Nursing the System

🎙 Episode OverviewYou put in all the effort to design a change project. You launch it, you train the team, you celebrate. And then a few months later, you look back and realize nobody's doing it anymore. The momentum quietly died, and now you're back at square one.This episode is about that exact problem—and what I actually do about it on my team at work. I'll walk you through my "Teddy and Judy" framing (visionaries vs. executors), why most sustainment failures are not actually people failures, and the concrete system I built with my team for Q2 of this year—which I lovingly themed "The Sea of Sustainment." You'll get the four-question monitoring plan and the three-tier triage system I use to keep change initiatives alive once the launch buzz fades.If you're someone who's great at getting the plane off the ground but loses interest once it's airborne, this one's for you.🔑 In This Episode, You'll LearnWhy most change projects don't fail at launch—they fail in the months afterThe Teddy/Judy framework (visionary vs. executor) and why you probably need to be bothWhy "people didn't follow through" is almost never the real explanationThe four questions every change initiative needs answered before you call it completeHow to distribute monitoring responsibility across a team without creating surveillance cultureHow to triage findings into three tiers—and why this distinction is everything for team trustWhy the #1 instinct in healthcare ("they need more training") is usually the wrong answer🧠 Key Ideas to Take With YouMaintenance is cheap, remediation is expensive—but maintenance requires a system, not good intentionsThe real failure point of most change projects is the absence of any system designed to catch backsliding earlyPeople are always going to people; you have to plan for thatTrack behaviors, not just outcomes—behaviors are the leading indicatorCadence should earn its way down based on team performance, not just timeWhen multiple people make the same mistake, the first assumption is not multiple people failing—it's that something about the system, training, or tool is brokenTeams take their cues about what matters from what their leader pays attention toA triage system that treats widespread errors as individual failures will destroy trust; one that treats them as system signals builds psychological safety AND better diagnoses📣 Special AnnouncementsThis episode is the part two to the holding period episode from a few weeks back. The holding period was about being deliberate before saying yes; this is about being deliberate after saying yes—long-term.If you've taken Change Maker Essentials and want structured support sustaining the leadership practice you built there, Nurse Leader HQ opens for enrollment at the end of June. The waitlist is where the application dates, the opportunity to book a discovery call, and all the details will be shared first.👉 Resources MentionedChange Maker EssentialsNurse Leader HQ (waitlist)Instagram: @nursing.the.system

🎙 Episode OverviewThis is my first-ever TV show case study episode, and it's one I've been sitting on for three years. After watching the pilot of The Bear on FX back in 2022 (the first episode is literally called "System"), I knew it was going to become content, I just wasn't ready. So I put it in the idea parking lot we talked about a few episodes ago, and waited.This past weekend, a horrific stomach flu finally gave me the bandwidth to sit down and watch the entirety of Season 1 with my notes app open. What you're getting today is the result: 11 vignettes from the show, each one mapped to a specific leadership principle I teach in Map Your Impact, Changemaker Essentials, and Nurse Leader HQ.You don't need to have seen the show to get value from this episode. I set up each scene before I analyze it. But by the end, you'll probably want to watch it. It really is a complete leadership case study packed into eight 25-minute episodes.🔑 In This Episode, You'll LearnWhy formal authority is only the starting line—and what happens when you mistake it for the whole gameHow the workarounds we don't have time to fix end up being the most expensive thing on our platesHow to bring people into a decision without asking their permissionWhy resistance is information—and the surface issue is almost never the actual issueHow to refuse the false binaries the workplace hands you (team player or troublemaker, comply or resist)Why usefulness is the currency that authority cannot buyHow language shifts are a lagging indicator of real culture changeWhy you cannot culture-train your way out of a structurally broken environmentWhat it actually means to hold a line as a team member, regardless of where you sit in the hierarchy🧠 Key Ideas to Take With YouAuthority + social power are not the same thing—formal authority is only a pieceThe workaround that becomes the workflow is never free of charge; it's costing you in smaller increments you've stopped noticingBringing people into your decisions is basic respect for the ones who have to execute and live with themYou have to hold the logic of the change AND the emotional reality of the person it's landing on—simultaneously, not sequentiallyPeople don't follow you because you're the formal leader; they follow you because you made their workday easierSometimes the bold systems-change move isn't innovation—it's reinstating the clarity that got eroded somewhere along the wayPsychological safety is not a policy, it's a moment—demonstrated by receiving hard feedback without flinching and responding with honesty of your ownUnprocessed stress is not a private personal problem; it moves through your team whether you intend it to or not🎧 How to Get the Most Out of This EpisodeIf you've seen Season 1 of The Bear, treat this as a rewatch companion—pause where the scenes resonate with your own work. If you haven't seen it, listen anyway (each vignette gets full context), and then go watch it. Either way, look for the moments that map directly to your own leadership reality right now.📣 Special AnnouncementsIf you want to build your own leadership practice and avoid the pitfalls you just heard mapped out on Carmy and Sydney, Nurse Leader HQ applications for the next cohort open at the end of June. Heads up—this is going to be a quieter enrollment opening, so I won't be loud about it on Instagram. Make sure you're on the waitlist so you don't miss the details.👉 Resources MentionedSeason 1 of The Bear (FX)Map Your Impact (mini course)Change Maker EssentialsNurse Leader HQ (waitlist)Instagram: @nursing.the.system

