could smile and recognize the feeling. I could be present during a conversation, notice the people around me, and experience small moments without immediately wanting to retreat from them.

Somewhere in those ordinary moments, I realized that I was still in there. I had not rediscovered my career. I had not rebuilt my résumé. I had not figured out my future. I had rediscovered life.

Once I could see again, I could also see who was standing there. There were people who stayed in my corner when there was nothing bright or shiny about being close to me, when I had very little to offer, when I wasn’t accomplishing anything, and when I couldn’t perform the version of myself that everyone, including me, had become accustomed to. They stayed. There were also people who left, and that taught me something too. For a person who had become convinced that her disappearance wouldn’t matter, being shown repeatedly that my presence mattered became its own kind of evidence. I will forever be grateful for the people who helped pull me back toward myself when I could not find that person on my own.

Rebuilding your identity when you feel as though everything that once defined you has disappeared is exceptionally difficult. My friendships, purpose, job, career path, future, athletic goals, and even my understanding of who I was became uncertain. Some of those things still are. For someone who had spent years measuring herself through movement, usefulness, and accomplishment, recovery required something surprisingly difficult: I had to intentionally slow down. I needed quiet. I needed to stop performing long enough to understand who existed underneath all of it.

Gradually, pieces returned. Sport began to feel like freedom, and I was finding my flow states. I wrote again and recognized my own voice. When I thought about nursing, I realized how much I missed it: not the résumé line or being able to introduce myself as an ICU nurse, but the actual work. I missed the thinking, the physiology, the responsibility, the patients, the teamwork, and the privilege of being trusted during vulnerable moments. Eventually, I understood something that seems obvious to me now: I did not stop being a nurse when I stepped away from nursing.

I also returned to endurance sport. I’ve now completed four full Ironmans, a 70.3, and a 70.3 World Championship. Those accomplishments mean something to me, but they don’t mean what I once needed them to mean. They are not evidence that I deserve to be here. They are evidence of things I love doing while I am here.

A long résumé and a list of accomplishments are not the price of admission for me to be accepted into the room. 

For a long time, I thought those things were my identity. I am beginning to understand that they are expressions of it. I had to go to dark places and meet myself there. I had to strip away almost everything I had once used to explain who I was and relearn the person underneath it. What remained was someone who loves movement because it gives her freedom, someone who writes because language gives shape to things she cannot otherwise hold, someone who loves nursing because being trusted in another person’s vulnerable moments gives her purpose, and someone who cares deeply about whether people can access healthcare and whether the systems intended to care for them actually do.

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This September, I am preparing to ride 926 miles by bicycle across New England to raise awareness around healthcare-worker mental health and suicide prevention. The irony is not lost on me. After spending years learning that my ability to endure was not evidence that I was well, I am choosing an enormous endurance challenge. But I understand endurance differently now. I don’t need 926 miles to prove that I can suffer. I already know that I can.

I can love demanding work without believing I have to tolerate everything. I can be deeply committed to nursing without allowing nursing to become the sole measure of who I am. I can be an athlete without needing a finish line to prove my worth. I can write, advocate, change direction, and have enormous goals for my career while accepting that I do not need to accomplish all of them today. I can be a nurse and be multidimensional. I can recover.

Healthcare workers spend extraordinary amounts of our lives entering rooms during other people’s most vulnerable moments. We learn how to make space for fear, uncertainty, grief, and pain. We understand that needing care does not make another person weak. We deserve to extend that same humanity to ourselves.

Taking a step back does not mean you no longer belong. Needing help does not erase your credentials, and mental illness does not retroactively invalidate the clinician you became. You are allowed to recover and return to difficult work. You are allowed to recover and decide you want something different. You are allowed to be excellent at your job while still having needs, limits, relationships, passions, failures, and an entire identity outside of it.

Healthcare workers are human. We belong in the rooms where care is given, and we belong in the rooms where care is received, too.

I am still rebuilding, and I still don’t know exactly what every part of my future will look like. But I know now that uncertainty does not mean I have disappeared.

I’m still here. And I believe you can be, too.

If you or someone you know is struggling, call or text 988 to reach the 988 Suicide and Crisis Lifeline, or text HOME to 741741 to reach the Crisis Text Line.

Today, Walsh begins The Pursuit, a 926-mile self-supported bicycle ride from Madawaska, Maine, to Provincetown, Massachusetts, benefiting the Dr. Lorna Breen Foundation. You can support the ride here.

🤔 Have you ever stepped away from nursing, or thought about it? What helped you find your way back, or forward? Share your thoughts in the comments below.