Illawarra Shoalhaven Local Health District (ISLHD)

Director, Clinical Operations

After Hours Nurse Manager (Casual) & Registered Nurse Emergency Department (Casual)

Project Manager - PMO, Redesign & Innovation

Project Manager - ED Transformation Redesign Program

Project Officer with focus on change management and commissioning of the new Bulli Hospital facility

Project Officer - Bulli Hospital Redevelopment Project

Deputy Director of Nursing - Bulli Hospital

Nurse Unit Manager - Medical Assessment Unit & General Medicine

Whole of Health Lead

Registered Nurse Emergency Department

Nurse Unit Manager - Medical Assessment Unit and Acute Aged Care

Clinical Nurse Educator

Emergency Department Clinical Nurse Specialist - Registered nurse

Assistant in Nursing

MedApps

Nursing & Midwifery Clinical Lead / Hospital Success Manager

Western Sydney University - School of Nursing & Midwifery

Sessional Academic - face-to-face teaching and marking for undergraduate students

Sessional Academic (Casual)

I help nurses who feel stuck in their job to feel motivated to chase their dreams | Career Navigator | Registered Nurse | Content Creator

I am an experienced leader, project manager and clinician, working within the healthcare industry for over  15 years. I have worked across several clinical areas and hospitals in operational, strategic and project roles. I currently work in the health tech industry as the Nursing and Midwifery Clinical Lead for Med Apps. I hold post-grad qualifications in Health Leadership and Management and a Master in Business Administration.

Dan Graham

If your business is making money but still isn’t delivering the upside you expected, you’re likely at an inflection point, not a failure.  Many leaders of established, growing businesses reach a stage where revenue is strong, the company is multi-million, and yet the business still depends too heavily on them to function well. Decisions stall without you. Execution varies. Cash flows, but never quite settles.You didn’t do anything wrong.Growth simply exposed what never fully moved into the system.This is where symptomatic fixes stop working.More sales, new tools, or another leadership program won’t transform a business where judgment, decision rights, and accountability are still concentrated at the top. The result is effort without relief, an itch you can’t scratch no matter how hard you work.That’s where my work begins.I work with leaders of established small and mid-market businesses who are ready to move from personal oversight to organizational reliability.  Performance, people, and profit no longer depend on the owner being everywhere at once.The work is strategic and practical: seeing the system as it actually operates, diagnosing what’s constraining performance, and designing corrections that fit the reality of your business. Nothing is added for the sake of growth, scale, or sophistication. Some of that work we do together. Some is implemented directly. Some requires specialist expertise brought in deliberately for speed and impact.This is not coaching, motivation, or incremental optimization.It’s business strategy at the intersection of performance, people, process, and profit, applied at the moment where growth alone is no longer enough.Most leaders begin by getting clear on what’s really holding their business in place.From there, the right path becomes obvious.If you’re at that point, you’ll know how to start.(Clarity Call available in Featured.)

Frances Strickland

Growth doesn’t just add volume.
It adds pressure.

Decisions multiply.

Coordination gets heavier.
 
Small mistakes stop being small. 

And the margin impact shows up before anyone understands why.

That pressure doesn’t arrive all at once.

It shows up as volume increases.

More team members mean more coordination touchpoints.

More volume means errors cost more to fix.

It overloads them.

At first, founders absorb the load themselves.

At 10 clients, the founder can handle most calls personally.

At 30 clients, decisions stack faster than one person can process.

Work waits.

Bottlenecks form.

People escalate instead of decide.

The business slows to match the constraint.

As teams grow, informal coordination stops working.

Small teams coordinate informally.

Larger teams need structure.

Without it:
Information doesn't flow.
Handoffs break.
Duplicated effort rises.

What felt seamless at 5 people becomes chaotic at 15.

The real damage isn’t visible at first.

It shows up in the cost of fixing mistakes.

Mistakes at low volume are cheap to fix.

Mistakes at high volume compound quickly.

A pricing error on 3 projects costs hours.

The same error on 30 projects costs weeks and erodes margin across the portfolio.

And the response is predictable.

They add more rules.

More meetings.

More oversight.

Creating more drag.

More delay.

More frustration.

Growth doesn’t simplify unstable businesses.

It multiplies the cost of every weakness.

More revenue.

More cost per dollar earned.

Lower profit per hour worked.

Businesses don’t fail from growth.

They fail because they weren’t ready for it.

Growth without stability doesn't create leverage.

It creates complexity you can't manage.


