Guest Contributor: Hyeyoung Hwang
DNP/PhD student at the Johns Hopkins School of Nursing

I still remember the excitement and nervousness I felt on the day of the Nightingale Pledge ceremony. Almost all nursing schools in South Korea, where I was born and raised, hold this ceremony to prepare nursing students for patient care. Before starting clinical rotations, I stood in my crisp new uniform, holding a candle, as I recited the Nightingale Pledge.

It was a meaningful moment that made me feel ready to embrace what nursing truly stands for. However, the final line of the pledge, “devote myself to the welfare of those committed to my care,” felt unfamiliar as it portrayed nursing in a way that differed from what I had learned in nursing school.

Only after graduating and starting my career as a nurse did I realize what “devote myself” meant in a real-world practice setting. I often worked unpaid extra hours in severely understaffed conditions simply because “that is just how it is done.” Over time, I began questioning whether this constant expectation of devotion and sacrifice genuinely benefited nurses or even their patients.

After working as a nurse for 10 years in South Korea, I immigrated to the United States to expand my experiences as a nursing professional, expecting a better work environment for nurses. Conditions here, however, were not so different from those back home. An American nursing staff agency was recently fined for underpaying nurses who worked overtime (DLP Law, 2023). Nurses endured long, grueling shifts but did not receive the compensation they rightfully deserved, showing that this issue extends beyond South Korea.

During the COVID-19 pandemic, the narrative of devotion and sacrifice reached its peak. Nurses were often hailed as “heroes.” However, this recognition masked the real challenges they faced, including inadequate protective equipment, short staffing, and relentless emotional and physical demands. For example, 87% of nurses reported reusing single-use personal protective equipment, such as N95 masks and face shields (National Nurses United, 2020). Rather than addressing these systemic problems, many people praised nurses for their “heroic spirit.”

The heroic nurse narrative has its roots in the traditional history of nursing, where social and religious influences emphasized obedience and self-sacrifice (Hopkins Walsh et al., 2022). Over many years, these values became intertwined with the image of Florence Nightingale, famously known as the “Lady with the Lamp.” While Nightingale revolutionized nursing by emphasizing hygiene, holistic care, and education, the public continued to see her more as an angelic figure willing to sacrifice herself for her patients.

Focusing only on the saintly aspects of nursing can unintentionally silence legitimate concerns about workplace safety and fair compensation. If every problem in healthcare is labeled a “necessary sacrifice,” it becomes much more challenging for nurses to speak up for themselves. If society expects them to be heroes, complaints about short staffing or lack of protective equipment can appear entitled. This expectation of heroism not only hurts nurses but also puts patients at risk. Tired and overworked healthcare workers cannot provide the same quality of care as those in supportive conditions.

What if we could move beyond the heroic nurse narrative? Critical posthumanism, a perspective that challenges traditional, human-centered ideas, offers a way to rethink this outdated perspective. Instead of focusing solely on humanistic ideals like self-sacrifice, it emphasizes the importance of collaboration between humans, technology, and the environment (Braidotti, 2013). Nursing should not be about one person taking on everything, but involve creating systems where care is shared and everyone contributes.

Through the lens of critical posthumanism, Hopkins-Walsh and colleagues (2022) critique the historical power dynamics within nursing and propose a new model of care inspired by Donna Haraway’s (2016) concept of composting. This concept involves breaking down outdated ideas and creating something new and sustainable. When applied to the heroic nursing narrative, this perspective advocates dismantling unfair assumptions, such as the belief that nurses must sacrifice everything for their patients. It also envisions a fairer and more sustainable approach to care.

We can move beyond the outdated hero trope by rethinking how care is provided. Instead of expecting nurses to do it all, we can build systems that protect both patients and nurses. This shift has transformed my perspective from “I must do everything for my patient” to “I can help reform the system for the benefit of all.” Importantly, this does not mean rejecting the altruistic heart of nursing. Rather, it means recognizing that viewing nurses solely as heroes can mask unsafe conditions and lead to chronic burnout. By stepping away from these heroic narratives, we open the door to envisioning a dynamic profession that values both patient outcomes and nurses’ rights.

Supporting nurses who advocate for safety, fair pay, and appropriate staffing fosters a healthier and more ethically sound healthcare system. When we move beyond the heroic narrative of the self-sacrificing nurse, we can genuinely recognize their expertise, support their collaborative contributions, and ensure they receive the resources they deserve. This shift not only enhances nurses’ well-being but also ensures that healthcare systems prioritize equity, safety, and high-quality care for everyone.

To conclude this post, I would like to leave you with this question: “What would you think of a nurse who refuses to care for patients without the proper equipment to safeguard their own safety?”

References

Braidotti, R. (2013). The posthuman. Polity Press.

Dougherty Leventhal & Price (DLP) Law. (2023). Nursing Staff Are Denied Their
Rightful Wages. https://dlplaw.com/nursing-staff-are-denied-their-rightful-wages/

Haraway, D. (2016). Staying with the trouble: Making kin in the Chthulucene. Duke University Press.

Hopkins-Walsh, J., Dillard-Wright, J., Brown, B., Smith, J., & Willis, E. (2022). Critical posthuman nursing care: Bodies reborn and the ethical imperative for composting. Witness: The Canadian Journal of Critical Nursing Discourse, 4(1), 16-35. https://doi.org/10.25071/2291-5796.126

National Nurses United. (2021). National nurse survey reveals devastating impact of reopening too soon.
https://www.nationalnursesunited.org/press/national-nurse-survey-reveals-devastating-impact-reopening-too-soon

Nightingale Pledge, 1893. (n.d.). The Truth About Nursing. https://www.truthaboutnursing.org/press/pioneers/nightingale_pledge.html#gsc.tab=0

About Hyeyoung Hwang

Hyeyoung Hwang, MSN, MBE, RN, OCN

I am a dual DNP/PhD student at the Johns Hopkins School of Nursing with over a decade of experience as an oncology nurse. My passion lies in implementation science and nursing ethics, which I have explored through master’s degrees in nursing and bioethics. These academic pursuits have deepened my commitment to addressing ethical challenges in nursing practice.

Between my extensive nursing experience in South Korea and my ongoing journey in the United States, I bring a unique global perspective to my work. These diverse experiences have broadened my understanding of the systemic challenges nurses face worldwide. In both academic and clinical settings, I advocate for sustainable and ethical care cultures where nurses and patients can thrive together.

I am grateful to Dr. Kamila Alexander, who led the Philosophical Perspectives in Health course at the Johns Hopkins School of Nursing. Her guidance and insights greatly enhanced my understanding of philosophical thinking and writing, inspiring me to share my perspectives through blog posts as a new creative endeavor.