“It Was the Best of Times, It Was the Worst of Times . . . ”
Managing and Facilitating Change and Transitions
The ability to facilitate change and manage transitions remains a relatively new competency for nurse managers. Although this area was formerly left to senior leaders and change management gurus, nurse managers had to deal with the fallout from staff transitions. Nurse managers who understand the potential impact of organizational change on the psychological transitions of staff and the workplace culture are better able to respond in a proactive and supportive manner.
In this chapter, you will learn:
1. The importance of understanding the human impact of organizational change
2. How psychological transitions influence staff behaviors in the workplace
3. Strategies for facilitating change in your practice setting
THE METAPHORICAL TRAIN OF CHANGE IS COMIN’ DOWN THE TRACK
To truly understand staff’s perception of organizational change, view it within the context of the metaphor of the “train is leaving the station.” Here, staff are invited to “hop on,” baggage and all; lay down on the tracks; or remain on the platform, which by the way is about to be burned! If you can visualize the feelings that accompany this journey such as fear of the unknown and what work will look like at the end of the journey, then you are well on your way to developing a plan for managing change and transition.
THE RIPPLE EFFECT OF ORGANIZATIONAL CHANGE
The degree of impact of organizational change on staff depends on several factors, including the frequency of change, staff experience with past change, and how well change was managed. When change occurs in one part of the organization, other unaffected staff may respond with the casual interest of a bystander. If, however, the change is imposed on them, staff members may respond in a variety of ways, including feelings ranging from joy and indifference to powerlessness, grief, and anger. Sometimes the presence of these feelings is not obvious. When negative feelings surface the quality of work life takes a direct hit as the atmosphere is dominated by anger, frustration, apathy, low self-esteem, resistance to change, and infighting.
At the same time, the work ethic of caring that staff normally extend to their peers, patients, and clients may assume a narrower focus if their energies are directed exclusively toward patient care and self-preservation. This situation leaves staff with little room or interest in supporting their colleagues and organizational change imperatives.
NURSES’ ANGER
Nurse managers must recognize the depth of emotions staff members have about work and female nurses’ potential for harboring deep-seated, often unexpressed anger. Research on women’s anger has not been extensive. Thomas, Smucker, and Droppleman (1998) shed light on the fact that anger develops in women as the result of an accumulation of feelings associated with “hurt, frustration and disillusionment” (p. 311). They also describe the medical impact of nurses’ unresolved anger, which may lead to conditions such as hypertension, obesity, and migraine headaches. For nurse managers it may be of more than a passing interest to note the possibility of a connection between organizational change, nurses’ anger, the health of nurses, and quality of work life.
KNOW YOUR WORKPLACE CULTURE
As nurse manager, how do you help nurses step back from the demands of a changing, hectic workplace and acknowledge their situation, name their feelings, and restore their sense of caring power when organizational pressures are bearing down?
One strategy is to conduct a cultural assessment of your practice setting to determine staff readiness to accept change. Once you determine where staff fit on the acceptance scale, you can identify what staff will need to engage in the change process. The following questions may help you identify potential “hot spots” and point you toward some steps to help staff adapt to and embrace a new way of being:
• How content are staff members? In other words, what is their degree of nattering?
• How well do staff work together?
• Is there a spirit of cooperation, collaboration, and support or is there conflict, tension, and in-fighting?
• If you sense or observe resistance, what is its source? Are staff members fed up, tired, burned out, lacking trust in the process?
• Who may be resisting and why?
• Who are the formal and informal leaders among your staff? Who is working with you and who is not?
• What kind of influence do these leaders exert?
• Which staff members are most likely to support organizational change? Who are your champions of change?
• What roles can these change-ready staff members play in positively influencing others?
• What type of language is reflected in your workplace? Is it upbeat, positive, and professional, or does it reflect, negativity, victimization, and resistance? Are there frequent references to “them” or “they”? Do staff members complain to patients and clients?
SMART MESSENGERS DON’T GET SHOT
Tis a perilous journey one takes when delivering a message of impending change. But it does not have to be so. The following scenario may help you in crafting and delivering a message of change:
Your practice area is about to be affected by a dramatic organizational change process. As part of this change, the service will now include treatment of patients who were formerly treated in another location. There will be no reductions in staffing.
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