#strategy #business #creativity #innovation #richbutbrokenomorewithfran

Frances Melvina Strickland 

Helping leaders of 7-figure SMBs build predictable performance and profit

Lately, I’ve been asking a different question.

Are your 2026 goals and intentions truly new or just warmed-over versions of 2025?

It’s only day 3 of the year, and already it feels… anti-climactic.

If that resonates, you aren’t broken.

There’s a quiet weariness in the air.
 
Not dramatic.
 
Just heavy.

I don’t do resolutions.
 
I do intentions. And even with that, there’s weight.

Here’s what I’m noticing in my conversations:
 
Many thoughtful leaders are done with “more consulting,” more grind, more frameworks stacked on top of fatigue.

Not multi-million-dollar SMBs.
 
Not anyone in their teams.
 
And not those of us who’ve been delivering it.

This isn’t confusion.
 
I know my zone of genius and the value it creates.

What’s changed is this:
 
I don’t need to be the superhero anymore.

My clients are the superheroes.
 
That’s where the real strength is.
 
And that’s how I want them to feel every day.

So this is intentional listening.

Because people aren’t asking for more pressure or performative hustle.
 
They’re looking for something else.

I am too.

I’m not rushing to name it.
 
I’m listening for it.

What I do know:   it won’t be a repeat of 2025.

Saturday feels like a good day not to pretend the answer is already clear.

#strategy #business #leadership #discernment #creativity #innovation #richbutbrokenomorewithfran

Partner to Established SMBs to Regain Control, Predictable Profits, and Their Lives | Fortune 500 Insights Brilliantly Sized for SMBs | Structure • Leadership • Flow | Rich But Broke No More | The Fixer

Growth doesn't fix instability.

It multiplies it.

Revenue can rise while profit predictability falls.

More clients.

More work.

More stress.

But margins thin.

Chaos rises.

Business owners chase growth thinking it will solve current problems.

It doesn't.

Expansion without day-to-day reliability amplifies every weakness in the 
business.

Growing before stabilizing is like adding floors to a building with a cracked foundation.

The structure collapses under its own weight.


#strategy #business #creativity #innovation #richbutbrokenomorewithfran

Growth doesn't fix instability, It multiplies it.

Here's why slow decisions are so expensive:

Work doesn't move in straight lines.

It waits.

While it waits:

• People context-switch

• Information decays

• Momentum breaks
• Quality drops

Then, when the decision finally comes, it often arrives late enough to create rework.

Multiply that by dozens of decisions a week.

That's not inefficiency.

That's margin erosion baked into the operating rhythm.

What actually happens:

Someone needs approval to move forward.
They ask.

You're in meetings, handling something else, or buried in other decisions.
They wait.

While waiting, they shift to another task.

When your answer finally arrives, they've lost context.

They have to rebuild their thinking.

The work that should have taken 30 minutes now takes two hours.

Spread across your organization.

The cascade:

One slow decision doesn't just delay one task.

It delays everything downstream.

Schedules slip.

Deadlines compress.

Rushed work produces errors.

Errors require rework.

Rework consumes margin.

The business truth:

Businesses with decision drag don't look chaotic.

They look busy.

But busy is not productive.

And it's rarely profitable.

Profit comes from flow.

Decision drag destroys flow.

When judgment bottlenecks at the top, the entire system slows to match the 
constraint.


#strategy #business #creativity #innovation #richbutbrokenomorewithfran

Decision drag doesn't look dramatic.

It looks like normal business conversation:
"Let me check."
"Run it by me."
"We'll circle back."

And it quietly destroys profit.

Every delayed decision slows throughput.

- Increases rework.
- Adds hidden cost.
- Trains hesitation.

By the time owners notice, they're already deep in the weeds again.

Answering questions they thought were handled months ago.

The issue isn't intelligence.
It's where decisions live.

When decisions default upward, margin collapses downward.
And no amount of hustle fixes that.


#strategy #business #creativity #innovation #richbutbrokenomorewithfran

Decision delays cost more than you think.

Availability is not leadership.

I learned this the hard way.

Early in my career, I believed being available was what great leaders did.

If my team needed me, I was there.

Questions? Answered.

Problems? Solved.
Fast.

I thought I was accelerating performance.

What I didn't see was what I was training:
People stopped deciding.
They started delivering problems instead of solutions.

Eventually, they told me directly:
- "We need you to stop solving everything so we can think."
- That moment changed how I understood leadership.
- Speed without restraint doesn't scale judgment.
- It replaces it.

