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Issue 45: Strategic Decision-Making Under Pressure

November 18, 20243 min read

Issue 45: Strategic Decision-Making Under Pressure

"In any moment of decision, the best thing you can do is the right thing, the next best thing is the wrong thing, and the worst thing you can do is nothing."

— Theodore Roosevelt, former U.S. President

Welcome to this week’s issue!

Let’s talk about one of the toughest challenges for nurse and physician leaders: making high-stakes decisions under pressure. Whether it’s a last-minute staffing issue, a critical patient decision, or navigating team conflicts, healthcare leaders often face situations where they need to act quickly—but thoughtfully.

The problem? When the pressure is on, it’s easy to get stuck. Overthinking or rushing can lead to choices that hurt team morale, patient care, and even your own confidence as a leader.

Here’s What It Looks Like When Decision-Making Goes Off Track:

  • Paralysis by analysis: Overanalyzing every detail when you're not in care giving situation leads to delays that stall progress and create frustration - and THAT is the part that ends up impacting medical care. You might find yourself second-guessing everything, afraid of making the wrong call. You know exactly what to do for the patient, but not for your team.

  • Rushed decisions: On the other hand, acting too quickly—just to get it done— leads to poorly thought-out choices that ripple into unintended consequences.

  • Inconsistent decision: When the weight of the pressure builds, it’s easy to make decisions that conflict with your past choices, leaving your team confused or even starting to question your leadership. Ouch!

What You Should Be Doing Instead:

  • Use a Structured Decision-Making Process: Pressure magnifies uncertainty. That’s why having a go-to process for making decisions is essential. For example, ask yourself: “What’s the most critical information I need right now?” and “What outcome aligns best with our top priorities?” A consistent framework reduces guesswork and builds confidence. (Check out my past issues covering decision-making frameworks here.)

  • Pause Before Acting: Even in urgent medical situations, you know you need to take a moment to center yourself. Same goes for operational and leadership decisions. A 30-second pause to assess the bigger picture can make all the difference between reacting emotionally and responding strategically.

  • Communicate the “Why” Behind Your Decisions: I know you've heard about the importance of WHY, but it gets lost when we're under pressure. Once a decision is made, clearly explain your reasoning to your team. This transparency builds trust (which we'll talk about in the next issue) and helps everyone align around how you're moving forward.

It's no secret I'm a fan of decision-making models. They don't even need to be the "best" model, but ANY structured approach that gets you asking the important questions and considering the challenge from different perspectives is guaranteed to enhance the quality of your decision-making.

High-quality decision-making helps you stay calm, focused, and strategic—even in the most intense situations. With a framework in hand, you’ll make timely decisions that are also well-considered, so you can be quick AND smart.

Check out my walkthrough of various decision-making frameworks HERE.

By mastering decision-making under pressure, you’ll not only improve your outcomes but also strengthen your leadership presence. Your team will see you as someone who can handle challenges with confidence and calm, even when the stakes are high.

Ready to Strengthen Your Leadership Presence?

If you’re ready to sharpen your decision-making skills and lead with more confidence and less stress under pressure, schedule a consultation. We’ll explore how to implement decision-making strategies that fit your leadership style and help you navigate even the toughest situations.

Next Week's Preview:

Next week, we’ll explore effective communication techniques that build trust—even with challenging team members. Strong communication is essential in any healthcare setting, and I’ll share tips for navigating those tricky conversations while still fostering a supportive and cohesive team. Until then, think about one decision you’re facing and how you might apply a framework to bring clarity to it.

Go out there and lead,

Asia

decision-making under pressureleadership in healthcarestrategic decision-making tipshigh-stakes decision-makingnurse and physician leadershiphealthcare leadership trainingdecision-making frameworks
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Asia Bribiesca-Hedin

Asia Bribiesca-Hedin, MBA, MPA, CPC, CPCC, Principal Coach and CEO of Bridgewell LLC Professional Services

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