I was speaking to a former CNO of a Kaiser Permanente hospital. We were discussing the changes we want to see within healthcare in support of healthier workplaces, in support of professional development for nurses. We were riffing back and forth, kindred spirits playing in the same sandbox; The energy exchange was palpable.

Then I said, “Yes, we have to focus on culture change!” And she stopped. The momentum ground to a screeching halt. She looked at me with what seemed like pain in her eyes and said, “That will take too long.”

I responded with outward curiosity, but my internal dialogue was spinning with disbelief. “What do you mean, ‘too long’,” I said to myself, “Culture is the our surest strategy!”

After that moment, our conversation went in a different direction; I never got a chance to ask her directly, “What do you mean?” But I do know, this Executive Emeritus is no stranger to the long game. The keynote she just finished giving was ripe with culture-talk. She definitely wasn’t saying, “Forget the long play.” The look in her eyes haunted me.

I have a high pain tolerance. It’s easy for me to push past it and keep going. Once a quarter I feel myself getting sick and that’s my cue to take a few extra naps. I recharge and do it all over again. The habit of “pushing past” is helpful in the short term, but it’s a lousy long term strategy. It means I neglect to notice all the little pain-points that would make brilliant leverage-points for quality improvement projects.

Giving ourselves permission to feel the pain is a necessary first to clearly identifying the pain-points. It’s the foundation of strategic genius.

I walked away from that game-changing conversation with this conviction: If we can’t become adept at bringing substantive relief to the frontlines right now, we won’t survive the long game. In fact, many of us aren’t.