When leaders confuse responsiveness with effectiveness, they become the system's crutch.

And crutches feel supportive…
until you realize no one can walk without them.

If stepping back makes your business wobble, it's not because people can't perform.

It's because they've never been allowed to.

Watch the video to hear the full story.
If this feels uncomfortably familiar, it's worth a short conversation.

Start with a 30-minute call. You'll walk away knowing exactly where dependency is preventing capability from developing. Link is in the comments.



#strategy #business #creativity #innovation #richbutbrokenomorewithfran

Burnout doesn’t arrive as exhaustion.

It arrives as system shock.

I didn’t recognize it the first time it happened to me.

My first factory startup was chaotic by nature. That part wasn’t surprising. 

What was damaging was the lack of clarity and decision flow.

No decisions could be made without the President or the Executive Vice President. Strict reporting lines. Everything routed upward.

On paper, it looked like leadership.

In practice, the system couldn’t think.

I had access to both leaders, which should have helped. Instead, it put me in the middle of conflicting priorities and quiet power struggles, with no shared judgment and no stable decision logic.

Only pressure.

When I left the organization, my body collapsed within 48 hours.

Not emotionally.
 
Physically.

It felt less like getting sick and more like shedding what my system had been carrying for too long.

That’s when it became clear.

Burnout wasn’t caused by workload or resilience.
 
It was caused by a system that forced people to compensate for missing structure.

When judgment has nowhere to live but inside humans, humans pay the price.

Burnout isn’t the failure.

It’s the signal.

And it almost always points to design.

Saturday feels like the right day to sit with that.

Frances Strickland in a quiet, reflective moment, looking downward with her hand resting on her chin, wearing a red sweater in soft natural light.

Your business isn't truly profitable if it only performs when you're everywhere inside it.

That's not leadership.

That's dependency dressed up as dedication.

I see this pattern constantly:

Revenue looks solid.

The team is busy.

Clients are served.

And yet, 

The moment the owner steps back, performance slips.

Decisions are slow.

Quality wobbles.

Profit gets thin.

That's not a people issue.

It's a design issue.

When a business depends on one person's judgment to function well, profit is fragile by default.

Because profit isn't created by effort.

It's created by repeatable decisions made at the right level.

If your business needs you everywhere to perform, it's not scaling.

It's surviving on borrowed attention.

And that's an expensive way to operate.

Swipe through to see how owner-dependency quietly destroys margins.

Most owners don't realize this is the constraint until it starts costing them their health, their margins, or both.



#strategy #business #creativity #innovation #richbutbrokenomorewithfran

Real profit doesn’t depend on One Person.

Why owner-dependent businesses bleed profit quietly.


Here’s what actually happens when everything runs through you:
• Decisions stack up
• Work waits instead of flowing
• People hesitate instead of acting
• You become the slowest, most expensive process in the system

Not because you’re bad at what you do, but because no human can carry that much judgment without distortion.

So people escalate decisions they could make, wait for clarity that never arrives fast enough, and optimize for safety instead of outcomes. 

Meanwhile, you’re answering questions instead of building capacity.

This is how margins erode, momentum stalls, and founders burn out while “being helpful.”

The business isn’t broken. It’s overloaded.

Every decision that defaults upward creates:
Delay → more context-switching
Hesitation → slower execution
Rework → compounded cost
Dependency → weakened capability

Profit doesn’t disappear overnight. It leaks out through delay, hesitation, and over-reliance on the founder to make calls the team should own.

Leadership structures that funnel all decisions to the top don’t protect quality. 

They create bottlenecks, and bottlenecks don’t just slow delivery, they quietly destroy margins through inefficiency you don’t see until the damage is done.
If your team can’t move without you, the issue isn’t their capability. 

It’s the system design that never gave them decision ownership.



#strategy #business #creativity #innovation #richbutbrokenomorewithfran

Most leaders think they have a delegation problem.

They don't.

They have a decision ownership problem.

If everything still funnels to you, you didn't delegate responsibility.

You outsourced execution.

The difference matters:

Execution without judgment doesn't scale.

It stalls.

Because execution is just motion.

Judgment is what determines whether that motion creates value or waste.

When you delegate tasks but keep decisions, you create a system where:

People do the work

But wait on you to think

What that looks like operationally:

Your team completes deliverables.

Then stops.

Waiting for your approval to proceed.

Waiting for your input on the next move.

Waiting for your judgment on what's good enough.

They're not leading work.

They're managing tasks on your behalf.

