Behind the Nurse's Smile: Critical Care Nurse Nicole Moore Pens Book About Life in the ICU

The author dubbed herself a "survivor of the system," and now she's telling her story. Or, a fictionalized version of it. 

One would think that being a working mom of five boys would be enough to keep anyone busy, but Nicole Moore (@chaoscoordinator86), BSN, RN, 38, from Kansas City, MO, decided to add just one more accolade to her busy life. The critical care float nurse penned "Behind The Nurse’s Smile," a best-selling novel that peels back the curtain on life as an ICU nurse in a very real and raw way. 

Nurse.org got a chance to hear directly from the author about why she wrote a book for the "burnt-out underdog," what her life as a nurse looks like, and why she has dubbed herself a "survivor of the system." 

A Nursing Evolution

Moore became a nurse shortly after her second baby was born and notes that nursing runs in the family, as her mother, aunt, and younger brother are all nurses. 

"Once I stepped into it, it clicked," she says. "It felt like joining the family trade."

Nursing is so ingrained in the family, in fact, that Moore's mother went to school and worked at the same facility where Moore would later be born, which also happens to be the facility she went to school and now works at, and the same facility her brother is now attending school and working at. 

She remarks that nursing is one of those jobs that you will know "immediately" after working your first shift if it's for you or not, and fortunately, for her, nursing worked. 

Eventually, Moore made her way into critical care, where she has remained as a float nurse for over three and a half years, working in ICU, telemetry, or stepdown units. She describes herself as the kind of nurse "who walks straight into the room that everyone else takes a breath before entering."

Moore's career as a bedside nurse has spanned everything from ICU to telemetry to stepdown. "If it required composure, chaos-management, and a sense of humor, that’s where I lived," she quips. 

"I’ve had everything from fresh post-ops to fresh traumas," Moore adds. "I’ve been the wide-eyed new nurse and the one who was handed the toughest patient because 'you can handle it.' ICU accelerates your evolution whether you asked for it or not."

A Burnout that Led to a Birth

In her book's description, Moore calls herself a "survivor of the system" and admits that she, like many other nurses, has experienced burnout.

"In critical care, the actual clinical work never scared me," Moore says, but notes that what did break her down was the environment where "asking for help was seen as incompetence, and exhaustion was treated like a moral failing."

"There were days I walked into my shift already bracing myself," she admits. 

She points to hardships that ranged from the way nurses are spoken to, to dismissiveness, to pressure to push through situations that were "objectively unsafe."

She blames "the system" for nursing burning out, pointing to factors such as unsafe ratios, impossible expectations, endless tasks, and the pressure to 'stay professional' even when the system is falling apart.

"Burnout is the emotional cost of pretending everything is fine, " says Moore. 

Unable to pretend anymore, Moore says she started quietly writing on her phone as a way to relieve the pressure of her job. Although she hadn't had any prior experience as a writer, the words flowed—sometimes at 2 AM—as she found an outlet for what she was facing as a nurse. 

"I wrote because I hit a point where staying silent felt more dangerous than telling the truth," Moore adds.

After her late-night writing sessions added up, Moore decided to self-publish her book, a move she says she made strategically because she wanted to be able to fully tell her story. 

"I didn’t want anyone watering down the truth I was finally brave enough to say out loud," she explains. 

The process of self-publishing was involved, with steps like formatting, making a cover, listing on Amazon, marketing, and sales, but Moore notes that jumping in and figuring it out were tasks she was well familiar with as a nurse, so she wasn't afraid to give it a go. 

Behind the Smile (and the Book)

Moore describes her book "Behind the Nurse’s Smile" as both a "love letter" and a "battle cry," for every nurse who has "ever swallowed a scream, bit back the truth, or dared to give a damn when nobody was watching."

The book is fictional, but is based on Moore's own experience as an ICU nurse. The story follows burned-out ICU nurse Callie, who reaches her breaking point.

"It’s a book about the cost of caring in a system built on our backs," says Moore. "Have I experienced what Callie goes through? Yes but so have more than 3,700 nurses.  Of course I drew from pieces of my lived experience. That’s why it hit as hard as it did. I’m not a unique nurse experience, and neither is Callie’s."

The book even got its name from Moore's own lived experience being told that she should continue to smile while working in grueling and dire circumstances.

"I don’t have to smile to do compressions," she points out. "I don’t have to smile to walk down a hallway. I'm not a prop to make a facility look good by smiling while ignoring the fact that the place is on fire."

"I’ve always been the woman people say, 'You should smile more,'" she continues. "I don’t not smile. I’m just not fake, and considering the same isn’t told to male nurses, it’s still an active problem that needs to be squashed. 

Clearly, Moore is a nurse with a lot of insight to talk about, and her message is making its way through her fellow nurses. Moore says nurses have been reaching out to her after reading the book, thanking her for the validation its pages provide. 

"The reaction has been overwhelming in the best way," Moore says. "Messages from nurses saying, 'I felt seen for the first time,' or 'This is my story,' and 'I cried because it felt like someone finally understood.'"

Part of the process of writing the book was also Moore's own healing journey from burnout, which she says she's still addressing. But she already has plans for a second book, along with some potential tools for nurses to use, and is moving forward by working PRN at the hospital and spending time gaming and enjoying her family. 

"If this book has opened even one door, started one conversation, or made one nurse feel seen…then it’s doing exactly what it was meant to do," Moore says. 

Find Moore's book, "Behind the Nurse's Smile," on Amazon and follow her on Instagram, TikTok, Substack, and Facebook. 

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