🎙 Episode OverviewThis one's a crossover. If you're on the System Sunday email list, it might sound familiar, I adapted this week's email into podcast form because I want podcast-only listeners to know there's a whole other arm of insights going out by email each week (and to be honest, this topic was just too relatable not to share).With my California sabbatical 10 days out, I've been grinding through a massive May to-do list—and a few nights ago I caught myself in a classic trap: crossing off all the easy, low-consequence stuff while avoiding the heavy, high-consequence things that actually matter. So I ran my own list through a filter I use with clients. This episode is me walking you through that audit in real time, with my own messy examples, so you can do it too.🔑 In This Episode, You'll LearnThe single filter question that cuts through to-do list overwhelmHow to sort tasks into high, moderate, and low consequence bucketsHow to spot a low-consequence task "dressed up" as high-consequence (and the reverse)Why we instinctively reach for low-hanging fruit when we're overloadedHow a skill you've mastered in one context (like work) has to be relearned in another (like life admin)Why "high consequence" includes positive consequences—the big levers, not just the emergenciesThe three questions to run your own list through this week🧠 Key Ideas to Take With YouWhen you're overloaded, you stop moving strategically and start moving emotionally—reaching for what feels good to cross off, not what mattersWe build lists, structures, and frameworks so we don't have to run our strategic brain 24/7—but if the system itself is skewed, your intuitive brain won't catch itHigh-consequence tasks feel heavier, so we avoid them—even when we know the payoff is hugeHigh consequence isn't just "the IRS is coming"—it's also the big lever that unlocks ease and impact when you finally pull itDread is data: if your list inspires dread, your prioritization system isn't matching your realityLeadership isn't about being perfect; it's about staying continuously curious about where you can improveThe skill is holding both the big strategic questions and the Tuesday-afternoon ones—zooming in and out and adjusting your focal depth👉 Resources MentionedSystem Sunday email listChangemaker EssentialsNurse Leader HQ (waitlist)Instagram: @nursing.the.system

