[00:00:00] Hey, y’all and welcome back to another episode of the pulse check podcast I’m HeHe! 

[00:00:04] And I’m mandy. 

[00:00:06] And today we are joined by Claire Phillips. Who’s the founder of nursing the system, and I am over the moon and to have this conversation. So I’m a long time follower of Claire. And she actually has opened my eyes to so much. When I first started following Claire the only two things that I really understood about how broken the nursing system is, is that nurses are treated really horribly. I think that’s kind of generally accepted. We all kind of know what’s going on there. And then the second thing is nurses are tasked with the role of being a patient advocate.

[00:00:39] But at the end of the day, when we look behind the doors of the system, their hands are tied in so many places. They can’t really be a patient advocate. So Claire, I know that these two things only like skim the surface of what you have seen. So welcome to the show. We want to hear all the details about just how broken our nursing system is here in America.

[00:01:08] Well, HeHe and Mandy, thank you very much. Those are some great conversation topics, and they look forward to diving into those as systems are kind of my bread and butter. Yeah. So I think you make a really good point when you say that nurses hands are tied. I think that that is certainly true in certain areas.

[00:01:28] Like there are system constraints that exist that do make it much harder to be a patient advocate and to really take on what it means to be in that nursing role. At the same time. I also see nurses putting some constraints on themselves that don’t necessarily exist or don’t necessarily have to exist.

[00:01:49] My whole thing is I believe that nurses have a lot more power than we actually acknowledge and have utilized throughout. Hundreds of years that we’ve been a profession. So yeah, I would just like to push back on that just a little bit because constraints exist and also we can take action through systems change to lessen them or change them and own our power.

[00:02:13] So keep going. What, what kind of things should nurses be doing? Where is that power that they are maybe consciously or subconsciously taken from themselves? 

[00:02:24] Yeah. So one thing I do want to say is that I don’t necessarily think of nursing as a broken system. I think it’s really important to put nursing as a profession in the context of the entire American health system.

[00:02:40] I assume that we’re talking about us healthcare in this podcast. Yeah. So I think. Basically, there are systems within systems and you can always expand wider and wider to bring more systems into the conversation. But especially with nursing and the U S I’d really like to make sure we zoom out and provide that context because nursing does not exist on its own.

[00:03:05] It exists with all the things that come with just working in acute care in United States or primary care, just working in healthcare in this country, 

[00:03:17] Are you saying the problems that exist within the nursing system are also seen in all the other aspects or a lot of the other aspects of healthcare as well. It’s like a system-wide problem. 

[00:03:28] Exactly. Exactly. Our, our profession is Limited significantly because of its position in the broader context. Yeah.

[00:03:36] I liked that. You said that and that correction, because it sounded so sad to hear broken nursing system. I have a million questions just stirring. When you, so I keep thinking about your business name and your handles on social media nursing the system. So as we kind of uncover parts of the system that nurses have control over, or don’t have control over, or the perception of power, what does your handle mean?

[00:04:11] Great question. And I’m going to give you a long answer. My background is in sociology. I went to a small liberal arts college. I thought maybe I wanted to be a lawyer. Didn’t really know what I wanted to do, but knew that I loved writing and critical thinking and just like. Deeply investigating problems and stewing about them.

[00:04:31] So I decided to major in sociology. I also had a minor in gender studies and I double majored in anthro too. So I was kind of all over the map, but the thing that kept coming back for me was social systems. How and why they were. Broken. Isn’t a word that I personally love to use, but how they were dysfunctional and what we could do to change them.

[00:04:56] And so I was sitting in a sociology of health and illness class as I think a sophomore and we were talking all about us healthcare. I had never realized the extent to which healthcare was so dysfunctional in the U S that’s not really something that you like. Learn about in high school or middle school.

[00:05:15] And I just was fired up about it. Health is everywhere. It touches everything and people’s lives. You cannot separate it. Say health is in a hospital or health is in the nurse’s office at school. It’s literally everywhere, our roads, our bridges, our families our political system. In that classroom identified the healthcare system as the social system that I really wanted to focus in on.

[00:05:41] It was like the epicenter of all of these other social problems and Social systems that had problems. And so I wanted to do something about it. And also in that class, we broke down the different healthcare professions and kind of their history and where they originated from and how they interacted together.

