Three Top Actions of Nurse Empire Builders

Are you an empire builder? And more importantly…how can you be an empire builder as a nurse?  An empire builder is someone who can see and hold a vision for change and then create action that motivates others to pursue the vision as well.  Building an empire in nursing is creating the spirit of revolution! Nurse’s need to have the confidence to approach social injustices that keep certain folk from life, liberty and the pursuit of happiness.  

lilian wald

Lillian Wald was a nurse empire builder who literally climbed up rooftops to get to her patients! She believed that social justice and nursing are one and the same, and because of it she was an influential leader called on for her skill and brilliance.  The strength of Transform Nursing is in the desire to bring clarity to nurses about their role as leaders in justice.  Let’s break down what Lilian did and see if we can do the same, huh?

  • Bring your leadership skills to disenfranchised communities.  You do this by bringing visibility to issues that would otherwise be ignored. Nurse’s who are advocating for safe consumption spaces for people who use drugs are really saying “hey, this community of folk have different needs and we have to be prepared to address them as healthcare professionals”
  • Hold a bigger vision of yourself and watch as your actions begin to reflect that vision.  A short term outcome for your patient with congestive heart failure may be to encourage him to take his medications.  However your vision might be to see him surrounded by a support system that empowers him to have the energy and ability to prioritize his health.  See the difference?
  • Be willing to have a position on nursing that is a little radical.  Not everyone is going to climb walls to get to their patients, but empire builders will.  Empire builders realize that structural and environmental changes are required for communities to not only survive but to thrive.  They are not afraid to venture out into uncharted territory and muddy waters because their vision gives them clarity.  

    Empire builders are aware that they have unconscious bias.

    If bias is unconscious how can you be conscious of it? Conscious nurses are aware that patients come into the system who are traumatized, disenfranchised, or people who have been generationally victimized. These nurse’s check their biases at the door.

Conscious nurses ask mindful questions such as:

“Am I treating this person with respect? Am I watching for non-verbal cues? Am I willing to ask questions when I don’t understand where my patient is coming from?”  

When it comes to addressing unconscious biases, empire builders are willing to practice a range of revolutionary wellness techniques such as trauma informed care, harm reduction and restorative practices.  They acknowledge and use cultural humility knowing that both diversity and inclusion matter in nursing and in healthcare.  And at the end of the day, if they have done nothing else they know that they did the work of being fully present to their patients.  This is how trust is built between communities.

Empire builders are willing to do the work because they know that by doing this work they are going to be able to equip their patients, and in essence the community, with the resources that are needed to thrive.  Nursing schools need to shift curriculum focus from individual patient care to population health. Nursing organizations need to have more platforms for leadership development based on the current health and political climate.  

Transform Nursing uses cultural humility in nursing conversations to help shift the focus from resistance to resilience.  We as nursing leaders create the context for these conversations by being willing to ask hard questions out loud, and hold our profession accountable for allowing economics and politics to shape these conversations.  Getting a seat at the table is less about being invited and more about pulling up a chair.

Social Determinants of Health .jpg 

Nursing has not changed drastically nor has the need to bring our services to the community. Empire builders realize that social factors make up 70% of population health compared to 30% of health behaviors and genetics. (image)  That means that where people live, work, play and pray impact their health much more than individual health behaviors.  What a powerful statistic! In a health industry which attempts to shift the blame to patients for not taking better care of themselves; being aware of the social determinants of health is a must.


Folk, pioneer nursing is our core.  Pioneering may sound glam, but just think what riding a horse does to your backside lol? It’s rough and rugged terrain! And still, nursing is built on accessing and reaching whole communities.  At Transform Nursing, we take care of teaching you how to have these difficult and, yes awkward conversations as professionals so that you can have the most impact possible on your patient and the community in which they live, learn, work and play.  So…are you an empire builder? Is it time to make that choice?


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