Nursing the System

This episode is brought to you by Sarah, a longtime Instagram friend and ER nurse who sent me a DM for Free Advice Friday that was so good I asked if I could turn it into a podcast episode. She said yes.

Sarah's story is simple and incredible. She and her coworkers had a plan to collectively ask their boss to fix a few small, annoying things on their unit. Before the group could even make the ask, Sarah just… did it herself. Submitted the facilities requests. Got the thermometers moved, got longer cords for the scanners and signature pads, made her entire team's job a little easier.

No one stopped her. No one told her no. And now life on that unit is a little better.

This is what change making actually looks like most of the time. Not grand projects, not million-dollar overhauls — just someone noticing the friction and doing something about it. Let's talk about why this story matters, when to take Sarah's approach yourself, and what leaders can learn from it.

As you listen, keep your actual workday in mind. What's the small, stupid thing that's been annoying you for months (or years)? The outlet that doesn't work, the workflow that needs one tiny tweak, the order set that would save you fifteen minutes a shift. Pick one and ask yourself: do I actually have the agency to fix this myself?

• The Impact Snapshot (free assessment)
• Map Your Impact (mini course)
• Instagram: @nursing.the.system

Mini episode today. I'm walking you through how I'm approaching Q4, which historically at my corporate job is absolutely bonkers, and which — based on conversations with my nurse leader clients — tends to be the same across hospitals, outpatient clinics, and corporate alike. End-of-year initiatives, hitting those final metrics, and planning for 2027 all collide in these last 90 days.

I'm going back to the word I set as my intention for 2026: unhurried. September blew that intention up for me (a move, a conference, the Change Maker Essentials launch, life admin), and now that I'm on the other side of it, I'm craving unhurried more than ever. So this episode is my three tactics for ending the year with more peace, not more pedal-to-the-metal.

Take what fits your season and leave the rest.

• Why Q4 tends to pull leaders into reactive, outcome-chasing mode — and how to interrupt that pattern
• How to use a word of the year as a filter for Q4 decision-making
• Why reevaluating a working system (not just a broken one) is a strategic move, not overkill
• How to intentionally schedule play, peace, and joy before the calendar fills itself with work and scrolling
• Why focusing on process over outcomes can be the thing that keeps you steady through a chaotic quarter

• You don't have to live your intention 100% — a 5–20% shift toward it by year-end is still a win
• A calendar that isn't broken can still be improved; "working fine" is not the ceiling
• The mental calm you want is not on the other side of empty evenings with a screen
• Play, peace, and joy need to be scheduled or something else will take that time
• Process-focused presence drops you back into the moment and keeps you unhurried about outcomes
• Change makers reflect, set intentions, and course correct early — even in Q4, it's never too late
• Come January 1, you'll be 90 days wiser no matter what you choose to do with them

• System Sunday email list
• Change Maker Essentials Waitlist
• Nurse Leader HQ
• Instagram: @nursing.the.system

Shorter episode today, and a candid one. I'm walking you through what I've learned in the last six days of the Change Maker Essentials launch — from inside the messy middle of a launch that has not gone the way I expected.

March 2026 was our record CME cohort. Coming into this one, we did a full post-mortem, replicated everything that worked, improved a few things, and expected similar (or better) numbers. That's not what happened. This episode is me sharing how I read the data, checked the story I was telling myself, identified what's within my control and what isn't, and how I'm choosing to respond.

There's a case study in here about resilience, a framework for sorting luxury vs. essential purchases in a tight financial season, and a reminder that CME closes tomorrow at midnight.

• How to read your data honestly when a project isn't performing the way you expected
• Why one record month is not the new normal — and the risk of treating it as one
• How to check the story you're telling yourself before you spend energy fixing the wrong problem
• What to do when your process is identical but your results are different
• How to give yourself grace when the roadblock is genuinely external
• Three questions to sort a "luxury" purchase from a "strategic essential" in a financially tight season

Change Maker Essentials closes tomorrow at midnight in your time zone. Payment plans (three-month and six-month) available. Most nurses who ask their employer for funding get it fully covered — DM me for the funding email template and PDF guide if you need them.

If this is not your season, put yourself on the waitlist. CME opens again in March. But if you're already leaning in, don't manufacture a reason to wait — reach out this week.

