EP 186: Solving Problems in Leadership with Michelle Troseth and Dr. Tracy Christopherson

EP 186: Solving Problems in Leadership with Michelle Troseth and Dr. Tracy Christopherson

Solving Problems in Leadership with Michelle Troseth and Dr. Tracy Christopherson

Solving problems in leadership is the key to easing the burden of many nurses and healthcare professionals. Burnout is an ongoing issue that many nurses are experiencing. The sad thing is it can happen to anyone’s career.

Long-term stress can cause anyone mental and physical exhaustion. And for the nursing profession, burnout results from their demanding job, nursing shortages, and frequent exposure to human suffering. 

Nurses are witnesses to death and grieving families each day. Add the long work hours, complex patients, workplace drama, and not having effective support or leadership in the workplace can lead to intense burnout.

When you are burnout, you feel helpless, but if you know how to manage it, you can enjoy a successful nursing career. But the question remains, how can we help our healthcare leaders? Is there a way to solve problems in leadership?

Our Guests

In this episode, we would like to introduce you to Michelle Troseth and Dr. Tracy Christopherson, co-founders of MissingLogic. They have more than 60 years of combined healthcare experience.

They also help healthcare organizations and healthcare leaders combat burnout and improve satisfaction through the power of a framework-driven approach founded on Polarity Intelligence.

We talk about how the idea of a single solution to a single problem approach does not always fit the healthcare model and how polarity plays a role in leadership and healthcare dynamics. 


The questions below are some we’d like to tackle. We often go off-topic, so we don’t expect to hit them all. If you have any ideas, please let us know.

Looking forward to our conversation!

These are the questions you had in Calendly. We’ll go off your questions and wherever else our conversation goes. 

  1. Can you give us your nursing experience & background
  2. Based on your experience, speak to us about leadership in healthcare 
    • Why do we need new leadership norms in healthcare?
  3. What are some toxic workplace behaviors/environments that lead to burnout?
  4. What is Polarity intelligence? 
    • How does it benefit hospital organizations and nurse leaders?
    • How do you identify tension in the workplace?

5. How do you guys go about consulting organizations in healthcare?

      • What are the three pillars of a healthy healthcare organization?
        • People, Processes, and Performance. 

6. How do you create dynamic balance in our lives – professionally and personally?


Before we end the show, we have one last question we like to ask all our guests. If you had the opportunity to have a Cup of coffee with anybody one last time, who would it be & why? 

Catch up with Michelle and Dr. Tracy to learn more about solving problems in leadership on their Instagram at @missinglogic_llc and follow them on their Facebook at Missing Logic, LLC. You can also connect with them through their LinkedIn profile at missinglogicllc for more information.

Let’s learn the ways to solve problems in leadership by watching the full episode here 👇



00:00 Introduction
02:00 About Michelle and Tracy
05:46 Importance of healthy leadership in healthcare
09:17 Stressors for nurse managers
12:34 Toxic behavior that leads to burnout
17:23 Polarity Intelligence
21:19 Margins and the mission
24:43 Challenges in union vs nonunion hospital
30:18 Is more nurses ever the solution?
36:21 How healthcare organizations solve problems
37:46 Unit satisfaction and culture
42:31 Characteristics of good leaders
50:22 End Remarks

EP 159: Pros & Cons of Being an ICU Nurse

EP 159: Pros & Cons of Being an ICU Nurse

EP 159: Pros & Cons of Being an ICU Nurse

Being an ICU nurse is not for the weak. Nurses are witnesses to a patient’s most vulnerable time of their life. And for us nurses, it is a blessing to be a part of that.

Working as an ICU nurse taught us many things workwise and experiencing the negative and positive impacts of being one. 

In this episode, we will talk about the pros and cons of being an ICU nurse, share our experiences and inspire those interested in becoming one in the future.

