How The Effective Nurse Leader Confronts And Deals With Resistance Change

Implementing change among all organizations is necessary to achieve success; within the health care industry change is constant and it is the role of management teams to assess, plan, implement and evaluate change to ensure satisfaction. Considering this among the other aspects of running a successful organization it is essential to ensure that there is minimal resistance and familiarity to change. Demands of the consumers and staff as well as regulations are continuously changing. The responsibility of managers is to successfully lead these inevitable changes.

According to Porter-O’Grady, 2016 et al p 324, our healthcare systems today are at the center of what is considered major change. Much of the change today is directly related to the foundational principles, concepts and associated with complexity in systems and relationships, and an understanding by nurse leader and follower; of what it takes to make meaningful change. Nurse Leaders, registered nurses, advance practice nurses, and other followers, at every level of our organizations must be increasingly aware of meaningful and sustainable changes that improves our healthcare systems (Porter-O’Grady, 2016 et al p 324).

Whether groups are formed for social or task oriented purposes, the ability to produce and maintain a sense of affiliation, peer support and collaboration is important for overall group functioning. The cohesion of a social group is produced through the establishment of a set of group norms, which are later defined as a guide for conduct accepted within a group of individuals. However, in order for a group to perform and produce results, the team leader should guide his/her team through the proper stages of group development, which includes the following steps: forming, storming, norming, performing and adjourning. Although teams should follow all these stages of group development, the forming and the norming stages are the most important,

In today’s healthcare system, effective leadership is essential to improving and reaching organizational outcomes. A leader is someone with the ability to influence others but, an effective leader uses positive strategies to inspire employees to work towards the same goal. Leadership in nursing requires a constant effort to motivate others to become part of the organizational transformation. This can be achieved using a transformational leadership style with a focus on communication, motivation, and empowerment.

Implementing a change in practice within these environments can produce anxiety or fear of failure in nurses, leading to a resistance to change. Several studies (Bozak, 2003; Lehman, 2008; Spetz, Burgess & Phibbs, 2012) expounded the need for a concise plan and clear communication between nurses and management when implementing a change of this nature. The use of Lewin’s Change Management theory can support nurses through the transitions and identify areas of strengths and resistances prior to implementing change. Without a framework for guidance, it can be difficult to keep on track.

A positive force for change centers on the nurse’s strong desire to change current practices. The combination of the turnover rate, low morale, and higher percentage of new nurses, is the driving

Planned Organizational Change: In this situation, University Hospital underwent a significant planned organizational change. They took traditional nurses and put them into “care coordinator” positions. This planned change is defined as a process where an organization explores the need for change and possible solutions, plans for how that change is to be instituted, implements the change and disseminates information about the change, and integrates those changes into the day to day operation of the organization. It seems as if University Hospital did not implement this change in the best way possible. They seem to have thrown care coordinators into their roles without giving them much input into what their job would really entail.

The features of effective team performance are set out in Brian Tuckman’s phases of team development theory, ‘Forming, Storming, Norming, Performing.’ This outlines the phases that a team will go through in order to become effective and reach maturity. At the ‘Forming’ stage of team development individual roles and responsibilities are unclear and each member of the team is concerned to avoid conflict with each other. From this point the team will go through the ‘Storming’ phase which is when they start to conflict as individuals put forward ideas which will be challenged by others in a bid to gain power and position over others. After this the ‘Norming’ phase follows and it is at this point that individual roles are defined and accepted

Implementing change can evoke stress, and nurses are not immune to this stress brought on by change, or this stress might be amplified due to the fact that nurses are usually at the forefront of change. Any change that is initiated in the healthcare industry will impact how nurse perform their duty, and can negatively can affect their workflow if extra precaution is not taken. Thus, nurses are a major force in resistance to

Nurse leaders are faced with issues or problems on a daily basis that are often expected and sometimes unexpected. It “comes with the territory” so to speak. If there were no issues to solve or hurdles to overcome the necessity of designating a leader would not seem quite as important. Nurse leaders can tackle issues that occur in their work environment using nursing theory to guide them. Nursing theory provides a framework that nurse leaders can use to implement interventions or changes to positively impact the staff they lead. This framework of the theory will set the standards for achieving the desired outcomes and is based on knowledge that is gleaned from practice and/or research.

Work Team development is a dynamic and often difficult process. Most teams find themselves in a continuos state of change and development. Eventhough, most teams never reach full stability, there is a general pattern that describes how most teams evolve. There are five stages of team development, the first stage is forming. In this stage there is a great deal of uncertainty about the teams purpose, structure and leadership. Members are testing the the waters to determine what types of behaviors are acceptable. This stage is complete when members began to think of themselves as part of the team. The second stage is called storming. In this stage there is much intragroup conflict.Team members accept the existence of the team, but there is resistance to the control that the team imposes on individuality. Conflict can arise from numerous sources within the team setting but generally falls into three categories:communication, factors, structural factors and personal factors (Varney, 1989/Townsley). In addition, there is conflict over who will control the team.

In the healthcare field, nursing leaders and managers face consistent issues in their respective practices that force them to alter the way they work and the way they think. In taking on a role as a leader within the field, nursing leaders and managers also take on the role of ensuring that work within an organization runs smoothly regardless of new issues that may arise in the healthcare arena. For instance, in today's healthcare environment, the issues of nurse shortage and nurse turnover have the capacity to alter the healthcare field and many of its respective branches and organizations should these problems not be managed properly by the leaders in the field. In viewing the issue at hand and in discovering how nursing leaders and managers are expected to act, and do act, in order to approach this issues, along with pinpointing the best approach possible to aid this issue, one can better understand which leadership styles are necessary for leaders to function.

Transformational leadership is an emerging type of leadership that is more adaptable the changing environment within healthcare and has the ability to guide and empower staff to embrace the changes (Finkelman, 2012). This type of leadership is especially important today with many nurses felling unsatisfied, or unappreciated. In order to have a successful organization, it must first have the ability to retain nurses through job satisfaction. Transformational leaders have the ability to encourage staff members to embrace the changes to come, by promoting such things as team work, and recognition of hard work done by staff members (Smith, 2011). Having the ability to recognize staffing needs along with the compassion to try and meet those needs while maintaining the functionality of the organization, is the key to future

Without competent leadership change can have negative impact on both the employees and the patients. According to Wright (2010), lack of leadership in change management could lead to adverse outcomes such as resentment, rebellious attitudes, and could end up damaging the same people it intended to make better (p.20). Therefore, experts warned that it is very important to have competent leadership at the helm of change management (p.20). As the focus of providing leadership shifts to nurse administrators who are often in the frontline of change management, nurse administrator should use essential tools such as the American Organization of Nurse Executives (AONE) five domain of competence as a framework in change management.

By empowering the community of nurses and sustaining employee engagement, patient and employee satisfaction would remain the same, if not increase (6 Leadership strategies for navigating perpetual change in healthcare, 2015). Change is tough for most people and the time to adjust varies with each individual. Taking some time to acknowledge each individual and their needs is an important factor to being a great leader (6 Leadership strategies for navigating perpetual change in healthcare, 2015).