[00:06:00] And that’s what. Really began to seriously consider nursing as a professional path. I hadn’t seen a lot of nurses in my life. I grew up in Silicon valley, so most of my, like knowledge of professions was in the tech sector. Watch any medical show, any show about healthcare, and it’s just physicians. And if there’s a nurse their like the funny older lady or the sassy black nurse, or a romantic interest and physicians are, yeah, they’re doing everything that a nurse would typically do. And so, yeah, I just had no like role model for what, a nurse, as a professional person even looked like.

[00:06:37] So in this class, when I was learning about the history of nursing and just how nursing was like this feminist response to this white male patriarchy exhibited in medicine that kept women out and nursing was like, fuck this. Yeah. Nursing was like, screw this.

[00:06:54] We’re going to do our own thing. And it’s going to fill the gaps that medicine has failed to acknowledge like what people needed in their homes, in the environment. So anyway, all that to say I identified nursing as like the professional vehicle through which I could potentially make systems change as that was my true passion.

[00:07:16] And so healthcare was just kind of like the target of that passion, if that makes sense. So after that I went and got my master’s in nursing, which was the generalist program and then started working in the emergency department. And it was in my first year of actually working as an acute care nurse in a hospital that I was like, oh, so I had an idea of what nurses faced in the healthcare hierarchy. And just with like having to be the Jack of all trades and being responsible for literally every other thing that didn’t exist under someone else’s professional umbrella. But once you’re living that out in a 12 hour shifts day after day it just, you just feel it in your bones, it feels so much more real.

[00:07:58] And so I started a blog. I started a blog. And I didn’t have a name for it. And I remember texting some college friends and I was like, I’m just starting a blog. Like what should I call it, like nursing notes. 

[00:08:12] Totally someone’s done already. It’s not very specific. 

[00:08:17] Yeah, it wasn’t, wasn’t a good fit for me. And one of my, one of my best friends from college Warren was like, what about Nursing the system? And I was like, oh my God. Cause I worked some, so many angles because like nurses are nursing the system.

[00:08:32] Okay. That’s what we’re going to do. I started in blogging and then my Instagram was just like, Hey, go read my blog. Which no people don’t read this like 10 page diatribe about the healthcare hierarchy. I mean, as some people did, but. Yeah. Anyway, that’s where the name came from. I’m getting my doctorate now in healthcare innovation and leadership, which is a nursing practice degree at my school. And really my specialty is systems change. So the name continues to serve me.

[00:09:08] That’s awesome. I feel like major girl power right now.

[00:09:10] Thank you for sharing that. That is really interesting. And it’s not, I don’t think it’s very common that someone goes, someone identifies the issues in healthcare and then becomes a nurse to tackle those issues. Because then you probably heard from all the nurses that were like, we can’t do anything about it.

[00:09:31] This is awful. We’re oppressed. Which right. They are in an abusive system and abusive relationships with the system. And there is a level of oppression and nursing, but the nurses from what I have also experienced is they feel powerless or they feel like the problems are so big. Like you said, you feel it on the inside, how could we ever make changes?

[00:09:57] And you were like, fuck that I’m going to become a nurse and like, do it all. I think it’s really empowering. I think it’s really exciting to have that perspective. 

[00:10:08] I think you bring up a really good point. Powerlessness is a key feature of nursing, especially in 2022. Maybe more so in 2021, I feel like we’re turning this corner into like we can freaking change it. Let’s go. That did not exist when I started my blog in January, 2019 it was hard to find anybody who was even like, yeah, the healthcare system needs some work.

[00:10:30] That really was not like the dominant narrative among nurses. And so when I would talk about it at work, people would be like, no, it’s fine. Like the real problem is people just like showing up to the ER too much. There was no acknowledgement of this. And I, I want to be clear here.

[00:10:44] I’m sure there were people who acknowledged it. Right. I’m not saying that we were all idiots, but I think that we’re now so much more awake to it, just on the other end of COVID. And I think Mandy, like had, I just gone into nursing on a more conventional path and been in the emergency department. I think it kind of takes someone on the outside with that different perspective going into it kind of like eyes wide open to what they’re dealing with.

