Resistance to Change literature review
Literary Review Article 1 Clark, (2013) used the transdisciplinary approach to shift the paradigm in the nursing profession toward a caring, love, healing approach when dealing with the phenomenon of resistance of change (ROC). The author further referenced that the nursing profession has shift from emphasis on technological aspects such as medical/cure-based modalities to humanism, spiritual, healing and the lived experiences of the interconnection of beings. The transdisciplinary approach takes in to account our values, ethics, and the personified lived understanding within our area of concern. Current Best Practice ROC Creating a paradigm shift using the transdisciplinary process; nursing must scrutinize the problems and issues differently. The process is as follows: Create an enquiry concentration from punishment- specific to analysis driven. Question our definitive personal outlooks, stressing a meta-paradigmatic tactic to building understanding. Using personal knowledge and strive toward the bigger picture integrate the inquirer into the process of inquiry. As the questions of the inquiry process for the inquirer’s own experiences rather than preexisting agenda dictated by the discipline. Once information is gather, then the inquirer navigates across the disciplines in search of the knowledge Application to Nursing The transdisciplinary approach can be used in matters of resistance to change. Clark, (2013), further maintains that resistance to change in nursing academia is like resistance to change in personal life based on fear, doubt, frustration, mistrust, confusion, and anger. From Florence Nightingale envisioning nursing to be kindness, love, and heart centered, compassionate service to individuals, the author further advocates the experience of self -care and reflective process in assisting individuals through the change process (Clark, 2013). Reference Clark, C. S. (2013). Resistance to change in the nursing profession: Creative transdisciplinary solutions. Retrieved July 2, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/23798243 Literary Review Article 2 Jones & Van de Ven, (2016), performed a study of the relationship between change resistance and the costs and advantages of the change resistance on the organizational change. The study reviewed forty health clinics undergoing a 3year period of significant organizational changes found that resistance to change has increasing negative relationships over time with two dire consequences employees’ commitment to the organization and perceptions of organizational effectiveness. The resistance to change became stronger rather than weaker over time. Change agents need to address employee resistance because if left unaddressed it can fester and inflict further damage. Best Practice ROC The quantitative study done by Jones and Van de Ven, (2016), maintain that not all employees react to ongoing changes within the organization. Some Employees react favorably and have a positive attitude and see change as an opportunity for leaning and growth while others resists the changes and feel frustrated, isolated and grieve the process Jones & Van de Ven, (2016). Consequences of Change Resistance Employees that are resistant to change negative experience emotions due to their personal feelings about change and fear negative consequences; these emotions contribute to decreased attachment and diminished identity to the organization. Leaders who are unable to cope successfully with change were less likely committed to the organization. Also, employees that are resistance to change are less likely to support others in future change efforts (Jones & Van de Ven, (2016). Implications for Practice Nurse leaders must engage employees throughout the change process not just at the beginning and to handle resistance quickly to prevent issues festering hurting movement in a positive direction. Treat employees fairly and provide positive supportive leadership to counteract the effect of resistance to change. Reference Jones, S. L., & Van de Ven, A. H. (2016). The Changing Nature of Change Resistance. Retrieved July 2, 2017, from http://journals.sagepub.com/doi/abs/10.1177/0021886316671409
Resistance to Change literature review
A.sk AONEs ABOUT MANAGEMENT TECHNIQUES BY MARJORIE BEYERS, PHD, RN, FAAN EXECUTIVE DIRECTOR THE AMERICAN ORGANIZATION OF NURSE EXECUTIVES management posi- tion, especially when everyone works to- what is expected. But • I have been troubk lately about how to handle the behavior of one of the staff members. When the staff discusses improvements, this person finds reasons why we cannot change. She always has some reason for not quite completing care respon- sibilities and often upsets other staff members with comments and innuendos. How can I turn this situation around? Pat Peverly, MSN, RN, Ad- ministrative Director, Patient Care Sen/ices, Anderson i-ios- pitai Mar/vilie, iiiinois responds: Managing in an environment of change requires a culture that accepts “change” as both constant and positive. Em- ployee feedback is necessary for accurately assessing all as- pects of care delivery, but the managerial challenge is to channel the feedback to pro- ductive work groups where pro- cess improvement will result. I will make two assumptions. The first is that you have pro- vided an environment where employee communication and participation is encouraged. Second, I will assume that the problem employee is just a “barrier to change” and that her negative focus can be redi- rected. Often employees react neg- atively due to lack of under- standing. I would start with fre- quent staff meetings where you provide a good orientation regarding the current status of health care, how your hospital has aligned its mission and ob- jectives to be successful with the changes, and specifically on how your unit/department must contribute. Provide time for discussion with the staff to solicit their feedback and to evaluate their commitment. Next, I would focus on “team building” exercises to promote the skills and cohesiveness of group interaction. Train team leaders and facilitators, then as- sign work groups to study some of the unit activities or problems. When