🎙 Episode OverviewMy default move is never to hand you a list of everything wrong with your organization—not because I think it's fine (I know it's not), but because I want to push you past the complaint and into the question: where do I actually have leverage?But today we're shifting the lens. This episode is for the nurse or nurse leader who has already done that work—who's already been asking "where's my agency here?" and genuinely trying—and is now sitting with a harder question: should I keep putting my energy into this organization, or do I need to find one that's more fertile for change?That question deserves a direct answer. So today I'm giving you a framework: the two things that have to be true for your effort to lead somewhere, plus a set of green flags and red flags to help you read your environment and decide whether to stay or go.🔑 In This Episode, You'll LearnThe two conditions that must be true for your effort at work to actually go somewhereWhy a personal vision is the filter that makes this whole decision possibleSix green flags that signal your organization is fertile for changeEight red flags that signal an organization is structurally or culturally resistant to itWhy landing in a resistant organization is not a personal failingThe one strategic exception where staying in a "red flag" org still makes senseHow an organization's type (startup, scale-up, established hospital) shapes its change time horizon🧠 Key Ideas to Take With YouTwo things must be true for your effort to lead somewhere: you have a personal vision, and you're in an environment fertile for change"Fertile for change" doesn't mean perfect or innovative—it means there's enough openness that your effort can actually move somethingYou don't need every green flag, but you do need some of themOne red flag isn't a verdict; look across all of leadership, not just the person you report toStaying in a resistant org is sometimes the right strategic call—if you're deliberately extracting something (a paycheck through grad school, a skill, a line on your resume)If you're not extracting and not moving anything, staying is still a choice—and it has a costLeaving a place that can't change isn't giving up; it's strategy📣 Special AnnouncementsIf you've done the work and still can't tell whether your org isn't ready or you just haven't found the right lever, spend a couple hours with Map Your Impact. You'll come out with a clear picture of what to try—then give it 90 days and watch whether the friction eases. That process is itself a useful diagnostic for the stay-or-go question.If you've completed the Changemaker Essentials practicum and you lead people or projects, Nurse Leader HQ fellowship applications open at the end of June. Get on the waitlist so you don't miss it.And if you're still working on your personal vision, Changemaker Essentials opens again in September—get on the waitlist.📲 Call to ActionDo a real green-flag/red-flag audit of your current organization this weekIf you're stuck on the decision, start with Map Your Impact and give your plan 90 daysDM me on Instagram and tell me where you landed—stay or go—and what tipped youShare this episode with a nurse or nurse leader who's been agonizing over whether to leave👉 Resources MentionedMap Your Impact (mini course)Changemaker Essentials (waitlist)Nurse Leader HQ (waitlist)Podcast episodes 14, 18, and 41 (personal vision)Instagram: @nursing.the.system

🎙 Episode OverviewThis one's a little different. Taylor (my right-hand at NTS) is putting me in the hot seat, running a Q&A pulled from Instagram submissions and a few of her own curveballs. I'm going in blind.We get into a day in my life, what people get wrong about me, what moving abroad taught me, when I first realized I was a systems thinker, the things I'm still figuring out about running NTS while working full-time corporate, and a lot more. It's a little more personal, a little less curriculum—and if you've been around for a while, this is your chance to get to know me (and Taylor) a bit better.📣 Special AnnouncementsThis is Taylor's first episode where she has had to edit herself and being featured—if you liked the format, let us know and we'll do more Q&A episodes.If you want to dig into Map Your Impact but aren't sure what's actually inside, there's a walkthrough video on the sales page where I break down the whole framework. And if you're a nurse leader and your organization is looking for leadership development support, this is your reminder: NTS now works with health systems directly. If there's C-level buy-in at your org for nurse leadership development, let your leadership know we exist.📲 Call to ActionDM us on Instagram with questions for the next Q&A episodeIf your hospital or health system could benefit from CME or NLHQ at scale, point your leadership our wayLeave a review—it's still one of the best ways more nurses find this podcast👉 Resources MentionedMap Your Impact (mini course) - Podcasct Listeners get $10 off with code 'MYI10OFF'Changemaker EssentialsNurse Leader HQInstagram: @nursing.the.system

