For many people, the holiday season evokes images of rest, celebration, and togetherness.

But for those working in healthcare—nurses, care coordinators, physicians, senior living staff, administrators—the season carries a different emotional weight. It is a time marked by joy and gratitude, yes, but also by intense workloads, heightened emotions, and a type of exhaustion that feels both familiar and unavoidable.

This is the holiday paradox: the coexistence of joy and fatigue, of meaningful moments and monumental stress. And it’s a rhythm anyone who has worked in care understands intimately.

The Data-Driven Surge: Where Holiday Stress Hits Hardest

Beyond the emotional weight of the season, the holidays also bring predictable surges in patient needs. The data reveal just how sharply cardiac, respiratory and mental-health pressures rise—intensifying the strain on frontline care teams.

Cardiac and Acute Care Spikes

TDuring the holidays, many people eat heavier meals, drink more alcohol and feel more stress than usual. Some also wait too long before getting medical help. These habits can be dangerous. Studies show there is a 5% to 15% increase in heart attacks and heart-related emergency room visits from Thanksgiving through New Year’s.

Research also shows that heart-related deaths are highest around Christmas and New Year’s. This means the holidays are a risky time for people with heart conditions, and it puts extra pressure on emergency and acute-care teams.

Respiratory Illness and ED Volume

Holiday travel, busy stores and indoor parties make it easier for viruses to spread. During a normal (non-pandemic) year, the biggest spike in flu-like illness visits to the ER happens between Christmas and New Year’s.

Some studies report that emergency departments see up to a 10% increase in overall visits during long public holidays compared to regular weeks. This rise in patients can overwhelm hospitals, especially when staff are already stretched thin.

Managing Mental Health and Delayed Care

The holidays can also be emotionally hard. Even if emergency psychiatric visits don’t always spike on the holiday itself, many people still struggle. A survey by the National Alliance on Mental Illness (NAMI) found that 64% of people living with a mental illness feel their symptoms get worse around the holidays.

The problem grows when clinics and family doctors’ offices close or reduce their hours. People who need help often have nowhere else to go but the emergency department. This includes those with rising mental-health concerns as well as people with physical issues that could normally be handled in a regular clinic. As a result, ER teams face even more pressure during an already busy season.

The Emotional Rhythm of Care—Amplified in December

Care work is always demanding. But the holidays amplify everything.

Families visit more often. Emotions run higher. Staffing becomes more precarious. Seasonal illnesses surge. Administrative deadlines pile up. Meanwhile, residents and patients feel the strain too—some experiencing loneliness, others nostalgia, others confusion as routines shift amid decorations and festivities.

For staff, it becomes a month of holding everyone else’s emotional needs while trying to manage their own.

And still, they show up.

Because showing up is what care workers do. But the emotional labour required comes at a cost. Consider that:

A 2023 national survey by the American Nurses Foundation found 56% of nurses report feeling “exhausted”, and 64% say they feel “burned out”—with stress peaking between November and January.

Nearly half of healthcare workers (40%) report symptoms of burnout, while healthcare worker burnout increased from 30% to 40% between 2018 and 2022, with holiday seasons cited as spike periods.

In care settings, joy doesn’t replace exhaustion—it exists alongside it.

Navigating the Contradiction: Sustaining Compassion

The defining challenge for healthcare organizations and their staff is not to eliminate this paradox, but to effectively navigate it. Recognizing that joy and exhaustion are two sides of the same coin—both products of deep engagement in human life—is the first step.

Strategies for Mitigation and Support: To lessen the impact of holiday stress and to sustain the compassion that defines the work, structural and cultural supports are critical.

Prioritizing Peer Support: Creating designated time and space for informal check-ins and debriefing is essential. When colleagues share the weight of emotional intensity, the burden is often halved. A supportive glance, a brief moment of active listening, or acknowledging the difficulty of a specific shift can provide immediate emotional relief.

Encouraging Micro-Breaks: The focus should be on short, intentional breaks to reset the nervous system. Five minutes of quiet time, a walk down the hallway, or a brief conversation about a non-work topic can prevent the complete depletion of energy reserves. Leadership must actively model and permit these restorative moments.

The Power of Gratitude: Implementing formal programs for expressing gratitude can be highly effective. A simple system of thank-you notes, brief acknowledgments, and other options signals that the organization sees and values the intense effort being expended.

Clear Boundaries: Staff should be strongly encouraged to maintain clear boundaries between work and personal life. When off-shift, the professional role must be consciously set aside. Engaging fully in personal rest and non-work activities is not a luxury; it is a clinical necessity for preventing burnout and ensuring the capacity for care in the next shift.

The Final Word

The holiday paradox, while challenging, is a testament to the profound nature of healthcare work. The coexistence of deep joy and profound exhaustion is merely a reflection of a field that engages daily with the extreme poles of the human condition—life and loss, hope and despair. 

By acknowledging the reality of holiday stress and implementing human-centered support, organizations can ensure that the enduring spirit of compassion remains intact, allowing the fleeting moments of holiday joy to sustain the dedicated individuals who carry the weight of care through the darkest and brightest of times.