Beyond Heroic Individualism: Cultivating Relational Buffers Against Healthcare System Strain
本文批判医疗系统中以个人责任为核心的问责模式，提出关系性责任框架，将责任分散到团队、政策和技术网络中，以减轻护士的心理压力并增强系统韧性。
ABSTRACT Nurses endure elevated rates of burnout, moral injury, and suicide. These outcomes are exacerbated by healthcare systems that prioritize individual responsibility, isolating nurses as sole bearers of accountability for systemic failures. This model of responsibility reflects broader patterns in feminized labor, where caregiving is framed as a moral duty rather than a professional practice requiring structural support. This paper critiques individual‐centric accountability models and proposes a relational framework to redistribute responsibility across human and nonhuman networks (teams, policies, and technologies), thereby mitigating psychological strain and fostering systemic resilience. This study employs a conceptual analysis approach, drawing on feminist and new materialist philosophies to examine accountability structures in nursing. Using the theories of Guattari's three ecologies (environmental, social, and mental), Haraway's response–ability, Braidotti's affirmative ethics, and Barad's diffraction we critically assess how traditional frameworks of individual responsibility reinforce systemic inequalities and moral distress. By integrating insights from gender studies and organizational research, we explore how responsibility can be reconceptualized as a relational process rather than an isolated punitive mechanism. The methodology is interdisciplinary, engaging theoretical perspectives from sociology, nursing studies, and posthumanist ethics to challenge entrenched notions of responsibility in healthcare systems. Individual blame obscures structural drivers (understaffing, resource shortages) and perpetuates moral distress. With the concept of relational forward‐thinking responsibility we rethink accountability as distributed across networks, emphasizing interdependence. Emerging technologies such as AI diagnostics further disrupt individual blame models, necessitating shared accountability among developers, institutions, and practitioners. Shifting from individual accountability to relational, forward‐thinking responsibility may reduce burnout, moral distress, and emotional exhaustion by redistributing emotional labor and systemic risk. This framework aligns with posthumanist ethics, prioritizing interdependence across ecological, social, and technological dimensions, while strengthening nurse well‐being, retention, and sustainable healthcare provision. Healthcare institutions must adopt organizational reforms: (1) policy: mandate workload equity, staffing reforms, and transparency laws; (2) practice: implement interdisciplinary collaboration, systemic incident audits, and mental health support; and (3) technology: regulate AI accountability, ensuring shared liability between developers and institutions. Such shifts foster resilient care ecosystems, centering nurse well‐being and sustainable healthcare delivery.