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As far back as 15 to 20 years ago, nurses felt rushed and complained about not having enough time to spend with individual patients. Those guilt-inducing conditions seem to have escalated as the number of vacant nursing positions in hospitals grow. Nurses tell tales of chronic guilt and the emotional drain it wreaks on their psyches. As patient acuity levels rise and staffing levels sink, the cycle of guilt keeps on spinning.

With a nurse for a mom, Richard Clapp, RN, knew what he was getting into when he graduated from college in the spring and started working a night shift in a hospital med/surg unit.

One thing he wasn't prepared for was the nagging guilt that follows him home at the end of his shift.

There are days when he goes home feeling he didn't do enough. That's not a good feeling, said Clapp, who works at Sarah Bush Lincoln Health Center in Mattoon, Ill.

"It's impossible to give nine patients the care they deserve," Clapp said. "You hop from one to one to the next. It's hard. I don't think I realized how often I would feel like this."

The kind of guilt Clapp experiences is not unique to the latest crop of nursing rookies. Many veteran nurses tell tales of chronic guilt and the emotional drain it wreaks on their psyches. As patient acuity levels rise and staffing levels sink, the cycle of guilt keeps on spinning.

More and more nurses are finding it difficult to reconcile their self-expectations with their work environment. When that happens, many nurses start looking for a way out of the profession.

Guilt has always been part of the emotional landscape for nurses, many veterans say. Candy Montalvo, RN, recalls feeling bad about her hospital work 15 to 20 years ago. Even back then, nurses felt rushed and complained about not having enough time to spend with individual patients.

Montalvo left hospital and clinic work 10 years ago to practice as a parish nurse. In that role, she visits patients in San Francisco Bay Area hospitals and sees that the conditions that used to fuel her guilt have grown worse.

"It looks like there's just not enough staff," Montalvo said. "The staff looks harried, like they're pulled in six directions."

It's common that no one answers a patient call bell, and when she goes out into the halls searching for a nurse to help one of her parish members, sometimes it's tough to track down the right caregiver. Her clients complain about things like needing to go to the bathroom in the night and waiting for someone to assist them. A nurse can do only so much in a day, Montalvo said, but knowing that doesn't make it any easier to shake those guilty feelings.

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