[00:11:13] If you go into it thinking I’m going to be a nurse and this is going to be great, I’m going to be changing people’s lives and have so much support and agency in my role. And then you realize that is not actually the case. That’s super disheartening. And I think that’s where a lot of that powerlessness comes from, but because I had this training and picking the social systems apart. I was, I was ready going into it to, to be upset. And it’s one thing to know that theoretically, and like I said earlier, it’s, you know, another to live that out. So that’s not at all to say, like I went into nursing knowing exactly what challenges I would face. Cause I sure didn’t and I didn’t know how they would present, but I did know that they existed. 

[00:11:56] Well, we know that a lot of nurses feel very powerless in their role. Can we talk about maybe the top places where the healthcare system is dysfunctional and what nurses might be able to do in those situations?

[00:12:09] If we know most nurses are facing these things, how can they make a change? Protect themselves, honor their mental health, things like that. 

[00:12:21] Well, HeHe, that’s a huge question. So I think right off the bat politically I think that our political system in the U S has also dysfunctional, dysfunctional, meaning that it, so basically a system is dysfunctional.

[00:12:38] If it has a stated purpose, like an espouse purpose that we, the people say that this is why our institutions have been created in this way in order to do this thing. But it’s dysfunctional if this spouse purpose is not aligned with the actual result. So there’s the purpose that we have designed for, and then the purpose that the design actually has resulted in.

[00:13:03] And so our political system is dysfunctional because we have the structures that exist in order to be this this democratic Republic. And we see every day how there’s not, people do not have equal voices for a variety of reasons. One of which is gerrymandering and all of that. And potentially the electoral college, depending on how you, you see that within your worldview.

[00:13:28] But I think politically. There is still a lot of power to be reclaimed particularly with nurses. I think, you know, say what you want about the American nurses association. I know people have their issues with some of the choices that they made in the past. But they exist to be a voice for nurses in the United States. And so if you do not completely align with their messaging or their leadership then my question to you is what do you intend to do about it? Because they have an incredible amount of influence and money coming in. And they’re, they’re in an incredibly established organization with a lot of relationships and partnerships throughout the country and frankly, the world.

[00:14:13] So it doesn’t make sense to me to throw that away and say, well, we’ll just start something new. You can certainly start additional organizations, but I, I think the only way to move forward is to move forward in partnership with the incredible work that’s being done in, in disparate organizations, but particularly in ANA.

[00:14:32] All of the professional organizations are problematic. They’re supporting the problematic right. The dysfunctional system. There’s always going to be problematic leaders when they come out of the dysfunctional system that are often echoing that like that rhetoric, like, oh, you just couldn’t handle it there. Or that’s just how it is. Or the, you know, patient blaming victim blaming, things like that. Are you part of the nurses association? 

[00:14:58] I am actually not a member of the ANA yet. And I intend to become one. I’m actually going to be doing an internship with them this spring in their innovation branch.

[00:15:10] Not to put you on the spot. I am so curious about that conversation. And we’re talking among L and D nurses and OB nurses about AWHONN, super problematic. Some things they put out you’re like, oh wow.

[00:15:22] Interesting. And some things you put out and you’re like, no, not it not, they’re not even close who wrote this? The leaders often are like recycled. Their leadership that isn’t necessarily in tune, not that relatable, especially to this movement. As you said, the awakening that nurses are able to do one because of the perspective shift after 2020, and the very aware of like Priorities of healthcare and healthcare establishments and also the beauty of the internet and how we are able to share ideas.

[00:15:59] And we’re not just stuck inside of our unit, just hearing that over and over and over the grass isn’t greener don’t you dare go anywhere. It’s going to be all the things that we’ve heard that kept us stuck or feeling stuck. We’re able to walk out and get kind of like our own unit, if we want that outside perspective that you, that you touched on.

[00:16:18] I am technically I’m part of AWHONN as of this week. And I did it kicking and screaming. Like I was, I’m still mad about it, but I had really smart people who were like, Mandy, who’s going to change it. I don’t see myself as like, let’s change the laws. Let’s go to Capitol hill. Let’s be in leadership in these programs because I see them as exhausting. It’s dysfunctional. So you think you’re making good change? It’s kind of like nursing, like I’ve been told for so long. Oh my gosh. You’re so important. And I felt like part of a pawn, like part of how the system is hurting folks, including nurses and including the professionals involved.

