Where is the roadmap?

March 15, 2026

I was asked this question, “Where is the roadmap?” a few years ago from someone who is not a healthcare professional. We were in a conversation about nursing and healthcare in general. I was explaining a bit about the culture in nursing and healthcare from a nursing experience. I have had far more nursing experiences than patient experiences. However, these are very different experiences.

To be a patient requires that someone has found a healthcare provider (e.g., doctor, nurse practitioner, nurse, phlebotomist, etc.) to receive some form of care. Before this happens, one is a person in need of care. However, how do you find it? How do you find the care that you need from the best person and/or organization that can deliver it?

While there are multiple pathways, the short answer today is ‘it depends’.

A logical first step is to search providers in network with one’s health insurance company, (if one has health insurance and/or a directory to search).

From there, one will receive a list of names that may say, “Accepting New Patients” or “Not Accepting New Patients”. One can then filter out the “Not Accepting New Patients” and work from the “Accepting New Patients” list. However, then one is making choices based on information that may or may not be available. This entire process could be enough to delay or stop some from getting to the initial appointment.

Another option is to take to a search engine or what now many are likely using, generative AI models, to provide responses. Yet, one cannot truly know if that healthcare professional is the best person for them without an initial appointment or consultation. The bedside manner, practice and/or organizational standards, wait times, responsiveness, supportive technology, trust, success rates, and more can all impact this experience. Sometimes, whether a person selects a provider or not has nothing to do with the condition or reason for visit that makes or breaks the next step on the healthcare roadmap journey.

If one is lucky, they may know someone who can provide the best name and/or be referred by someone else. However, this is not something available to everyone.

Yes, there are a few emerging companies working to provide these matches. However, this is just the beginning of the healthcare experience. What does one do when they have passed the entry point? What is one to expect? What questions should be asked? What should they know? What could be learned on the side of the patient? What is expected of the patient but not clearly communicated to the patient?

Now, the healthcare experience is not one that can be prescriptive as each person has different clinical and personal needs for care. However, we do not have a consistent onramp for anyone to know how to navigate what could be the most important decision that one could make around who to see (or not see) for a specific healthcare concern.

Patient-centeredness is one of the six parts of quality care. To be patient-centered is to provide care that addresses the individual needs of the patient to make decisions for optimal care outcomes. Being both a nurse and a patient at times, there is great opportunity to increase the voice and experience of the patient within the care experience.

~ Tiffany Kelley PhD MBA RN NI-BC FNAP FAAN


To be a nurse.

November 02, 2025

Today, Sunday, I moved a bit slower through the day than normal. In doing so, I happened to notice this sign in my office. The sign has been on my wall for the last several years. I picked it up at a local gift shop one day during the height of the covid pandemic. I read through it again today and thought I would share here for others to have a chance to read and reflect on relating to their own experiences as a nurse, or perhaps as a patient that has had the opportunity to be cared for by a nurse.

Sincerely, ~ Dr. Kelley

Induction into the American Academy of Nursing

October 20, 2025    |   , ,

On Saturday, October 18th, 2025, I had the honor of being inducted as a Fellow into the American Academy of Nursing in Washington DC. I was honored alongside 300 other talented nurses from across the globe to join the 3400 Fellows in the American Academy of Nursing (FAAN).

The American Academy of Nursing (AAN)’s purpose is to serve, “the public by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. Academy Fellows are inducted into the organization for their extraordinary contributions to improve health locally and globally.” During the ceremony, I learned that there are over 3400 Fellows in the Academy who are accomplished and recognized leaders in policy, research, administration, practice, and academia. 

When speaking, teaching, or writing about nursing and associated topics of interest, I will often be sure to mention that nurses belong in all places where healthcare decisions are made. I share this statement so that one can imagine a career path that both suits the talents and interests while matching an aligned expertise need for society.

As I listened to my fellow inductee introductions, it was clear to me that the statement I have shared in an aspirational way to encourage others, is not only possible, but it is happening all around us across the globe.

There will always be new needs for nursing knowledge, expertise, interests, products, processes, services, roles. How we, as nurses, care will continue to shift as society evolves to further digitize healthcare. Yet, people need the care, knowledge, and expertise of nurses and healthcare professionals to truly deliver human centered care.

“If it is not documented, it is not done.”

October 16, 2025

As a nurse, this phrase holds the same meaning regardless of the clinical area where you may be providing direct care. The phrase is reflecting on the role of nursing documentation in nursing care delivery.

