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It is called Between Shifts. A short meditative audio and video series for paid subscribers, meant for the minutes right after your day ends, before you walk back into the rest of your life. No advice. No steps to follow. Just a few minut…

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What this episode is about

This one steps away from the usual ground of career, burnout, moral injury. It turns toward the person living inside the nursing role. The whole episode rests on a single premise: you are a human being first, a nurse second, deserving of the same attention you hand out all day to everybody else.

Who inspires you

The episode opens with a question meant to be sat with, not answered quickly. Not who inspired you today. Not who inspired you yesterday. Who inspires you now, in an ongoing way. The reflection moves through a chief nursing officer who modeled transformational leadership, floor nurses whose practice set a standard, then a more recent influence who prompted a whole change of direction into coaching, Substack, this podcast. Your version of that question: who makes you a better human inside the frame of the nursing job you hold?

The human being inside the role

Nurses define themselves by the caring. Hospital, long-term care, home health, wherever the work happens, the role tends to swallow the person. This segment asks you to look past it. How is your health? Your blood pressure? Your cholesterol? Your cortisol? Those questions land uncomfortably for a reason. Nurses give everything to everybody around them, rarely to themselves. That gap shows up in diet, in physical activity, in the twelve, thirteen, fourteen-hour shifts spent running nonstop that do nothing for cardiovascular health.

There is a light moment here worth keeping. Stand up, say out loud, “I’m a nurse, I’m stubborn.” Resilience, stubbornness, both true. Naming it clears the way for honest reflection.

One degree of change

The central idea of the episode. Transition in your life does not have to be dramatic. One degree of change, compounded across a year, leaves you somewhere entirely different. That works in both directions, which is the warning inside the encouragement. Ignore what is happening in your life, focus only on the work, the bills, the lunches, the kids, a year still passes. The challenge posed to you: define one degree of change. A health goal. A relationship goal. A personal fulfillment goal. Your choice.

Stories from the coaching room

The remote nurse. She had worked remotely through COVID, stayed remote afterward, felt terrible at the end of every day. Her words: brain warped, body having done nothing. She named what she wanted: better core strength, more movement. Her one degree of change arrived in pieces. First a sit-stand desk. A couple weeks later, an under-desk walking treadmill. Then goals for how often she would use both. By the end of the coaching sessions, she had lost weight, built core strength, gained better control of her hypertension, and found a way to metabolize the stress of the day.

The nurse who quit soda. One decision, no more soda. It sounds almost too small to matter. It is harder than it sounds. That single change changed everything for her.

The nurse who called it mumbo jumbo. High-caliber, highly responsible role, blood pressure well managed, stress still enormous. Asked what breath work, what meditation she used during stressful moments, she looked straight into the camera: none of it; it is a bunch of mumbo jumbo. Her one degree of change became five minutes of breath work between encounters. Supply room, linen closet, at her desk, anywhere. Deep in, slowly out. Five minutes of mindfulness can turn a whole day.

Do not ignore the warning signs

A frank stretch of the episode. Fatigue. Blood pressure climbing. Type 2 diabetes. Nurses carry a third sense about their own bodies, the self-assessment nobody else can run. Ignoring the result is easy. Moving on is easier. The ask here is direct: today is the day to commit to the change you already know you need.

Plans worth looking forward to

Health is one piece. Life is the other. What are your plans for the next thirty days, three months, six months, a year? The story offered here comes from single fatherhood: kids need something to look forward to, a flight to visit cousins, a trip to Disney World, a day at Six Flags, a family gathering. Adults need the same thing.

This is also where the show’s name gets explained. After you clock out, your second shift starts. The days blur. On the rare day off, when nobody calls at four in the morning to cover a shift, you want the couch, the bathrobe, the coffee, the iPad, nobody bothering you. That is understandable. It is also not a plan.

Nobody gets to steal your joy

The anchor story of the episode. Thirty years ago, a nurse author, known for speaking about joy, kept a small hand puppet on the podium during her lectures. She said one thing that has framed a career, a fatherhood, a life since: never let any situation, any person, steal joy from your day.

Plenty of things will try. The invitation is to make a plan for joy the way you would make a plan for anything else that matters. In this house, that looks like the podcast itself, connection with nurses who need help, fulfillment that runs both directions. It looks like a camper van pointed toward a daughter in Minnesota, a mother in Ohio, dear friends in Michigan. It looks like the coach who travels in an airstream with her husband, two dogs, coaching from the road, sharing her joy publicly.

Whichever nurse you are today, the one who strips down in the garage after a fourteen-hour shift then stands staring into the refrigerator wondering why she opened it, the academic who gave everything to the next generation of nurses then came home to a second shift with no joy in it, the message holds. You deserve joy. Make a plan for it.

The closing invitation

Your inner knowing, your wisdom, your resilience are real. Sometimes a partner still helps. Somebody who will call you on your bullshit. Somebody who holds a space where you can say out loud what you have never said before. Somebody without judgment, letting you be you. That is what coaching is for here.

Reclaim your health. Reclaim your happiness. Most of all, reclaim your joy.

Reflection questions from this episode

• Who inspires you? Not today, not yesterday. Who inspires you?

• When did you last look honestly at your health as a human being rather than as a nurse?

• What would one degree of change look like in your life right now?

• What plans do you have, outside health, outside work, that you actually look forward to?

• If you have none, why not?

What is happening on Substack

• Meditation series launches September 1, for paid subscribers. Three sessions on launch day at 10 Central, 11 Central, 12 noon Central. A new meditation video drops every week after that.

• Two gifted coaching sessions in September for upgraded paid subscribers.

• The Break Room meets September 11, the monthly live gathering for paid subscribers. The first one drew nurses talking honestly about their lives, some already on the other side of a change, some still naming what they want. The link is available on request.

Take the Next Step

Each step is defined.

☕ Schedule a Conversation, Nurse to Nurse: thirty minutes, real, honest, no fancy frameworks.

Book a Call, Nurse to Nurse

🚪 The Break Room: Community. Your way in. Once a month, we gather live. There is no agenda and no toxic positivity. This is just real talk with nurses who understand where you are, led by a nurse who has spent many years standing there too.

Join The Break Room

💬 Join the conversation: leave a comment on this post.

Leave a comment

🔔 Subscribe to The Second Shift for a new essay plus episode every week.

Subscribe now

☕ Upgrade to the paid tier. The paid tier is a space that provides you with resources and support as a premium member of The Second Shift. These resources include:

• The Break Room, a monthly gathering space for nurses.

• Interactive Nurse-Driven Workshops designed for nurses in transition and nurse managers, provided at no additional cost.

• Nurse Resources - all a part of your premium membership.

• First to hear about gifted coaching opportunities.

Something new and exciting:

About The Second Shift

The Second Shift is a newsletter plus podcast for nurses who carry the weight of caring for 12 to 14 hours, then come home to begin a second shift - this one is for their families. This is the shift no one sees, one that is equally important. As a nurse, this is my story as well. As a coach, I create space for nurses built on real, honest conversations: a plan that moves you from chaos to a life you feel alive inside of again.

Patrick LaRose, DNP, MSN/Ed., RN, NC-BC Board-Certified Coach | Life Coach lifenursecoach.com

There is nothing we have not faced that we cannot fix, address, or make better.

Some might say that is our superpower.

I often think of my response during a rapid response or, worse, a code blue.

The adrenaline pumping, the memory of mega codes we would do in ACLS training.

We move with grace, calmness, and a command of the room like we own it. Because, really - we do.

There is a certain kind of confidence you have when you are needed. When you are making a difference.

Here is the question that I sit with. Why do we not have that same diligence in our personal lives when it comes to assessing what is draining us?

Things need to change, and sometimes it may not even be the job. It may be things we are putting up with in our lives that we know are not good for us.

Relationship.

Living arrangement.

Health issues that we know how to address.

Despite what we know, there are times when taking any form of action feels impossible.

In fact, sometimes we may sit in that situation longer than needed simply because we do not trust our own ability to make a decision.

To set in motion change that will bring some joy back.

Here is what I know from my work with nurses. Sometimes rocking the boat adds to an already touchy situation. So they settle.

Balance.

Closing a blind eye.

Ignoring.

Sound familiar? Yes, me too.

I use the word “we” in this writing because I was not immune to that feeling.

Balance looks like not rocking the boat. Keeping harmony and keeping things as they are.

Ignoring behaviors that we should not have to put up with. So much so that sometimes going to work feels like a relief.

