Behind the controlled chaos of the emergency room, nurses remain a steady constant as they address people’s medical needs. As patients, we see them swiftly navigate diagnoses, treatments and more. However, there’s more to their shifts than meets the eye.
Nothing captures that quite like “The Pitt,” a medical drama that premiered on HBO Max this year. The show gripped viewers with its raw portrayal of health care behind closed doors, exposing the haunting realities ER nurses endure on the job ― realities that many who don’t work in medicine may not even realize are occurring.
Take, for instance, a disturbing plot in Episode 9, where charge nurse Dana Evans (played by Katherine LaNasa) walks away with a bloody nose after being struck in the face by a frustrated patient. The interaction leaves a medical student stunned. After the incident, other nurses on the show spoke up, revealing that they have dealt with similar experiences.
Following the episode, real-life ER nurses began sharing their own stories of workplace violence on social media, praising “The Pitt” for accurately portraying the issues frontline medical staff face.
Research shows that health care workers in the emergency department are highly likely to experience workplace violence, including physical violence. According to a 2023 survey of all types of nurses from National Nurses United, nearly 50% of respondents noted an uptick in workplace violence compared to the previous year, with 26.3% reporting that it had “increased a lot.” A 2024 study found that emergency room nurses face elevated levels of role-related stress, occupational burnout and depression.
And that’s not all nurses are navigating. From the emotional toll of traumatic cases to the quiet moments of human connection that linger long after their shifts end, HuffPost asked nurses to share some of the unseen issues they encounter on a regular basis.
Here’s what they want you to know about what’s going on behind the scenes. (Interviews have been edited for clarity and length, and some last names have been hidden to protect medical workers’ job privacy.)
Nurses think about every medical decision they make during their shift — even after they leave the hospital.
“Emergency department experiences don’t just end when you clock out ― they stay with you. They’re emotional in every sense: personally, professionally and humanly. The things we see and do in the emergency department are things most people will never encounter in their lifetime, and those moments leave an imprint that doesn’t fade quickly.
Some memories stick because of their weight, others because of the intensity of the decisions we had to make in a matter of seconds. That’s part of what makes nursing so remarkable ― the ability to process complex checklists, assess and act with lifesaving precision in moments where every second counts. One of the hardest parts of being a nurse is lying in bed after a shift, overwhelmed with anxiety — replaying every decision, every action, wondering if you missed something or made a mistake. Did I chart everything correctly? Did I remember to titrate the drip before I left? Did I overlook a subtle sign of decline? Did I notify the doctor about that critical lab? No one really prepares you for that — the relentless loop of what-ifs follows you long after you leave the hospital.” ―Stephanee Beggs, a registered nurse
They help patients and loved ones navigate grief, which weighs on them.
“We spend 12 hours a day trying to make others feel better but when it comes to grief and uncomfortable emotions, although we intend to help, we often try to use our same nursing skills of fixing. It has taken me many years to learn this, but grievers don’t need to be fixed, they just need to be heard. In many ways my greatest gift and healing as an ER nurse was not my ability to medicate or give CPR but to be present, hold a hand and simply listen.” ―Tara Rynders, registered nurse
Disrespect and physical violence are becoming more common.
“We have to be ready to care for anyone who comes through our doors … patients of all ages and acuity levels. We see toddlers with unexplained rashes, gunshot victims, heart attack patients, people experiencing mental health struggles. And we care for these patients simultaneously, which requires the ability to pivot and adjust accordingly.
The challenges that absolutely aren’t supposed to be part of our jobs are the disrespect and physical violence coming from patients or their companions that is occurring all too often today. Crowding and ED boarding place extra burdens and make it harder for emergency nurses to provide the best care.” ―Ryan Oglesby, registered nurse and president of Emergency Nurses Association
It’s also becoming harder to build resilience.
“We work 12.5-hour shifts with only a 30-minute break all day. You don’t get a moment to reset if you just had to deal with a difficult family or sad case. The screaming cry of a mother who just lost her child is a sound I will never forget. And then you have to go home and try to take care of yourself. You can’t pour into other people if you’re empty yourself. So resilience in nursing is definitely a problem, and burnout can happen easily.” ―Megan T., registered nurse
ER nurses have to navigate the aftermath of attacks in their daily lives.
“I have been kicked, tripped, bitten, hit and groped by patients I treated with care and respect. And then on I go into the next task, face wiped clean, and tell myself I’ll think about it later. I still get jumpy with sudden movements in my peripheral vision because one time that was a chair coming towards my head. My husband surprised me with an embrace and I turned and shoved him away because I felt cornered, like that one time a patient grabbed me from behind and reached for the stethoscope around my neck.” ―Natalie M., registered nurse
They don’t get much help with their burnout.
“During COVID, we were running six, eight, even 10 patients each, constantly. I caught my director in the hallway and begged him for help. I pleaded with him, ‘This is not sustainable,’ and he said, ‘Get used to it.’ It absolutely destroyed me. I lost all hope, all courage, all care. It changed my relationship with the emergency room.” ―Kelsea H., registered nurse
They deal with a lot of ‘darkness.’
“You see, as an emergency department nurse, you’re not typically afforded the time or space to truly experience the devastation that unfolds in front of you. You are trained to move. Move to the next patient, the next task, the next crisis. This is why ED nurses burn out. There is only so much darkness a person can hold before they begin to crack.” ―Kristen G., registered nurse