Nursing Management

What evidence of resistance to change can you find in this case study?
According to this case there are several examples of resistance presented. There was an increase in absenteeism, vacation time requests, and early retirement. These incidences occurred because the changes made it more difficult for the staff members to socialize with one another and with families. According to (Tappen, Weiss, & Whitehead, 2015) “New strategies introduced by the director threaten the safety and security requirements of the staff members.” Also, it became evident that the most basic need (socialization) that motivated them to perform their tasks was ignored.
What kind of resistance to change did the staff members exhibit?
The nursing staff members displayed a passive resistance to change which is less direct and harder to recognize (Tappen, Weiss, & Whitehead, 2015). They did not respond to the change directly through raising complaints to the director but preferred an indirect reaction. As stated by (Tappen, Weiss, & Whitehead, 2015) “Passive resistance is characterized by the avoidance of the implementation of new guidelines.” This explains the increasing requests for vacation days and retirement.
Why did staff members resist the change?
The staff members opposed the change because the new measurement approach would require weekly reviewing of the time they spent on patient activities such as baths, medication, dressing change, incontinence care, feeding of a resident, or trip off the unit.

This meant that they would spend less time in consulting with their colleagues and talking with families. According to the new method, these actions would constitute wastage of time unless justified. According to (Tappen, Weiss, & Whitehead, 2015) “Technical change creates anxiety, much of it related to what the staff members fear they might lose.” Consequently, the manager’s proposed method failed to materialize and there followed a shortage of staff.
If you were a staff nurse at this facility, how do you think you would have reacted to this change in administration?
If I were a nurse at this facility, I would reflect on my performance and evaluate its need for improvement. As stated by (Tappen, Weiss, & Whitehead, 2015) “A reflective nurse understands that change at the micro level is manifested through his/her participation in it.” As stated by (Kupperschmidt, Kientz, Ward, & Reinholz, 2010) “A nurse should be candid in explaining the impacts of the approach on my work to the director.” This is because the development of a character that can accept and acknowledge change is vital to adaptation.
How do you think the director of nursing handled this change? What could the nurse managers and staff nurses do to improve the situation?
The nursing director handled the change in a dictating manner that compelled staff members to actualize his wishes. This was a risky approach because the cooperation of the staff members meant that they would be more unenthusiastic, passive, and discouraged. According to (Tappen, Weiss, & Whitehead, 2015) “Nurse Directors should provide psychological safety by considering staff interests, involving them in implementation, and recognizing their competencies.” The staff nurses can improve the situation by learning to communicate their grievances on the challenges that a new approach brings to them. This will ensure the provision of excellent patient care by staff nurses that are encouraged, energetic, and highly dedicated to their work.
How could the new administrator have made this change more acceptable to the staff?
To start with, the manager should have given the staff nurses a chance to participate in the realization of change. Secondly, as stated by (Tappen, Weiss, & Whitehead, 2015) “He should have comprehended the true nature of resistance and acknowledged that officials tend to resist technical changes that affect their human relationships.” Third, the directors should not have overemphasized on technological features of the new approach while forgetting the consequences. Fourth, the new director should have taken steps to handle staff attitudes. These measures would involve urging nursing managers to think differently and stressing new guidelines of implementation for them. Moreover, as stated by (Quast, 2012) “The new manager should have utilized the fact that signs of resistance provide useful indications in regulating and timing of technical changes.” Lastly, the manager should make his efforts more efficient in trying to tackle the issue of resistance in group meetings. According to (Tappen, Weiss, & Whitehead, 2015) “Resistance results from the misinterpretation of a recommended change.” Thus, the new manager should have shared information about the planned adjustment with everyone.

References
Kupperschmidt, B., Kientz, E., Ward, J., & Reinholz, B. (2010). A Healthy Work Environment: It Begins With You. A Scholarly Journal of the American Nurses Association, 15(1), 1-8. doi:10.3912/OJIN.Vol15No01Man03
Quast, L. (2012, November 26). Overcome The 5 Main Reasons People Resist Change. Retrieved from http://www.forbes.com/sites/lisaquast/2012/11/26/overcome-the-5-main-reasons-people-resist-change/#3be107693393
Tappen, R. M., Weiss, S. A., & Whitehead, D. K. (2015). Essentials of nursing leadership and management (6th ed.). Philadelphia: F. A. Davis Company (6th ed., pp. 133-143).