Closing a blind eye and allowing the dysfunction to continue.

Where is Super Nurse during these times?

Oh, she is in there; make no mistake. And sometimes, all you need to do is activate her.

But that is where the problem is.

As nurses, we can be stubborn. I have the right to say that because I am a nurse, and stubborn can be my reality too. It is ok. Nurses - say it out loud with me.

Ok, now that we got that out of our system, let’s get back to the topic.

I have been publishing on Substack since October of 2025, building a community. In May of 2026, I turned my attention and focus to nurses and have been steadily building a community of nurses since then.

Here is what I have learned about my colleagues.

We are tough. Sometimes tough as nails.

Makes perfect sense, right?

We see things others cannot even imagine.

In order to face what we have seen, we raise a protective barrier between us and the world.

In the comments, let me know what protective barrier you have to keep your heart and mind protected.

Leave a comment

When that protective barrier begins to wear you, rather than you wear it, this can lead to becoming stuck, doubting our own abilities, and allowing fear and doubt to rule our lives.

When we know something needs to change, we feel powerless to make that change. There are a host of reasons. What I hear most from nurses I work with is fear.

Fear of change.

Fear of judgement.

Fear of failure.

And here is the biggest fear of all. Not making enough money.

There is no shame in needing to make a certain wage.

Here is where the reframe starts.

Let’s look at what you are facing today through the lens of Super Nurse.

I want you to harness the power of that nurse and jump to the rescue of your own life.

It does not need to be dramatic.

It certainly does not need to be transformational (although sometimes it feels like that).

If you have been reading my Substack for a while, you know I am the guy who talks about one degree of change.

With one degree of change, in a year you will be in an entirely different place.

The decision to move forward and make that change rests with you.

Listen, I do not need to sell you on my services because I know they are great and the people I work with have said they are great too. It is not about me. It is truly all about you.

Here is where the ball is in your court. As a stubborn nurse, make the decision that a personal investment in your life is worth it. Hands down, there is no better way for you to get moving on plans than to invest in yourself and your future.

Sure, there are those out there that have been burned on a 5-day plan or some crazy promise of transformation. That is not me. Here is my promise.

I promise to sit with you and listen.

I promise to hear what you want.

I promise to co-create a plan that meets your needs and helps you get to where you want to be.

I promise to hold you accountable, call bullshit when I hear it, and most importantly, stand with you through the process.

The nurses who have inquired ask me what coaching with me looks like. I generally share this with my paid subscribers, but I want you to see how this works.

I call it The Shift Method:

Each step is designed by you.

You are the center of this change.

The method is flexible because we know how life as a nurse can be.

The plan breathes with you.

Meeting the goal is always optimal, but in weeks where the goal was not achieved, this becomes the work for the next week, and you know what?

That is perfectly fine.

Let’s close the loop. As a Super Nurse, your power is always there. It is time to activate that nurse and have her start looking deeply at the life you want.

Not one that was chosen for you or a job where you feel like you cannot change.

But this decision is about making an investment in yourself and your future.

You are the one who is driving that car.

Whatever you decide, I am glad you are part of this community, and I am excited to see you each month in The Break Room.

Until next time - Patrick

Take the Next Step

Each Step Gives You The Power To Reclaim Your Life

☕ Schedule a Conversation, Nurse to Nurse: thirty minutes, real, honest, and a space to get real about what you want.

Book a Call, Nurse to Nurse

🚪 The Break Room: Community. Your way in. Once a month, we gather live. There is no agenda and no toxic positivity. This is just real talk with nurses who are at different levels and sharing their experience. This is a community of nurses and a space created by a nurse for nurses.

Join The Break Room

🔔 The companion podcast:

💬 Join the conversation: leave a comment on this post.

Leave a comment

🔔 Subscribe to The Second Shift for a new essay plus podcast episode every week.

Subscribe now

☕ Upgrade to the paid tier. The paid tier is a space that provides you with resources and support as a premium member of The Second Shift. These resources include:

• The Break Room, a monthly gathering space for nurses.

• Interactive Nurse-Driven Workshops designed for nurses in transition and nurse managers, provided at no additional cost. (Announced as planned)

• Nurse Resources - all a part of your premium membership.

• First to hear about gifted coaching opportunities.

About The Second Shift

The Second Shift is a newsletter plus podcast for nurses who carry the weight of caring for 12 to 14 hours, then come home to begin a second shift - this one is for their families. This is the shift no one sees, one that is equally important. As a nurse, this is my story as well. As a coach, I create space for nurses built on real, honest conversations: a plan that moves you from chaos to a life you feel alive inside of again.

Patrick LaRose, DNP, MSN/Ed., RN, NC-BC Board-Certified Coach | Life Coach lifenursecoach.com

A nurse can run a code, catch a bad order, learn new equipment overnight, walk into a falling-apart room, find the next right move before anyone asks twice. That same nurse can sit in her own driveway with a decision about her own life and go completely blank.

This episode looks at why that happens. At work there is a protocol, a physician order, a policy, a chain of command, a second set of eyes on anything that matters. Personal life hands over no such framework. It hands over a blank line, with only one person able to fill it in.

The question at the center of the episode: what happened that made a nurse stop trusting her own judgment in her own life, when that judgment is trusted with patients every single shift?

What This Episode Covers

• Why a decision at work feels anchored, while a decision about a life feels like free fall

• The blank line no protocol fills in, plus the small honest answer that starts it

• Gratitude for a job versus indecision about a job, two very different things

• A body that never clocks out: light sleep, phone checked before the eyes open, triage running during a child’s birthday party

• Two words worth retiring: stuck, burnout

• What sits underneath: fear, exhaustion, identity, the question of who a nurse is away from the bedside

• A real story from the emergency department, one sentence said out loud, ten minutes in a car, eight months of change

• Why a lapse is information rather than failure

• The SHIFT approach, built on the nursing process, with the nurse at the center

• Clarity as a product of momentum rather than certainty

• One degree of change, compounded across a year

Lines From This Episode

“I love my patients. I do not love what this job has become.”

“Being the one everybody can count on was never really supposed to mean you stopped counting on yourself.”

“Clarity comes from momentum.”

“Gratitude and staying with indecision are not the same thing.”

Two Places To Begin

The Break Room. A monthly gathering where nurses talk with other nurses about change, some already on the other side of it, some just beginning to ask what else is out there. Next gathering: September 11. Access comes with a subscription to The Second Shift.

Subscribe now

Book a call. Thirty minutes, nurse to nurse, no obligation, no expectation. Just a conversation about where things are now, plus where they could go.

Book a Call Nurse to Nurse

More Links

• lifenursecoach.com

• Free guide for nurses

Share This Episode

Copy the link. Text it to a nurse who needs to hear it today. Do it now, before it slips.

Take the Next Step

☕ Schedule a Conversation, Nurse to Nurse: thirty minutes, real, honest, no fancy frameworks.

Book a Call, Nurse to Nurse

🚪 The Break Room: Community. Your way in. Once a month, we gather live. There is no agenda and no toxic positivity. This is just real talk with nurses who understand where you are, led by a nurse who has spent many years standing there too.

Join The Break Room

💬 Join the conversation: leave a comment on this post.

Leave a comment

🔔 Subscribe to The Second Shift for a new essay plus episode every week.

Subscribe now

☕ Upgrade to the paid tier. The paid tier is a space that provides you with resources and support as a premium member of The Second Shift. These resources include:

• The Break Room, a monthly gathering space for nurses.

• Interactive Nurse-Driven Workshops designed for nurses in transition and nurse managers, provided at no additional cost.

• Nurse Resources - all a part of your premium membership.

• First to hear about gifted coaching opportunities.

About The Second Shift

The Second Shift is a newsletter plus podcast for nurses who carry the weight of caring for 12 to 14 hours, then come home to begin a second shift - this one is for their families. This is the shift no one sees, one that is equally important. As a nurse, this is my story as well. As a coach, I create space for nurses built on real, honest conversations: a plan that moves you from chaos to a life you feel alive inside of again.

Patrick LaRose, DNP, MSN/Ed., RN, NC-BC Board-Certified Coach | Life Coach lifenursecoach.com

Episode Overview

The episode opens at 7:15 a.m. in the ICU, with a red light flashing in room eight during a routine fire drill. What follows is a thirty-second hesitation before pulling the alarm, despite already knowing exactly what needs to happen. That pause becomes the frame for the episode’s central theme: permission.