• Change Maker Essentials (closes Monday, September 28 at midnight)
• Instagram: @nursing.the.system

This episode is repurposed from an Instagram Live I did this week during the CME Launch — and I'm bringing it to the podcast because the questions people asked are the exact questions I get every launch. If you've been considering CME or a program like it, this is the deepest, most honest FAQ I've ever done in one sitting.

I answer questions submitted via DMs, lightning calls, and the story question box: what CME actually is, how much time it takes, whether it works if you're not in healthcare, what a lightning call is like, cost and payment options, whether you can take longer than 12 weeks, how CME stacks with one-on-one coaching and Nurse Leader HQ, and what happens if you decide this isn't the right season for you.

If you've been on the fence, this is your all-in-one answer.

Change Maker Essentials is open through Monday, September 28. The program is $1297 with pay-in-full, three-month, or six-month payment plan options. RNs earn 30 contact hours of continuing education toward license renewal.

If you miss this cohort, CME opens again in March. But if you're already leaning in, don't manufacture a reason to wait — reach out this week.

• Change Maker Essentials program page (enrollment closes Monday, September 28)
• Instagram: @nursing.the.system

This episode was sparked by a DM from a nurse considering Changemaker Essentials. Her question: "What does being a changemaker actually look like in real life? How would my life be materially different after the program?" Fair question. So I'm answering it with a real case study.

Meet Heather (name changed). She joined CME as a new grad nurse, six to nine months into her career, sitting on her unit's nursing practice council watching four-hour meetings dissolve into circular arguments with nothing to show for them. Over 12 weeks, she pulled four specific tools from the CME curriculum and used them to change how her council operated — without a title, without seniority, and without waiting for permission.

If you're on the fence about CME, this is the concrete "what would I actually do with this?" you've been asking for. And if you're already a grad, this is a masterclass in stacking the tools you already have.

• How Heather diagnosed three distinct problems hiding underneath what looked like a "bad meeting"
• Why "staffing shortage" is often the symptom of a deeper acuity-assignment pattern
• How to spot the difference between a problem you can solve and a problem that isn't yours to solve
• The four specific CME tools Heather used and exactly how she applied each one
• Why the change myth of "start with a solution" is one of the most damaging patterns in team meetings
• Why CME gives you a toolbox, not a checklist — and why that matters for real change work

Changemaker Essentials is OPEN for enrollment today (Monday, September 21) through Monday, September 28. You have one week.

• Change Maker Essentials (enrollment open Sept 21–28)
• Instagram: @nursing.the.system

Middle leadership is the loneliest job in healthcare. I know because I've lived it—and I hear it from my nurse leader clients every single week. Even when you have a great one-up leader, a peer to share an office with, and a team you care about, the role itself carries a specific kind of loneliness that most people never name.

And if you're not a formal leader listening to this: stay with me. Understanding what your middle manager is actually up against changes how you ask her for resources, how you bring her ideas, and how effectively you get things done in the system. That's a change leadership advantage.

Today we're breaking down where the loneliness comes from structurally (spoiler: it's not about you), and four concrete actions middle managers can take to feel less alone and become more effective changemakers.

• Where downward loneliness comes from—and why it's real even in the healthiest cultures
• Where upward loneliness comes from—and why it's actually healthy (to a point)
• Why your role as a "boundary spanner" is the source of both directional lonelinesses
• The perception trap: how frontline staff and senior leaders both misread you
• Why so many middle managers feel isolated even when other middle managers exist in the building
• Four concrete actions you can take to build connection into a role that structurally resists it

It's Change Maker Essentials season. Waitlist is open now, enrollment opens September 21st.

CME is my direct response to exactly the problem this episode names: middle leaders (and future middle leaders) don't have the permission structure, support, resources, or cohort to train effectively as change leaders. That's what CME is built for.

Waitlist perks:

• $200 off tuition (early bird discount, waitlist only)
• Sneak peeks of lessons
• A set of mini-lesson emails I just finished writing
• Option to book a free 15-min lightning call with me before you decide

• Change Maker Essentials Waitlist
• Change Maker Essentials Sales Page
• Instagram: @nursing.the.system

Today's episode was sparked by a question from Jessica, a podcast listener and Changemaker Essentials grad—thank you, Jessica. She asked how to actually cultivate belonging on a team, because most of the advice out there stops at "be nice and hope your team catches the vibe." That's not enough. Belonging is not a vibe you set—it's a system you design.

