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  • Writer's pictureMegan Filoramo

What to do when you just don't care

Once upon a time I had empathy. I connected with my patients quickly and seemingly effortlessly. But then, over time and without me even noticing, my empathy started shriveling up until, poof! One day it was gone altogether, leaving a hole in me where it had once been. I’m not sure what happened to it, I didn’t WANT it to go. It is unlikely that it will come back.

The end.

Not the most inspiring story, I know, but it was MY story a number of years ago.

Does this sound like a summary of your recent nursing career? Do you feel heavy just reading about it?

It’s a terrible way for a nurse to feel, that their empathy just somehow disappeared. I mean, no one goes into nursing because they DON’T care.

And yet, this is a common trend in nursing (and one of the signature traits of burnout).

So what happens? How do so many nurses get into this situation where they feel powerless to care and then pile guilt or shame on top of this powerless apathy?


And more importantly, what do we do about it? How did I get from that story to where I am now, loving that same job, rekindling my empathy, AND starting a business dedicated to helping other nurses change their stories too?

I am so glad you asked 🙂

First, let’s start with some basic truths.

  1. You are not a bad nurse or a bad person if you find yourself not caring anymore.

  2. Your empathy is not gone, it is being stored. (More on that later.)

  3. This is not an irreversible state of affairs. It is not the end of the story.

My journey through this was messy, with lots of false starts and wrong turns, but I am so glad that I went through it so that I can give you some strategies to get through it faster.

So why DO we stop caring? It’s a faulty application of a coping mechanism, of a survival strategy.

Let me explain.

It’s based in the Conservation of Resources theory. When we have a big expenditure of resources (like working in nursing for years) and those resources are not replenished, we default into conserving the resources we have (like the energy we spend caring).

It makes sense when you think about it, it’s like calories in vs calories out. You can’t just keep putting calories out without ending up in a dangerous, life threatening situation.

But here’s the problem. When our survival mode kicks in, we withdraw as a self-protective measure to conserve resources, which would make sense IF IT WORKED.

This is where the “misdirected” part comes into play.

Withdrawing inward doesn’t make us feel better as nurses, especially when the care of the patient is one of our core values, one of our intrinsic character traits. While it might conserve energy initially, it robs us of one of our greatest sources of energy, care of the patient. It continues to depress our resources.

Is your mind blown yet? I know mine was when I realized that pulling away was the direct opposite of what would help me. Not caring was taking away one of my resource replenishment sources.

Leaning IN is the answer, not leaning OUT.

Right about now you are probably thinking “Nice story, so the answer to not caring is to care? Thanks so much. If I knew how to make myself care, I wouldn’t be reading this.”

I love the skeptics- here’s the how to care part.

First off, let’s let go of the blame. Sure, we can blame ourselves, or the system, or the patients, but this just makes us feel worse. Blame takes away our ability to move forward. It gets us caught in anger, self-deprecation, and resentment (talk about an energy suck).

There are lots of contributing factors to the stress of nursing but I know for a fact that you can feel better without the system changing. I have done it and it changed my life.

So let’s not wait for the system to be fixed for you to feel better.

What if there is no blame? What then?

Show yourself some compassion, you aren’t a bad person for not feeling empathetic, you are just trying to protect yourself.

  1. Give yourself some credit for the work you ARE doing. You are making a difference in a lot of people’s lives, even when you don’t have enough time, energy, or resources. These things don’t equate to your lack of value.

This is more important than it may seem. Feelings of inadequacy also suck our resources. Stop telling yourself you could do better and appreciate that you are doing a lot of good in a system that maybe doesn’t support your idea of “perfect” patient care.

There is no such thing as perfect patient care, only the care we give.

  1. Focus on the patient in front of you. Lean in to what they are saying. Find a way to support them. Tell yourself that it is important and will make you feel BETTER, and not worse. Research shows us that nurses who feel that there is meaning in their work have less burnout symptoms. Sign me up.

  2. Remember that having or not having empathy is not something that has to just happen to you. You can affect your level of empathy by doing these things. Caution: do not slide into blame here. No one is to blame, it was just your survival instincts kicking in in a faulty way. Now that you know, you can get unstuck.

  3. Actively look for some other ways to restore your resources so that you don’t have to fall into giving up empathy. These may include getting enough sleep, drinking enough water, collaborating with teammates, relaxation, exercise, reframing negative work experiences, becoming involved in other things. Yes, it may take some time and creativity but if it allows you to keep your empathy, it’s worth it.

I promise you these things will work. It doesn’t have to be hard. Your empathy is not gone, you don’t have to find it, it’s just stored as energy.

I feel like this is so important, I am going to say it again.

Here’s the short version of how to get your empathy back.

  • Stop blaming yourself and show yourself some compassion that you are struggling with this difficult work that we do.

  • Take control of finding a way out, despite the less than stellar healthcare system. Responsibility = power and power feels great.

  • Focus on the patient and drown out the other noise around you, one patient at a time. Tell yourself something good about the patient interaction before going into it, even if it’s just “I can help anybody”. This is easier once you realize that feeling empathy is within your control and you can redirect your misdirected coping mechanism. It just takes a quick mental reminder.

I hope this gives you some comfort. Your core values are still intact. You are still an empathetic nurse.


I know this work can feel overwhelming to do on your own. If you need help like I did, I am here to help. I am offering a webinar on this exact topic on 4/26/23 at 7:30pm EST. Register here.

Can’t make the webinar but need some 1:1 help? Schedule a free consult call here or send me a message.

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