The discussion covers why so many nurses wait for permission that was never really anyone else’s to give, whether the decision is leaving the bedside, saying no to a shift, or telling a manager the truth about the workload.

Nurses.org data on bedside burnout and a client story mirror that same hesitation, landing on the episode’s core line: the only signature required on a permission form belongs to the person holding the pen.

Key Takeaways

• The hesitation before a hard decision often is not about ability or a plan. It is about waiting for someone else’s permission.

• 43% of nurses report wanting to leave the bedside within the next year, and 41% stay only for the paycheck (Nurses.org).

• Permission is not handed over. It gets taken back one decision at a time.

• Feeling unmoved even when life looks right on paper is not ingratitude. It is information.

• Certainty is not a prerequisite for moving forward. Certainty comes with movement.

Questions to Sit With

• Whose voice is actually being waited on to say it is okay?

• What decision has been sitting unresolved for six months, two years, or longer?

• What would change this week if the wait for that voice simply stopped?

Notable Moment

Standing in front of the fire alarm panel during a monthly fire drill, running through a checklist, a charge nurse simply gives the instruction to pull it. No permission slip gets requested. The permission assumed to be necessary was never anyone else’s to give.

Share This Episode

For anyone this episode names something for, sharing it with a nurse who needs to hear it is encouraged.

New episodes of The Second Shift publish weekly. Comments and topic requests are welcome.

Resources Mentioned

• The Break Room: monthly community gathering for nurses. Subscribe on Substack for access.

  The Break Room

• Bedside and Beyond Guide: resume support and 4 AI prompts to help you translate your skills and get past AI screening.

  Bedside and Beyond Guide

• Book a 1:1 call with Patrick.

  Book a Call Nurse to Nurse

Connect

Patrick LaRose, DNP, MSN/Ed, RN, NC-BC
The Second Shift on Substack - Once a nurse, always a nurse. Stay strong.

Subscribe now

Take the Next Step

☕ Schedule a Conversation, Nurse to Nurse: thirty minutes, real, honest, no fancy frameworks. Book here

🔔 The companion podcast:

💬 Join the conversation: leave a comment on this post.

Leave a comment

🔔 Subscribe to The Second Shift for a new essay plus episode every week.

Subscribe now

About The Second Shift

The Second Shift is a newsletter plus podcast for nurses who carry the weight of caring for 12 to 14 hours, then come home to begin a second shift. This is the shift no one sees, one that is equally important. I have lived this story. As a coach, I create space for nurses built on real, honest conversations: a plan that moves you from chaos to a life you feel alive inside of again.

Patrick LaRose, DNP, MSN/Ed., RN, NC-BC Board-Certified Coach | Life Coach lifenursecoach.com

I sat down live with Karen Retardo, the Conscious Nursepreneur Coach, for a conversation about nurses stepping into business ownership. Thank you to those who attended live. It was great to have you in the audience.

Who Karen Is

Karen is a registered nurse who writes The Conscious Nursepreneur here on Substack. She works with introverted, quietly ambitious nurses who are ready to shift from an employee mindset to a CEO mindset, whether that means building a coaching practice or moving a passion project forward. Her sister was her first client, and that relationship pushed her to start building her own business two years ago.

What We Talked About

Building in public. Karen made a conscious choice to build her coaching practice in public on Substack starting in January of this year. That decision, out of a desire for accountability, is what led her to the connections filling this room tonight.

Moral injury, not burnout. We pushed back together on the word burnout. Nurses are not tired from a vacation-worthy kind of exhaustion. They are carrying the weight of giving care in ways they never wanted to give it, cutting corners they know matter, working short staffed year after year. That is moral injury, and it has not been addressed just because the world has moved on.

Identity underneath the transition. Karen named the layer under every nurse’s business transition: identity. Nursing asks so much of us to earn that title that it becomes part of who we are. Stepping into ownership means learning to hold “I am a nurse” and “I am a business owner” at the same time, without one erasing the other.

Values checked against your calendar and your bank statement. Karen’s line landed hard for me. If you want to know your real values, do not just say them out loud. Look at your calendar and your bank statement. Time and money tell the truth.

A coach tells you what you need to hear. We talked about the difference between a friend and a coach. A friend will tell you what you want to hear. A coach is going to tell you what you need to hear, and that shift matters when you are trying to build something real.

Karen’s framework. She shared her Conscious Nursepreneur Ecosystem, three steps: alignment, expressing yourself, and stewardship. The goal is a business that serves you, not one you are serving.

The Takeaway

If you are a nurse in transition and looking at doing something different, you have two people in your corner. Karen can help you on the business end. I can help you on the transition end. You already have the wisdom and the knowledge to get where you are going. The only question is how long you want that road to take.

Connect with Karen

The Conscious Nursepreneur

One conscious business at a time. Real strategy, practical tools, and values-led thinking for nurse coaches and nursepreneurs building on nights, weekends, and days off — because your business should fit your life and honor who you are.

By Karen Retardo, RN, ICF-PCC

Connect with Patrick

The Second Shift

I work with nurses who can calm a family, catch a mistake, and keep moving on three hours of sleep, but are one more "you are so strong" away from coming undone. If your whole life has become one long emergency response, you belong here.

By Patrick LaRose

About The Second Shift

The Second Shift is a newsletter plus podcast for nurses who carry the weight of caring for 12 to 14 hours, then come home to begin a second shift - this one is for their families. This is the shift no one sees, one that is equally important. As a nurse, this is my story as well. As a coach, I create space for nurses built on real, honest conversations: a plan that moves you from chaos to a life you feel alive inside of again.

Patrick LaRose, DNP, MSN/Ed., RN, NC-BC Board-Certified Coach | Life Coach lifenursecoach.com

Take the Next Step

Each step is defined.

☕ Schedule a Conversation, Nurse to Nurse: thirty minutes, real, honest, no fancy frameworks.

Book a Call, Nurse to Nurse

🚪 The Break Room: Community. Your way in. Once a month, we gather live. There is no agenda and no toxic positivity. This is just real talk with nurses who understand where you are, led by a nurse who has spent many years standing there too.

Join The Break Room

🔔 The companion podcast:

💬 Join the conversation: leave a comment on this post.

Leave a comment

🔔 Subscribe to The Second Shift for a new essay plus episode every week.

Subscribe now

☕ Upgrade to the paid tier. The paid tier is a space that provides you with resources and support as a premium member of The Second Shift. These resources include:

• The Break Room, a monthly gathering space for nurses.

• Interactive Nurse-Driven Workshops designed for nurses in transition and nurse managers, provided at no additional cost.

• Nurse Resources - all a part of your premium membership.

• First to hear about gifted coaching opportunities.

Our Monthly Conversation

Community. Your way in. Once a month, we gather live. There is no agenda and no toxic positivity. This is just real talk with nurses who understand where you are, led by a nurse who has spent many years standing there too. The Break Room is where you finally put your feet up and have real conversations. The monthly Break Room schedule will be provided here each month.

Our next scheduled Break Room:

Read more

In this episode Patrick asks the question most nurses avoid. What is stopping you from defining a future that looks like this? Are you seeking permission? Are you afraid to change?

Nursing today is overworked, short-staffed, stretched past capacity. Nurses keep showing up anyway. Patrick unpacks why, using real conversations with nurses who feel stuck, who are waiting for a breaking point (a pandemic, a shift too far) to give themselves permission to change.

Through two case studies, Joan (a veteran bedside nurse facing another ownership change) and Tomeka (a new graduate questioning if this pace is sustainable), Patrick makes the case for a different measuring stick. Not a crisis. Your health. Your time. Your own limit.

In This Episode

• Why “another pandemic” should not be anyone’s breaking point

• Joan’s story: reading the difference between a CNO-led and CFO-led hospital, and what to do when your limits are reached after years at one hospital

• Tomeka’s story: the whiplash from nursing student to RN, and why new grad burnout is common, not personal

• Your skills have market value, even if you have not job searched in years

• Why leaving the bedside is not the only path, and why staying does not mean losing your voice

Resources Mentioned

• The Break Room: monthly community gathering for nurses, first session August 14th. Subscribe on Substack for access.

  The Break Room

• Bedside and Beyond Guide: resume support and 4 AI prompts to help you translate your skills and get past AI screening.

  Bedside and Beyond Guide

• Book a 1:1 call with Patrick.

  Book a Call Nurse to Nurse

Connect

Patrick LaRose, DNP, MSN/Ed, RN, NC-BC
The Second Shift on Substack - Once a nurse, always a nurse. Stay strong.

