Upside of Changes: Nurses Make the Best of Change

Change comes to us all. In the nursing profession, it can be particularly challenging to accept and adapt to change over time. In this article, the author discusses possible strategies.

Upside of Changes: Nurses Make the Best of Change

I read my email and felt that sinking sensation—change is coming and fast. The memo stated that in 7 days we would be changing over to the new system. Despite months of preparation, the looming deadline was anxiety-provoking. Would it go well? Would I be able to adapt? Would our patient care suffer? These and many other questions repeated in my mind as I clicked my laptop shut for the day, hoping that I would be OK with the changes.

Nursing is all about change, isn’t it? Just when we feel we have adjusted to the new technology, system, machine, arrangement, we get the memo from administration, “Be aware that we will be converting to xyz next week.” Adapt accordingly.

Some change is good and leads to improvement. Some change is pretty neutral and some is just plain old bad. The fact remains that we all have to learn to cope with changes and to keep our morale and practice intact no matter how much change comes at us and how fast. How do we stay on an even keel when faced with change?

Stay centered

When change comes, we all hope to be that unflappable nurse that handles everything with grace, quietly, serenely coping with the new skill or information that he/she is required to master. But no. Reality rarely resembles the dream and most of us struggle mightily to keep our composure, to learn the new way and to not allow our patients to experience any adverse effects.

I recently attended a memorial service for a Jewish friend. The rabbi spoke eloquently and wisely about life truths. One thing he said really stayed with me, and compelled me to go back later and listen to the recorded service to capture accurately what he said. Here is the quote from Rabbi Wolfe Alterman from Asheville, North Carolina:

“If you see what is in need of repair and a way to repair it, then you are seeing what God has called you to do. If you only see what is wrong and ugly in the world then it is you yourself that is in need of repair. And all of us are in need of repair in one way or another. There is so much in need of repair that this task feels overwhelming.”

He finished with a quote from the Talmud:

“You are not required to complete the task, neither are you free to ignore it.”

Whether or not you are religious in any way, it is possible to see the thread of truth in both statements. We live in a broken world where people get sick and often die; where tragedies happen but where goodness also abounds. When we are able to stay centered on who we are, what our skills are, what our goals are, we are better able to identify our role in the change process and help in the repairs the change is attempting to make.

The second quote is also freeing because it helps us shake off the guilt when the desired change doesn’t turn out as we had hoped. We have to continue to try; we cannot quit. Not every change is going to go well or produce the desired results. By not ignoring the problem and doing our best to effect change, we may have at least improved some part of the issue by trying.

Stay flexible

We have all heard the refrains, “That is not the way we do things,” or “The administration doesn’t care about nursing” or “I wish we could go back to the good old days of nursing.” When we read these phrases we hope that we are not the ones speaking them but, truth be told, we all struggle from time to time when asked to do something new or to endorse and support change when it doesn’t seem to be for the better. Staying flexible and seeing new possibilities is hard, especially as we gain age and experience. Becoming more set in our ways can go hand in hand with being around for a while and it can also mean that we run the risk of being the “stick in the mud” when it means adapting to a new EMR or to a new staffing system.

In Simon Sinek’s book, Better Together, he encourages, “Don’t complain, contribute.” It is up to each of us to seek out the positive. Complaining can be a bad habit that threatens our well-being and the general feeling on our unit or office. Sometimes we think that venting our concerns helps to release tension and provides us with much needed psychological relief but the opposite may be true. Complaining can be a habit that drags us down and pulls those around us with it. On the other hand, making a contribution, or suggesting a positive change can do a lot for our job satisfaction and help to influence our whole workforce.

I remember working with one of the women from housekeeping that was particularly upbeat. No matter how many rooms were switched out, no matter how much extra she had to do, she seemed to find a way to keep her comments positive and to refrain from complaining. And people noticed. We all loved working her hall!

As we face repeated change, it may help us to look back and see times when change did turn out for the better; we can take encouragement from those times and be those nurses that smile and say, “Let’s see what we can do with this!”

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jeastridge

About jeastridge, BSN, RN

(Columnist)

Joy is currently an FCN who has worked as a nurse for 35 years. In her time off she enjoys long walks, cooking for crowds and sitting on the swing with her grandchildren.

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Specializes in Geriatrics, Dialysis.

Change that actually improves work flow  or outcomes for staff seem to be few and far between however. 

Usually any policy change does not make things better for staff, quite the opposite in fact. Policy changes seem to be driven by the bean counters whose only goal is to save a buck. That buck is often saved at the expense of staffing, supplies and equipment. 

Case in point is a recent policy change affecting extra pay for picking up shifts. It was a flat dollar amount per hour, now it's changing to a percentage of base pay. This is advantageous for the nurses who make enough per hour that the percentage over base will be higher than the previous flat dollar amount. The majority of the shifts that need filling however are tech shifts and the percentage over their base pay means the extra pay for picking up that shift will be considerably less than the previously paid flat dollar amount.  Just a guess but I bet it's going to be a lot harder to fill those shifts now.

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Specializes in Faith Community Nurse (FCN).

It is certainly hard to see the bigger picture, but I agree that it often confusing. Does leadership mean well and get bad advice? I don't know. I hope your situation proves to turn out OK. Thank you for your comment. Joy

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3 hours ago, jeastridge said:

It is certainly hard to see the bigger picture,

What exactly do you think is the "bigger picture" of the scenario posted by kbrn. It seems prety straighforward to me. 

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Specializes in Emergency.

A recent change I found disgusting? (Mind you, I left the "floor" because of these types of changes among other reasons.)

We added "hourly rounding", a nifty video showed how happy and helpful we would all be by doing this. In the training they admitted out loud that it was a simple way to raise Press-Ganey scores. No functional or medical reason, just P-G scores. And they said in the video that it would benefit the nurses more than the patients. I'm not sure how that was supposed to work out.

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Specializes in Geriatrics, Dialysis.
11 hours ago, CKPM2RN said:

A recent change I found disgusting? (Mind you, I left the "floor" because of these types of changes among other reasons.)

We added "hourly rounding", a nifty video showed how happy and helpful we would all be by doing this. In the training they admitted out loud that it was a simple way to raise Press-Ganey scores. No functional or medical reason, just P-G scores. And they said in the video that it would benefit the nurses more than the patients. I'm not sure how that was supposed to work out.

My husband had a long hospital stay fairly recently, not COVID by the way if you are wondering. Pretty sure they had that stupid policy there, complete with a white board on the wall with a spot for the rounding staff to initial every hour. To prove they were there every hour I suppose. 

There was always at least one set of initials on the board at change of shift. Otherwise not so much, LOL! A couple of the nurses would go back and initial all the little boxes towards the end of their shift, most just left the board  blank.  So that's how it worked out, it didn't!

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

I related to so many things in your article, jeastridge!  Admittedly, my first reaction to most proposed change is to feel a giant wall of resistance forming very quickly... but once I step back and accept that I'll need to step out of my comfort zone, the outcome pretty often is a growth experience.

Yes, some changes dealt from areas outside our immediate working environment turn out to be total misfires, but we don't generally discover that until we at least give the changes a decent try.  Then also, our objections will be reality-based and have a better chance of being heard.

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Specializes in Faith Community Nurse (FCN).

Thank you for your thoughtful comment. Giving changes a try can be hard but with your positive attitude and your "step back" you will go far! Joy

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