change management in the nursing leadership

Leadership in nursing is a challenge, just like in other disciplines, and it also applies a lot of conceptual and practical management of change. Nursing, being a dynamic profession that needs to keep at par with technological advancement and the other changes in the millennium, requires that nurse managers manage and implement change. However, change implementation is not without barriers. It is never a smooth process. The nurse managers have to apply their skills to overcome the barriers. This paper looks at the process of implementing change in regard to a new rostering system by a nurse manager. The process has adopted the change management theory by Lewis. The likely barriers posed by the characteristics of the organizational culture, worker’s attitudes and behavior, as well as, practices have been pointed out. Additionally, it is important to evaluate the change after the implementation, through the consideration of the SWOT analysis. McGregor’s theory X and Y have also been found useful in the process of implementing change.

Theory:

In the practice of nursing, theories have been very useful in providing some guiding principles on how to go about the process. Many theories and models have been devised to explain the process of change. The paper adopts Levin’s change management theory. Levin’s theory of change has been applied in many situations in the nursing profession, and it has been found to bear fruits in regard to change management (Daly, Speedy & Jackson, 2003). In expounding about the change process, Levin appreciated the concepts of driving forces, the restraining forces and the equilibrium (Ziegler, 2005). He observed that a change is necessitated by some factors, and also reiterated that there are some factors that prevent change from occurring. For a change to occur, the manager has to manage the restraining forces since they have a tendency to preventing change from occurring.

Levin’s theory of change consists of three important and different stages. The stages are unfreeze-change-refreeze (Daly, Speedy & Jackson, 2003, p. 187). The unfreezing stage occurs in the early stages, and it is a process involving encouraging the stakeholders to see the need to leave the old ways and adopt new ways. It is characterized by resistance to change, which comes through group conformity, as well as individual resistance. Due to such, there is a need for the management to reinforce the driving forces and apply methods that will lead to a decrease in the restraining forces. The second stage, the change stage, involves a process of transformation in thoughts, feelings, and behavior that is more productive and liberating (Daly, Speedy & Jackson, 2003, p. 188). The third stage of refreezing involves reinforcing the realized change, and aligning it with the organizational culture, to prevent a situation of getting back to the old ways of doing things.

In the setting of a hospital environment where the nurse manager is expected to apply the change through changing the rostering system, Levin’s theory is applicable. Some studies have proved its applicability in the nursing practice settings, and this explains the rationale for picking this theory in the change management of the current case. According to Ziegler (2005, P. 220), Levin’s theory offers nurses a very good platform for managing real nursing problems through change implementation.

Resistance to change:

Introducing a new rostering system requires a systematic process, lest it will fail terribly. The unfreezing stage of the process will not be without challenges. Challenges are multifactorial, and as Daly, Speedy & Jackson(2003Such undertaking may be disastrous to them, rendering their perception of change to be negative. Similarly, a worker who had suffered negative consequences of change might be very resistant to the change.

An organization’s culture is a key element for the resistance to change. According to Harvey and Broyles (2010, p. 42), some individuals in the organization can prevent change just because they do not feel the ownership of the change. Interestingly, the management itself can be resistant to the change because they fear it will fail, whereas they do not want to appear as failures. For example, implementing a new rostering system will come with new responsibilities and tasks for the nurse manager. The manager may fail to initiate the change process because of fear of responsibility and failure. Lack of knowledge and awareness also act as barriers to change (Harvey & Broyles 2010, P, 78). The change manager may be a poor communicator; thus it may be that one has not communicated the change well, during the unfreezing stage. Since the members of the organization need to see the need for change, they cannot embrace a change they do not understand how it will benefit them. Suspicion and ambiguity have also been identified as barriers to the implementation of change. Many workers fail to support change initiatives because of the ambiguity of the explanations, which raises the levels of suspicion (Harvey & Broyles 2010, P, 90).

In relation to the organizational structure and culture, incongruent group dynamics do affect change negatively (Harvey & Broyles 2010, P, 69). When people live together as a group, they adopt some established norms, which they do not feel to leave. In line with the needed change, the group members may feel that their norms do not conform to the proposed changes. Due to such conflicts, the members are highly likely to resist the proposed changes. For example, introducing a new rostering system may mean separating some workers who had paired, and have been working together. Since the new change is a threat to their relationship, they are likely to do their best to reject the change.

Overcoming Resistance and Managing change:

Managing change requires knowledge, skills, experience, dedication, determination, and responsibility. One also requires to have strong critical and leadership skills. In terms of knowledge, one needs to know why the change is necessary, and how well to articulate the same to the workers, as well as, other relevant stakeholders. In terms of skills, one needs to be in full possession of change management skills, for example, how to handle resistance. Experience counts as additional strength. There is, thus, the need to do SWOT analyses to know the probability of succeeding in the implementation.  In addition, one as to be determined to achieve, and dedicated to sacrifice for the benefit of the organization (Harvey & Broyles 2010).

Daly, Speedy & Jackson, 2003, p. 188).

and having the psyche to work (Schermerhorn 2010, P. 38). On the contrary, the nurse manager can apply McGregor’s theory Y on the employees who do not seem to like work, and who will be very resistant to change.

Education and communication too are very essential tools for managing resistance to change. In the current case, the nurse manager ought to communicate the intention of the change clearly. The message should be directed towards the need for change, the expected results, and how the organization, as well as, individuals will benefit. In addition, the message needs to be articulated with a clear language that everyone will understand (Griffin 2011). Further, the management needs to make sure that the process of change is facilitated. The facilitation comes in the change and the refreezing steps. The purpose is to ensure that the introduced change is sustained and do away with the possibility of getting back to the old situation.

An analysis of strengths, opportunities, weaknesses and threats is also necessary to manage change implementation. In the current case, the nurse manager needs to consider whether there are enough resources for introducing the new roster system, the advantages, the abilities and the cost implications. Similarly, the nurse manager considers the disadvantages, timelines and the likely negative effects of the new rostering system (Schermerhorn 2010). The nurse manager will also consider how the introduction of the new rostering system will impact on technological innovation, and the outside market in general, as well as, the legislative, environmental and political pressures that may affect the implementation of the new rostering process.

A good consideration of all the factors necessary while introducing change leads to a bit easier process of implementing the change. According to (Daly, Speedy & Jackson, 2003 p. 190), planning is the basis of management, and planned change is likely to succeed. The nurse manager, in the current case study, needs to consider the particular areas, as well as, the realities of the implementation challenge. In addition, the manager needs to follow up after the implementation, to make sure the employees adapt to the new rostering system.

Conclusion:

In sum, change management is a process which is carried out through steps. The current paper has adopted the Levin’s change management theory, which presents change management as a process of three steps, inclusive of unfreezing-change-refreezing.

 

 

 

REFERENCES

Daly, J., Speedy, S.,& Jackson, D. 2003. Nursing management. Chatswood, Australia: Elsevier Australia.

Griffin, R. 2011. Fundamentals of management. Bedford Row, London: Cengage Learning.

Harvey, R. T., & Broyles, A. E. 2010. Resistance to change: a guide to harnessing its positive power. Lanham, MA: R & L Education Publishers.

Kotter, J. P. 1996. Leading change. Boston, MA: Harvard Business Press.

Schermerhorn, R. J. 2010. Management. Hoboken, NJ: John Wiley & Sons.Ziegler, M. S. (2005). Theory-directed nursing practice (2nded). New York, NY: Springer Publishing Company.

 

 

 


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