The “Good" Nurse vs. The “Good Nurse” (Part 1)
From Survival to Self-Sovereignty in Nursing
By Dr. Rachel Y. Hill, DNP, APRN, FNP-BC, PMHNP-BC, AHN-BC, HWNC-BC
Authors' Note: I am writing these two blog posts as a reponse to the recent Kaiser Nursing Strike, because I believe this strike is crucial in the call for nurses to change the healthcare system by standing up their own needs.
This week's article will define what I believe to be a core component of the nursing strike: how nurses are taught to be "good".
(NOTE: In Part 2, I specifically address how this standard of "goodness" is treated by the healthcare system- and why this strike matters.)
The Hidden Curriculum of Nursing
You might find this hard to believe, but when I was in nursing school, there were still a few diploma programs left — the last of the original models that defined what nursing was supposed to be.
One of my deans shared a story about how she had to ask her headmaster for permission when she wanted to go on a date (and even get married!)
I remember thinking, "How absurd! How could anyone accept that?"
But what I didn’t realize then was that I had inherited a similar kind of submission — a quieter one, woven through my upbringing, my faith...
And my desire to be good.
Long before we pinned on our badges or walked the floors, we learned to care for others at our own expense.
In nursing school, we were taught to anticipate, to sacrifice, to put the patient before ourselves, but no one ever taught us how to protect our own energy, emotions, or boundaries.
One of my instructors told me she worked a night shift with just one other nurse covering the entire floor. She wore it like a badge of honor. She called it duty, seemingly fully convinced that her sacrificial behavior exemplified the standard of a "good" nurse.
But what does that even mean?
To me, being a 'Good' nurse sounds an awful lot like 'good' dog or cat.
Behind the selfless image of the 'good nurse' lives an older identity- the people pleaser, the one who equates love with usefulness and self-worth with sacrifice.
There’s a big difference between being a 'good' nurse who people pleases... and a 'good nurse' who knows her worth and practices boundaries.
Whenever there are judgments passed others on who is a good nurse or a bad nurse, I often wonder about the criteria that they are using to define them.
The Two Good Nurses
1. The “Good" nurse (The People Pleasing One)
This nurse is driven by external validation.
She thrives on praise, on being needed, on being indispensable.
Somewhere along the way, she learned that her worth is tied to how much she gives.
She says yes when she wants to say no, she apologizes for resting.
Her exhaustion is mistaken for commitment, and her silence falsely appears like strength.
She is celebrated for selflessness but privately runs on empty.
She has forgotten how to receive.
She saves everyone but herself.
2. The “Good Nurse” (The Empowered One)
The empowered nurse still cares deeply but has learned to honor her energy.
She knows that boundaries are not selfish- they are sacred.
She gives from overflow, not depletion.
She knows when to rest and when to rise.
Her care flows from coherence, not compulsion.
She doesn’t need to prove she’s "good"; she knows she’s whole.
The “Good" nurse gives to be loved, fears rejection, and equates exhaustion with excellence, while the “Good Nurse” loves to give, trusts herself, and equates rest with readiness.
The Psychology Behind the People Pleaser
In psychology, people-pleasing is a protective adaptation. It’s develops in situations where we learn to keep ourselves safe by keeping others happy.
Attachment theory (Bowlby, Ainsworth) shows that when affection is given conditionally, children learn: 'I am loved when I make others happy.'
That belief grows into adulthood and develops into chronic overgiving and lack of boundaries.
In family systems, the identity of the child who learns to people please to get needs met is called the 'hero child'- and her job is to fix, rescue, and manages others' emotions.
I developed this pattern early- my grandmother taught me to bake pound cakes when I was six, and soon after everyone praised my skills, I was baking every weekend.
When someone said, "You bake like Sara Lee" I thought, "Sara Lee is a business — maybe I can make money!"
But when I decided to charge, the same people who praised me stopped coming.
That was my first lesson in conditional love: I get love and praise when I put in work for free.
And that same child who baked for approval?
She grew into the adult nurse who worked for validation.
3 Reasons Nurses try to be "good"
Nurses are systemically conditioned into people pleasing in three main ways:
1. Our Primary Training Reinforces "goodness."
The underlying message throughout our journey to practice?
"Good nurses put patients and institutions first."
Nursing education rewards compliance and perfectionism, and demonizes diversity of thought and questioning the status quo beyond "approved" methods.
