Nursing: Promoting Change and Change Theory

As a new nurse leader, you have decided to make changes to the procedure for the end-of-shift report because you have received many complaints that the report is time-consuming and has already caused frustration among the staff members. You inform the charge nurses that you would like to meet with them to get their input.

You start the meeting and begin speaking about the problems that the current method of giving end-of-shift report has caused and you would like to look at changing the method. Immediately there is a deluge of comments. One charge nurse states,” why fix something that isn’t broken? I really don’t have time for this. I’ve worked here longer than you. Don’t you think we would have changed it before you got here?” She walks out of the meeting. The next charge nurse states, “I believe the process is really broken and I suggested changing a while ago to a system we used at my previous job, but no one liked my idea. Now I am here wasting my time again.”

[Note: you are aware of the suggestion made which you had reviewed and found out that this nurse had worked at a very large non-profit hospital and the cost to change to the suggested method was exorbitant. Your hospital is a small, for-profit hospital and there would never be funding for such a proposal]. Another nurse states, “let’s get on with this and decide. I really believe that you should decide for everyone how we are going to do it in the future because you are in charge, and you should make all the decisions.”

Questions:

1. A) How would you handle each of the charge nurses and their comments?
2. B) What kinds of issues will need to be dealt with in the future in relation to change theories?

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This assignment involves the application of change management and leadership skills in a nursing context. Here’s a step-by-step guide on how to approach it:

1. Understand the Scenario: Carefully read the scenario, taking note of each charge nurse’s reaction to the proposed change. Understand the context of the hospital (a small, for-profit hospital) and the financial constraints that may limit the adoption of certain procedures.
2. Respond to Each Charge Nurse’s Comments: In answering question 1, address each nurse’s concerns individually:
   • For the first nurse, who seems resistant to change, consider ways to foster open communication and demonstrate respect for her experience while explaining the need for improvement.
   • For the second nurse, who had suggested a change before, acknowledge their initiative, explain why their particular suggestion couldn’t be implemented due to cost constraints, and encourage them to continue sharing their ideas.
   • For the third nurse, who wants you to make all the decisions, balance the need for leadership with the importance of collaborative decision-making and staff engagement.
   • In each case, demonstrate empathy, active listening, and assertiveness.
3. Discuss Future Change-related Issues: In answering question 2, identify potential issues related to change theories that may arise in the future, such as:
   • Resistance to change due to lack of understanding, fear of the unknown, or lack of perceived benefits.
   • Communication issues, such as misunderstanding the need for change or the specific changes to be implemented.
   • The need for adequate resources (time, training, and potentially money) to implement changes successfully.
   • Possible conflicts between individuals or groups with differing views on the change.
4. Structure Your Response: Begin with an introduction that outlines the context and the purpose of your response. Then, answer each question in its own paragraph or section. Use headers for clarity if necessary.
5. Use References: Apply theoretical concepts and models of change management to support your response. Reference these appropriately using your institution’s preferred citation style.
6. Write Clearly and Coherently: Use diverse vocabulary and sentence structures, avoid generic or repetitive phrases, and ensure that your text flows logically. Check your grammar and punctuation for correctness.
7. Proofread Your Work: Read through your work after writing to ensure that you have fully addressed the questions, your arguments are sound, and your text is free from typos or other errors. Make any necessary revisions to improve clarity, coherence, and correctness.

Remember, as a nurse leader, your role is to facilitate change in a way that respects the views and contributions of all staff while keeping the focus on improving patient care. Good luck with your assignment!