For eight years, Judy Rich worked as a nurse in intensive care units in Philadelphia and New York — days, nights and weekends — long enough to become frustrated with bureaucracy she believed made caring for her patients more difficult. From staff nurse to nursing manager to nursing director to chief operations officer at Wellmont Health System in Tennessee, Rich took her first executive position when she had three kids in three separate schools. Today, as president and CEO of TMC Healthcare, she knows from experience what many on her staff juggle.