Hello Reader,
You step into a new role. Maybe it's a charge nurse position, a department director seat, or a system-level executive chair. Either way, the pressure lands fast. Everyone is watching. You want to make your mark.
So you get moving. You solve problems. You introduce yourself by showing what you can do.
But what if the most powerful thing you could do right now is to stop — and listen?
That's the central insight from this week's episode of the Transforming Healthcare Coaching podcast, where I sat down with Kurt Mosley and Neill Marshall of HealthSearch Partners. Together, they've conducted thousands of interviews with healthcare executives. What they've learned about leadership transitions is worth paying attention to — whether you're stepping into your first leadership role or your fifteenth.
If you're a busy clinician or leader and can only take three things from this episode, here they are:
- The first 90 days aren't about proving yourself — they're about understanding the context you just entered.
- Listening tours and small, symbolic actions build trust faster than big strategic announcements.
- Whether you have a formal title or not, you are already leading. These lessons apply to you.
The Pressure to Perform Is Real — and Often Gets in the Way
One of the first things Kurt and Neill named was the pattern they see over and over: leaders who step in and immediately want to try to demonstrate value through action. It's understandable. Healthcare systems are under pressure, teams are stretched, and the expectation to perform is baked into our culture from day one of training.
But the leaders who thrive in transitions — the ones Kurt and Neill consistently see succeed — tend to do something counterintuitive in those first weeks. They slow down enough to actually understand what's happening around them before they start changing things.
That's not passivity. It's strategy.
What Listening Actually Looks Like in Practice
Kurt described the concept of a "listening tour" — a deliberate, structured approach to meeting with the people you'll be working with and leading, not to introduce your agenda, but to understand theirs. What are they proud of? What's frustrating them? What have they tried before that didn't work?
In healthcare, this matters enormously. Our teams are often carrying the weight of previous leadership decisions — restructurings, failed initiatives, unfulfilled promises. When you walk in and immediately announce what you're going to fix, you may be stepping on landmines you don't even know are there yet.
A listening tour signals something different: I'm here, I'm paying attention, and what you know matters to me.
Neill added something equally important: this isn't just about gathering information. It's about building the relational foundation that everything else depends on. Trust is built in the quiet moments — in the hallway conversations, the one-on-ones, the times you showed up and actually listened.
Culture Is Something You Read, Not Just Something You Change
One of my favorite moments in this conversation was when we got into organizational culture — specifically, how new leaders often underestimate how much culture shapes what's possible.
Kurt and Neill both emphasized that misreading culture in the early months is one of the most common reasons leadership transitions stumble. A strategy that worked beautifully in your last organization may land completely differently here. The norms around hierarchy, communication, disagreement, and change are often invisible until you accidentally violate them.
Treat the culture like a text you're reading, not a problem you're solving. Be curious. Ask questions. Notice what gets celebrated and what gets quietly ignored. Pay attention to how decisions are actually made, not just how they're supposed to be made.
Small Symbolic Actions Carry Outsized Weight
Kurt shared how seemingly small, symbolic gestures early in a leadership role can set the tone for an entire organization.
Showing up to a night shift to say thank you. Attending a meeting you weren't expected at. Remembering the name of a staff member's family member. These aren't grand gestures. They're quiet signals that say: I see you, and I'm paying attention.
In healthcare, where burnout is often tied to feeling invisible and undervalued, these moments are more powerful than most leaders realize. They're not just nice to do — they're leadership strategy.
Three Things to Focus on in Your First 90 Days
We asked Kurt and Neill directly: if a healthcare leader was stepping into a new role tomorrow — at any level — what would you tell them to focus on? Here's the essence of what they shared:
- Listen before you lead. Schedule intentional conversations with the people you'll be working with and leading. Ask more than you tell.
- Find your cultural guides. Identify two or three people inside the organization who can help you read the culture — trusted, honest voices who will tell you what the org chart doesn't.
- Look for a small, early win that reflects your values. Not a performance to prove yourself, but a genuine action that shows what you stand for
This Applies to You — Even Without a Formal Title
I want to name something explicitly, because this is important to me and to the work we do here at Transforming Healthcare Coaching®.
The lessons from this episode aren't just for executives. Every healthcare professional leads — in patient interactions, in team dynamics, in the way you show up at the start of a shift. The principles Kurt and Neill described — listening, building trust, reading culture, making small meaningful gestures — apply whether you're a charge nurse, a bedside clinician, a team lead, or a department head.
You are already leading. The question is just how intentionally you want to do it.
🎧 Listen to the podcast sneak peek episode below and listen to the full episode on YouTube, Apple, Spotify, Podbean, or Amazon Music.
What's inspiring us this week:
Seeing the successes of my mentees. It's so lovely to watch everyone grow and make meaningful impact in their various institutions and spaces!
The Practice: Celebrating Wins
We get more of what we focus on. The practice of gratitude and celebrating the goodness of life is the first step in changing our brains, mindsets, and circumstances for the better.
Getting to teach a pre-Congress workshop at national conference for my specialty, Society of Critical Care Medicine on Leadership and Professional Development. Grateful for the opportunity to help design and facilitate the program and participation and engagement of all the participants!
Stay mindful and keep leading,
Lillian
Founder & CEO
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