Where Is the Care in Health Care?

Patricia Jakel, MN, RN, AOCN

Jean Watson captured the essence of nursing in her well-known “Theory of Human Caring,” first introduced in 1979. At its core, the theory asserts that “humans cannot be treated as objects, [and] that humans cannot be separated from self, other, nature, and the larger universe.”¹ This foundational belief highlights that caring is not only healing for those receiving care but also for those providing it.

When did the health care system in the United States lose its caring for ourselves and others? Why do our patients feel less cared for as we move forward with improved technology, such as artificial intelligence (AI), that has increased efficiency in our large, burdened systems? Why do the many text messages reminding us of an appointment, arrival time, location, and parking make us feel less seen and cared for?

We can trace the lapse in feeling cared for back to before COVID-19, when health care shifted its focus from caring to efficiency, cost-cutting, and advanced technology. Of course, health care workers (HCWs) still want to provide compassionate care, but pressures from the system make compassion difficult to invoke for each encounter. Several key factors have contributed to this decline in compassionate care, such as burnout, staffing shortages, and the growing dominance of technology.

Staff Burnout

Burnout, which is a reaction to work or environmental stressors such as staffing and workload, causes HCWs to decrease their empathic response, withdraw from patients and coworkers, and possibly even leave the position. HCWs spend less time with each patient, have fewer personal interactions, and are pressured by administration to see more patients, with reimbursement rates falling.²

In AMN Healthcare’s 2025 survey of registered nurses, which surveyed 12,271 registered nurses, 58% of nurses reported feeling burned out most days, and 64% indicated that compassion fatigue has impacted their health.³ In addition, 71% and 42% reported sometimes, often, or always receiving verbal or physical abuse from patients, respectively. Thirty-eight percent and 8%, respectively, even reported receiving the same treatment from colleagues.

Shortages in nursing are still reported in 2025.

Nursing Shortage

A “severe” or “moderate” nursing shortage was reported by 94% of the 18,226 respondents to AMN Healthcare’s 2023 survey of registered nurses, which focused on postpandemic effects on nursing.⁴ Expectation of the shortage to become much worse or somewhat worse in the following 5 years was reported in 80% of respondents.

In 2025, 82% of nurses said that reducing the number of patients per nurse would be moderately or extremely helpful in improving working conditions for nurses.³ Additionally, only 49% of nurses report feeling valued by their employer.

Technology’s Takeover

Advanced medical technology has shifted the attention away from the patient, resulting in less personalized approaches. In the era of surgical robotics and AI, holding on to emotions such as kindness, compassion, or empathy is a top priority. Embracing new technology is key, but maintaining a grasp on fundamental human values is critical to our patients and colleagues. There is no objective measurement for kindness, empathy, mercy, or compassion—it is only felt by the person on the receiving end of these emotions.

In a literature review on the relationship between AI and health care, researchers found that 113 of 197 research articles reviewed mentioned the term “health care,” and 25 explored arguments regarding concerns over AI ethics, health care jobs, and loss of empathy.⁵

Cost factors into this shift, as well. Reimbursement does not keep pace with rising costs, causing HCWs and patients alike to feel financial strain. A system focused on profit has little time for patient well-being, and our patients are feeling stressed and hurried. The focus on efficiency over patient-centered care has harmed the trust and connection we once had with our patients and pushes us toward technology-led approaches.

Where do we go from here?

As nurses, we are seen as the most trusted and compassionate professionals while remaining the center of caring in the health care system.⁶ Compassion is a core value, an expectation, and a moral obligation of nurses, which is memorialized in the American Nurses Association’s Code of Ethics for Nurses.^7,8

Along with our ability to provide loving care, we are also asked to undertake expanding duties and complex tasks every day at work. AI and care robotics are changing the health care landscape, and nurses are tasked with keeping the caring in all we do for our patients. AI continues to grow, surprisingly including the technology to focus on ways to improve empathetic awareness, compassionate responses, communication skills, health coaching, therapeutic bond and alliance, and therapeutic interventions.

As the landscape continues to evolve, we must fiercely protect and preserve the essence of nursing: caring. Despite the growing pressures—staffing shortages, financial strain, and emotional fatigue—we carry a legacy of resilience, advocacy, and compassion. Let us lead the way in shaping a future for health care where technology supports but never replaces the human spirit.

To all nurses: You are not only essential—you are irreplaceable. Stay strong, stay compassionate, and, above all, stay human. Be well, nurses.

References

1. Watson J. The theory of human caring: retrospective and prospective. Nurs Sci Q. 1997;10(1):49-52. doi:10.1177/089431849701000114
2. Dean W, Talbot SG, Caplan A. Clarifying the language of clinician distress. JAMA. 2020;323(10):923-924. doi:10.1001/jama.2019.21576
3. Nursing in Transition: Workplace Changes, Challenges and Solutions—2025 Survey of Registered Nurses 2025. AMN Healthcare; 2025. Accessed July 17, 2025. https://online.flippingbook.com/view/408979689/18/
4. The Pandemic’s Consequences: 2023 Survey of Registered Nurses. AMN Healthcare; 2023. Accessed July 17, 2025. https://www.amnhealthcare.com/siteassets/amn-insights/surveys/amn-healthcare-rnsurvey-2023.pdf
5. Morrow E, Zidaru T, Ross F, et al. Artificial intelligence technologies and compassion in healthcare: a systematic scoping review. Front Psychol. 2023;13:971044. doi:10.3389/fpsyg.2022.971044
6. Brenan M, Jones JM. Ethics ratings of nearly all professions down in US. Gallup. January 22, 2024. Accessed July 17, 2025. https://news.gallup.com/poll/608903/ethics-ratings-nearly-professions-down.aspx
7. Provisions. American Nurses Association. Accessed July 17, 2025. https://codeofethics.ana.org/provisions
8. Stokes F, Palmer A. Artificial intelligence and robotics in nursing: ethics of caring as a guide to dividing tasks between AI and humans. Nurs Philos. 2020;21(4):e12306. doi:10.1111/nup.12306