I am one of the nurses who began my nursing career using paper based charts and documentation records. Little time was spent on learning how to chart on the paper flowsheets, medication administration record (MAR) and nursing notes. The same is true of getting and giving report.

I learned from my preceptor during my first Registered Nurse (RN) role as a new graduate nurse. As a travel nurse, the orientation time was at most a day or two with another nurse. Thus, little focus was placed on how to document on the paper record for the patient.

Many of the nurses working today began their career on electronic nursing documentation. The choices of what one can document far exceeds what was visible on a paper based flowsheet. For a new graduate nurse, differentiating between all of the different fields and deciding which must be completed and/or which are not necessary for that patient is not easy to decipher when there is an underlying thought of:

“If it is not documented, it is not done.”

In Episode 8 of KnowMyVoice®, I discuss the context behind this phrase. I also explore how we may begin to shift away from something that feels like a “have to do” toward something that resembles a way to communicate through a digital form for the benefit of the patient.

Nursing documentation is a requirement but it is a requirement because of what the documentation provides to deliver the care patients need to make the best informed decisions as well as monitor progress and intervene as necessary.

Take a listen when time permits. Subscribe to the podcast and stay tuned for the next episode.

American Business Women’s Day

September 22, 2025

Today, September 22nd, is American Business Women’s Day!


Here you see me headed off to my 1st day of Kindergarten. However, the way I am carrying that Care Bear lunchbox may have been be a foreshadowing to the future.


I pursued an MBA at Northeastern while working on my MS in Nursing Administration to understand healthcare from a business perspective.

Why did care delivery feel so hard as a nurse? The time I got to spend with patients was never the incredibly challenging part. The challenging part was trying to get to the patient to deliver the necessary care. There was always some form of a barrier that made even the simplest of acts more challenging than they needed to be. I would often wonder why other industries did not appear as chaotic in the day to day.

I imagined that if I pursued an MBA and understood healthcare from the business lens, perhaps I could better make an impact on the nurses who are in the direct care delivery roles in the future.

All of that being said, I never imagined going on to start businesses after obtaining the degree.

Yet, it happened and the mindset instilled from my MBA Program at Northeastern helped me in so many ways both in and out of my entrepreneurial endeavors.

From a national historical perspective, there were over 12 million women who owned businesses in the U.S as of 2024. The day was formally recognized in 1986, nearly 40 years ago now.

~ Dr. Kelley

‘Dare to Dream’

September 21, 2025

I am in the heart of marathon training at the current moment. Thankfully, the humidity and outright heat has largely passed in Boston to better support the longer runs that are needed to prepare.

Yesterday, I geared my mind up for the longest run yet this season, somewhere between 10-12 miles. So, I planned a route that would support such distance and picked an area by the ocean.

Sometimes the mental lift of knowing that distance, time requirements and overall physical demands on the body could absolutely psych you out. I find this to often be the hardest part.

Starting, and knowing the challenge ahead for any big goal, can be paralyzing at the beginning. Paralyzing to the point that maybe you do not even start.

In the example of my run, the whole time I ran, I kept having to keep my mind on the goal, even when I thought it was hard. (Spoiler alert: it is ALWAYS hard for me ). I wanted to stop after 1 mile but if I did, I would then need to make up the distance today or tomorrow. I would then start down a spiral of discouragement, and disbelief in whether or not I could make the half marathon in 3 weeks.

It becomes a cycle. I am using running as an example here but apply it to any large goal.

You are often capable of more than you think. However, to hit that upper limit, sometimes referred to as a ‘ceiling’, of what is possible for your goals, you must depend on several different internal characteristics.

Some of these include:

  • A willingness to try,
  • Determination,
  • Discomfort in the work,
  • An ability to let the naysayers say what they might say to you or around you, and keep going anyway,
  • A desire to see what your ceiling may be at that time,
  • and so many others that do not photograph well for social media platforms 🙂 .

As I was running around the Marina yesterday, at a point where there was not a single human around me, I looked up and noticed this boat.

The boat’s name is ‘Dare to Dream’. I stopped, took a picture and then kept going.

Daring to dream includes the ability to think beyond your current moment and envision the future, no matter how big or small the goal may be. However, it also includes moving forward, both physically and mentally forward.

Sometimes, to begin to bring those dreams into fruition, it is literally taking one step in front of the other, embracing the uncomfortable stretch of the ind and body for whatever it may be…. Dare to Dream

Enjoy your Sunday,

~ Dr. Kelley