Change is the only constant in health care organizations as they adapt to today’s realities. Staff nurses face countless challenges as they struggle to provide care in environments fraught with uncertainty and unrelenting pressures. Simply anticipating the next round of changes can set off, throughout their practice settings, an undercurrent of staff anxiety and fear. Many staff members turn to their nurse manager, looking for answers to questions when there may be none. Left unexpressed, fear-based emotions and behaviors can spread like a malignancy, taking on a life of their own that has a negative impact on quality of work life and patient care. This chapter will help you to manage and lead staff through that tangle of fear, anxiety, and uncertainty about their future. In this chapter, you will learn: 1. The importance of identifying, within yourself and staff, change-induced anxiety and fear of the unknown 2. Strategies for managing anxiety and fear in the workplace Anxiety and fear in a workplace shrouded in a climate of uncertainty are heightened during significant organizational change. The constant fear of job loss poses the greatest threat to the emotional well-being of most leaders and staff. At such a time nurse managers bear several burdens. In addition to managing the operational aspects of a practice setting, nurse managers must be adept at identifying and helping themselves and staff members manage emotional, psychological, and behavioral responses to change. When organizational change requires cost cutting and new efficiency measures, nurse managers are under extraordinary pressure to do more with less particularly when their overall performance is being judged on whether they achieve the bottom line. Often caught between the proverbial rock and a hard place, they too may fall victim to anxiety, uncertainty, fear, and feelings of self-doubt. Many may wonder, “How do I support my staff when I am feeling so vulnerable?” If you are feeling this way, you need to recognize and acknowledge it. Otherwise you cannot effectively help staff manage their responses. You must take time to reflect on your workplace situation, name what is happening within you, and plan how you will manage. FAST FACTS in a NUTSHELL • Many nurse managers and their staff may have to unlearn certain previous coping behaviors and learn new ones to adapt to a changing workplace. • Nurse managers must go first in modeling a new way of being! When faced with anything new it is normal to experience a psychological response ranging from mild apprehension to fear of the unknown, indifference or even excitement. However, when butterflies take up permanent residence in your stomach, fear at work prevents you from doing your job well, and workplace woes spill over to negatively affect your private life, you must first take action to deal with these powerful emotions. When you finally “get a grip” (or “suck it up,” to use the present-day vernacular), staff members are more likely to follow your lead and model your fearless behaviors. Naming our feelings can be difficult for nurses because most of us were taught not to express our feelings while providing patient care (or risk being considered “unprofessional”). Now that the “soft” or people issues are recognized as powerful indicators of organizational success, nurses must unlearn the imposed stoicism of such dictates as, “Never express your feelings in front of a patient or at work.” Many nurses will face a learning curve as they begin to express (at least to themselves) what they are feeling, name the emotion, and deal with it. Some nurses have adopted this new behavior and verbalize all too well. When nurses whine, natter, and complain in front of patients, they have crossed a professional boundary into a danger zone where they can transfer their fear onto the patient. Add this problem to your “To-Do” list and address it ASAP. Both large-scale and small-scale organizational change evokes a variety of responses among staff. These responses range from indifference to the ripple of mild concern and the outright devastation of a tsunami! The extent of anxiety and fear that exists among staff in your workplace will depend on a number of variables, including: • The magnitude of change (e.g., unit closure, relocation, or the presence of a new nurse manager). • The organizational and workplace culture. • How well the organization handled change in the past. • What change means to individuals (among leaders, frontline staff, and physicians) and their personal circumstances. • The individual and the staff group’s capacity to cope. • The quality of communication sent out from senior leadership and their nurse manager, and how it is received.
Anticipating Change
Managing Staff Anxiety, Uncertainty, and Fear
ANXIETY, UNCERTAINTY, AND FEAR IN A CHANGING WORKPLACE
GO AHEAD: EXPRESS YOURSELF!
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