The Second Shift

Patrick LaRose

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. simplypaddy.substack.com

  1. 3d ago

    Pull the Damn Alarm: E11

    The Second Shift - Show Notes 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. * Bedside and Beyond Guide: resume support and 4 AI prompts to help you translate your skills and get past AI screening. * Book a 1:1 call with Patrick. Connect Patrick LaRose, DNP, MSN/Ed, RN, NC-BCThe Second Shift on Substack - Once a nurse, always a nurse. Stay strong. 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. 🔔 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 The Second Shift is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Get full access to The Second Shift at simplypaddy.substack.com/subscribe

    Pull the Damn Alarm: E11
  2. Aug 9

    Before The Straw Breaks E10

    It’s 6:30 AM. No hospital call. No rush to get kids out the door. Just quiet. This is what life looks like on the other side of a decision. 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. * Bedside and Beyond Guide: resume support and 4 AI prompts to help you translate your skills and get past AI screening. * Book a 1:1 call with Patrick. Connect Patrick LaRose, DNP, MSN/Ed, RN, NC-BCThe Second Shift on Substack - Once a nurse, always a nurse. Stay strong. 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. 🔔 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 Get full access to The Second Shift at simplypaddy.substack.com/subscribe

    Before The Straw Breaks E10
  3. Jul 26

    When the Best Bedside Nurse Becomes the Nurse Manager: E9

    Episode Description 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 * Visibility is central. Know what your nurses need to do the job. * Listen, then act. Treat your workforce as trained professionals who want care to exceed benchmarks. * 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. 🎧 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. 📞 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. 🏥 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. ✉️ 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 The Second Shift is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Get full access to The Second Shift at simplypaddy.substack.com/subscribe

    When the Best Bedside Nurse Becomes the Nurse Manager: E9
  4. Jul 20

    Starting Over Is Not Starting From Zero: E8

    The Second Shift with Patrick LaRose, DNP, RN, NC-BC Episode 3 · 17 minutes 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. 🔔 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 The Second Shift is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Get full access to The Second Shift at simplypaddy.substack.com/subscribe

    Starting Over Is Not Starting From Zero: E8
  5. Jul 12

    Twelve Hours; One Comment: E7

    It is 7:46 PM. You clocked out sixteen minutes ago. You are still in the parking lot, replaying one comment from 1:15 this afternoon. 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. 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 The Second Shift is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Get full access to The Second Shift at simplypaddy.substack.com/subscribe

    Twelve Hours; One Comment: E7
  6. Jul 7

    When Doubt Defines Your Future: E6

    There is a voice most nurses know well. It is the one that says someone else has it worse, so sit down and stay quiet. The Second Shift podcast opens by admitting that voice almost kept this episode from existing at all. This episode is about what self-doubt actually costs a nurse, why disqualifying your own experience became a professional reflex, and what years at the bedside teaches you about showing up before you feel ready. Lessons you will take away: * Loving nursing while hating the conditions are two separate problems, not one. You get to define what your nursing career looks and feels like. * The most transferable skills you own today are proven by every shift you work, by every decision you make. Your inventory of skills gives you choices you may have never thought you had. * Why permission is never coming from anyone else, except you. You hold the key to your future. Nurses: Is this you? You know when you’re mid-shift, running on fumes? You stop in that moment of chaos, for a brief moment, and think, there has to be something better than this! If this describes a typical day in your nursing life, you are in the right place. I help nurses stop white-knuckling their way through chaos. I help them hear what they actually want, then rebuild a life around it that pays the bills without losing themselves in the process. Connect: This conversation continues in my Substack community, posts, and daily notes. If you are the nurse tired of working in the chaos and you are ready for a real, honest conversation about your future, let’s schedule a conversation nurse to nurse. This will be the easiest conversation you have had all week. Are you interested in hearing more? These are designed for you. 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. With care, Patrick LaRose, DNP, MSN/Ed., RN, NC-BC Board-Certified Coach | Life Coach lifenursecoach.com The Second Shift is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. Get full access to The Second Shift at simplypaddy.substack.com/subscribe

