Between shifting technologies, staff shortages, rising levels of burnout, and new expectations from patients and employees alike, healthcare has never been more complex than it is right now. And nowhere does this complexity show up more than in the emergency department. If we are to continue to do a great job of serving the patients who count on us—and the caregivers who do that crucial work—the ED must be rewired for today’s reality.
This rewiring begins with culture. When healthcare teams are asked to do more with less, their work environment must be grounded in a culture of loving care. Yes, I used the “L” word, because I have seen its power firsthand. Love in healthcare isn’t soft, and it isn’t a nice-to-have. It’s foundational. When leaders use loving care to show ED staff that their well-being is a priority, trust grows, burnout decreases, and patient outcomes improve.
Here are seven ways to create a culture where staff feel safe, supported, and seen.
Understand that culture is linked to systems and outcomes. Stop treating culture as separate from operations. In the ED, flow, staffing stability, leadership behavior, and patient experience are interconnected. Boarding increases stress. Stress erodes communication. Poor communication weakens trust. Trust, of course, is central to retention and patient outcomes.
Rewiring means redesigning systems and culture together. We cannot fix throughput without addressing burnout. We cannot improve patient experience while ignoring how caregivers feel delivering care. When leaders align people, processes, and expectations, the right care happens the first time, and performance strengthens across the department.
Treat staff well-being as a foundational discipline, not a side initiative. If well-being is optional, it won’t survive the hectic pace of the ED. Leaders must treat emotional safety, structured debriefs, and workload conversations as operational priorities, not extras. That means asking better questions, listening for strain, normalizing support resources, and following up visibly. When leaders consistently model presence, empathy, and accountability, they send a clear signal: Caring for the caregiver is infrastructure.
Rewire your rounding practices… If your rounding centers on, “Do you have what you need?” you’re missing the real pressure points your team feels every day. Ask instead: “Where are you feeling stretched too thin?” “Do you feel safe speaking up?” “What’s been most overwhelming lately?”
…And act on what you hear. When leaders document themes and follow up visibly, rounding shifts from a task to a trust-building strategy—and trust is the foundation of both retention and performance.
Normalize employees’ using available support tools. If tools like peer support, Code Lavender, EAP services, or structured debriefs are treated as crisis-only interventions, staff will resist them. Instead, normalize these resources before they’re needed. Talk about them in staff meetings. Use them yourself. Frame them as protection, not labels. Support tools work only when leaders help teams accept them as part of the job, not as a sign that someone is failing.
Develop new leaders to build trust. Do not assume clinical excellence translates into leadership readiness. Identify emerging leaders early and equip them with the skills they were never formally taught: how to manage flow under pressure, hold accountability with respect, communicate clearly in crisis, and lead through change. These are the building blocks of trust, and in today’s environment, leaders need these skills from day one. When leaders are confident, consistent, and emotionally intelligent, trust takes root. And in the ED, trust is the foundation of both well-being and performance.
Empower staff to see the person behind the patient. The ED has long operated under a “treat-and-street” mentality. But a culture of loving care asks more. It requires staff to shift from seeing a diagnosis to seeing a human in distress. This shift is practical, not sentimental. Making eye contact, using a patient’s name, explaining delays, and offering clarity about what happens next builds trust, offers dignity, and strengthens outcomes.
Caregivers are gritty and resilient, but resilience is not a strategy. At the end of the day, they need a culture that values them as human beings. When staff feel safe, prepared, and respected, performance changes. A culture of loving care creates a ripple effect that reaches patients, teams, and the entire organization. When we can create that in today’s ED, we’ve found our competitive advantage…and we’ve created a place where the best people want to be.
Regina Shupe will present on Rewiring the Way We Care for Our Team Members and Rewiring the Emergency Department: Designing the Future of Emergency Care at the Rewiring Healthcare: Foundation to Future Conference, to be held April 28-29, 2026, in Atlanta, Georgia. To learn more about the conference, to see the detailed agenda, and to register, please visit RewiringHealthcare.com.
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About Regina Shupe:
Regina Shupe, DNP, RN—author of Rewiring the Emergency Department: Innovative Solutions for Modern Emergency Care—serves as an advisor, speaker, author, and thought leader for Healthcare Plus Solutions Group®. She brings greater than 30 years of nursing leadership and healthcare operational leadership with expertise in emergency services. She is an innovative healthcare leader driven by the correlation between positive team culture and improved patient outcomes. She leads transformative organizational change by leveraging proven clinical, operational, and leadership development.
She holds a doctor of nursing practice degree. She is a member of Sigma Theta Tau International and the Emergency Nurses Association. She holds a certification in LEAN for Healthcare.
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