Change Theories Change Management and

If the need for change is accepted, rationally, then emotionally, then gradually workers will become more willing and open to learn, and to incorporate the change into the organizations standard operating procedures. Individuals are more apt to accept change if, for example, they are convinced that it will improve patient care in the long run, than if the directive is merely dispensed as required because management says so.

The critical aspect of fifth phase of the change process of “learning” is how changes are introduced. Communicating is an essential aspect of buy-in but so is fostering a positive sense within the organization about the proposed changes by creating early wins (Campbell 2008). This will lead to an increase in peoples perceived own competence in their new roles. Unfortunately, starting with easier projects is not always feasible, but even if it is not, a Clinical Nurse Leader must be particularly sensitive to feedback from members of the organization at this learning time and even when confronting setbacks, focus the organizations attention on achievable short-term goals.

During the sixth stage, or “realization stage,” staff begins to “understand which behavior is effective in which situation. This, in turn, opens up their minds for new experiences. These extended patterns of behavior increase organizational flexibility. Perceived competency has reached a higher level than prior to change” and individuals are more capable of learning autonomously, and with an open mind, from their own, practical experiences (Recklies 2010). Finally, during the seventh integration stage, the change has become the organizational norm.

Even under the best of circumstances, old attitudes may be entrenched.

“Change within a health care organization means that individuals must transition from one identity to a new identity when they are involved in a process of change” (Campbell 2008). Fears of lack of competence, fear of the unknown, and having a lack of positive role models for the new changes can all conspire to create reluctance to adopt new procedures (Schuler 2003). The change process often requires a great deal of fine-tuning to individual circumstances, and responsiveness to problems that occur can help, rather than hurt the routinization of the new change. For example, if there is resistance to a new form of technology being used, having nurses who are comfortable with the technology demonstrate its use, or rotating nurses who have used it before onto the floor for several weeks will demonstrate to the neophytes that they are capable of learning. Clinical Nurse Leaders are uniquely valuable in their ability to balance the needs of management and organizational objectives with their intimate understanding of the nursing perspective and the point-of-view of the daily life of a nurse.


Campbell, Robert James. (2008, January/March). Change management in healthcare.

The Health Care Manager. 27 (1): 23-39

Recklies, Oliver. (2010). Managing change. The Manager. Retrieved February 24, 2010 at

Schuler, a.J. (2003). Overcoming resistance to change. Retrieved February 24, 2010 at

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