When “sustainability” becomes a silencing tool

In health-care organizations, “sustainability” is often presented as a neutral and rational criterion – an objective standard used to decide which initiatives continue and which are quietly withdrawn.

In practice, sustainability is rarely neutral. It’s shaped by decisions about who holds responsibility, who provides labour and who controls recognition.

A common but under-discussed phenomenon in nursing workplaces is the removal of nurse-led recognition initiatives under the rationale that they’re “no longer sustainable,” without parallel examination of organizational accountability.

Here’s an example. A peer recognition board was introduced in a critical care setting as a grassroots initiative to acknowledge everyday acts of nursing excellence. Participation was initially high. Nominations were visible. Momentum was sustained through informal but consistent facilitation – names were announced, contributions were highlighted and the board was actively moderated.

When that facilitation stopped, participation declined. No replacement process was implemented. No one was formally assigned responsibility to moderate, communicate or integrate the initiative into existing structures. Over time, the absence of organizational stewardship was reframed as evidence of the initiative’s failure.

The board was removed.

The explanation offered was familiar: lack of sustainability and limited use. 

What went unexamined was the organizational choice not to resource, support or assume responsibility for the work required to sustain the initiative. The labour of recognition – often invisible, often relational – had been carried informally by a nurse. When that labour ceased, the system didn’t adapt. Instead, the initiative was judged.

This pattern reflects a broader issue in nursing workplaces: empowerment is frequently encouraged in principle but constrained in practice. Nurse-led initiatives are welcomed when they align neatly with managerial priorities and require minimal oversight. When they require sustained attention, shared accountability or structural support, they’re often reclassified as unsustainable. 

Importantly, the language of sustainability shifts responsibility downward. Rather than asking why leadership didn’t integrate the initiative into formal processes, the burden is placed on the initiative itself – or implicitly, on the nurse who led it. 

This has consequences. Nurses learn, often implicitly, that stepping forward carries risk. That innovation without formal ownership can later be reframed as failure. That recognition work is valued rhetorically, but not operationally.

For unions, this raises important questions: Who is responsible for sustaining initiatives that benefit staff morale and retention? How is invisible labour accounted for? When empowerment is withdrawn, who decides – and on what grounds?

This isn’t an argument against evaluation or change. It’s an argument for honesty. Sustainability should be assessed alongside leadership responsibility, resourcing decisions and structural follow-through. Without that, the term becomes a managerial shield rather than a meaningful metric.

Nurse empowerment can’t exist only at the level of encouragement. It must be supported by systems willing to carry responsibility when individual labour ends.