Subscribe now

Take the Next Step

☕ Schedule a Conversation, Nurse to Nurse: thirty minutes, real, honest, no fancy frameworks. Book here

🔔 The companion podcast:

💬 Join the conversation: leave a comment on this post.

Leave a comment

🔔 Subscribe to The Second Shift for a new essay plus episode every week.

Subscribe now

About The Second Shift

The Second Shift is a newsletter plus podcast for nurses who carry the weight of caring for 12 to 14 hours, then come home to begin a second shift. This is the shift no one sees, one that is equally important. I have lived this story. As a coach, I create space for nurses built on real, honest conversations: a plan that moves you from chaos to a life you feel alive inside of again.

Patrick LaRose, DNP, MSN/Ed., RN, NC-BC Board-Certified Coach | Life Coach lifenursecoach.com

Each resource was inspired by my own journey and the challenges I went through making shifts in my career and in my life. Resources like this were not available, so I created them specifically for you at whatever stage in your life and career you find yourself.

What you will find here are resources that ask the hard questions. They ask you to think deeply about your life, career, experiences, and to dig to find the answers that are within you, but may be buried deep.

These resources are born from my personal experience, what I went through, and the deep thinking process I needed to create to move myself forward, change a mindset that was deeply held, or re-envision a life where I could feel alive within. I truly hope you find these resources helpful on your journey.

If you are a free subscriber, these resources are available to you once you upgrade to the paid tier. Considering upgrading today.

Subscribe now

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I recently read a note from Dr. Brandon Luu () that really spoke to me. Not because I was looking for a message from the universe, but because his message hit me closer to home than I expected.

As a nurse and someone who has worked with people who have felt like broken humans, the message I frequently share is that it is rarely too late. Dr. Luu provides a reminder that we all need. The lungs recover, the liver heals, and muscles regain strength.

This is powerful on so many different levels. Because it speaks to the inner resilience we have as human beings. But when we are sitting in a place of fear or questioning how, sometimes we lose perspective on what possibilities look like.

And maybe the idea of change and remembering what your body can do feels too big, or too large a change. Here is a message I recently wrote.

The larger idea here is that small, incremental change makes all the difference. It is the mechanism that reminds you that change is within your reach.

What does this look like for you?

It looks like shifting a mindset that limits your thinking. It looks like beginning to consider the possibilities you may have thought were lost. It looks like gaining a perspective that is not based in fear of change, but in possibilities.

A degree of change is small, manageable, and something that you can do today. I am reminded of a client who had lost a lot of core strength because of an illness. He had always been physically fit, but felt powerless after the illness to regain that strength. His doctor told him he could increase his activity. He simply did not know what steps to take.

Our conversation focused on small incremental steps. He recalled a friend who started doing chair exercises and agreed that this would be a great starting point for him. He reached out to his physical therapist and was provided with low-impact chair exercises he could do several days a week. This was the start. That was the one degree of change for him.

A year later, he was walking in his neighborhood. That one degree of change put his life somewhere entirely different than where he was. A small shift that compounded.

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The Next Step

Step 1: Ask yourself, where would you like to be in the next thirty days?

Step 2: Make your goal ridiculously small. A one-degree shift is all you need.

Step 3: Schedule the new thing. Put it on your calendar and set a reminder.

Step 4: Be consistent. Follow the schedule and do not expand it. Just do the thing for the next thirty days.

Step 5: Remember, starting might feel uncertain. That is part of change.

Step 6: After the first thirty days, evaluate your progress.

Step 7: Realign and adjust, never forgetting the goal. Reset the degree of change when needed.

It is through small incremental steps that we can realize important change and achieve something we may have thought not possible. The human body and mind are amazing.

If you are in a place in your life where you are not sure where to begin or if you are ready for that one degree of change and do not want to carry this alone, may be it time to reach out. That one degree of change can help you be in an entirely different place in a year or maybe even sooner.

Schedule a call

As Dr. Luu said in his post, “start today, wherever you are.”

Good luck.

Patrick

About The Second Shift

The Second Shift is a newsletter plus podcast for nurses who carry the weight of caring for 12 to 14 hours, then come home to begin a second shift. This is the shift no one sees, one that is equally important. I have lived this story. As a coach, I create space for nurses built on real, honest conversations: a plan that moves you from chaos to a life you feel alive inside of again.

Patrick LaRose, DNP, MSN/Ed., RN, NC-BC Board-Certified Coach | Life Coach lifenursecoach.com

For Patrick, the human experience is not always driven by the work. It is driven by perspective, our internal narrative, and a mindset that we have grown accustomed to over the years. Sometimes this mindset sets us up on a course where being high achievers is not something we signed up for, but by our very nature, is who we believe we are. I am excited to join with Dido in sharing some insights that can help high achievers become more aware, set personal boundaries, and define a life focused on balance. My perspective comes from that of a nurse. But high achievers can live in any profession. So the message is universal.

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For Dido, high achievers don’t have very different lives from nurses, but the behavior patterns and result of running into burnout tend to show up the same. They have always been competent people, actually a little bit too competent for their own good! Everything gets done for the people they’re responsible for, but nobody cares to check in on them. Yes, this might be interpreted as having high capacity, but it should not be interpreted as invincibility. The problem that happens is high achievers will forget about their own needs, trying to keep up with all the things on their plate.

This collab article will dive deep into both Patrick’s and Dido’s angles for how to address this issue for nurses and high achievers, respectively.

The Compliment That Isolates

[Patrick]

It is 8:15 PM; you are finally clocking out from a day where you were chasing the clock for the entire shift. Meds not available from pharmacy. Running labs because you were short-staffed again. Sitting with Claire, an elderly woman who just needed you to hold her hand before her family arrived. Three discharges and three admissions. No time for lunch and barely enough time to use the bathroom.

Walking through the hospital lobby, exhausted and wondering how you are going to drive home, Claire’s family stops you and says, “You are such an angel for staying with mom until we got here.” “You will never know how much that means to us.” You smile, say “you’re welcome” as you move through the front doors to the parking lot.

Sitting in your car, the word “angel” is on repeat in your head. It is not that you are ungrateful for the compliment; it is that you have no capacity to process it. The exhaustion of the day. The emotional toll. The physical neglect you are feeling at this moment makes you wonder if you have the strength, the energy, and the ability to keep doing this. The compliment almost fades as you drive home and prepare for your second shift. Because you have a family that needs you.

The work of nurses is hard. It has always been a hard job and probably will always be. But sometimes the job is impossible. What happens in these moments is nurses give all they can. All they have. When they receive a compliment, or someone says, “You are so strong,” they have no idea the emotional injury a nurse faces in the work they do. The lack of alignment between how they are feeling and how that compliment lands is not a lack of appreciation; it is an emotional response from the exhaustion.

[Dido]

I spent years as a high achiever. I was in an engineering career while balancing a side business for 3 years. I was always a hard worker, and ambition was second nature to me. A lot of my friends would praise me and wonder how I was able to “do it all”.

I didn’t know that this would eventually lead to problems down the line, so I enjoyed the praise while it lasted. In fact, it grew my ego. I would work late nights on the business and not give myself time to rest on weekends either, and it was mostly so I could have a good story to tell to friends the following Monday.

The problem was that eventually it got to a point where I felt trapped inside the life I had created for myself. So much of my worth was dependent on external validation that I couldn’t stop. If I did, I was afraid of what would happen. How would I cope? That’s how much of a shell of myself I had become.

This external image that I created myself also had a second consequence, which was covering up my intuition. In the first year of both my engineering career and the side business, I had a feeling that it wasn’t for me. But the mask that I was wearing in order to gain status/validation quieted that feeling temporarily. So, I stayed for another 2 years after that, and this only made me more resentful underneath this other issue.

The Shared Perspective:

Dido shared that removing the mask allowed him to quit seeking external validation from those who never really had permission to provide it. He was enough. And that is all that matters.

This shared understanding is true with nurses as well. Seeking permission or validation about what defines a nurse and what a healthy work environment looks like. Removing the mask and seeking validation from yourself is all that is required. In both cases, Didos’ perspective and mine, this opens the doors to possibilities.

Nobody Audits The Person Who Never Complains

[Patrick]

Nurses are taught to be problem-solvers. The work a nurse does impacts the safety and care of a human being. A person who relies on their knowledge, experience, and understanding to provide care that is evidence-based and competent. This is seen as incredible strength by the public because it is.

