The essence of nursing remains grounded in the concept of caring, formed on the premise of what Florence Nightingale set out to achieve so many years ago: doing good for others. As centuries have passed, the scope of nursing has evolved and technology and health care have expanded. The heart and soul of nursing have undergone a tumultuous journey.

The role that caring plays in the nursing profession has achieved a certain irony as the health care industry has become more competitive. Professionalism, respect, and teamwork are the foundations of nursing, but they have come under fire as a dog-eat-dog world falls prey to bullying, violence, cronyism, and addictions. Health care organizations plunge forward with their legislative mandates of promoting people’s health and well-being while nurses feel the pinch of no protection, no policies to safeguard them, and no support from senior leaders or executives. This divide can jeopardize nurses’ mental health, their performance, and ultimately even their lives.

The issue of nurses' mental health is reaching epidemic proportions, especially in light of the global nursing shortage and aging population that places increasing demands on current nursing resources. Health care organizations, hospitals, and governments need proactive legislation, supportive resources and infrastructure, zero tolerance policies, mandatory education in-services, and mental health promotion strategies to support individuals and develop processes to protect nurses from mental health threats.

My book, the Workplace Mental Health Manual for Nurse Managers, analyzes in-depth the factors of health care work environments that affect stress and mental health. I also address individual and group dynamics in the context of institutions and make suggestions on how to make unhealthy work environments healthier, more productive, and more caring. I suggest that managers in the health care industry read it in order to improve the workplace environment and mental health of their employees. But broader changes need to be made.

The majority of nurses spend approximately 30% of their lives at work. As the nursing profession has undergone significant transformations and nurses' mental health has gone virtually unchecked, it is imperative to rejuvenate nurses' senses of self and value, their integrity, confidence, and most of all, their psychological well-being. Action to support our nurses and their mental health comes under the directive of what nurses are licensed to do: protect the public.

Nurses care for patients and vulnerable populations more than any other health care provider. Their expertise, knowledge, competence, and confidence are critical for the quality and safety of patients' health and lives. The promotion of nurses' mental health is a win-win goal, and it needs to be addressed now.

For nursing to be truly responsive to the needs of society and make contributions that are consistent with its roots and early origins, both nursing education and the healthcare delivery system need to be based on human values and the concern for the welfare of others.
- Jean Watson, 2014