Why Excellence Still Matters

Burnout is real, but disengagement should not become the culture we pass on to the next generation of CRNAs and other professionals.

I saw a post recently in a private CRNA Facebook group that has stayed with me longer than I expected.

The image included several phrases that have become common in the broader “anti-work” or “act your wage” culture. Things like “work as little as possible,” “the company is not your family,” “food is not a bonus,” and the idea that people should leave jobs every few years because that is the only way to get paid appropriately.

On one level, I get it.

Healthcare has been hard, and pretending otherwise would be dishonest. Staffing shortages are real. Burnout is real. There are organizations that have asked too much of clinicians for too long without providing the staffing, resources, appreciation, or compensation needed to make the work sustainable. Many nurses and healthcare professionals have felt underappreciated, overworked, and sometimes even used by systems that celebrate them publicly while failing to support them meaningfully.

So yes, I understand the frustration. I understand why a pizza party can feel insulting when the deeper issues are unsafe staffing, excessive workload, poor leadership, or stagnant wages. I understand why clinicians sometimes feel that the only way to protect themselves is to pull back.

But I also do not get it.

What surprised me most was not that the post existed. We have all seen versions of this before. What surprised me was how much support it received from CRNAs. Seeing highly educated, highly skilled, high-earning anesthesia professionals embrace a message that seems to celebrate disengagement left me feeling a little deflated. Honestly, it left me concerned, not only for our profession, but for society in general.

CRNAs are in an extraordinary profession. We care for patients during some of the most vulnerable and complex moments of their lives. We manage complex and critical physiology in real time. We keep patients alive and safe while surgeons perform procedures that would otherwise be impossible. We are trusted with airways, hemodynamics, pain, fear, and the entire anesthetic experience. That is not ordinary work, it is extraordinary.

In my opinion, the answer is not to care less, and it certainly is not to mail it in. Once we accept that mindset, even subtly, we risk lowering the internal standard that makes this profession so meaningful. We should never confuse protecting ourselves with becoming indifferent to the work, the patient, or the profession. The answer is to care better: about the patient, about the profession, about ourselves, and about the culture we are building every time we walk into the OR.

That does not mean we should tolerate poor work environments. It does not mean we should ignore unsafe staffing or accept disrespect from facilities, administrators, surgeons, or anyone else. It does not mean we should confuse professionalism with being taken advantage of. Healthy boundaries matter. Fair compensation matters. Safe practice environments matter. Advocacy matters.

But boundaries and excellence are not opposites. Advocacy and gratitude can exist together. Wanting to be paid fairly does not require us to abandon pride in our work.

That is where I think some of this messaging goes wrong. It takes legitimate frustration and turns it into cynicism. It takes real systemic problems and suggests that the solution is to care less, do less, and emotionally detach from the work. I understand why that may feel protective in the short term, but I worry deeply about what it does to us over time.

For my entire career, I have tried to do the best job I could. Not because every employer deserved it. Not because every facility was perfect. Not because anyone was rewarding every small extra effort. I did it because the work mattered, the patients mattered, and I took pride in doing things well.

Doing the little things right has always given me a sense of personal joy and satisfaction. That internal satisfaction matters. It creates a form of happiness that does not depend entirely on external recognition. It builds professional identity. It creates gratitude. And in my experience, gratitude is one of the strongest protections against burnout.

Burnout often grows when people feel disconnected from purpose. If work becomes nothing more than a transaction, then every inconvenience feels heavier, every frustration feels personal, and every extra effort feels like exploitation. But when we remain connected to the meaning of the work, the patient in front of us, and the privilege of being trusted in critical moments, the work can still be hard without becoming empty.

That distinction matters.

I am not arguing for blind loyalty to any employer. The company may not be your family, and that is probably a healthy thing to remember. Employment is a professional relationship, and both sides have responsibilities. But the fact that a company is not your family does not mean your work should be reduced to a cold transaction. It also does not mean your professionalism should rise or fall based solely on whether the organization around you is perfect.

There have been plenty of times in my career when I have been frustrated with organizations, systems, policies, or leaders. I have not always felt appreciated. I have not always agreed with decisions. I have not always been treated exactly how I thought I should have been treated. But I never wanted someone else’s poor leadership to determine my character, and I never wanted a frustrating workplace to lower my own standards.

That, to me, is the danger of the “work as little as possible” mindset. It may begin as a defense mechanism, but over time it can reshape the person practicing it. It lowers the internal bar. It chips away at pride. It turns a profession into a transaction and then wonders why the work feels so unfulfilling.

The answer to burnout cannot be collective disengagement. The answer has to be better leadership, better systems, better staffing, healthier boundaries, meaningful advocacy, and a renewed connection to purpose.

We can acknowledge the broken parts of healthcare without allowing them to break us. We can push back against exploitation without abandoning excellence. We can demand fair treatment and still feel gratitude for the incredible profession we are fortunate to practice.

I know some will disagree with this. Some may say this misses the point or that it is too idealistic. But I believe the way we approach our work matters deeply, not just for our patients, but for ourselves and for the culture we pass on to the next generation of CRNAs.

I want future CRNAs to know they are entering an amazing profession. It is a profession built by generations before us who fought for education, practice authority, reimbursement, respect, and recognition. It is a profession that allows us to make a wonderful living while doing deeply meaningful work. It is a profession where excellence still matters.

I do not want them to inherit a culture of resentment. I want them to inherit a culture of gratitude, advocacy, professionalism, and pride.

So yes, I get the frustration. I understand where some of these sentiments come from, and I agree that healthcare systems and leaders need to do a better job supporting clinicians.

But I do not get the surrender.

We should set boundaries, support one another, and leave toxic workplaces when necessary. But we should not let frustration convince us that doing less is the answer.

The answer is not to care less.

The answer is to care better. About the patient. About the profession. About ourselves. And about the culture we are building every time we walk into the OR.