Staff resistant to change - why?

Nurses Relations

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Change is inevitable, it's natural to the world, if no change ever happened in the health care world what would it be like? {shudder} How can resistance to change be overcome? Will you please share a story from your experiences in adapting to change in the health care world?

AliNajaCat

1,035 Posts

Homework, or is your unit (what kind?) starting to institute a change (what?) and you need some perspective? (I'm guessing homework, in which case, please tell us your thoughts first before we do it for you.)

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Rose_Queen, BSN, MSN, RN

6 Articles; 11,658 Posts

Specializes in OR, Nursing Professional Development.

What do you think are some ways to overcome resistance?

Here's a story of resistance where I work (I am not management). With about 16 hours notice, we were informed that our shift start time was going to be changing. 16 hours doesn't give enough time to modify child care arrangements, reschedule appointments that were set up with the set shift time in place, and the short notice with zero discussion, zero explanation, and zero warning did not make the staff happy at all. And when we brought up those issues to management, we were insulted instead of listened to.

So how are you trying to make changes? Are you doing it in a way where staff are being informed? Given notice? Explained why the change is being made? Look at your own practice and evaluate it, then you can look at how others are reacting.

Specializes in NICU, ICU, PICU, Academia.

Is this a homework assignment? If so, what are your thoughts?

amoLucia

7,736 Posts

Specializes in retired LTC.

Sounds like a school assignment to me.

offlabel

1,557 Posts

Where the change has no basis in science whatsoever, where it is applicable to very specific circumstances but it enforced broadly and without discretion, where the group responsible for the change is removed from the sphere of expertise by orders of magnitude where implementation is to take place, where unqualified individuals interpret science incorrectly and arrive at invalid conclusions....yeah, resistance.

Libby1987

3,726 Posts

I don't care if this one is homework, the responses will benefit everyone.

Here are a few causes, usually in combination, that I know to perpetuate resistance..

1) Everyone is already at a saturation point, even good change increases the saturation initially to boiling over.

2) The processes aren't always thoroughly vetted, some players provide feedback, but not all players are included so a process that is being inacted/promoted as vetted falls flat when layed on the other players, namely the ones that must carry out the change and thus most directly impacted.

3) No explanation for the method to the madness equals no buy in. No buy in can result in anything from resistance to all out resentment.

4) Most clinical staff, who would say that the upper mgmt doesn't know their world, themselves don't know the reimbursement/costs/compliance/legal etc aspects of the business. It's non sensical for all players to not be provided with knowledge of how things work on both sides of the curtain. If a nurse doesn't understand what it takes to keep the doors open, it's much more natural to resist/resent change that seems otherwise unnecessary and/or excessive.

5) A universal attitude of staff that the reimbursements/costs/compliance/legal etc issues aren't their problem, they're there to to take care of patients, not help fun the business.

Libby1987

3,726 Posts

^^

*run

nutella, MSN, RN

1 Article; 1,509 Posts

There is a whole "science" called change management dedicated to this topic. It also boarders on leadership in general, healthcare systems and quantum age / quantum leadership, and project management.

It sounds like homework so you should take the time to read and learn about it. There is a reason why probably around 90% pf projects that aim at change fail. It is also important to consider the bigger context. Are we talking about a change in culture, change in workflow, change in .... . If we are talking quality improvement - are we thinking about complex interventions for complex problems?

Are physicians involved - oh dear - that is a whole specialty problem on it's own and how to overcome that.

Most projects fail. Most quality improvement initiatives fail or do not lead to the outcome planned.

That is the reason they want you to learn about it....

Amethya

1,821 Posts

Specializes in Cardiology, School Nursing, General.

Mine was mostly, the staff was resistant in a new person and different hobbies. All the girls in the office knew each other for years, so when I came in I was the new person in the last 2 years. I like different thins, I like girly things like them, yes, but I wasn't so into fashion. I like anime and video games, I like my hobbies, and I never announce them that much to people. But when they saw me just bring in some small stuff Pokemon animal for my desk, the difference started to come out and they began to question me about my hobbies, then the questions turned into ridicule type questions and then the making fun of me happened a lot. Then after that I was mostly ostracized and no one wanted to eat lunch with me or talk to me anymore. I was mostly treated like an Idiot there and I hated it! It became very suffocating to me there, so I left. I wasn't happy. But after that I felt ashamed of myself on who I am and what I like, and it took a long time for me to trust co-workers for a while.

At my new job, there's more of a range of hobbies and some of them like the same things I like, so I'm welcomed here extremely. I really like it here and I don't regret leaving my old job, but when I think of the pain I had there... I don't want to go back ever again to that.

TheCommuter, BSN, RN

102 Articles; 27,612 Posts

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Why do I sometimes feel resistant towards change?

Change is inconvenient. Change can be frustrating when implemented poorly. Change can alter the manner in which we work permanently. Change sometimes slows down the workflow. Change can add time-consuming steps to an already stressful setup.

blackribbon

208 Posts

Specializes in Med/Surg, Gyn, Pospartum & Psych.

When I see resistance to change by good nurses it usually is related to two things:

1. Too much change at one time...or constant change. When your email has a "new policy" and "new practice" in it almost weekly while your unit is packed to the gills and you aren't getting a break, you don't have time to think about doing something a new way.

2. When the policy makes our job harder and our perception that patient care is going to be sacrificed. We have to understand the "whys" of the change. Just saying "that it is evidence based" without actually tell us what that evidence actually says/proves isn't usually enough unless it is common sense. Most changes appear to be made by someone who obviously doesn't care for patients at bedside. Even saying something like "sorry, joint commission now requires this" is better than "here's a new policy...just do it...we don't care that it makes your life harder and more difficult to meet the patient's actual needs" (and they never reduce the patient load when they increase our required activities).

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