    When Doubt Defines Your Future: E6
  7. Jun 28

    It Was You. You Were There: E5

    From Fine to Free | Show Notes It was You. You Were There. The Decision That Changes Everything A weekly podcast for people living in the crossing between fine and actually free. Hosted by Patrick LaRose — nurse, coach, and someone who has lived the transformation from the inside out. About This Episode Have you ever sat in your car in the parking lot before a shift and had to talk yourself into walking through those doors? If you know that feeling, this episode is for you. This is not another conversation about burnout statistics. It is not a self-care checklist. This is a conversation about the moment a person decides their own life is worth showing up for — what that decision looks like, what it costs, and what it gets back. Patrick speaks directly from his own experience as an ICU nurse — tripled on the unit, managing vents, drips, and split-second decisions — while carrying a quiet question he could no longer ignore: Who am I outside of this work? Key Highlights The Parking Lot Moment The episode opens with a scene every exhausted nurse recognizes — driving home on autopilot, changing scrubs in the garage, standing in the kitchen with the refrigerator open and nothing to reach for. That moment the thought surfaces: Is this all there is? The Exhaustion That Sleep Cannot Fix Patrick names what nurses rarely say out loud. The exhaustion is not about the work. It is about losing yourself inside of it. When you have been reliable and capable and giving for so long, the role absorbs the human being wearing it. The Disguise "It doesn't feel like weakness. It feels like loyalty." That kind of exhaustion disguises itself as professionalism. The structure becomes the identity. The schedule becomes the person. Until one day you look in the mirror and do not recognize who is looking back. Three Lessons From the Other Side The exhaustion is not the enemy. The silence is. Nurses are trained to respond, to move, to act. Sitting with the question of what you actually want is harder than any shift you will ever work. Performing strength is not the same as having it. Pushing through without complaint is not toughness. It is performance. Real strength looks like telling the truth about where you are. Real strength looks like asking for something for yourself without apologizing for it. Choosing yourself is not selfish. It is the prerequisite. You have watched patients decline because their baselines were compromised long before the acute event. The same principle applies to you. Choosing your own life, your own voice, your own direction is not abandonment. It is maintenance. The Takeaway You do not have to sell everything and drive across the country. That was Patrick's path. Yours will look different. The point is the decision underneath it — the one that says: I am worth choosing. The version of you that existed before the nurse title, before the sacrifices became the default — that person deserves to come back. Your One Action for Tomorrow Before the shift starts. Before the kids wake up. Before anyone needs anything from you. Find 10 minutes. Open your Notes app. Answer this question in writing: What did I want before all of this? Not what the unit needs. Not what your family needs. What did you want? What did the version of you who walked into nursing school believe was possible? Write it down. Do not edit it. Do not judge it. Just write it down. That is where you come back. Send This to a Nurse Who Needs It You know exactly who came to mind while listening to this. Stop right now. Copy the link. Text it to them. Do not do it later. Later never comes. She will thank you for it. Connect With Patrick If something in this episode hit differently, Patrick wants to talk to you. The link to schedule a call is in the show notes. It is not a sales pitch. It is not a program presentation. It is a conversation between two nurses — one who has been exactly where you are, and one who found a way through. Not a show notes person? Find Patrick directly on Substack at From Fine to Free. DM him. Tell him what landed. Tell him what you are carrying. From Fine to Free is for the person living in the crossing between fine and actually free. New episodes weekly. Get full access to The Second Shift at simplypaddy.substack.com/subscribe

    It Was You. You Were There: E5
  8. Jun 22

    A Bigger Stage, Same Performance: E4

    A Bigger Stage, Same Performance Same act. Bigger stage. Still no time to ask what you want. What do you do when you finally get everything you wanted, and nothing in your life changes? A friend of mine chased a promotion for six years. She got the email, and about an hour later, she was sitting in a parking garage crying, hands on the wheel, not going anywhere. She did not know why. I think she did. She just did not want to say it out loud, at least not yet. We talk about what happens after the thing you wanted finally arrives, and why a reward does not end the performance. It only gives the performance a bigger stage. In this episode: Why getting the job can sometimes be harder on a person than not getting it The difference between a reward and a real change Three questions to ask yourself before you keep performing on the new stage The questions worth sitting with: When was the last time you took a moment to think about what you actually want from your life? How long has it been since you asked yourself that question honestly, instead of staying busy with everything in front of you? If it has been a while, what do you think staying busy with everything else has cost you? The lesson: A reward does not end the performance. It only gives the performance a bigger stage. The only way to actually change your life is to stop performing long enough to ask yourself what you really want. You have the power and ability to look at your life and create one that has meaning and is yours. You. Two ways forward: If you stay in the performance, here is what it actually costs you. Not a crisis. Just more years on a stage you did not choose, telling yourself there will be time later to ask what you actually want. There will not be, unless you make the time. If this episode landed somewhere and you are ready to get to work, DM me or use the link below to schedule a conversation with me. It is free and may be the best call you could make today. If you are still not sure what your thing is or are not ready for that conversation yet, start with the 10 Question Audit. If you already know you are ready for the next thing that will change your life and you have named it, the Quick Start program gets you on the road. Coaching is not about fixing. It is about witnessing. Patrick LaRose, From Fine to Free Get full access to The Second Shift at simplypaddy.substack.com/subscribe

    A Bigger Stage, Same Performance: E4

About

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. simplypaddy.substack.com