But here is what nurses rarely talk about. They hold the weight of being in spaces where it may be one of the worst days in a person’s life. They witness the human experience on a visceral level that few people really understand unless they have lived it.

They rarely complain. Despite the workload. Despite the belligerent patient or family. Despite the abuse they may endure. This is the job. But is it really? Systems and organizational culture that do not recognize these issues often leave the nurse feeling like they are required to endure impossible emotional obstacles. This defines the work.

The nurse who says little and goes about his/her day without questioning the assignment or not taking the lunch break. These are the nurses that are unseen because they are quietly competent, quietly compliant, and quietly suffering.

The end of a 12- or 14-hour shift does not finish their day. They drive home and sit in the driveway composing themselves so they can start their second shift. Not wanting to burden their family with the emotional toll of the day. When asked how they are, they say fine. Because fine leaves it at the door, even though the events of the day persist while preparing tomorrow night’s dinner in the crockpot, and while tucking the kids into bed.

[Dido]

For my whole life, I was known as the reliable person. It started within my family dynamic, learning how to troubleshoot tech issues, help with my parents’ finances, and fixing things around the apartment. I did it because my parents needed the help and were busy, but I also enjoyed doing them as well.

There was a good and a bad side to that. It did build up my competence, but it also made it hard to say no when I didn’t have enough capacity to get something done. The thing is, when survival is part of the equation (saying no to my parents’ requests was not feasible), it makes you feel guilty for placing that boundary.

This, of course, translates into career. Taking on that extra project, taking on more managerial responsibilities, and not pushing back on anything - even when my body was screaming no.

This is the same dynamic that many high achievers rehearse over and over due to the fact that they are usually the most reliable in the room. The people around them see how much they are capable of, so the most work gets pushed to them.

But what is the effect of not saying no repeatedly? It means you slowly start to lose track of your priorities. There is no time for rest or regulation. And on top of that, you also start to lose the meaning you had for your work. If everything gets the same amount of attention, then what is actually important anymore?

The Shared Perspective:

Dido talked about being the reliable one. The one people could count on. The one who got the job done regardless of what personal sacrifices he had to make. As a high achiever, Dido learned his own power is taking his time and remaining focused on his ability to say no and set those boundaries.

As a high-achieving nurse, setting those boundaries can be one of the hardest things we do in practice. We are available, all the time, for our family, our work, and those we serve. Saying no almost feels like a betrayal when, in reality and to Dido’s point, saying no is the recognition that your life, your family, and your personal time are equally as important. You can say no and it not be betrayal.

What Happens When The Strong One Finally Cracks?

[Patrick]

Over time, the emotional drain from the work becomes more and more challenging. A vibrant nurse who loved the work becomes so exhausted, so numb, that they can barely get out of bed to face the day. On days off, they simply want to sleep and just get some rest. Home responsibilities prevent this, so they give more. The missed baseball games, daughter’s recital, they all create a lived experience that eventually causes the nurse to break.

This break is not something announced. The nurse realizes that their life is no longer theirs. The hopes and dreams they had as a new graduate, the plans they had with their family, none of them are what their life looks like today.

This is when leaving the work, maybe even the profession, feels like the only option. While the quick relief is what the nurse is looking for, they love nursing; they simply can no longer endure the impossible workload and the conditions they face every shift. Feeling stuck and broken at the same time is paralyzing. However, nurses have incredible skills that may not always be appreciated by the hospital; a new world is emerging where the skills nurses possess are deeply sought after.

So while nurses may feel disconnected from the work, the conditions, and the requirements of the job, they love nursing. It is possible to continue to care without losing the connection to who the nurse is as a person and professional.

[Dido]

Being a high achiever might feel great for a while, and that’s most likely the reason why you felt a need to keep up the hard work. You WERE able to handle it all at one point.

The issue arises once you get to a point where the work consumes your whole identity and you feel trapped under those extra responsibilities. What ends up happening is that by the time the weekend comes along, you are completely drained. This is where the Sunday Scaries originate.

You end up trying to catch up on rest and self-care on the weekends. And yes, maybe this is a good Band-Aid to allow yourself to keep pushing through. But it will falter eventually under all of that pressure. The body keeps score regardless of what happens.

You can either choose to keep putting out the fires or you can address the root cause and fix the broken gas line. That’s what you need to address if you don’t want to stay in this cycle anymore.

The Shared Perspective:

Dido shares his recent article on the Sunday Scaries and what it looks like when you are at the point of collapse and dreading what the start of the work week looks like. For nurses, it is similar except the start of our work week begins with the first of three or four twelve-hour shifts.

A time when the nurse becomes disconnected from the world around them, their family, and their life. Their entire world is the hospital and their unit. Dido talks about the power of recognition and awareness and the decision that is before a person when they realize they are in a dysfunctional cycle. The real question to be asked here is whether this is a cycle you want to continue or one that you want to change. The true answer rests with you.

The Reframe

[Patrick]

The next time you need to sit in your car to decompress before greeting your family. The next time you respond to someone by saying you are fine when you are not, consider the emotional cost of the work. Consider the loss of your dreams. Your plans, and how you want to live your life. Sometimes the best thing a person can do is to evaluate where they are in their lives and where they want to be. This is the important work I do for nurses. They do not need to travel by themselves.

I have worked with nurses in the midst of this transition, helping them to process the cost of the work. Translating nursing skills to match the current and evolving job market. Designing a future where they feel alive in their life again. Here is what this looks like on the other side. Imagine a life where you have time for your son’s baseball game, your daughter’s recital. A professional life where you are not emotionally spent and have the time to actually live a life that you have designed. To feel alive inside that life, once again.

If you are this nurse, book a call with me, nurse to nurse. Let’s talk. There is a whole other life waiting for you. Book the call today.

Schedule a Call Nurse to Nurse

[Dido]

Yes, you keep hearing the words “you’re so strong”. It makes you feel good in the moment, but you know that the words don’t matter if you can’t enjoy them yourself. Instead of looking at what’s making you so strong, ask yourself if you yourself are benefiting from being that way.

If the answer to that question is that everyone else benefits except yourself, it’s time to question the direction of your life. This most likely means that you have never built the foundation of what type of work you will accept and not. As well as what type of work fits best within your own strengths and values.

The issue that you are running into cannot be solved through a quick hack. As stated before, rest and self-care will only make you feel better temporarily. This is a structural issue that requires a re-design of your life. And yes, this may sound daunting, but you also have to realize that the strength that you have is still there. The only difference is you are now redirecting into an aligned direction instead.

If you are a high achiever who keeps running into burnout, I help you by coaching you to design a life you don’t have to escape from anymore.

Work with me

Authors

Patrick LaRose

The Second Shift

I work with nurses who can calm a family, catch a mistake, and keep moving on three hours of sleep, but are one more "you are so strong" away from coming undone. If your whole life has become one long emergency response, you belong here.

By Patrick LaRose

Dido Torchi

Trials, Tribulations, & Torches

You’re disciplined. You work hard. So why does your life still feel off? This is about fixing where your effort is going before burnout does it for you.

By Dido Torchi

You do your work, and to be truthful, a new manager is irrelevant to you unless they make your work harder. Some have.

The idea of taking on the role has crossed your mind from time to time over the years, but you always arrive at the same place: you like the job, it is hard enough, and becoming the manager just adds a new layer of stress that you and your family do not need right now. Of course, the financial incentive looms in the back of those thoughts each time you consider the change.

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You come on shift, and you see and hear the warning signs that the nurse manager role is about to change again, for what feels like the one hundredth time. It is not a surprise, and the conversations at the nursing station confirm your suspicions.

One of the nurses you have worked with for the last five years comes up to you and says, “You need to take this role; you are an excellent nurse and have been on the unit long enough that you know where the bodies are buried.” You both laugh, and you nod because she is right.

You are a good nurse. Your performance rating confirms it. Patients and families say it. You are one of the best.

The DAISY Award you won last year is a confirmation that you are respected and valued.

Several weeks passed. Your suspicions are right. The nurse manager role is open on your unit, and the nurses are encouraging you to apply for the job. This time is different. You get a call from the Chief Nursing Officer (CNO) asking you to visit with her. “Well, this has never happened before.” You thought.

In the ten years you have worked at the hospital, you have known some of the CNOs but only those who were visible. You know this one; she frequently visits the unit, and you hold a level of respect because she is visible.

After the initial greetings, the CNO asks you to consider the role of the nurse manager. She says, “You have been a steady and skilled clinician, someone who understands the importance of the work we do. I am confident you can lead, helping the unit achieve the strategic plan and goals.” The meeting goes on for the next hour. In the end, you have accepted the nurse manager role. You start next week.