you deter- mine adequate “readiness” ex- ists for some formal activities, target those “barriers” for spe- cial assignments and roles. Your goal is to make that “vocal” em- ployee work toward problem resolution and take some own- ership for unit outcomes. If these activities are not suc- cessful, realize that in any work- force you will have that small percentage of employees who are never going to be “shining stars” regardless of our man- agerial abilities. Concentrate on the majority of employees and celebrate the successes. Sharon Denning, BSN, RN, Nurse Manager, iCU/ACMS, Nortii i/lemoriai i/ledicai Cen- ter, Minneapoiis, Minnesota, re- sponds: This employee demon- strates several challenges: resis- tance to change, less than optimal performance in patient care and poor interpersonal skills. In this time of unprece- dented change, it is not unusual to experience resistance to new ideas. To reduce resistance to change, involve employees in the change process, and com- municate regularly about ex- pected changes. In this in- stance, however, all of these is- sues should be addressed by coaching the problem em- ployee. Coaching should be con- ducted in privacy so that her dignity is preserved. Begin by describing the undesirable be- haviors and the impact of those behaviors, such as, “When you do not complete your work, pa- tients do not receive the best possible care and your cowork- ers have to do extra work to compensate.” Be as specific as possible. Discuss your expecta- tions in regard to each of the performance issues. Follow the coaching session by giving feedback on a regular basis. When you see improvement, provide immediate positive feedback. If performance is- sues continue, additional coaching may be required. If necessary, formal disciplinary processes may need to be im- plemented so that there are consequences for not demon- strating improvement. Denise Ringer, MS, RN, Vice-President, Patient Care Services, Aibany Memoriai Hospitai, Aibany, New Yoric, re- sponds: Sounds as if it is time to have a serious talk with this employee. I would point out the patterns of incomplete care responsibilities and the upset- ting comments using specific, objective examples. The impact of the actions, such as patient complaints or other staff mem- bers completing the tasks, should be explained. Give her an opportunity to identify what barriers may exist and develop an action plan for improve- ment. It is essential that she perceive your desire to be sup- portive but also understand the consequences of not complet- ing care responsibilities or re- sisting change in a destructive manner. If the other stafi’ members have complained to you, help them set appropriate bound- aries in dealing with her. In my experience, these behaviors usually have come from em- ployees who were unhappy in their present situation and eventually switched to another nursing career. Although nega- tive at first, several later thanked me for helping them face a dif- ficult decision. Good luck! • Abstract: An employee’s negative focus can be redirected. Three nurse executives discuss management techniques to use in an environment of change. [Nurs Manage 1998:29(5):56] 56 Nursing Management/May 1998 www.nursingtnanagementconi
Resistance to Change literature review
Home Health Care Management & Practice 23(5) 381 –382 © 2011 SAGE Publications Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/1084822311407292 http://hhc.sagepub.com Psychosocial Perspectives Nurse educators and nursing leaders in home health and other community-based venues, such as hospices, wellness centers, and family shelters are aware that nursing practice is changing. The high unemployment rate has created the need for fewer nurses in hospitals and new graduates are finding their first job is in community settings. It is projected that in the near future, less than 25% of nurses will be employed in the traditional hospital setting but, instead, will be providing nursing care within various community settings (Bureau of Labor Statistics, 2010). In addition, one of the goals of health care reform is to keep people out of hospitals and manage their health and wellness in the community cared for by nurses. The changes brought on by health care reform and employment opportu- nities are forcing nurse educators and nursing leaders to rec- ognize that the traditional trajectory for undergraduate nursing education is not adequately preparing students to enter into practice. Furthermore, nurse educators are finding it more and more difficult to obtain adequate and sufficient clinical placements in hospital settings. The urgent need for nursing education to respond to the changes in health care delivery is particularly evident in pedi- atric nursing. Nursing leaders and educators are struggling with ways in which students can be provided with the neces- sary clinical experiences to care for well and critically or chronically ill children and their families. Hospital pediatric units are not available in sufficient number to provide students with pediatric clinical experiences. This crisis has forced nurs- ing programs to seek alternative community clinical place- ments ranging from home health agencies to family shelters. The change from inpatient pediatric nursing education to working with community partners has dramatically changed the faculty’s role. A hospital environment provides built-in distractions, which guide the faculty toward a care delivery model, which has become increasingly complex and time- consuming focusing primarily on mastery of technical skills. Ask any experienced expert clinical nursing educator to change their clinical site to home health or another commu- nity setting, particularly for pediatrics, and you will be met with varying degrees of resistance. The role of pediatric clin- ical faculty have historically been very clear and defined by the institution—the rules, routines, culture, and required technical skill sets are so ingrained that the faculty generally have a good idea what to expect before they arrive at the hospital pediatric unit. In contrast to the acute care setting, home health and other community-based settings require faculty interacting accord- ing to rules, routines, and