Pros & Cons of Being an ICU nurse

Is it worth being an Intensive care unit (ICU) nurse? As an ICU nurse, you will be working with patients experiencing life-threatening health problems, and now, the pandemic. The complexity of care in the ICU requires critical thinking as the central core of all responsibilities.

What inspired us to become ICU nurses?

How we became ICU nurses started at the hospital when we were still new nurses ourselves. In Matt’s case, becoming an ICU nurse was easy – he was inspired by an ICU nurse who showed him what’s it like to handle a situation, which left him with a good impression.

Moments like this are rare because when you are a new grad nurse, you often get assigned to one area where you get to work for a year or so and not be able to explore other areas in nursing. 

Being an ICU nurse is interesting because we get involved in the littlest thing with our patients. Every orifice, drop, whatever comes in or out – we know it all. It’s like doing science and history at work.

We all get to see where our patient came from, their present condition, and working ways to help them be better in the future. 

Nurses as Role Models

Imagine if Matt’s interaction with that ICU nurse was a negative one. Perhaps he wouldn’t even try exploring the ICU or being an ICU nurse.

As nurses, we have to be good examples to people because our actions can either impress or distress others who have the potential to be good nurses someday.

That said, here are the pros and cons of being an intensive care unit nurse: 

Pros of Being an ICU Nurse

  • Collaboration with other healthcare professionals to help the patient as a team – you get to see the whole picture of the situation.
  • Easy access to the medical team. Intensivists vs hospitalists.
  • Larger autonomy and scope of practice – nurses can practice using their critical thinking skills to help the patients.
  • Great career progression to reach CCRN or even management. 
  • 2:1 and 1:1 patient ratios.
  • Learning curve – learning to prioritize/critical thinking.

Cons of Being an ICU Nurse

  • We get the worst of the worst, like ETOH withdrawals – you want to help, but sometimes the situation can be stressful because of unruly patients. 
  • Crashing patients with a lot of drip management – is the opposite of the “worst of the worst”. Your patient keeps crashing, no matter how much you try to help them. 
  • High stress – we don’t respond stressed out all the time, but the tasks/care we give is a constant level of stress. It can be exhausting by the end of the day. 
  • Difficult dealing with family, decision making & family drama. – an emotional strain that can put you in a tough spot. You are the response team.
  • Physical labor – this is not just ICU. We are in charge of full care usually because patients in our unit don’t participate in our care. There’s a possibility of workplace injury. 
  • Nasty wounds and messy patients – you get to clean up the body fluids that come out of your patients, like sputum, drool, urine, feces, etc. If you are easily squeamish, this is not the place for you. 
  • Loss of patient care – higher mortality in the ICU. Dealing with the hardships. How to cope. 
  • No extra pay – some healthcare facilities don’t pay ICU nurses much, given all the responsibilities that they have.

How did C19 affect the ICU as far as workload?

Usually, an intensive care unit is limited only to two patients, but hospitals have been flooded with critical patients since the pandemic broke out.

More patients are sent to the ICU nowadays, and nurses’ role has tripled over time. From monitoring patients to dealing with the loss, and helping families, it’s a tough job, to be honest. 

The idea that nurses are navigating new territories adds to the emotional stress of their work, more critically ill patients, dying patients, and dealing with the emotions of the families who just lost a loved one. It is a stressful time to be an ICU nurse.

But then again, it is something worth taking because of how rewarding our job is. 

How to know if ICU Nursing is right for you?

Being an ICU nurse is not for everyone. It’s a tough job, to be honest. But as you grow with the job, your perspective in life changes too.

There’s no specific personality or knowledge to being an ICU nurse. You don’t need to be perfect for the job because you will never know if it is the right job for you unless you give it a try. 

As you go, you learn with experience. We all learned from experience in nursing school and now in real life. Nursing school was hard, but you made it.

The same goes with ICU nursing, it may be hard from the beginning, but that doesn’t mean it won’t help you grow in your career. 

Of course, you have an option to give it a try and see where it goes. As a nurse, there are so many fields of nursing that you can explore.

