There are seasons in healthcare leadership, and leadership in general, when everything feels upstream. The path is difficult, progress feels slow, resistance feels constant. Our first instinct may be to ask: “What are we doing wrong?” Nature, however, reminds us of something important… not all struggle means something is wrong. Sometimes struggle means we are moving toward something that matters.
As explored in What Nature Teaches Us About Leadership: Building Connected Healthcare Cultures, the natural world offers meaningful lessons about connection, resilience, and leadership. The journey of the salmon provides another: resistance is not always a signal to stop.
Hard Does Not Mean Impossible
Each year, salmon begin an extraordinary journey. They leave the vastness of the ocean and return upstream, often traveling against powerful currents, navigating obstacles, and overcoming conditions that would seem impossible. The current does not mean they are going the wrong direction. The resistance is part of the journey and leadership often feels the same.
Creating meaningful change, transforming culture, and challenging old ways of working rarely happens without resistance. Yet resistance does not always mean people are unwilling. Sometimes resistance means people are uncertain or tired, or that they need help understanding why the journey matters. Resistance can also reveal where leaders need to listen more carefully, communicate more clearly, or provide greater support.
Reconnect People to Purpose
Salmon are driven by something deeper than ease and comfort. They are guided by purpose.
In organizations, purpose is what sustains people through difficult seasons of change. When teams only understand what is changing, they may focus on what they are losing. When they understand why the change matters, they can begin to see what they are working together to create.
Healthcare leaders should continually connect change to a meaningful purpose. How will the change improve patient care? How will it strengthen the work environment? How will it help healthcare professionals provide the care they want to deliver? Purpose creates movement, resilience, and reminds people that the challenge they are experiencing today is connected to something meaningful tomorrow.
Leadership During the Upstream Journey
When the waters become difficult, people watch their leaders. They watch for signals. Are leaders calm or reactive? Committed or uncertain? Focused only on the obstacles, or still connected to the destination?
Leading through resistance does not require pretending the journey is easy. People recognize when circumstances are difficult. What they need are leaders who acknowledge the challenge while continuing to create belief that progress is possible. This requires honesty, consistency, presence, and a willingness to remain connected to the people experiencing the change. Leaders must communicate what they know, acknowledge what remains uncertain, and create opportunities for people to ask questions and influence the journey.

How Healthcare Leaders Can Navigate Resistance
When resistance emerges, healthcare leaders can help teams continue moving forward by:
- Listening for what resistance is communicating. Concerns may reveal uncertainty, change fatigue, operational barriers, or unintended consequences that leaders need to address.
- Reconnecting the change to shared purpose. Help people understand how the work supports patients, families, colleagues, and the organization’s mission.
- Acknowledging the difficulty. Honest recognition builds more trust than minimizing the realities people are experiencing.
- Inviting meaningful participation. People are more likely to support change when they have opportunities to ask questions, share their expertise, and help shape implementation.
- Recognizing progress. Celebrating meaningful steps can restore energy and remind teams that their efforts are making a difference.
Resistance should not simply be overcome or dismissed. It should be understood. The goal is not to force people upstream, but to help them find purpose, support, and a meaningful role in the journey.
Recognizing Your Salmon Season
Every leader will experience moments when the work feels harder than expected. Whether it is a new strategy, culture transformation, different way of thinking, or a needed change, these moments do not always mean it is time to stop. Sometimes it means leaders must pause and listen. Sometimes it means the approach needs to change. Sometimes it means the team needs more clarity, involvement, or support and that you should keep swimming upstream because the most important journeys are rarely the easiest ones.
Nature has always known this. Resistance is not always a sign you are failing. Sometimes it is a sign you are moving toward something worth reaching.
Support Your Organization Through Meaningful Change
Creative Health Care Management (CHCM) helps healthcare organizations navigate change by strengthening leadership, workplace culture, relationships, and shared purpose. Through customized Leadership Development and Cultural Transformation solutions, CHCM works alongside leaders and teams to create meaningful, sustainable progress. Interested in more nature-based leadership development work? We also offer Lead from the Wild™, a nature-based leadership development framework that is tailored to any organization.
If your organization is navigating its own salmon season, contact CHCM to begin the conversation.

Frequently Asked Questions About Leading Through Resistance in Healthcare
Resistance to change in healthcare may stem from uncertainty, change fatigue, limited resources, unclear communication, workflow concerns, or fear of losing established practices. It does not always mean people are unwilling to change. Often, resistance reveals where teams need greater clarity, involvement, or support.
Healthcare leaders can respond by listening carefully, acknowledging concerns, communicating openly, and reconnecting the change to a shared purpose. Providing meaningful opportunities for team members to ask questions and influence implementation can also build trust and engagement.
Purpose helps healthcare professionals understand why a change matters and what they are working together to create. Connecting change to patient care, team well-being, or the organization’s mission can sustain motivation when progress feels difficult.
Leaders build trust by remaining visible, consistent, honest, and responsive. They should acknowledge challenges without minimizing them, communicate what is known and unknown, and follow through on commitments.
Not necessarily. Resistance may indicate that the change needs clearer communication, additional resources, greater employee involvement, or an adjusted approach. Leaders should treat resistance as valuable information while continuing to evaluate whether the change remains aligned with the organization’s purpose and goals.

Gen is driven by the desire to help clients create organizational excellence through measurable improvement. She thrives on helping others reach meaningful goals, including Magnet® designation.