culture defined by the client, fam- ily, and community. Faculty, client, and student interaction and communication require that each situation be approached with expectation of the unexpected. Faculty must be able to take classroom/laboratory content and effectively demon- strate how to transfer that knowledge to a very unfamiliar and ever changing environment. Facilitation of student suc- cess requires the faculty effectively demonstrate how to transfer classroom content to the home or other community setting to evaluate, plan, and implement health education on both a community and individual level. In addition, faculty must be able to communicate to the students their personal commitment to the development and promotion of a pediatric community health care model as an acceptable venue for pediatric clinical education. Should 407292 HHC XX X 10.1177/1084822311407292Cof feyHome Health Care Management & Practice 1Humboldt State University, Arcata, CA Corresponding Author: Catherine Coffey, 1 Harpst Street, Humboldt State University, Arcata, CA 95521 Email: [email protected] Faculty and Student Resistance to Change: The Need for Home Health and Other Nursing Community Leaders to Partner With Nurse Educators to Change Nursing Education Catherine Coffey, RN, MSN, CNS, PNP 1 Keywords pediatric nursing, community pediatric nursing, student resistance, faculty roles, community partners 382 Home Health Care Management & Practice 23(5) faculty communicate that they do not value this particular clinical education model, students will experience only frus- tration and disappointment. They must also be successful in developing and maintaining community partners. The nurs- ing leaders in the community partnership must also be com- mitted to continuing relationships with the nursing program and influencing the direction of nursing education to meet the current and projected needs of their clients. There have been limited studies on students’ perceptions of their experiences in pediatric community settings, but the findings to date have consistently noted that students initially experience reticence and confusion regarding the value of a community-based pediatric clinical experience. They are more comfortable in the familiar hospital setting where they feel more in control. The author’s own experiences in changing students’ clini- cal experiences from hospital to the community are that stu- dents are initially very resistant, that they are fearful and unsure of their role, and that they realize that they now must rely heavily on their ability to effectively communicate with clients to gather information needed to develop an optimum plan of care. Frequent student comments include “What does this have to do with nursing?” “This is not real nursing, why do we have to do this?” “How do I talk to these people?” “I am really uncomfortable with this lifestyle.” “Why do they live like this?” “Why do they have so many kids when they can’t take care of themselves?” “Someone should take their kids away.” “I am not learning anything.” Studies and personal experience have found that most stu- dents after several weeks into the community experience began to verbalize the importance of the opportunity to care for pediatric clients/families in their homes and other com- munity settings. They recognize that home health and com- munity nursing are essential components to optimum children’s recovery, health maintenance, and prevention. They begin to internalize how they as nurses can positively assist pediatric clients/families to attain their optimal level of wellness. Comments noted at the culmination of the clinical experience include “I hate to go back to the hospital now . . . I will miss the families I have worked with . . . I would have missed a lot if I hadn’t been here.” “I was able to really make a difference . . . just me and what I did . . . no medicine or doctors just me.” “It was hard to be here . . . really sad for me . . . much more difficult emotionally than the hospital.” “I can see how important it is to start figuring out where people will go after they get out of the hospital . . . I just didn’t realize.” Even in the face of major paradigm shifts in health care delivery, many faculty and students continue to resist needed changes in the delivery of clinical education, holding fast to the notion that the acute care hospital is the only appropriate clinical education venue. Although it is clear that the development of technical expertise is critical to care for the hospitalized and home- bound pediatric client, technical prowess is far more effec- tive when coupled with an inclusive approach, which demands careful consideration of all aspects of the client’s life. Nurse educators and nursing leaders must work together to make a paradigm shift. Nursing leaders need to become more active on nursing school’s educational advisory com- mittees and influence the direction of nursing education to reflect the changing health care model. If the mounting changes taking place in health care are ignored and nursing education continues on the same trajectory that has been used for the past 30 years, nursing educator and leaders will be part of the problem rather than the solution in adequately preparing nursing students to enter into practice. Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The author(s) received no financial support for the research, authorship, and/or publication of this article. Reference Bureau of Labor Statistics. (2010). Occupational outlook hand- book, 2010-11 edition. Retrieved from http://www.bls.gov/oco/ ooh_index.htm Bio Catherine Coffey, RN, MSN, CNS, PNP, is currently an assistant professor at Humboldt State University, Arcata, California, and had formerly taught at Oregon Health Science University in the School of Nursing and the Department of Developmental Pediatrics. She has worked as a pediatric nurse practitioner in Oregon and California where she primarily worked with high-risk pediatric clients in rural, urban, and academic settings. She is currently working on her Doctorate of Nursing Practice at University of San Francisco, with particular research interest in community-based care of the high-risk pediatric client.