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Why do we keep falling into the trap of “us versus them” thinking in healthcare? Whether it’s nurses vs. doctors, middle managers vs. staff nurses, or bedside vs. non-bedside roles, these divisions don’t just limit our potential—they actively undermine it.
The reality is, healthcare is a complex web of interconnected roles, responsibilities, and relationships. To create real change, we need to rethink how we see ourselves and the people we work with. This blog unpacks the pitfalls of the blame game, introduces systems thinking as an alternative, and offers actionable steps to help you move from frustration to collaboration.
The Problem with “Us vs. Them” Thinking in Healthcare
Healthcare is a breeding ground for “us versus them” thinking. It’s not just limited to nurses vs. doctors—it’s everywhere. Think:
Middle management vs. frontline staff.
Clinical professionals vs. administrators.
Bedside vs. non-bedside roles.
These divisions don’t just make our work harder—they actively harm collaboration and innovation. They create:
Frustration and friction among teams.
Missed opportunities to work together effectively.
Burnout and moral injury stemming from misaligned goals.
What’s worse, this mindset perpetuates the very systemic failures we’re trying to fix. When we default to blame—whether it’s Big Pharma, senior leadership, or “that one nurse who never follows through”—we miss opportunities to make meaningful change.
Systems Thinking: The Antidote to Division
Instead of getting stuck in the blame game, we need to embrace systems thinking. This framework helps us:
See the big picture: Understand how interconnected roles, processes, and policies shape outcomes.
Identify leverage points: Focus on where small changes can create big ripple effects.
Collaborate effectively: Build relationships that strengthen our ability to drive change.
An us-versus-them mindset puts a black-and-white filter over a world that’s rich with nuance. Systems thinking removes that filter, allowing us to see the complex dynamics at play—and how we can influence them.
Two Steps to Break Free from Us vs. Them Thinking
So, how do we stop falling into the trap of divisive thinking? Here’s a two-step approach that’s rooted in systems thinking:
1. Look at Yourself
A core principle of systems thinking is self-reflection. Before pointing fingers, ask yourself:
How might I be contributing to this dynamic—intentionally or unintentionally?
What assumptions am I making about others that might not be true?
Where do I have room to grow in my communication, collaboration, or understanding?
This isn’t about taking full responsibility for systemic failures. It’s about acknowledging that even with the best intentions, we all have areas for improvement.
2. Look at Others
The next step is to shift your perspective from seeing others as obstacles to seeing them as potential partners. Start by:
Identifying their system: Visualize the other person’s daily challenges, pressures, and goals. For example, if you’re frustrated with your nurse manager, ask yourself, Who are they answering to? What’s on their plate?
Finding shared goals: Even when priorities differ, there’s almost always common ground. Do you both care about patient safety? Staff well-being? Efficiency?
Building trust: Initiate small, authentic conversations. Ask open-ended questions like, What’s the most frustrating part of your role? and listen.
The Power of Relationships in Systems Thinking
Here’s the magic of systems thinking: it turns relationships into leverage points. When you build strong connections across silos—between ER and ICU teams, bedside nurses and administrators, or even clinical staff and patients—you create networks that make change easier and more sustainable.
Relationships aren’t just “nice to have” in healthcare; they’re essential. The richer and more interconnected our relational networks are, the stronger our systems become.
Reflective Prompts
As you’re reading this, take a moment to reflect:
Where might I be unintentionally contributing to an “us vs. them” dynamic?
Who in my professional ecosystem could be a potential partner for change?
How can I start building trust and collaboration today?
From Blame to Collaboration
Blame shuts down possibilities. Collaboration opens them up. When you shift from asking, Whose fault is this? to How can we work together to solve this?, you’re choosing the mindset that drives progress.
Healthcare is complex. Your clinic, hospital, or organization is complex. But complexity doesn’t mean chaos. By embracing systems thinking, looking at yourself, and seeking collaboration, you can find the hidden opportunities for progress.
Take the Next Step
If this resonates with you, keep the momentum going. Listen to the full episode on the Nursing the System Podcast for an even deeper dive into breaking down silos and building collaborative change.
And don’t forget to subscribe to Systems Sunday! Every week, I’ll send you actionable insights, strategies, and inspiration to help you thrive as a nurse changemaker.
Together, let’s build systems—and lives—that truly work.
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