Why “systems thinking” feels hard in clinic
NPs don’t struggle with intelligence—they struggle with time, volume, and competing priorities. Systems thinking can feel like opening 10 tabs at once. The goal is not to chase every possibility; it’s to organize complexity into a usable clinical map.

The BridgeWell rule: reduce complexity, don’t ignore it
A systems approach should do two things:

1. help you ask better questions, and
2. help you choose one next step confidently.

The 4‑Bucket Framework (fast + practical)
When symptoms sprawl across systems, start here:

1. Sleep + Circadian (duration, quality, timing)
2. Metabolic (glucose stability, weight changes, energy crashes)
3. GI + Absorption (bowels, bloating, tolerance, reflux)
4. Stress + Nervous System Load (anxiety, burnout, trauma load, overwhelm)

These four buckets influence hormones, inflammation, pain perception, immune resilience, and mood.

Pattern clues that should trigger “systems mode”
Flip into systems mode when you see:

• fatigue + brain fog
• anxiety + GI symptoms
• weight change + sleep disruption
• pain + poor recovery
• “labs normal” but function declining

Documentation shortcut: write a one‑sentence pattern statement
Example:
“Fatigue with afternoon crashes + poor sleep + constipation suggests sleep/circadian disruption and metabolic instability; will start with sleep + glucose stability assessment.”

That one sentence keeps you grounded.

What to do this week
Pick one frequent clinical presentation (fatigue, headaches, IBS, weight gain, perimenopause symptoms). Start using the 4 buckets and write one pattern statement per visit.