[00:16:57] So there’s this. Like devil angel going on constantly with these professional organizations. So it’s interesting to hear you say that. And I think important to keep having this discussion because they have not been supporting me and my needs. They have not been supporting black, brown, indigenous nurses and their needs.

[00:17:18] They’ve not been supporting the, the most vulnerable communities that I want to support. So there’s a battle of, well, they require me to pay to be in the club, but I don’t know if the club is going to play by the new rules. I think it’s cool to talk about it.

[00:17:37] I don’t want to start a new club. You can’t burn it all down and we want to burn it all down and you can’t burn it all down. So how are we going to collectively move in the right direction. And you say one of those ways is the professional organizations, but in a smart way and not in a backseat way.

[00:17:54] I think it’s important to note too, that no organization is going to come without problems and not everybody’s going to agree with every single thing of organizations. And so Claire, to hear you talk about being in alignment, I think there are pros and cons to weigh to figure out whether you’re in alignment to these things, right?

[00:18:13] We’re not hating on these big organizations because they have things wrong. Every organization has things wrong. 

[00:18:22] Yeah, absolutely. And I think like the main takeaway, when I think about professional organizations that are active politically is diversity of perspective is really the only way forward.

[00:18:37] And so if I go and start my own professional organization called nursing the system. Only people who are fully aligned with my vision are allowed in this organization and we’re going to make change just us. Like we’re just going to go at it. That is not a sustainable model for change.

[00:18:53] And the reason for that is, is if everybody in the room is thinking just like me and has the same lived experience as I do, then we are completely shut off from other people’s experiences and realities. And so we cannot be effective problem solvers and accurately see a system from just one angle.

[00:19:15] And I think that’s the risk we’ve run into particularly on social media. I like to push back against the dominant narratives that I see about nurses, because I, you know, I think we see one thing, one reel go viral, and then everyone’s sharing it. And then people are saying, yeah, I want to go off for that.

[00:19:31] And this narrative becomes the truth with a capital T when that’s not necessarily the case. And so we do kind of create little echo chambers for ourselves. And that is kind of what I mean when I say We we put constraints on ourselves and the way that we talk about our profession that does not serve us.

[00:19:52] Quit bitching about professional organizations and take action in a way that feels aligned with my lived experience and personal values. 

[00:20:04] Yeah. I mean, I, I will never claim to tell people what to do with their social media accounts. I just like to ask questions of people because I don’t have all the answers, you know, I, I work with one-on-one clients in my business. People come to me and say, well, what do I need to do? I’m like, okay, well, I need to know way more about you and who you are and what your professional mission is about the passion problems that lay you up inside. I need to know about what your background is. I need to know about what your gifts are, what your opportunities for growth are.

[00:20:40] I can’t just say, okay, you’re an L and D nurse. Great. Here’s what you got to do. There’s no cookie cutter answer. And I think that’s where we get into problems is people are like, I got to make change and I just need someone to tell them how to do it. And that’s not how it works or you get someone like on tick tock and they’re like, if you want to make change, we all gotta go march.

[00:21:00] Okay. So tell me more about this march. What are the objectives? Who are your partners? Who is your, who is the person whose mind you are trying to change with this march? You know, there are so many questions that we have to ask, and I’m not saying that a march is a bad thing, but the marching to be thoughtful and intentional, otherwise we are frankly wasting our time and we do not have the time to waste.

[00:21:25] So what are the change projects that nurses come to you with in one-on-one? 

[00:21:29] So a lot of people don’t come to me with a change project at all or they will come to me with like five. 

[00:21:37] My people. 

[00:21:39] People who I tend to attract are like, oh, I know the system is broken. And here’s the eight ways that I have identified it’s broken. And so these are my ideas and I need help making it all happen. And so my role is to say those sound fascinating. And we’re going to back up. So HeHe tell me more about yourself, you know? How did you, how did you get into this profession? Think back to 10 years ago, what, what got you excited about potentially going to work, you know, blah, blah, blah.

