When Your Business Feels Like Another Shift
You know the moment I'm talking about.
Maybe for you it's 4:15 PM, sitting in your car after a 7–3 shift, staring at your phone longer than necessary.
Or it's 8:15 PM after your third 12-hour day in a row. Four days off ahead of you… and instead of relief, there's a quiet knot of dread.
For me, it looks a little different.
I work from home doing utilization management. I close my laptop after reviewing cases all day—and there it is, on the same desk.
My business to-do list. Waiting.
The clinical work ends.
The business shift begins.
And here's what I want you to hear—really hear:
If your business feels like exhausting overtime…
like another patient assignment you didn't ask for…
you're not failing.
You're just operating in the wrong mode.
You don't need more hours.
You don't need more motivation or willpower.
You need to stop running your business with Nurse Brain—
and start leading it with CEO Brain.
You're Still Clocking In
This is what I see happening for so many nurses building businesses.
You finish your nursing job and immediately report for duty to your business.
You open your laptop.
Check email.
Scroll social media.
Reply to messages.
Wonder what you should be posting.
Feel guilty about what you didn't get to.
There's no pause.
No transition.
No leadership moment.
You show up reactive instead of intentional.
You treat yourself like staff… not like the CEO.
And the result?
Exhaustion.
Resentment.
That sinking feeling that your business is draining you instead of fueling you.
I know this pattern well. I lived it.
Because here's the uncomfortable truth we don't talk about enough:
Nursing trains us to be responsive, not strategic.
We're conditioned to handle what's right in front of us—not to design what comes next.
The very skills that make us exceptional nurses don't automatically translate to running a business.
That's not a personal failure.
But it does require a conscious shift.
Nurse Brain vs. CEO Brain
Let me slow this down for a moment.
Nurse Brain lives in triage.
What's urgent? Who needs me right now? What can't wait?
It's reactive. Immediate. Fire-fighting.
CEO Brain thinks in arcs.
What actually moves the needle this week?
What creates momentum three months from now?
What can I build once that keeps serving me?
Nurse Brain responds instantly.
Because that's what we were trained to do. Be available. Don't make people wait.
CEO Brain creates containers.
It batches communication. Protects focus. Understands that constant availability erodes leadership.
Nurse Brain chases perfection.
Everything must be right before it's shared. Polished. Approved. Safe.
CEO Brain chooses progress.
Published beats perfect. Learning happens through movement, not refinement.
Nurse Brain self-sacrifices.
I'll skip lunch. I'll stay late. I'll say yes even when I'm depleted.
CEO Brain protects energy like capital.
Because it is. No energy, no business.
Nurse Brain trades time for money.
More hours, more effort, more output.
CEO Brain builds leverage.
Systems. Structures. Assets that don't require constant presence.
You don't need more time.
You need a different operating system.
Your business doesn't need another shift worker.
It needs a leader.
Operational Anatomy (This Is the Part That Changed Everything for Me)
In utilization management, we ask one core question over and over:
Is this medically necessary?
Not "Is it helpful?"
Not "Is it nice to have?"
But—necessary.
I started asking the same question in my business:
Is this business necessary?
Checking Instagram five times during CEO hours?
No.
Replying to every DM immediately?
No.
Spending three hours perfecting a graphic no one will remember tomorrow?
Also no.
What you actually need is what I call Operational Anatomy.
A business structure that can stay on observation status while you're working your nursing job—
so when you step into CEO time, you're fully present. Fully resourced. Fully alive.
And here's the reframe that often lands hardest (and frees people the most):
Your 9-to-5 isn't the enemy.
It's your venture capital. It’s your investor.
It funds your vision while you build the business vitals.
But those vitals won't develop if you keep treating your business like another patient load.
What Comes Next
You might be thinking,
"Okay, Karen… this makes sense. But how do I actually do this?"
Fair question.
At a high level, there are three shifts that matter most:
Systems that don't depend on your constant presence
Focus instead of fragmentation
One task per CEO session. Not ten.
A schedule that respects your nervous system
Not hustle. Not grit. Sustainability.
But none of that works until you make the identity shift first.
From Nurse Brain…
to CEO Brain.
The Invitation
Your business feels like another shift because you're still leading it like a nurse instead of a CEO.
I'm not saying that with judgment.
I'm saying it because I know what becomes possible when the shift happens.
It doesn't happen overnight.
It's a practice.
An orientation.
And it starts with one simple question, asked again and again:
What would the CEO version of me do right now?
Not the people-pleaser.
Not the over-functioner.
Not the "I'll just squeeze this in" version.
The CEO.
The one who knows her energy is precious.
The one who builds systems instead of burning herself out.
The one who leads—rather than reacts.
That version of you already exists.
She's just waiting for you to clock out of Nurse Brain…
and clock in as the CEO.
Is your 5-to-9 flatlining?
Take the FREE Business Vital Signs Audit and discover:
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It's a quick diagnostic that shows you which vital signs are strong—and which ones need immediate intervention.
Because you can't fix what you can't see.
