Welcome to the murky, energy-sapping world of resistance, with its cast of shady characters. How do you recognize and manage overt and covert forms of resistance? This chapter outlines what to look for and how to handle behaviors that can spell trouble if ignored. In this chapter, you will learn: 1. Resistance is a normal part of change that creates crises and opportunities 2. The 20/60/20 Rule of Resistance 3. Basic principles and strategies for removing the masks of resistance Change is inevitable, and so is resistance to it. People resist for any number of reasons, and nurse managers need to recognize it, understand the reasons, and then manage the behaviors. Unchecked resistance can have a negative impact on the quality of patient care and staff relationships, and can jeopardize the success of a change initiative. Among the reasons for resistance are: • Fear of the unknown • Perceived threat to the status quo • Perceived threat to image or professional identity • Potential threat to a personal or power base • Fear of not being able to do the work that may be required (fear of failure) • Fear of being exposed as incompetent • Intentional malfeasance! In his book, Beyond the Wall of Resistance (1996), Rick Maurer, a highly regarded expert in the field of organizational change and resistance, defines resistance as “a force that slows or stops movement” (p. 23). Engaging in or resisting change involves an investment of energy, which for many is a precious commodity and depleted personal resource. Fortunately the energy required to resist change also has the potential to convert to energy that supports change. Nurse managers are catalysts for that conversion. Many managers believe that negative comments are “bad” and staff silence and lack of complaining or feedback are “good.” While both may be true, so is the opposite. Resistance wears many masks. Overt resistance generally includes what you see and hear, such as verbal protests, endless questions, sarcasm, and excuse making. Resistance becomes especially problematic when it becomes covert. Your nurse manager antenna will tell you, “Something is up,” even though things look fine. You may hear staff grumblings but you can never pin down the source. Examples of covert, destructive, resistant behaviors include sabotage, such as not showing up for meetings, incomplete tasks related to the change initiative, and deliberate attacks on persons, processes, and equipment. Individuals and groups can demonstrate endless creative capacities to resist change. Underlying both overt and covert resistance on its deepest level is usually an issue of fear of the unknown; perceived loss of status, power, and control; or self-doubt, either from a personal or group perspective. Dealing with matters of resistance is never optional. If you are aware that it exists, ignoring it will only give it strength. When nurse managers are informed and mindful of the dynamics of resistance, they acquire a distinct advantage for facilitating change. This simple 20/60/20 Rule of Resistance provides an unscientific yet useful guide for determining the extent of resistance that may be present among your staff. Knowing these approximate percentages and using your nurse manager antenna will enable you to meet resistance and manage it before it gets out of hand. These individuals thrive in a changing workplace. They are your champions for change, your cheerleaders. These supporters never lose sight of the patient. They put actions behind their words and do what needs to be done. Some staff may consider these individuals to be weird or “possessed” by an unknown force. Because of their support they can be vulnerable to or held suspect by their peers as “sucking up to the boss.” When the subject of change is introduced, approximately 60% will sit politely, listen, and appear interested. What happens inside their heads is another matter. This 60% is probably thinking, “How is this change going to mess up my life?” They are neither supporting nor resisting. They quickly move into a mode of wait and see. They are mulling things over, need more time to see and believe why change is necessary, and may reserve endorsement or engagement until they are convinced. The good news is that in the end these 60% will merge with the enthusiastic 20% in accepting proposed change. This 80% now represents a critical mass that is ready to move forward with varying degrees of speed. What about the remaining 20%? Resistance within this group is particularly complex and difficult to manage because the behavior is generally covert in nature. In this situation, staff members wear their smiley-face masks that hide their true character: Freddy from Nightmare on Elm Street. Resistance can sound like support in statements such as, “That seems like a very good plan; you can count on me for support.” Don’t count on it! Conversely, some who say “That will never work!” may not be resistors. In fact, they may become your strongest supporters once they have a chance to express their reasons and seek clarification. When resistance occurs behind your back it can turn nasty and has the potential to cause extensive damage to your change management efforts and workplace relationships. These most challenging resistors are the (thankfully) rare few who openly with other personnel (but behind your back) “trash” the proposed change, you, the workplace, and the organization. They have no intention of ever supporting the change and make it their mission to ensure that “it” will never happen. These people are not happy campers and will make sure no one else is either. They are especially adept in recruiting physicians to join “the resistance.” These individuals are not poor misguided souls. They have forgotten their professional role, their standards and code of ethics. Instead they have chosen the role of professional saboteur who will challenge you to your greatest power struggle. They typically possess informal power and influence within the staff group, can undermine your authority, and are very difficult to catch in the act. If you have someone like this on staff you may not know it. The night shift can be a hotbed for propagating resistance and recruiting members for “the movement,” especially when staff are permanently assigned to this shift. Once you get wind that sabotage, bad-mouthing, or complaining to patients (and anyone else who will listen) exists, it must be dealt with. When patients become drawn into the fight or aware of staff dissatisfaction, it frightens them, compromises trust, and negatively affects care. The longer this behavior is allowed to continue, the greater will be the damage and some will be irreparable, causing staff to leave and patient care to suffer. The bottom line is, this behavior is inconsistent with professional standards and the code of ethics. So how do you deal with resistance? Watch for it, attempt to understand it, and fearlessly nip it in the bud! The following scenario describes a typical mild to moderate expression of resistance from staff: The stage is set. You are about to deliver an elegant soliloquy on impending change. All players are assembled and you begin. As you look about the audience you notice that some have discovered that their shoes are absolutely fascinating, others are gazing out the window, and one or two valiantly struggle to keep their eyes open while stifling a yawn that threatens to explode their lungs. Bravo! Your message delivery was Tony Award–worthy. Feeling confident and comfortable that you communicated the right message, to the right people, at the right time, you ask if there are any questions. The pause seems as interminable as Simon and Garfunkel’s “The Sound of Silence” plays in your head. Finally some brave soul comments, “Sounds like a good idea to me.” Music to your ears! Then a voice from the back mutters, “Been there, done that, bought the t-shirt,” followed by a series of bobblehead nods from those sitting closest to the voice of resistance. You are startled into your own awkward silence.
Got Resistance?
Expect It! Welcome It! Manage It!
RESISTANCE IS A NATURAL PARTNER OF CHANGE
KNOW YOUR RESISTANCE HOT SPOTS
THE 20/60/20 RULE OF RESISTANCE
The 20% Who Love Change
The 60% Who Wait and See
The 20% Who Take 80% of Your Time
BEWARE THE WORKPLACE SABOTEUR
MANAGING RESISTANCE
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