[00:22:16] And so we, we go through this intake process where I get to really understand who they are at the same time. They’re uncovering their own professional identity and changemaker identity in a way that they hadn’t before. So then by the time we get to let’s talk about your eight projects, they’re going well, you know, now that we’re looking at these, I feel like these six probably aren’t for me. And I’m like, oh, well, if that’s how you feel, let’s look at these two.

[00:22:47] It’s nice though. It’s in a container of someone who can kind of understand and hear objectively, but also, you know, like I would value your opinion and feel safe to kind of uncover that on my own. 

[00:23:01] Yeah. So that’s kind of like the first stage is just that self-discovery and not really priority management, but kind of and then you move into, okay, we’re going to focus on one thing because the one change project is a hundred times harder than you think it’s going to be just straight up their reality.

[00:23:20] Everything takes longer. There are all these partnerships that you need to go after that you didn’t anticipate, which is a good thing because it means more help. More hands. So then we get to go into the nitty gritty of how do we actually move the needle? How do we look at these systems? Map them out. Systems mapping is something that every nurse should be able to do. And most of us have no idea what that even means, which is fair because no one taught it to us. How are we supposed to know things we don’t even know exist? So you map out the system, you see what’s going on. You get that in front of other people.

[00:23:52] You always want to validate your own perception of a system, because like we talked about earlier, you can never see everything in system because you are one person in one position. 

[00:24:02] What project are they? Did they pick, what are they doing? Are they, are they doing projects on their unit?

[00:24:10] I worked with a therapy professional actually, so she was not a nurse and she came to me with a few different projects and she was incredibly bright. I was blown away. She had some really strong ideas. And I won’t go too much into it cause I want to protect her like coaching experience, but Ultimately she settled on one.

[00:24:29] And we talked through, it was going to basically be like an education, but not just education. Cause we always need to go a step beyond that, into the, the application. But it was like an education and support framework for other therapy professionals at her place of work to understand this piece of their professional role that people were struggling with.

[00:24:51] And so she identified different executive sponsors who could help make that a priority in her organization. So things like that. Get to know ourselves. We narrow it down and then we, we get nitty gritty on how they actually make the change happen. 

[00:25:06] So the professionals listening that started the podcast with yeah, there is a lot to change. Yeah. It’s exhausting. Yeah. It’s overwhelming. How could we ever do it? I’m totally in the boat of it’s too big for me now. Oh my gosh. I can feel like that is a weight lifted. Like they, your clients, the folks that learn from you can feel like, oh, I have a direction. I might even have like a side gig.

[00:25:33] I’m not stuck. I don’t feel so helpless or hopeless. Because I can see, you know, I’m making change in moving forward on something that is most important to me and not just sitting in the cycle of clocking in clocking out, maybe, which is where they’re at. 

[00:25:52] Yeah. I think a lot of the powerlessness feeling is connected to overwhelm and overwhelm is that result of imbalance of perceived resources and the task at hand.

[00:26:03] So we look at, oh, the entire system, is dysfunctional. And I am a RN in Alabama is, is faced with this reality. And I want it to action, but how the hell do you even start? And so when you can acknowledge that you are one among millions who is interested in taking this kind of action that really relieves the burden. There’s literally no way that a single person in the U S can change our healthcare system and that’s absurd. And when you state it, you’re like, oh yeah, that’s crazy. That is actually completely unrealistic. But it’s, it’s, we carry that in ourselves.

[00:26:42] I think, especially as healers, especially as people who like HeHe said at the start of the pod was. That we go into nursing to be patient advocates. And so that’s a lot of responsibility and when health is everywhere and when you see an entire country, sometimes an entire world as our patients, that’s, that’s who we are. That’s why we get into nursing. That’s freaking overwhelming. It’s a terrible feeling. 

[00:27:12] Yeah. But if if enough of us who carry that I want to change the system get together, then we can change the system. Right? It’s it’s about all of us finding each other, which I think is hard too. It’s hard sometimes depending on what your unit culture looks like to find people who think like you, if everybody on your unit, culture is not challenging the doctors and not being patient advocates and not going to speak up and just watching things happen. That adds another layer of like, oh my God, am I even safe to speak up and be a patient advocate? Probably not. I won’t have a single person on my side. I’m going to be fired. I’m going to be reassigned. You know, there’s my rent money. That’s hard.

