When It’s Time to Pivot — and When It’s Not

At some point in practice, nearly every nurse practitioner asks the same question:
Is this a sign that something isn’t working—or am I just in a hard season?

Private practice, integrative work, and even traditional clinical roles all come with moments of discomfort. Growth stretches us. Responsibility can feel heavy. And not every challenge is a message to change direction. Knowing the difference between temporary discomfort and true misalignment is one of the most important skills you’ll develop as an NP.

Discomfort Isn’t a Signal to Quit

Discomfort often shows up when you’re:

• Learning something new

• Taking on more responsibility

• Setting boundaries for the first time

• Charging appropriately for your work

• Being visible in a way you haven’t been before

These moments can feel unsettling, but they’re often signs that you’re expanding, not failing. Discomfort usually comes with growth, curiosity, and a sense of “this is hard, but I’m learning.”

If you still feel connected to your work—even when it’s challenging—that’s often a sign to stay and refine, not pivot.

When You’re in a Hard Season (Not a Wrong One)

Hard seasons tend to feel:

• Tiring, but purposeful

• Challenging, yet meaningful

• Stressful, but aligned with your values

In these seasons, the work may need support, not abandonment. Mentorship, systems, clearer boundaries, or adjusted expectations can often resolve what feels overwhelming.

A hard season asks for structure and support, not a total reinvention.

Misalignment Feels Different

True misalignment tends to show up as:

• Persistent dread that doesn’t ease with rest or time

• A sense of shrinking rather than growing

• Repeatedly overriding your values to “make it work”

• Feeling disconnected from the patients or work itself

• A quiet, consistent inner knowing that something is off

Misalignment doesn’t usually feel loud or dramatic. It’s often subtle, steady, and draining. And unlike discomfort, it doesn’t soften as you gain skill or confidence.

That’s when a pivot may be necessary—not because you failed, but because you listened.

Before You Pivot, Ask These Questions

Before making a major change, pause and ask:

• Am I avoiding discomfort—or honoring alignment?

• Would more support change how this feels?

• Is the problem the work itself, or how I’m doing it?

• What would it look like to adjust instead of abandon?

Many pivots are actually refinements: changing hours, patient population, pricing, offerings, or boundaries—rather than starting over entirely.

A Pivot Isn’t an Emergency

One of the biggest mistakes NPs make is treating uncertainty like an urgent problem that needs immediate action. You don’t have to decide everything at once. Clarity comes from listening, not rushing.

Sometimes the most aligned move is staying put long enough to learn what the season is trying to teach you.

And sometimes the most courageous choice is letting go of something that no longer fits—without needing it to make sense to anyone else.

Both are valid. Both require trust.

If this resonates and you’d like support discerning your next step, please reach out—I’d love to work with you.