I'm going to walk you through the framework I use, both on my international virtual corporate team (7 of my 10 team members are fully remote across multiple time zones) and inside the Changemaker Essentials cohort. Same principles, different contexts. You'll get the three layers to build—relationship, orchestration, and culture in the room—plus a bunch of concrete examples of structural touchpoints you can steal.

• Why psychological safety starts in one-on-ones—and how the way you show up there sets the standard for everything else
• The difference between structure (the skeleton) and culture (what happens in the room)—and why you need both
• Why you as a leader are not the source of belonging; you're the orchestrator of it
• Concrete structural touchpoints that build belonging in virtual and hybrid environments
• How to run icebreakers that people actually don't hate
• Why having a team culture mission statement makes hiring, meetings, and daily decisions easier

Change Maker Essentials enrollment is opening in September. Waitlist emails start going out next week, so if you want first access to the details, dates, and the opportunity to book a vibe-check Zoom with me before signing up—get on the waitlist now.

Joining the waitlist is zero commitment. You'll have plenty of time to make a thorough decision, ask questions, and see if this is the room you want to be in.

• Change Maker Essentials (September enrollment — join the waitlist)
• The Impact Snapshot (free assessment)
• Instagram: @nursing.the.system

We're back. About a month ago, in my mid-year reflection (episode 75), I made a decision on air: pause the podcast, force myself to rebuild consistency on Instagram, and see what happened. This episode is the results report.

The short version: it worked. I've been posting on Instagram four to five times a week, I have dozens of posts in the queue, and it now feels easy—which honestly floored me, because I've been telling myself for years that Instagram was too hard. And in the process of leaning into Instagram, I also had the creative bandwidth to build something new for you: The Impact Snapshot, a free assessment I'll tell you about at the end of the episode.

Consider this a model. If there's something you've been avoiding because you keep telling yourself it's too hard, what could you deprioritize for the next four to six weeks to prove yourself wrong?

• What actually happened when I paused the podcast for a month and forced myself into Instagram
• Why the "it's too hard" story about a skill is almost always a story, not a fact
• The unexpected creative and strategic benefits I got from switching my focus
• How this experiment surfaced a new front door to Nursing the System (spoiler: it's the Impact Snapshot)
• The reflection to run on yourself right now to try the same experiment

• The Impact Snapshot (new free assessment)
• Instagram: @nursing.the.system

It's Wednesday, the first week of July. I just spent three hours writing my mid-year self-review for corporate, and it hit me: I haven't done this for the rest of my life. The first half of 2026 is done—how did that happen?—and it's really easy to skip over the milestone and just keep moving.

So this episode is my mid-year reflection, out loud, in real time, with you. I'm reviewing my word of the year (unhurried), the three "wildly unexciting" goals I set in January, what I actually accomplished, where life bled into work, what I've been postponing, and what I want the second half of the year to feel like.

Fair warning: this is unfiltered. I made three real decisions live on this recording, including one I did not see coming when I hit record. If you set intentions in January—even quietly—I want to encourage you to do this exercise too.

• Why mid-year reflection matters even (especially) when things are going well
• How to review a word of the year to see if it still fits, or needs revision
• Why setting attainable "basement goals" is often the more strategic move than audacious ones
• The value of a decision log at the end of any reflection—so the insights don't evaporate the second you close your laptop
• Why organizations (and people) tend to only reflect when something goes wrong—and how to break that pattern

• The goal is the ideal—reflection is about seeing how close you got, not judging whether you were perfect
• Life is a system; your work doesn't happen in a vacuum, and neither does your fitness, your relationships, or your creative output
• If your system isn't producing the results you want, don't blame yourself—look for the right lever to pull
• "Basement goals" (bare minimum baselines) are more inspiring in a season of unhurried than audacious ones
• The thing you keep postponing is often the thing you'd tell a client to just do
• Do this reflection when things are good, not just when things are on fire—that's where the compounding growth is
• Learning is only possible from reflection, and reflection needs some structure (even if it's just sitting on your sofa with your phone)

This is my last podcast episode until August. I realized during this reflection that I keep defaulting to podcast (which I love) over Instagram (which I need for reaching new listeners and growing the business). To break the pattern, I'm pausing the podcast for the rest of July and forcing myself to rebuild consistency on Instagram.