[00:27:55] Yeah, for sure. There, there is risk to being the squeaky wheel to being a change agent. At the same time, we don’t need to be on a unit full of change-makers in order to make change. It really, you know, as much as one person alone cannot change the world. One person can start getting other people to question the status quo, to poke holes in their schema of what healthcare is and what health is and what a nurse’s role is.

[00:28:20] And so, yeah, you’re not changing the system by asking people questions necessarily. Cause there’s a lot of work that goes into that, but you are potentially getting other people into that mindset where they might, they might end up partnering with you. 

[00:28:38] Yeah. If you were one of the only nurses that were kind of willing to speak up how would you start this conversation? Do you start by asking questions? Do you start by like one-on-one conversations? How does that look? 

[00:28:51] So I’m just going to speak very vaguely. As much as I would love to give like more concrete examples. I think it’s easy to imagine that we’re the only person when you see something a certain way. And if that is what you believe then you are going to see reinforcement of that throughout your day. If I believe that all of the nurses on my, in my department are racist.

[00:29:18] Every time I see somebody say something racist. That’s just another drop in that bucket, but it’s unlikely that every single person on my unit is saying something racist, but because I have primed myself to see that that is my expectation. And so I’m putting people unfairly into boxes. Now, some people can be fairly placed into that box. Right. But anyway, so I guess my first thing would be to. Don’t assume that you’re alone, just because you don’t see anyone else speaking up, because if you’re not speaking up, but you are thinking things differently than what you’re hearing, maybe someone else is doing that. So don’t assume that you’re the single hero in this story who has to fight their way out.

[00:30:03] Right. I think you might be giving yourself a little too much credit and I have been there myself. Wow. No one’s saying anything. Maybe they should. And then it’s like, oh, maybe they should Claire fricking say something, you know? So that’s my first thing. What was your, what was your question? 

[00:30:27] How would you do it? So if you were feeling really, really alone, so after you go through that emotion of like, okay, this is scary, but somebody else on my unit has to feel this way. How do you go about starting that conversation? Is it as simple as saying, like, did you see what Dr. Brown did? How do you feel about that? Is that really kind of how you break the ice and just pull out who feels, what about what you’ve been witnessed?

[00:30:52] Yeah, for sure, for sure. And also recognize that they’re going to be. So, okay. So it’s like, depending on what, the thing that you’re passionate about is there are going to be people on your unit who may or may not see eye to eye with you about that one thing, but you probably, if you are a multifaceted person with many interests and desire for equity and multiple areas of social systems, you probably have like multiple passion areas.

[00:31:18] Right? So. You could care about gender equity, trans equity, racial equity, all of these things, and what you’ll find, if you start to pay attention, or if you start to initiate conversations with people like that, there are going to be some people who check two out of four boxes. Some people who check one out of four boxes. So we cannot with certainty say, oh, well, this person doesn’t doesn’t understand the trans experience. Like if you have like a 60 year old nurse on your floor, she might think that she’s progressive and she just may not have been exposed to the same things that you have about the changing world for numerous reasons, access to information, being one of them, her own social system being one of them.

[00:32:03] And so if you count her out because she mis-gendered someone And say, well, we can’t work together on sustainability or this person is just toxic or whatever label you want to put on them. Then you are really closing yourself off to partnerships that could exist. And through partnerships about sustainability you could generate connection with this person or interest and then ultimately help them to see to see a new way of understanding the trans experience and what that means. People are not black and white, and I think we love to put people into black and white categories and that plays out a lot on social.

[00:32:42] For sure. Yeah. I was thinking, cancel culture. What you were talking about that and just thinking like we’re all on a journey, whether it’s, you know, whatever equity journey we’re on, like you said, in those categories, just to keep the theme, we’re all on that journey and kind of like what we see in OB nursing. There’s plenty of nurses who’ve never had a baby and they’re OB nurses. And so they’re on a spectrum of like experience. They have ton of nursing experience. They have a ton of other life experience. You have a ton of other exposure. Doesn’t count them out as someone who can truly educate.

