Are You the Problem? Reclaiming Power in Nurse-Led Healthcare Change

When things go wrong in healthcare, it’s easy to point fingers at “the system.” But let’s flip the script for a moment: what if the real issue starts closer to home? What if it’s us?

Stay with me here. This isn’t about assigning blame—it’s about uncovering where your power lies. When you recognize how you fit into the bigger picture, you gain something incredibly valuable: the ability to change it.

The System Isn’t a Monster: It’s Human-Made

Healthcare systems can feel overwhelming, like massive, unfeeling entities that are impossible to influence. We’ve all been there: watching harm unfold and wanting to distance ourselves from the system responsible.

It’s comforting to think, “The system is failing us,” as if it’s something separate from us. But to be uncomfortably real with you: we are the system. Every nurse, clinician, administrator, and leader—through daily actions—helps create and sustain it.

No, you didn’t design the healthcare system. But when you clock in, provide care, interact with colleagues, and make decisions, you’re participating in it.

Acknowledging this connection is Step One in nurse-led healthcare change.

It’s not just about what the system does to us; it’s about how we can start reshaping it from the inside (or outside, depending on where you sit!).

Acknowledging the Challenges Nurses Face

Working in today’s healthcare environment is a grind. Let’s call it what it is: short staffing, administrative burdens, and the relentless emotional toll of moral injury leave many nurses barely holding on. If you’re feeling exhausted, frustrated, or even cynical about the state of healthcare, you’re not alone. Those feelings are valid.

While the system is undeniably flawed, focusing solely on its failures can make us feel powerless. The truth is, as challenging as things are, there are opportunities to make small yet meaningful changes—starting with how we see ourselves within the system.

Stop Selling Yourself Short: A Client Story

Nurses often internalize societal narratives that undervalue their roles. Think about the times you’ve heard or said, “I’m just a nurse.” These words carry weight. They can limit how you see yourself and your potential to lead change. But what if you shifted that perspective?

A client of mine, a quality improvement leader, once shared a story that stuck with me. She was tasked with presenting complex data to a group of nurse leaders. 

But when she showed her detailed charts and analysis, the nurse leaders suggested she simplify everything into a basic bar chart. The reasoning was simple but frustrating: "Nurses aren't going to understand data sets this complex."

Instead of following this advice, my client pushed back. “There was a time when I didn’t understand this data either,” she said. “But I learned, and they can too.” 

She explained that oversimplifying the information would strip away critical context and meaning. Instead, she created an opportunity for growth by presenting the full picture and providing guidance on how to interpret it.

When the time came for the presentation, the outcome was exactly what you’d expect. Nurses dove into the data. They asked sharp questions, drew connections, and quickly grasped how it tied to patient outcomes and system improvements. My client’s decision to believe in their abilities paid off—not just in comprehension, but in sparking a sense of ownership and agency that’s often underestimated in nursing teams.

This isn’t just about data. It’s about recognizing that nurses are capable of so much more than they’re often given credit for. Where might you be selling yourself short in your capacity to learn, grow, or lead?

Reframe Responsibility: From Blame to Opportunity

It’s easy to point fingers at “the system,” but here’s the thing: when we make it the sole villain, we give up our power. Instead of focusing on how broken it is, let’s look for where we can move the needle. This isn’t about taking on the whole world’s problems; it’s about finding those small, specific spaces where we can create momentum. 

Ask yourself, where are the small spaces in your daily work where you can spark change? For example:

• Can you challenge a team habit, like deflecting blame during post-shift reviews, by reframing the conversation toward solutions?

• Is there a small process improvement, like standardizing shift handoffs, that could make your team’s work smoother?

• Could you use a moment in a meeting to model curiosity and collaboration, encouraging others to do the same?

  
  

These actions may seem minor, but they create ripple effects. Change doesn’t always have to be a grand overhaul—it can start with consistent, thoughtful steps that shift dynamics and influence the broader system.

Reflect on Your Role

When you start to see your role in healthcare differently, the right questions can unlock new possibilities. Consider these:

• Where might you be underestimating your ability to create change?

• How might your actions or assumptions contribute to unhelpful dynamics in your workplace?

• What narratives about nursing or healthcare might be holding you back from stepping into the role of change leader?

  
  

These reflections are just the beginning. When you identify where you can take ownership, you start building the mindset and habits of a systems thinker—someone who can navigate complexity and drive meaningful change.

Take the Next Step

If this resonates with you, don’t let the conversation end here. Join the Nursing the System community for practical, actionable strategies that tackle the real challenges nurses face. 

Subscribe to the Nursing the System Podcast on Apple Podcast or Spotify for sharp insights and real talk about leading change. And don’t miss the Systems Sunday Email List—your weekly dose of tips to take impactful action without burning out.

The system won’t fix itself, but we have the power to start driving meaningful change. Are you ready to take the first step?