Discomfort with attempting to make changes in health care and beyond

In complex systems, change requires persistence.

Over the years, coworkers often described me as a “dog with a bone.” Once I spend money on something, I do not hand over on it. This persistence has helped me drive significant change in healthcare systems. It also showed me how much organization, follow-up, patience, and emotional stamina significant change often requires.

I also learned how often the reply is not any. Sometimes “no” is direct. Other times it comes through silence. Some ideas take longer to realize traction in large organizations than people initially expect. Creating change in any environment could be difficult. In healthcare systems, this will seem particularly difficult.

Healthcare organizations are accountable for large numbers of patients, employees, regulations, budgets and risks. Decisions that appear easy from the surface often require layers of oversight, approvals, coordination, and competing priorities that almost all people never see. However, understanding these realities doesn’t necessarily make the method any less daunting.

The temptation to offer up.

I actually have experienced this in clinical practice, advocating for patient education initiatives, operational changes, or workflow improvements that originally seemed easy. In healthcare, even small changes can require multiple approvals, cross-department coordination, competing priorities, and months of follow-up before progress becomes visible. Sometimes strong ideas come slowly, not because people don’t care, but because large systems balance many demands directly.

In large organizations, people may come to expect change to be slow, difficult, or unsuccessful. After seeing strong ideas struggle to advance, some people stop trying altogether.

Finding one other option to make a difference.

Over time, the will to create change on a bigger scale contributed to the choice to determine a non-profit organization.

Initially, I saw obtaining 501(c)(3) status because the major obstacle. In reality, it was more like being given permission to begin. Status provides a seat on the table, but it surely doesn’t create credibility, partnership, momentum or funding. These things still need to be built slowly.

Starting a nonprofit was humbling. One of the more surprising lessons was the conclusion that sometimes I spent less effort providing a small amount of support and an enormous effort providing none in any respect.

Large grants often require infrastructure, demonstrated results, reporting systems, and relationships that newer organizations simply don’t yet have. Meanwhile, essentially the most significant support got here from local firms and individuals who focused on something much simpler: authenticity, consistency and visual effort.

I do not consider myself as a salesman. I do not even consider myself a very sociable person. I prefer one-on-one conversations over networking rooms. I like validation. I wish to hear that somebody likes an idea. I proceed to envision my inbox in hopes of receiving replies to emails I already suspect I’ll never receive.

Tolerating discomfort.

Yet non-profit work requires getting used to discomfort. Even something so simple as handing out leaflets can seem surprisingly vulnerable.

There are many social signals that individuals use when standing outside a store with flyers in hand. Some people avoid eye contact, so you will not start talking to them. Some people offer you a large berth, clearly taking a less direct path to the shop to avoid interaction. Some people politely wave at you before you’ll be able to finish your sentence.

There are some ways people communicate that they are not looking for one other request, conversation, or commitment. Even if what you are really attempting to do is share a mission that you just truly imagine can assist people. At first, I took these interactions more personally than vital. But over time, I learned to think less about convincing people and more about finding common ground.

People are overwhelmed. They are continually driven by demands, decisions, and competing priorities. Sometimes the moment will not be right. Delivery is insufficient. Or the mission just doesn’t align with what’s most vital to them in the intervening time.

That doesn’t make rejection any easier.

Nursing could seem similar. Supporting patients, proposing changes to practice or questioning existing workflows doesn’t all the time result in immediate support. Sometimes resistance is logistical. Sometimes culturally. Sometimes persons are simply bored with competing demands and constant change.

I’ve also learned over time that attempting to make a change often means accepting that not everyone will immediately understand or support what you are doing. If every decision is filtered through fear of criticism or discomfort, maintaining meaningful work will change into difficult.

If I can tolerate discomfort, I can learn from it. I can refine my message, refine my approach, and proceed to try.

What’s the difference between large organizations and small nonprofits?

Working in each health systems and a small nonprofit has highlighted something else for me: large organizations and small nonprofits each have strengths that the opposite lacks.

Large health systems can create infrastructure and scale that small nonprofits cannot replicate. Some grants from larger organizations have funded significant programs that will have been difficult to implement independently. At the identical time, implementing ideas in large organizations often requires coordination across multiple departments, timelines, approvals, and competing priorities. Even strong ideas can take time to implement.

On the opposite hand, some decisions in a small nonprofit organization could be made extremely quickly. At one point we decided to arrange a comedy fundraiser. Within a number of weeks, we selected a date, reserved a spot and established a working budget.

Small nonprofits also operate in a different way. We haven’t got the staff, resources or institutional reach of a big organization. But we’ve flexibility. Smaller organizations can sometimes adapt more quickly to emerging needs. We can respond on to the needs we actively see locally. No structure is inherently higher. They simply create different paths for change.

It’s a matter of time.

One thing I didn’t fully appreciate before starting my nonprofit was the problem of time. If you devote your evenings, weekends, and emotional energy to mission-oriented work, what are you now not spending time on? This query matters, especially when you’ve a family.

In my case, my husband and daughter were incredibly supportive. But I try to not think concerning the proven fact that my family “allows” me to spend time like this. Instead, we predict of it as supporting me in pursuing work that’s meaningful and aligned with who I need to be.

My daughter sees the hassle that goes into constructing something you care deeply about. He sees failure, perseverance, continuation and uncertainty. And if possible, take part in this with me. She helped distribute leaflets. He helps me with a giant raffle. She participated in an area drum circle to higher understand the programs we run for cancer patients. Some lessons are best learned directly. It is best to show others by example.

I still have so much to find out about constructing and maintaining a nonprofit organization. I also know that I’ll face more rejections. More emails with no response. More failed applications. More ideas that do not work as I expected. But I deeply imagine in what we are attempting to create: practical, compassionate support that helps make cancer treatment less overwhelming for patients, caregivers and oncology nurses.

Nurses attempting to make changes should expect resistance. Not because ideas lack value, but because health systems are complex and significant change often occurs slowly. Learning to separate rejection from value, adapting when vital, and continuing to indicate up regardless could also be some of the essential skills advocacy work teaches us.

I’m still learning this.

But for now, I keep showing up.

Sometimes with grant applications.

Sometimes with lottery baskets.

Sometimes standing in front of the shop and holding leaflets.

Some goals are price pursuing anyway.

COurtney Desy, BSN, RN, OCNis an oncology infusion nurse. He cares for adults undergoing chemotherapy and immunotherapy. She is the founding father of the Foundation Stronger than Chemistry FoundationA nonprofit organization focused on improving patient education and support during cancer treatment. Her previous posts on this blog could be found here.

Because this text touches on the human side of advocacy and creating change, we have also created a practical resource page on lessons learned from founding a nonprofit at strongthanchemo.org.