Now What?
Managing Chaos and Confusion
Once change has been introduced to your staff as inevitable, your main task and that of staff is to “make it work.” Meet your new best friends: chaos and confusion! This chapter describes some of the antics that staff members may craft in response to their emerging new reality, and tips for managing their innovative and occasionally challenging behavior.
In this chapter, you will learn:
1. How chaos and confusion impacts staff as they move through the second phase of transition toward a new way of being.
2. Tips for managing chaos and confusion.
THE PERILOUS JOURNEY OF CHAOS AND CONFUSION ON THE BIG THUNDER MOUNTAIN RAILROAD
If you have ever taken Disneyland’s Big Thunder Mountain railroad ride, you have been initiated into a world of surprises, obstacles, and exhilaration. This experience is not unlike the new world that can follow the introduction of planned change. The metaphorical train of change has left the station loaded with a mix of anxious, excited, and a few reluctant passengers. They are embarking on a journey but are unsure what the destination will look like. Little do they know that along the way they may face perils of frightening proportions. They know that they cannot turn back, and they expect the trip to get worse before it gets better.
AQ: I checked the name of this ride and have revised to match the name used at Disneyland.
Remember the boulders that threatened to crush you on the Disneyland ride? The train’s steep, slow climb up the mountain and rapid and shaky descent? Crossing the ravine on the rickety bridge before finally reaching the station? As the passengers jumped off the train, most were smiling and excited. Some disembarked dazed and shaken. In a few instances, a small number of brave passengers quickly ran to catch the next train for another exciting ride! This pretty much sums up the second phase of the journey of transition between endings and new beginnings.
As the metaphorical conductor, your job is to make the passengers are as comfortable as possible in the learning journey ahead; in other words, to support staff as they prepare for things to get messy, uncomfortable, and at times simply wretched! Knowing this phase can be rough gives you a heads-up on how to manage the obstacles you may face. This phase of transition is characterized by chaos, confusion, and potential nastiness, underpinned with a modicum of anticipation.
THINGS YOU MAY HEAR ALONG THE JOURNEY OF CHAOS AND CONFUSION
1. “H-E-L-L-L-P!”
2. “Just Tell Us What to Do!”
In the muck and mire of chaos and confusion, frustration can be the norm. Feelings of powerlessness play out in a number of ways. In particular, the drama associated with merging staff is played out through territorial battles, power struggles, and competition. In-fighting can distract from the work.
3. “Show Me the Policy!”
When departments or organizations merge, multiple policy and procedure manuals are supposed to merge as well, but this rarely happens fast enough. In the meantime when nurses are challenged by a practice issue and go looking for the correct policy or procedure to follow, they may find several or none. When this happens, staff can feel confused, anxious, frustrated, and fearful for patient safety.
4. “That’s Not My Job. If You Make Me Do It, I’ll Grieve!”
This “line in the sand” response is an indicator of the level of distress staff members feel as they move through this tumultuous period. They are looking for anything to hold onto, to reassure them that they are okay and their patients are safe. Despite solid plans and implementation strategies being in place, there are no sure-fire rules for managing successful change. A book by Warren Bennis, Managing People Is Like Herding Cats! (1999) captures the essence of managing people during organizational change. At this time, there are only guidelines.
5. “I’m Tired of All This Change. I Just Want to Nurse My Patients!”
Staff members are more inclined to withdraw into themselves during this phase. They become “me” focused and have little energy to spread around. They are in survival mode, and their morale may plummet. They may feel patients are being cheated of quality care and feel guilty about it, but not necessarily motivated enough to change.
6. “I Don’t Like This. I Want to Go Back to the Good ol’ Days.”
Wanting to return to the familiar is natural. What is not natural is to sabotage progress or to be angry enough to negate change efforts.
THINGS YOU MAY SEE
Polarized Staff
If change requires you to bring two or more distinct staff groups together, expect that their natural inclination will be to band together in their groups of origin. Turf wars, competition about who is the better group of nurses, and nasty comments are all expressions of staff’s struggles with adapting to a new way of being. Teamwork temporarily goes the way of the dodo bird. (Unlike the bird, it will return!)
Increased Use of Sick Time
Mixed emotions, accommodating different practices, and mental and physical exhaustion can cause staff to more readily call in sick and feel less inclined to go the proverbial extra mile.
Following the Informal Leader
According to Bridges, this is when people struggle with ambiguity, look for answers that not be there, and readily attach themselves to someone who is authoritative, seems to know what they are doing, and appears competent and confident (1991, p. 39). This is fine, as long as this newfound and informal leader is positive, proactive, and aligned with the direction of the organization. If this person is negative, reactive, and challenging your leadership, you may be facing a potential power struggle of mythic proportions. Bring it on!
FAST FACTS in a NUTSHELL 