Applications for Nurse Leader HQ are still open. If you've been sitting on the fence, DM me or apply at the link in the show notes—we'll hop on a quick call to see if it's the right fit.

While the podcast is on pause, come find me on Instagram (@nursing.the.system)—and please bully me in the DMs if I'm not posting. I've given you full permission.

• Nurse Leader HQ (applications still open)
• Change Maker Essentials
• System Sunday email list
• Instagram: @nursing.the.system

I coach a lot of nurse leaders, and one pattern comes up constantly: "I want to get better at X." The hard conversation. Strategic thinking. Making data-informed decisions. And when someone tells me they want to grow a skill, my first job is to help them figure out what kind of problem they're actually solving—because the fix is completely different depending on the answer.

Today I'm walking you through a six-question diagnostic to help you tell the difference between a knowledge gap and an implementation gap. I open with my own real-time example (getting my ass kicked at Dutch birthday parties) and then take you through the questions you can run on yourself right now, before you spend real money, time, or attention on the wrong fix.

Because most of us, when we feel the discomfort of a gap, reach for the thing that looks like progress instead of the thing that is progress. And solving the wrong problem is costly.

• The difference between a knowledge gap and an implementation gap—and why almost no one diagnoses it correctly
• Why buying another course, book, or certification feels good in the moment but often makes the gap worse
• Six diagnostic questions you can run on yourself before spending another dollar on skill building
• Why implementation gaps show up under pressure (and knowledge gaps don't)
• How to use the same diagnostic on your team members' skill gaps and on rollouts of new tools or processes

• Doing something that looks like progress relieves the discomfort of a gap faster than doing the actual right thing
• Knowledge builds understanding; reps build ease—and if what you're missing is ease, no amount of additional knowledge is going to get you there
• Implementation gaps have a signature—they don't show up when you're calm, they show up when the stakes are high
• If you're reaching for a second course or degree on material you already have, pause and ask what's actually missing
• There's no certificate for the 31st time you do the hard thing, and that's the point
• Solving the wrong problem always has a cost—opportunity cost, dollar cost, energy cost—even when it "isn't the end of the world"
• Micro knowledge gaps come up inside implementation work, and they can be filled in real time—you don't need a whole new program for them

Run the six-question diagnostic on the skill you're trying to build:

1. Can I already explain this correctly out loud when nothing is at stake?

• If no → real knowledge gap. Go get the input.
• If yes → the knowledge isn't the problem. Don't buy more.

2. Does it fall apart specifically when the stakes go up?

• If the skill is fine in low-stakes conditions and disappears under pressure → that's the signature of an implementation gap, not a knowledge one.

3. Have I already paid for this input once?

• If you're reaching for a second course or certification on the same material, pause and ask what specifically is missing that a repeat would fix. Usually the answer is nothing.

4. Am I choosing this fix because it's right or because it's comfortable?

• Courses feel safe—syllabus, start date, certificate. Reps don't look like anything. Get honest.

5. What would confidence actually require here—more input or more exposure?

• Confidence from consumption = understanding. Confidence from repetition = ease. If you're chasing ease, only volume gets you there.

6. If I skipped the input step entirely and only did reps for the next month, would I get worse or better?

• If the honest answer is "probably better"—that's your diagnosis, whether you like it or not.

Apply the same diagnostic beyond your own skill building:

• On your team: when a staff member isn't performing a skill on the floor, would they be able to explain it correctly to you in a calm moment? That tells you which fix they actually need.
• On rollouts: when your team is misusing a new tool or process, audit whether they understand it OR whether they're just under-practiced. Solve accordingly.

Nurse Leader HQ applications are open through the end of this week. If you're a Change Maker Essentials grad and this episode landed—if you're sitting in an implementation gap right now, wanting more reps with support and accountability—that's exactly what NLHQ is built for.

NLHQ is not a knowledge bank. It's a supervised implementation container. You'll be putting reps in on your real leadership situations, with a peer group of nurse leaders doing the same, and with me giving you direct support along the way. Micro knowledge gaps that come up? We fill those in real time inside the fellowship.

If you're thinking about it but haven't reached out yet—now is the time. Email me or DM me on Instagram to talk it through, or fill out an application to get on my calendar for a conversation.

• Change Maker Essentials
• Nurse Leader HQ (applications close end of this week)
• Instagram: @nursing.the.system