Maybe ICU nursing is your thing, maybe not. And that’s fine too.

The important thing is that you know where your heart is in this profession, so you can excel at the work you have chosen. 

In Closing

There are so many ways being a nurse can take you. It would be best if you didn’t waste your time doing something you are not happy with.

Our time as ICU nurses has been a real blessing. It taught us wisdom and humbled us in many ways. We wouldn’t want to change that.

Of course, we enjoy being travel nurses, but the lessons we have learned as ICU nurses will always have a special place in our lives.

Hopefully, you can also find that as you embrace being an ICU nurse in the future. 

Learn more about the pros and cons of being an ICU Nurse in this full episode. Click here 👇👇👇


00:00 Intro
00:55 Plugs
02:36 Episode Introduction
07:06 Pro: Health Care Team Collaboration
10:38 Pro: Access to other medical teams
12:40 Pro: Larger autonomy and scope of practice
15:03 Pro: Great career progression
15:52 Pro: Patient ratio
18:36 Pro: More on the critical task
19:59 Con: ETOH or unruly patients
21:20 Con: Crashing patients
23:51 Con: High stress
27:12 Con: Physical Labor
30:59 Con: Dealing with nasty wounds, blood, sputum, etc.
32:16 Con: Compensation
34:16 ICU is for you if…
36:08 Wrapping up the episode


Looking for more nursing and travel nursing information? Check out these helpful links!

EP 141: 4 Problems in Nursing

EP 141: 4 Problems in Nursing

EP 141: 4 Problems in Nursing

Problems in nursing have been there since the beginning, but not a lot has been changed or resolved.

Nursing is the nation’s largest healthcare profession, with over 4 million registered nurses nationwide. Yet it feels like nurses have no voice, no say in what goes on in healthcare.

The struggles nurses face seem to be a nationwide occurrence.

Nurses are plagued with the same revolving problems nationwide. Management in nursing seems to be driven by politics.

The idea of healthcare is centered around patient care. It looks more like hospitals are centered around money.

Top 4 Issues in Nursing We Are Facing

Slowly nursing and healthcare are becoming more of a business. Patient ratios, nurse retention and recruitment, burnout, and patient satisfaction are the current nationwide issues that nurse managers are facing.

Here are some of the problems in nursing we face:

Patient ratios are among the problems in nursing

Currently, California is leading with the best and most complete nursing union. The whole state is union-based, meaning that every hospital in the state is required to have a nursing union.

Some people are anti-union, and it is understandable why but as nurses who have worked in both union and non-union hospitals, we see some major differences.  The main difference is patient ratios.

California has the best nurse-to-patient ratios because its nursing union sets strict guidelines on how many patients a nurse has.

It also states that based on a certain level of acuity, a patient might need closer monitoring. These guidelines are clear-cut and strictly adhered to. 

When there are good patient ratios, this increases nurse satisfaction. It is hard to understand that nurse managers don’t seem to address this issue.

If you were to ask nurses what would make their job less stressful and empowering, they would all say better staffing ratios. This shouldn’t come as a surprise, as it is a common problem in nursing.

With appropriate nurse ratios, care would be more personal to the patient and patient-centered.

Let’s face the facts, nurses are overworked, and the amount of tasks they have to do decreases the nurse-patient experience.

This means nurses have less time to get to know the patient, and the concept of holistic care fades because we only have time to treat the body, leaving out the mind and the soul. 

Nurse Retention and Recruitment

Another problem in nursing that we face is nurse retention and recruitment. Retention and recruitment are something managers struggle with all the time.

Especially during a pandemic with increased demand for nurses finding and keeping them is tough. If your hospital was already short prior to the pandemic, it is most likely in an even worse state.

Trying to keep a nurse is always a struggle because there is endless opportunity for the nurse.

They don’t have to be tied down long-term to one area because almost every staff position has openings, meaning nurses can almost come and go as they please. 