You Get the Job

As you walk away from this meeting, the one statement that stays with you is when she said, “strategic plan and goals.” You are a good nurse, but those words make you nervous because you have no idea what she meant.

Monday comes, you unlock your new office door, put your things on the desk, and think, “Now what?”

The ICU nurse manager has been assigned to be your leadership mentor. You meet with her. She begins to share what a typical day looks like for her. Appointments, interviews, meetings, committee work, and the phrase “strategic planning and goals management” come up.

Walking back to your office, you are feeling the pressure to be visible and available to the nurses on your unit. The morning of your first day has been so fast; you have not made rounds and have not checked on the staffing for the day. “Strategic plans and goals” will have to take a back seat because you need to ensure you have staffing set for tonight, and you need to meet with an unhappy family.

From Expert to Novice

If this sounds familiar, you are not alone. Excellent nurses. Well-versed in the clinical care of the patients, team players, loyal, and the ones who mentor all the new nurses. These are the nurses promoted to the manager/leadership role. Here is the sad truth. A strong nurse is not always a strong leader without development, guidance, and mentorship.

In fact, nurses promoted to leadership roles often talk about how they had to learn most of their leadership skills on the job. Leadership is teachable. Some may have had leadership courses in their undergraduate or graduate work, but these are rarely enough to lead others.

This is the important work I do, helping new nurse managers transition from the bedside to the manager of the unit. I remember standing right where you are now and thinking it is all a bit overwhelming. The job can be thankless. But when done correctly, it can be enjoyable as well. With the right guidance and coaching, it can be a job that you learn and one that meets the needs of the patients, the nurses, and satisfies the C-Suite.

If you have recently accepted a nurse manager role and you need the guidance of a seasoned and experienced leader, reach out to me. Here is what is teachable:

• Leadership

• Creating systems that address care quality.

• Designing a staffing plan that works.

• Leveraging your nursing workforce to meet the goals set for the operation.

Together we can create a leadership plan that meets you where you are. Book a call or send me a DM. I am happy to talk with you to determine what your needs are and how my coaching program for nurse managers fits your needs.

You are the new nurse manager, now what? The role and responsibilities are now yours. “Now what” is up to you, but you do not need to answer that question alone.

I will see you next week. Patrick

Take the Next Step

☕ Schedule a Conversation, Nurse to Nurse: thirty minutes, real, honest, no fancy frameworks. Book here

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About The Second Shift

The Second Shift is a newsletter plus podcast for nurses who carry the weight of caring for 12 to 14 hours, then come home to begin a second shift. This is the shift no one sees, one that is equally important. I have lived this story. As a coach, I create space for nurses built on real, honest conversations: a plan that moves you from chaos to a life you feel alive inside of again.

Patrick LaRose, DNP, MSN/Ed., RN, NC-BC Board-Certified Coach | Life Coach lifenursecoach.com

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You come on shift today. The nurse manager has resigned. Again. Why do nurse managers turn over so fast? What actually happens when an excellent bedside nurse accepts the role?

In this episode, we talk about stepping into the nurse manager role after years at the bedside. The conversation is direct. At times it is harsh. It is also lived, not theoretical.

Main Message

Excellent bedside nursing does not prepare you to lead a unit. New nurse managers turn over because they are handed a relentless job with no mentoring, no coaching, no leadership training. Talent got you the title. Support is what keeps you in it.

Lesson 1: Visibility Is Not Optional

You may be a great bedside nurse without the leadership skills the role demands. Staffing, patient satisfaction, practice standards, care benchmarks, goal planning, budgeting. Most of it never appears in the job description.

Credibility gets built where the work happens. Arrive before shift change. Walk to the nurse. Skip the meeting invitation. Ask two questions:

• What do you need to do your work?

• What is your biggest pain point?

Show up on nights. That shift gets the stale pizza. Your presence tells them their needs matter.

Lesson 2: Listening Without Acting Makes You Part of the Problem

Nurses are the front line of care. You direct the front line. You are not on it.

Engagement means delivery. The upgraded IV pumps. The additional supply scanners. The equipment that saves minutes on every task. When a nurse thanks you on rounds for something she asked for weeks ago, you have earned something no title grants.

Lesson 3: The Moment You Take the Office, You Become the Enemy

The conversation shifts when you walk into the break room. Your intuition is correct. You are not imagining it.

Nothing about you changed. What changed is that you now hold control over employment, performance, and future. Your staff is asking the same questions you once asked about a new manager. How long will she last? Will I meet her expectations?

The question underneath all of it: Is she going to advocate for us in the C-suite, or become one of the minions?

Get clear with the C-suite on what they need. Hours per patient day. Care benchmarks. Turnover. Patient satisfaction scores. You will never hit any of it without the cooperation of your nursing workforce. Your advocacy sits in the middle. That balance defines you as a leader.

Summary

1. Visibility is central. Know what your nurses need to do the job.

2. Listen, then act. Treat your workforce as trained professionals who want care to exceed benchmarks.

3. Understand your advocacy role. You stand between the nurses and the C-suite. How you serve both decides whether you are the enemy or the advocate.

This Week’s Assignment

Open your huddle on day shift. Open your huddle on night shift. Ask one question:

What can I do today that will make your life as an RN on this unit a little easier?

Determine the priority from what your nurses said. Make it happen if it is possible. Then come back to this episode. Leave a comment or send a direct message. I want to know what your nurses asked for, what you did, and what happened.

🔗 Next Steps

📬 Subscribe on Substack: Join The Second Shift for the weekly conversation on becoming a nurse manager.

⭐ Upgrade to the paid tier: Join other nurses in the discussion about the support new managers actually need.

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🎧 Follow the podcast: Listening in your podcast app? Tap follow so the weekly episode reaches you.

📲 Text this episode to a new nurse manager: Someone came to mind while you listened. Copy the link. Send it now, not later. She will thank you.

💬 Leave a comment: Tell me what came up for you. I read and respond to every comment.

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📞 Book a free call, nurse to nurse: New to the role? Struggling at 1:15 in the morning wondering how you will face the next few days? No obligation. No requirements. Just a conversation about where you are today.

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🏥 Nurse executives: Your new nurse managers are the best nurses on the unit. Coaching helps them transition. Book a call to talk about supporting your leaders together.

Executive Leadership - Book a Call

✉️ Direct message on Substack: Prefer to reach out privately? Send a DM anytime.

About The Second Shift

The Second Shift is a newsletter plus podcast for nurses who carry the weight of caring for 12 to 14 hours, then come home to begin a second shift. This is the shift no one sees, one that is equally important. I have lived this story. As a coach, I create space for nurses built on real, honest conversations: a plan that moves you from chaos to a life you feel alive inside of again.

Patrick LaRose, DNP, MSN/Ed., RN, NC-BC Board-Certified Coach | Life Coach lifenursecoach.com

It is your sister-in-law. “Quick question. You are a nurse.”

Every nurse reading this just felt something in their chest, because you know exactly what comes next. The toddler with the fever. The husband with the chest tightness he swears is heartburn. The neighbor whose mother “just seems off today.”

You do not sigh. You do not tell her to call the doctor in the morning. You go to work.

Shifting from the task you were doing, you grab your coffee and sit on the couch.

You ask about the fever. How high, how long, what she has given him, when she gave it. You ask about the rash she did not mention until you asked. You listen to her voice as much as her words, because panic changes what people report. Within three minutes you know whether this is a wait-and-watch or a get-in-the-car-and-go. You explain it in plain language. You give her two things to look for overnight. You tell her if something changes, call the doctor or head to the ED. It will all be fine, because that is what she needs to hear in this moment.

Ten minutes. You hang up. You go back to the laundry as if nothing happened.

Here is a universal truth that every nurse knows.

You assessed with incomplete information delivered by an unreliable source. You triaged. You educated. You de-escalated a person in crisis. You helped walk someone through next steps simply because they needed your guidance. There was no waiting room, no check-in, and no co-pay. A simple call between you and someone who needed your opinion.

You did it on a Sunday. In your slippers. For free.

As a nurse, you have been doing this for years.

The Skills Everyone Values

Every family has one. Every street has one. Every group text has one. The nurse everyone calls.

The invitations to look at a mole at a barbecue. The friend who wants you to translate what they did not understand from their last visit with the doctor and were too afraid to ask. The spouse of a friend who was recently discharged from the hospital and does not understand the words on the discharge summary.