[00:33:19] And, you know, we educate patients about that and families about that. But I think that’s something that kind of comes up as, like who’s saying, what and what experience do they it’s nonsense. But it’s the perspective of this person has knowledge around this and this person doesn’t have knowledge on this and we’re, we’re just, we’re just on a journey.

[00:33:38] So maybe someone wants. Like you said, they’re moving forward with their trans advocacy and equity, but they have yet to encounter whatever experience. I feel so excited when I hear, oh my gosh, you partner up with that person. They’re going to have other experiences that you don’t have. They’re going to have books that they’ve read that you’ve never heard about.

[00:34:00] They’re going to have these, whatever they want to teach with you. They want to read with you. They want to start a book club with you. They want the little things that bring other nurses. This isn’t a game of let’s change it individually. This is a totally a game of using with our powers combined our experiences, right.

[00:34:19] Our education. Moving forward in new directions together. And not at all, there is not, I try to do nothing on my own. It is always so much fuller with others knowledge and experience and perspective, and like, that’s exactly what you’re saying. And what I’m hearing is like aligning with folks wherever you can.

[00:34:43] It’s either in your work, in your faith, practicing, you know, calling out folks in your family, folks, in your, in your community before you do it at work or online, not, not necessarily calling out, calling in calling it right. Having those discussions of like, oh, I saw you do that. Where’d you, where’d you get that?

[00:35:01] You know, identifying like, Hey, we’re aligned in this way, but maybe I’m not even as far along in my journey than you are, but connecting on that same journey I think is really exciting. And it’s, it’s kind of, my question would have been, what would you say to a new grad? What would you say to nurses who are coming in?

[00:35:19] They might have a different perspective that especially than I did going into nursing, maybe a little closer than yours. It’s a shit show out there. What am I getting into? And then a year or two in their charge, right? Or they’re like asking to be director or a manager. And they’re like, what is happening?

[00:35:43] What you would tell them. But I’m, I’m getting so much already from what you’re saying and how these little changes and exercise and flex are like, need to move, move the system forward. 

[00:35:56] Yeah. You know, one thing to add to what I would say to new grad nurses and what I, what I do say to new grad nurses is systems are neutral. Systems do not have an intent on their own.

[00:36:11] So people design systems and people might have good or bad intentions but systems are neutral. And so we have the capacity to adjust them. And so when I hear. You know, the system is working against us or it’s evil or all of this. Stop thinking about the system as this entity with a mind of its own, because that’s really not the case.

[00:36:33] And when you set up this oppressor when you set up a massive industrial complex system as this machine. 

[00:36:45] Of course it overwhelms you. But if you just look at it as a product Humans design over years and years, that is constantly changing. Changing every day. Systems are always in flux. There is not a stagnant system right now, particularly when you go through something like a pandemic.

[00:37:03] So when you say the systems evil and you think of it as this static mean machine like you’ve described, I love that word. I’m going to take that with me.

[00:37:11] I feel like it’s like color, 

[00:37:15] but instead if you see it as this fluid expression of Daily human decisions, then you can understand like, damn I make daily human decisions.

[00:37:27] Yeah. I’m literally affecting the system every day. We are affecting the system every single day and every day we’re either more deeply moving into the status quo or moving away from it. So you do have agency, and that’s what I would tell new grad nurses. 

[00:37:46] I love that I just was so jazzed that this conversation.

[00:37:50] So one thing that came to my mind when you guys were just talking about you know, like having that older nurse or that racist nurse, calling them in. It doesn’t do so much good to call people in and have a conversation without also having that follow through of giving them how they could fix it next time, maybe staying with them, to give them more feedback along the way, if you really want to make an impact.

[00:38:16] And you’re truly going to be that change maker that you set out to do. You’ve got to be willing to get down and dirty and nitty gritty with the people that you’re trying to make that change with too. And sometimes that looks like really hard and awkward conversations, but just really the cancel culture, I think was the comment that made me think like, yeah, when we cancel people and we don’t ever give them an opportunity to do better or to learn from their mistake or to right their wrong, then we haven’t actually made a change. We’ve not made any impact. 