🎙 Episode OverviewThis episode is not "Five Ways to Prep for Your Interview." It's about the relational and strategic dynamics that most people completely miss because they've been conditioned to think about interviews the wrong way.The same mechanisms that have us sitting in bad dates and bad relationships are the same mechanisms that have us sitting in bad interviews and holding positions that aren't a good fit. So today, we're talking about how interviewing is like dating and what nurses and nurse leaders need to unlearn to actually find good fit on both sides of the table.🔑 In This Episode, You'll LearnWhy most people walk into interviews with a fundamental power asymmetry in their heads—and why it produces the wrong behaviorHow nurses get socialized into being grateful for opportunities rather than selective about themWhy "looking for the one" perfect job is the same flawed logic as looking for a soulmateConcrete strategies to move through interview nerves (without faking calm)What hiring managers need to do differently if they actually want to find good fitWhy good job fit is a systems problem—and the interview is one of the earliest leverage points🧠 Key Ideas to Take With YouThe interview is a mutual audition—you are also deciding whether this organization deserves your skillsNerves come from framing the problem; they shrink you into a smaller, less interesting version of yourselfSilence is not the enemy in an interview—it's a signal of comfort and power in the dynamicPeople who run a checklist disqualify almost-right opportunities; people who stay curious end up in the right placeYou're not looking for the one perfect job; you're looking for the next right stepIf you gatekeep through intimidation as an interviewer, you select for people who are good at being intimidated—not people who are good at the jobYour conditioning to "take what you're given" doesn't serve you, your team, or your patients📣 Special AnnouncementsIf you're in the middle of a job search, Interview with Intention is the practical companion to this episode. It's a weekend course that walks you through how to prep without sounding rehearsed, build your core four stories, approach negotiation, and walk away with a professional portfolio you can use for every interview after.If you're a nurse leader doing the hiring, Nurse Leader HQ opens for enrollment this summer (end of June, early July). I'm currently developing a "How to Interview Effectively" training for the curriculum hub, so HQ members will have access to it on demand. Get on the waitlist to be the first to know when doors open.👉 Resources MentionedInterview with Intention Nurse Leader HQ WaitlistChange Maker EssentialsInstagram: @nursing.the.system

🎙 Episode OverviewThis episode is a follow-up to last week's conversation on action bias—and it's one I think a lot of nurse leaders need to hear.Today, I'm introducing a framework I've been using in my own work and with my nurse leader clients: the holding period. It's a structured pause between receiving an idea and committing to it—and it might be one of the most underrated leadership practices out there.🔑 In This Episode, You'll LearnWhy action bias is trained into nurses—and why it becomes a liability in leadershipThe hidden cost of saying yes too fast (it's not just a full plate, it's a credibility problem)What the holding period actually is, and how it's different from avoidance or delayHow to calibrate the length of your hold based on the stakes of the decisionThe three diagnostic questions to run every idea through during a holdHow to communicate a hold to your team or your boss without undermining your authority🧠 Key Ideas to Take With YouSaying yes to everything is not responsiveness—it's reactivity dressed up as competenceMost leaders are better at starting things than sustaining them, and the real value of any change is whether it lastedThe strength of the pull you feel to commit is a signal, not a reason to skip discernmentA holding period is bound by a return date—that's what separates it from delayTime alone doesn't do the work; what makes a hold substantive is what you do with the idea while it sitsYour own ideas have to go through the same process as everyone else's—they are not exemptBeing deliberate is not the same as being slow, and fast is not always better📣 Special AnnouncementsNurse Leader HQ opens for enrollment at the end of June. It's a high-touch program with a small cohort, biweekly group meetings, monthly 1:1 calls with me, weekly async check-ins, and daily Slack access for real-time leadership issues. It's only open to Changemaker Essentials graduates who are leading people or projects.If you're earlier in this journey and haven't taken CME yet, Map Your Impact is the right starting point. It's the mini course that gets you thinking in systems and approaching your workday more strategically.📲 Call to ActionPick one idea sitting on your plate right now and put it through the three-question diagnosticShare this episode with a nurse leader who you know is drowning in commitmentsDM me on Instagram and tell me where action bias is showing up in your leadershipIf you're a CME grad, get on the Nurse Leader HQ waitlistIf you haven't taken CME, check out Map Your Impact as your first step👉 Resources MentionedMap Your Impact (mini course)Changemaker EssentialsNurse Leader HQ (waitlist)