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It feels like there is something missing. "How did they not see this patient was becoming more unwell?", "I can't trust anyone to do their job".

We tend to think we think with logic at the forefront, but as this episode unpacks all of us have flawed, clouded with emotions and biases. In this episode Tubi and Naomi unpack critical thinking and developing it in out nursing teams.

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The Clear Shift Consultation Diagnostic Tool will help you clearly articulate the gaps in language that connects the clinical experience with the executive impact.

"Is nursing turnover eroding your bottom line? Stop managing the crisis and start leading the culture. Book a Strategic Consultation at bettereveryshift.com.au/consultation to turn your clinical culture into a measurable business performance indicator."

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"Judgment is an emotion. Every time you articulate a clinical judgment to a colleague, you are delivering an emotional message, whether you like it or not."

In this episode of Better Every Shift, Naomi and Tubi dive into a rich and provocative article by Margaret Bearman et al. titled "Feedback with feelings: the human complexity of expressing judgements about performance." We dismantle the myth that emotions in healthcare are merely "internal psychological states" to be managed in private; instead, we recognize them as the literal "elephant in the room" in every clinical learning environment.

We explore why claiming to give feedback "without judgment" is actually a form of professional dishonesty that can make a situation worse. From the physiological impact of adrenaline and cortisol on our ability to hear properly to the "story" we create in our heads about our peers, this episode provides a roadmap for "naming the edge". Stick around to learn how to move beyond sterile clinical checklists and start having the pragmatic, transparent conversations that actually move the needle on performance.

Key Discussion Points

The Myth of the "Internal State": Why the literature is misleading when it suggests emotions are only the individual's problem to manage.

Judgment as an Emotional Act: Understanding that expressing a judgment is an emotional event for both the supervisor and the trainee.

The Honest Debrief: Why admitting you are upset about a poor outcome can actually lead to a more useful conversation than pretending there is no problem.

Physiological Barriers: How high-stress triggers (like a pager going off) flood the body with chemicals that make it impossible to process complex conversations.

The Pre-Mortem Strategy: How to forecast "icky" feelings on day one to normalize struggle and keep the lines of communication open.

Gendered Judgments: Addressing harmful social hierarchies, such as the "angry mum" feedback trap, and how to keep feedback factual rather than personal.

Pastoral Conversations: Why understanding the context of a student's life is often more powerful than any clinical performance checklist.

Timestamps

[00:00:00] Intro: The Bold Statement—"Judgment is an Emotion".

[00:01:46] The Elephant in the Room: Why we ignore emotions in debrief.

[00:03:00] The Dishonesty of "Feedback Without Judgment".

[00:05:00] Adrenaline and Cortisol: Why you can’t think straight when the pager goes off.

[00:07:00] The Pre-Mortem: Forecasting the "year of disaster" for students.

[00:09:00] Why we value some feedback more than others: Impressing the "right" people.

[00:12:00] Scenario 1: The "Long, Audible Sigh" and naming non-verbal cues.

[00:15:00] Scenario 2: Dismantling gendered judgments and the "Angry Mum" comment.

[00:18:00] Scenario 3: Legitimizing pastoral conversations over checklis

Thanks for supporting this content. Please share your favourite episode with a colleague today so we can support more leaders.

The Clear Shift Consultation Diagnostic Tool will help you clearly articulate the gaps in language that connects the clinical experience with the executive impact.

"Is nursing turnover eroding your bottom line? Stop managing the crisis and start leading the culture. Book a Strategic Consultation at bettereveryshift.com.au/consultation to turn your clinical culture into a measurable business performance indicator."

Text us here. We'd love to hear from you

"Without relationship, that content is not going anywhere.".

In this episode of Better Every Shift, we are joined by Nathan Oliver, a simulation expert and PhD candidate who has spent over a decade leading medical and nursing education in the UK and Australia. Nathan challenges the traditional "medical paradigm" by arguing that rapport, trust, and safety must be prioritized over clinical content if we want learning to actually land.

We dive into the "spicy" world of simulation and debriefing, exploring how to manage disruptive "clinically strong" team members and how to support struggling new grads who feel like they are "underwater". Nathan shares his unique insights on "debriefing by eyebrows"—why your tone and cadence are more important than your specific questions—and the vital importance of mental rehearsal in high-stress emergencies.

Key Discussion Points

• The Social Learning Shift: Moving beyond Kolb’s 1984 model to understand simulation as a social practice where we learn in community.
• Reading the Room: Identifying "micro-communication" leaks and body language in "muted" or "shut down" teams.
• The "Lizard Brain" in the Clinical Space: Why we don't rise to our aspirations under stress but instead lower to our level of training.
• Mental Rehearsal: Why athletics and aviation prioritize mental walkthroughs and why healthcare needs to make this practice explicit.
• Fake vs. Genuine Curiosity: Why your team "smells a rat" when you ask inauthentic, judgment-laden questions.
• The Burnt Memory: A powerful story of how one piece of negative feedback can stop a clinician from apologizing for a decade.

Chapters

Intro: Nathan Oliver’s journey from "underwater" student to simulation expert.

[04:00] The Social Practice of Learning: Watching and reflecting in community.

[06:00] Scenario 1: Managing the highly disruptive but clinically strong team member.

[09:00] Making the Implicit Explicit: Modeling transparency

[17:00] Scenario 2: The struggling new grad—is it capability or stress overload?.

[20:00] The Adrenaline Secretion: Why we can’t think clearly in the first five minutes of an emergency.

[23:00] Debriefing by Eyebrows: The impact of tone, cadence, and genuine curiosity.

[25:00] The Burnt Memory:

[28:00] The Gold Tip for Educators: Why relationship always trumps content.

[31:00] Debriefing the Debrief: stay in the growth space.

Resources

Fixing, Helping and Serving Rachel, Naomi Remen

Author of Kitchen Table Wisdom Daily Good Story

Emotional Culture Deck - Riders and Elephants

Work Nathan is contributing to:

Thanks for supporting this content. Please share your favourite episode with a colleague today so we can support more leaders.

The Clear Shift Consultation Diagnostic Tool will help you clearly articulate the gaps in language that connects the clinical experience with the executive impact.

"Is nursing turnover eroding your bottom line? Stop managing the crisis and start leading the culture. Book a Strategic Consultation at bettereveryshift.com.au/consultation to turn your clinical culture into a measurable business performance indicator."