The structural reality:
If your team is "doing the work" but still waiting on you, you're not leading a business.

You're running a help desk.

And help desks don't generate profit.

They manage demand.

The leadership shift required:
Decision ownership means people don't just execute.

They evaluate.

They adjust.

They own outcomes, not just outputs.

When decisions live with the people doing the work, flow accelerates.

When decisions funnel upward, everything slows to match your capacity.

The constraint:

You can only make so many decisions per day.

If your business requires more decisions than you can handle, growth creates 
gridlock.

That's not a people problem.

It's a design problem.

If this feels uncomfortably familiar, it’s usually a signal worth paying 
attention to.

Link is in the comments.


#strategy #business #creativity #innovation #richbutbrokenomorewithfran

Episode 12: Flash-back! Tonia, where are you now?

In this special flashback episode, we’ll explore Tonia’s journey, from the past to where she is now, and how she’s been a powerful force in helping others—me included—stop hiding and get seen.

Tonia’s insight and dedication to leadership are a true testament to the power of supporting others in their personal growth.

Frances Melvina Strickland, 🔸️Roeland VanderHelm and 2 other attendees

Episode 12: Flash-back! Tonia, where are you now?

Watching Queen and Max always reminds me how systems really work.

Max knows exactly when it’s time to eat.

If I don’t move fast enough, he doesn’t bark.
He doesn’t whine.

He goes to his crate, flops down, and starts chewing his ball.

The ball squeaks.
That’s the point.

At first, I get irritated.
The noise.   
The timing.

But the pattern is simple.

He’s hungry. 
I delayed.
So the system adapted.

Not gracefully.

He chews harder.
The noise escalates.
He’s not solving the problem.
And I still haven’t moved.

Nothing is “wrong.”
But everyone’s uncomfortable.

Eventually, I feed him.
The squeaking stops.
The system settles.

Not because he changed.

Because I did.

Frances Strickland interacts with her two small dogs outdoors, holding a yellow ball while they stand on leashes facing her near a wooden play structure.

Most leaders think clarity is a communication problem.

 It’s not.

It’s a design problem.

Clarity —
not a buzzword, but a system that directly shapes cash flow, decision speed, and profitability.

This is where leadership either stabilizes the business or builds it on shifting sand

Clarity only works when three things happen at the same time, across people, process, structure, and execution.

1️⃣ Designed Clarity
Clarity starts with business system design, not a better communication plan.

Someone has to decide:
 • who decides what
 • when decisions get made
 • where authority lives

People need to know their roles and their limits.   Processes need owners, not assumptions.

When clarity is designed at the right level, decisions happen where the work happens.

No bottlenecks. No heroics.

Example:
When sales and operations roles are clearly designed, the handoff from closed deal to delivery is clean.   Nothing stalls. Nothing disappears. Money moves.

2️⃣ Distributed Clarity
Designed clarity fails if it stays at the top.

It must be distributed — across teams, partners, and handoffs — especially in growing businesses relying on fractional support.

Everyone doesn’t need the same information.   They need the right clarity to act.

Structures either support this distribution or quietly block it.

Example:
Customer-facing teams know exactly what they can adjust, approve, or resolve.  They don’t escalate by default.

Customers stay. Cash stays. Trust stays.

3️⃣ Empowered Clarity
This is where many businesses break.

People are informed but not authorized.  They understand but hesitate.

Empowered clarity means teams act within clear boundaries, without waiting for permission that slows execution.

When execution waits, profit waits.

Example:
Sales teams don’t pause to ask if they can adjust terms.
They know the guardrails and act.
Deals close faster. Revenue cycles shorten. Repeat business increases.
------------

Alignment meetings or better messaging won’t answer the clarity question.

Without clarity built into the system, companies don’t collapse.

They bleed -- one delayed decision, a point of hesitation, a stalled or dropped handoff -- at a time.

So the real leadership question isn’t whether clarity matters.

It’s this:

Where is clarity breaking down in your business and what is it already costing you?

If this feels uncomfortably familiar, it may be worth a short conversation.
The link is in the comments.

#businessclarity #leadership #profitability #operatingmodel #cashflow #richbutbrokenomorewithfran

Episode 11:  More than Mechanics - Fit Presenter Speaking

World Class speaking coach and author Mike McQuillan and I have a rich exchange about what it takes to deliver a talk that captivates your audience.

Frances Melvina Strickland and 1 other attendee

Episode 11:  More than Mechanics - Fit Presenter Speaking

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Dan Graham

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The Battle

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