2. Work Culture Normalizes It
Though working short staffed to charting overload, we’re told to 'be strong,' and subtly encouraged to invalidate our needs.
When we speak up, we’re called difficult- and when we set boundaries, we’re told we’ve lost our compassion for our colleagues and patients (and/or our respect for "how things work")
3. The Nervous System Perpetuate the Patterns
As many of our bodes already associate safety with being needed, we are primed to fall prey to conditional praise for ignoring our own needs.
Each time we’re praised for violating our boundaries, dopamine rewards the pattern.
Over time, being "good" becomes the only way to maintain safety- and being authentic and honest feel more dangerous than ever.
The Cost of Chronic People-Pleasing
Over time, people-pleasing becomes an invisible illness.
When we chronically overgive without receiving, we develop compassion fatigue, resentment, and physical symptoms- including headaches, insomnia, gut tension, and anxiety.
We begin to ask, "Who am I if I’m not helping someone?"
We continue functioning, but stop feeling, becoming ghosts in our own lives- clinically competent, spiritually dry, and emotionally detached.
Healing: From People-Pleasing to Self-Possession
Healing begins with compassion, not shame.
Our inner people-pleaser isn’t the enemy; she’s (or he’s) the protector who learned love was conditional.
Healing requires us to thank her for her service, and to show her that safety can now come from authenticity.
Here's how we can support the part of us that feels compelled to be "good" as we heal:
- Acknowledge Your Origin Story – Overgiving once kept you safe. Awareness turns guilt into gratitude.
- Rebuild Safety Through the Body – Somatic awareness helps. 'The Body Keeps the Score' by Bessel van der Kolk teaches that trauma lives in the body until it’s released. Notice how your body feels when you say yes but mean no. Healing starts there.
- Practice Healthy Boundaries – Boundaries are compassion with structure. They are self-respect made visible. Boundaries help you protect your needs, and create integrity around when you say yes- and no.
- Reparent the Inner Nurse – Internal Family Systems (IFS) invites us to meet our inner parts. The pleaser is a protector. The child within her deserves rest and love. Talk to her. Let her know she doesn’t have to earn her place.
- Learn New Patterns of Attachment – In 'Attached' by Amir Levine and Rachel Heller, we learn that healthy connection allows independence, not control. You can be connected and still free. Therapeutic Integration – Consider reading:
- 'The Emotion Code' by Dr. Bradley Nelson – releasing trapped emotions.
- 'The Body Keeps the Score' by Bessel van der Kolk – healing trauma through embodiment.
- 'Attached' by Amir Levine & Rachel Heller – understanding attachment and relational safety.
- 'Radical Acceptance' by Tara Brach – learning to belong to yourself.
- 'The Gifts of Imperfection' by Brené Brown – releasing shame and embracing authenticity.
A New Definition of Caring
As holistic nurses, we are redefining what it means to be "good."
True compassion doesn’t require self-abandonment, and the future of nursing rests in coherence — when our minds, bodies, and spirits work and move together in harmony within us.
When we care for ourselves, we regulate the energy in the room.
We become mirrors of wholeness, and we lead by example- not from exhaustion.
The "Good" nurse is a black hole, seeking peace from the outside to fill the emptiness within.
The Good Nurse creates peace within herself- and lets it ripple outward.
Reflection & Affirmation
Take a deep breath, nurse.
You don’t have to earn your worth through exhaustion. You are allowed to rest, to receive, to say no, and still be worthy.
Healing our inner "Good" nurse is how we reclaim our sovereignty- and how we become the nurses our souls are meant to be.
Here are a few Reflection Prompts to help you identify your inner "Good" nurse:
- Where in my practice do I overextend myself to feel safe or appreciated?
- What part of me is still seeking approval- and what does she really need instead?
- How does my body signal discomfort when I overgive?
- What would it look like to nurse from wholeness, not depletion?
Once you've reflected, invitation to repeat this Affimation:
I honor the nurse I was, I celebrate the nurse I am becoming, I release the need to prove my goodness, and I embody the peace of knowing I am enough.
The “Good" nurse vs. The Good Nurse” is not a battle- it is a call for transformation.
Every nurse who takes a stand, every nurse who honors her limits, and every nurse who says no more is rewriting the definition of what it means to be good.
Because being a good nurse has never been about seeing how much self-sacrifice we could take-
It’s about how courageously we decide to protect what we can give.
--Dr. Rachel