The struggle with nurse retention is related to job satisfaction. Nurses don’t just leave because they feel like it. There is a reason for them wanting to work somewhere else.

Job satisfaction seems to be the biggest motivator for a change in employment. This means that nurses are unhappy. It can be due to many things, such as unit politics, working conditions, stress, workload, and pay.

There shouldn’t be a surprise that nurses are leaving a unit to pursue travel jobs. They pay more, allow you to travel, and explore different units.

If you can’t pay your nurses fairly, don’t expect them to pass up opportunities. 

Tough on Managers

Recruitment is also tough on managers. Finding nurses to hire in your unit is a mission in itself. New grad nurses are easier to hire but usually more expensive and use up more resources upfront because they are fresh out of school and need a lot of training.

New nurses are an investment. Nurses from other positions need to be sold on the new job because they don’t want to leave their current job and get stuck with a worse one.

Higher pay and a better working environment are the best way to maintain nurse retention and increase recruitment.

It may seem impossible to provide those, but as we’ve seen during the pandemic, there is money for nurses in healthcare.

Burnout is one of the most common problems in nursing

Another problem in nursing that plagues nurse managers is the burnout of their nurses. Being burnt out leads to less productivity and a weaker work environment.

There are two culprits to nurse burnout, one is related to the work environment, and the second is related to overtime,

Stressful work environment

Nurses get burnt out because of poor work environments. This means an environment where the nurse is overworked mentally or physically.

Unit politics plays a big part in this because no one wants to work at a job where there is constant negativity.

Nurses talk about other nurses, day shift vs. night shift mentality, and a lack of teamwork deafly to a unit. It is important to foster cohesiveness in the unit to promote a better work experience.

A lot of this also has to do with ratios and proper staffing. It is hard to be happy in a career where the expectation is to always do more because there is a lack of support. 

Too much overtime

Some nurses work a ton of overtime. For whatever reason, a lot of nurses pick up too much overtime.

This leads straight into burnout because, many times, the reason why nurses pick up is to help their coworkers due to staffing issues.

It’s great to help out your peers, but there comes the point where you start to forget to help yourself. You lose touch with yourself and your emotions, get stuck in a fog, and slowly fade from your true self.

You start feeling tired every day, and in a slump you cannot get out of; that’s how burnout feels.

Nurses also pick up overtime for financial benefit because they can earn more. This can be due to college debt that many nurses suffer through.

Making more money is always good, but money isn’t always the root of happiness.

Many nurses that pick up overtime to make more money don’t even enjoy that money because they don’t even put aside the time to spend it on themselves and take care of themselves.

It’s just more numbers in the bank. And it’s a growing problem in nursing that we all face. 

Patient Satisfaction

We hear about patient satisfaction scores during our huddles and monthly meetings. Are we hitting the quota for the month?

The medical industry puts continuous emphasis and patient satisfaction and positive care experience.  Nurses have proven essential for driving patient satisfaction.

It’s ironic because if you’d like to increase patient experience, we would need more time to deliver holistic care, which does not happen in our current healthcare system.

Making time for patients, listening, and having empathy take time; our time is only so finite in work. Nurses are currently busy charting on the cash registers instead of giving empathy to patients. 

Topics covered in HCAHPS Survey:

  • Nurse Communication
  • Doctor Communication 
  • Responsiveness of Hospital Staff 
  • Pain Management
  • Communication About Medicines 
  • Discharge Information 
  • Cleanliness of Hospital Environment
  • The Quietness of the Hospital Environment

What are these nursing issues we face? How can we solve the problems in nursing? Watch the full episode here 👇👇


0:00 Introduction
0:49 Sponsor Ads
2:34 Episode Introduction
2:58 Issues in Nursing We are Facing
6:48 Patient Ratios
11:17 Nurse Retention and Recruitment
20:00 Burnout
20:24 Stressful Work Environment
23:16 Too Much Overtime
27:24 Patient Satisfaction
28:02 Topics covered in HCAHPS Survey