The 8 pm text that just says, “what do these lab results mean?”

You have never charged for any of it. You have never once written it down.

I want you to notice something about all of this. The skills you have are the exact skills that people need and rely on. They have been out in the world this whole time, working in kitchens and driveways and church parking lots, solving real problems for real people.

The only person who has not noticed is you.

These Skills Translate

Here is where it gets interesting. Ask that same nurse, the one everyone calls, whether she could work outside the bedside, and watch what happens.

“I could never. I am too old to change. I would be starting from nothing.” “I really do not want to start over.”

Her sister-in-law knows better. Her neighbors know better. The market, which is scrambling to build virtual nursing, care navigation, case management, and coaching roles faster than it can fill them, knows better.

The only one still arguing is the voice in her own head. That voice has a very specific accounting method. It counts everything you have done but still says you will start from zero if you left the bedside. It looks at years of clinical judgment, earned in the hardest rooms there are, and writes down zero.

I am not asking you to believe me over the voice. I am asking you to check the facts. Look at your own Sunday afternoons. Look at your own group texts. If your experience were worth nothing outside of your bedside role, why does everyone in your life call you?

The Invisible Work

Here is something to try this week. It costs nothing and takes almost no time.

Every time someone outside of work asks for your judgment, write it down. One line. “Neighbor, chest pain question, talked her through it, sent to the hospital.” “Mom’s medication list, caught an interaction.” “Neighbors’ lab values, provided an explanation.”

I call this the invisible work. It is the space you have been holding for years and a confirmation that what you have to offer is needed.

Keep adding to your list for seven days. Then sit down with it, read it out loud, and ask one honest question.

What exactly does this mean? Does that list represent a nurse that would be starting from zero? Or a nurse that has mad skills?

The Invitation

If you keep that list and something in you starts to shift, I want to hear about it. Leave a comment and tell me one line from your invisible caseload. Your one line might be the exact permission another nurse needs when she reads it with her first cup of coffee.

If you are further along than that, if you already know you are ready to look at what comes next, I built two things for you.

The first is a free guide for nurses transitioning away from the bedside. It walks you through translating your skills into the language the market is hiring for. You can grab it at lifenursecoach.com/free-guide. No strings.

The second is a free 30-minute call, nurse to nurse. Bring your invisible caseload. Bring your questions. You will leave with the first two steps of a plan written down, whether we ever work together or not.

You have been the nurse everyone calls.

It is time you took the call yourself.

See you next time.

Patrick

Take the Next Step

🎁 Free guide, Transition Out of the Bedside: translating your skills, refining your job search, AI prompts to sharpen your resume for the role you actually want. www.lifenursecoach.com/free-guide

☕ Schedule a Conversation, Nurse to Nurse: thirty minutes, real, honest, no fancy frameworks. Book here

💬 Join the conversation: leave a comment on this post. What did you set down this week? I read every one. I respond to every one.

Leave a comment

🔔 Subscribe to The Second Shift for a new essay plus episode every week.

About The Second Shift

The Second Shift is a newsletter plus podcast for nurses who carry the weight of caring for 12 to 14 hours, then come home to begin a second shift. This is the shift no one sees, one that is equally important. I have lived this story. As a coach, I create space for nurses built on real, honest conversations: a plan that moves you from chaos to a life you feel alive inside of again.

Patrick LaRose, DNP, MSN/Ed., RN, NC-BC Board-Certified Coach | Life Coach lifenursecoach.com

It is 2:14 in the morning. A job listing glows on your phone, one you have opened four times this month. Hope lasts about nine seconds. Then the voice arrives: too old, too late, too far in. This episode puts that voice on trial.

Fear is a terrible accountant. It counts decades of bedside experience as zero. The job market counts that same experience as the exact thing it cannot find enough of. Only one of them is telling the truth.

Patrick begins with what the data confirms nurses already feel: 43 percent now want a role away from the bedside, up from 38 percent a year ago, with nearly six in ten reporting burnout most days. Most stay anyway, held in place by real bills, real families, real life. Nothing is wrong with these nurses. The response is rational; the environment is what changed. From that honest starting point, the episode builds a way forward.

Three Lessons From This Episode

Zero is a myth. Your skills are currency; they travel. Assessment becomes analysis. Triage becomes prioritization under pressure. Patient education becomes training, coaching, communication. Corporations pay consultants a fortune to teach what you practiced at 3 a.m., short-staffed, without a lunch break. The skills only feel invisible when the job title does all the talking on your resume.

The market is opening, not closing. Close to one million RNs are over 50, with roughly 40 percent of the workforce preparing to step back in the coming years. The system is inventing roles fast to hold onto that knowledge: virtual nursing, care navigation, informatics, legal nurse consulting, nurse coaching, education. Home-based care alone is projected to grow 26 percent this decade. Experience is the requirement, not the obstacle.

Starting over is a care plan, not a cliff jump. Keep the job. Keep the income. Build anyway, through four small interventions: research the market a few hours a week, talk with one nurse who already made the move, retool the resume into the market’s language, explore a certification where your license carries over. The plan moves you forward the way a good care plan always does.

The heart of the episode is a single takeaway, worth writing down:

Refusing to abandon yourself is not a betrayal of nursing; it is the recognition that you deserve more.

This Week’s Assignment

Write your other resume. No jobs, no titles, no dates. Ten lines, each one finishing the sentence “I can walk into a room and...” Read it out loud. Then have one conversation with a nurse who already made a move you are curious about. One page, one conversation. Notice what changes.

Take the Next Step

🎁 Free guide, Transition Out of the Bedside: translating your skills, refining your job search, AI prompts to sharpen your resume for the role you actually want. www.lifenursecoach.com/free-guide

☕ Schedule a Conversation, Nurse to Nurse: thirty minutes, real, honest, no fancy frameworks. Book here

💬 Join the conversation: leave a comment on this post. What did you set down this week? I read every one. I respond to every one.

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🔔 Subscribe to The Second Shift for a new essay plus episode every week.

Music Credit: Suno.Com - “The Second Shift”

About The Second Shift

The Second Shift is a newsletter plus podcast for nurses who carry the weight of caring for 12 to 14 hours, then come home to begin a second shift. This is the shift no one sees, one that is equally important. I have lived this story. As a coach, I create space for nurses built on real, honest conversations: a plan that moves you from chaos to a life you feel alive inside of again.

Patrick LaRose, DNP, MSN/Ed., RN, NC-BC Board-Certified Coach | Life Coach lifenursecoach.com

You planned. You got the education. You built the experience.

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You have the skills, and you know what you want. And still, somewhere in the still moments, you are asking yourself if this is really what success feels like.

Success was never the checklist. It was never the paycheck, the calendar, the certifications, or the years put in.

Success is a definition, and most of us never wrote our own. We took what we were told or learned and adopted this idea of success without ever being told it was a choice at all.

I did not learn what success looked like from a lecture. I learned it from watching my father, a welder, leave early in the morning and come home at night. Each week he received a paycheck, a reward of sorts for the work he did. At the time, this is what I thought success looked like. For many of us, it was.

He was a strong man, but his success was measured every week by how he provided for the family. Food. Housing. Clothing. There was never any talk of being independent. There was no teaching on what it meant to be successful on your own. Success came through someone else. An employer, someone who held the control, and the reward was simply transactional. Time for money.

You may have learned this too. Not by a welder, maybe, but by a profession that taught you what a good nurse sacrifices, by a family that measured success the way most families do, and by whatever you absorbed early about what counts as achievement.

No one sat you down and explained it. You simply learned it, the way I learned it, by watching, listening, and absorbing.

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There is a cost of never questioning what you learned. Being rewarded each week by a paycheck, despite the exhaustion. The feeling of powerlessness of not being in control of your life, your time, your ability to do something important for yourself.

Staying exactly where you are today, for the foreseeable future, because the old definition of success is the only one you have ever known.

I sit here today, having built a coaching business from nothing. I have everything I once thought would be enough to settle the question. The education, the experience, the certifications. The infrastructure. What I know now is that none of it answers the question by itself. What does success look like?

The answer came when I stopped asking whether I was successful by the old measure and started asking what success meant on my own terms. What it looks like today under my own independent control.

That old measure is exactly what keeps nurses in impossible situations. If success has always meant staying, enduring, and being rewarded, leaving an impossible job can feel like disloyalty.