[00:38:50] Yup. Exactly. I developed this change pyramid, the framework that I use in my programs. And it is based on just books and books and books about systems thinking and social teams that I’ve read. And at the bottom of the pyramid, you have changing yourself and the middle of the pyramid is changing others. And the tippity top of the pyramid, the smallest triangle is the changing systems. And so the idea that I teach is that you can never jump straight to step two or straight to step three, whenever you were trying to make a change of any kind, it needs to start in here in yourself. And so if I am looking at how to talk to someone on my unit, a fellow nurse who I think has a flawed perspective of X, Y, or Z. I don’t get to just go to her and say, I don’t get to go right to teaching others and say, I have a real problem with you and how you, even if I say it nicely like HeHe, I’m concerned about how you. Blah, blah, blah. If I have not first, it can even be a 30 second reflection if I have not first thought: is this person is struggling with this thing? Am I struggling with that thing? Have I mastered that thing? Probably. Maybe you have, maybe you haven’t. But then if you at least do that mini reflection and then you move into the second step changing others, then you can go and you can say Lisa I noticed something that you did and I wanted to talk to you about it because it’s something that I too do or I, I once did. And I want to have just a real conversation with you because this is hard and here’s my experience. What do you think about that? And so you’re not coming like I’m the teacher, you’re the student you’re going into an experience open-minded open-hearted and you’re ready to hear what they have to share with you. We’re all just people with something to share. And I guarantee you, Lisa has something to teach you in another area, but if you started a relationship of teacher student, Lisa’s not ever going to share that with you, you are closing down an opportunity for growth and a relationship and connection. So the pyramid yourself, others, then the systems. 

[00:41:17] That is so powerful and also not surprising that the largest portion in the base is yourself, right? Like if you’re going to make change, the biggest work that you can do is on yourself and everything else, you can see piles on top of that and kind of flows from there.

[00:41:35] Claire, this has been such a life-changing conversation. I think so many people are going to walk away and really walk into work the next time that they go feeling inspired that they actually do have a lot more agency. Like you said, like I can make a change. And maybe up until this point, they had felt a little clouded about how do I actually make an impact because I feel so overwhelmed. So you’ve mentioned several times that you help people kind of find that clarity, find their voice, know how to make that change. Tell us how people can get ahold of you. How can they work with you? What are some of the things that you offer as this. 

[00:42:15] Sure. You can find me on Instagram at nursing dot the dot system. That’s mostly where I hang out. I’m kind of restructuring my business right now. I recently left my job in anticipation of a move and my doctoral graduation. So I’m devoting more time to the nursing the system work, which I’m really excited about. But that means I don’t have a super clear answer for you of what my business is going to look like and the programs that we’ll offer whenever this year.

[00:42:45] But I do offer one-on-one coaching and support around change thinking. You can just shoot me an email. I have an application on my website that you can fill out as well to see if it would be a good fit because that’s important. And I just recently launched a career development course.

[00:43:03] That’s all about integrating systems thinking into identifying your professional mission and then how you can then identify a career path that’s actually going to support that mission all while fostering this alignment mindset. So you’re not getting into jobs that you think you should take because of status or someone thinks you would do a good job, but it’s actually an intentional choice that you’re making to further our mission.

[00:43:25] So there’s that that’s called interview with intention and I’m planning on introducing a whole suite of change making courses in programs that I’m really excited about. Yeah. It’s going to be like a three tier the thing I’m super pumped about it, but I do not yet have more details to share.

[00:43:43] I’m like finalizing some things on the backend, but I’m really excited about that. And hope if you’re listening to this and felt like my perspective or the things that I coach on is something that could help you, that you check me out and stay tuned for those program releases. Cause I’m super excited about them.

[00:44:02] Yeah. Just teasers there you guys. 

[00:44:04] Yeah, no, I’m like, jeez. We’ll have to have you back to hear about all those classes, cause I want to take them. Oh my gosh. That’s so exciting. 

[00:44:15] I would love to come back. This was so fun. You guys are awesome. 

[00:44:20] Well, thank you so much. Listeners go check out what Claire has up her sleeve. We’re really excited and it looks like we just made a second date. So be on the lookout for that as well. Thanks for tuning in today, guys. And you can check us out on Instagram at pulse check dot podcast. See you later.

[00:44:41] Thanks so much, Claire.