Maybe you are sitting at exactly these crossroads. You are an excellent nurse. You perform every day, giving yourself to people in the moments they need you the most. You love nursing. You love what you do. This was never a question. What you can no longer tolerate is the conditions in which you are forced to work.

Short-staffed. An increasingly complex patient load. A schedule that requires a debrief on your day off just so you can get up to speed on what is happening with your family. Calls to work on your day off.

You most likely never signed up for this. I remember learning in nursing school that nursing is a tough job. It has always been a tough job. It will always be a tough job. Maybe so. But what we never learned in nursing school was that it would be an impossible job. Hard work was never the concern. Impossible is.

Strength is not the absence of the old narrative running in the background. Strength is naming what you learned, questioning whether it was ever true for you, and defining success on your own terms anyway.

Success is not a job that disregards your health, your time off, or your contribution. It is making decisions for your career that let you use your education in a way that pays the bills and still gives you peace, knowing you are making a difference. It is being able to manage your time so you can attend your daughter’s recital, and maybe even her softball game.

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What it looks like to me:

The freedom to define your day. The freedom to enjoy the work you are doing. The flexibility to pivot when needed. The freedom to control your future, your destiny. Most importantly, knowing that your life is not in the control of someone else.

What does success look like to you?

If you are a nurse who is ready to reclaim a career that has started to consume you, one where you are not in control of your professional future, it is time to talk. I help nurses who carry impossible responsibility recover and rebuild a healthier relationship with their work and themselves. So you can keep caring for others without sacrificing your own health, identity, and ability to enjoy your life outside the hospital.

So you stop operating in survival mode and recognize your own needs, rebuild emotional capacity, and learn how to respond instead of constantly absorbing the weight of every crisis around you.

I help nurses rediscover their passion for nursing and their life again. The shift is moving from “I can handle anything” to “I can care deeply without destroying myself.” You avoid reaching the breaking point after years of pushing through. Gain the ability to stay in a meaningful profession with more energy, boundaries, and longevity instead of having to choose between your calling and your well-being.

If this is a place where you live right now, let’s talk nurse to nurse and discover a way to move you forward to a decision that recognizes your value not only as a nurse, but as a person.

Until next time - stay strong and know you are seen.

Patrick

Resources + links

🎁 Free guide, Transition Out of the Bedside: translating your skills, refining your job search, AI prompts to sharpen your resume for the role you actually want. www.lifenursecoach.com/free-guide

☕ Schedule a Conversation, Nurse to Nurse: thirty minutes, real, honest, no fancy frameworks. Book here

💬 Join the conversation: leave a comment on this post. What is your definition of success?

💬 Visit my website for more information. Lifenursecoach.com

🔔 Subscribe to The Second Shift for a new essay plus podcast episode every week.

About The Second Shift

The Second Shift is a newsletter plus podcast for nurses who carry the weight of caring for 12 to 14 hours, then come home to begin a second shift. This is the shift no one sees, one that is equally important. I have lived this story. As a coach, I create space for nurses built on real, honest conversations: a plan that moves you from chaos to a life you feel alive inside of again.

Patrick LaRose, DNP, MSN/Ed., RN, NC-BC Board-Certified Coach | Life Coach lifenursecoach.com

This episode meets you right there.

We are not talking about fixing you, because you are not broken. The short staffing is real. The mandatory overtime is real. The pizza party that showed up where a raise should have been, real. This episode is about the one territory no staffing grid, no manager, no survey score can reach: the conversation inside your own head, the one deciding what you are worth at the end of every shift.

I spent many years letting other people run that conversation. What pulled me out came down to three lessons. I hand you all three in this episode, each one applied to your actual life: the text on your day off, the family member who screamed at you, the comment you carried home.

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In this episode:

• The system is real. You are not imagining it. You are not weak; you are trained.

• Lesson one: the voice in your head is borrowed. It is not yours. What to do when the staffing text arrives on your day off.

• Lesson two: you can hear an opinion without wearing it. The counter practice, applied to the worst moment of your shift.

• Lesson three: valuing your worth is quiet, daily, unglamorous. You have held the hands of dying strangers. When was the last time anyone held that kind of space for you?

• All three lessons in one ten-second moment, plus your assignment for the week.

• For the nurse who knows it is not one comment, it is the whole environment.

This week’s assignment: One question each morning: whose approval am I carrying today? One act: a single unapologetic no, a single comment set down in the parking lot instead of carried through your front door.

Resources + links

📄 The companion essay: When Your Worth Is Up for Debate

🎁 Free guide, Transition Out of the Bedside: translating your skills, refining your job search, AI prompts to sharpen your resume for the role you actually want. www.lifenursecoach.com/free-guide

☕ Schedule a Conversation, Nurse to Nurse: thirty minutes, real, honest, no fancy frameworks. Book here

💬 Join the conversation: leave a comment on this post. What did you set down this week? I read every one. I respond to every one.

🔔 Subscribe to The Second Shift for a new essay plus episode every week.

About The Second Shift

The Second Shift is a newsletter plus podcast for nurses who carry the weight of caring for 12 to 14 hours, then come home to begin a second shift. This is the shift no one sees, one that is equally important. I have lived this story. As a coach, I create space for nurses built on real, honest conversations: a plan that moves you from chaos to a life you feel alive inside of again.

Patrick LaRose, DNP, MSN/Ed., RN, NC-BC Board-Certified Coach | Life Coach lifenursecoach.com

Music Credit: Suno, The Second Shift

This one hit hard because, for so many of us, our worth, our identity, how we show up in this world gets defined by what other people think. There is a gap between how we see ourselves versus how others see us. That gap is where most of us live.

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I struggled to value myself for many years. Much of that came from the messages I heard growing up, the opinions of my parents, of family members, of the kids at school. The kids were harsh. At some point I internalized that narrative until it became part of my own thinking.

How I valued myself followed me into adulthood, showing up in my personal life, in my professional life. It started with small sacrifices. Over time, those sacrifices consumed me, to the point where I cared more about the happiness of others than my own.

Two People

I lived as two people. The professional me was driven. My pursuit of career success was unstoppable. I was good at what I did; I knew it. Underneath, that confidence was fragile. Any criticism could send me into a spiral of self-doubt. The saddest part? It would take me weeks to recover.

The personal me was a different story. I had little confidence there, often feeling like I was living on the end of a kite string, going wherever the wind blew me. That lack of confidence translated into failed relationships, into an inability to say no.

People-pleasing sat at the core of it all, though it took me years to realize it.

No Grand Epiphany

At 42, I found myself in a conversation with someone I had not chosen to have in my life. She was passing judgment on decisions that were mine to make, decisions she had no stake in. Listening to her, I realized how much I had been undervaluing my own worth. That was the moment I ended the conversation. What I found in its place was an internal strength I had never felt before: the decisions I make for my life are mine, not subject to the approval of anyone who has no right to an opinion.

42 years.

That is a long time to let the influence, the opinions, the judgment of others rule your life.

A very long time.

My Work Today

My work today as a coach is defined largely by that moment. Not because it was some grand epiphany. Because it was the day my voice became my advocate. The strength, the conviction, they were always there. That moment showed me that what others thought no longer had to matter. If I kept letting their opinions dictate my future, I would stay exactly where I was. Nothing would ever change.

Just to be clear, you do not wake up one morning as a changed person. Change is something you work at every day. It is not muscle memory; it is a decision.

To advocate for yourself when the conversations get tough.

To advocate for yourself when people hand you an opinion you never asked for.

To advocate for yourself when you already know the road you are taking.

To that creator I read at 5 AM, who spent years refining his thinking down to one sentence. Thank you for sharing your experience. It took me 42 to find mine. Now let me ask you what I had to ask myself.

Where is your worth still up for debate? Whose opinions are you still treating as direction? That answer is where your work begins.

Leave a comment. Share your thoughts.

The second shift is a newsletter and podcast designed for nurses who carry the weight of caring for 12-14 hours and then come home to begin a second shift. This is the shift no one sees, but one that is equally important. I have lived this story and want to share with nurses that there is relief. As a coach, I create space for nurses that is based in real, honest conversations. The development of a plan that moves you from chaos to a life where you feel alive inside of it again. No fancy frameworks, no 5-day plans that never seem to work. A real, honest conversation from someone who has lived the experience.

If you are ready for that conversation, I am excited to hear from you.

Schedule a Conversation Nurse to Nurse

With care,

Patrick LaRose, DNP, MSN/Ed., RN, NC-BC Board-Certified Coach | Life Coach lifenursecoach.com

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