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How can I prepare the nurses on my unit for changes in our organization?


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Change efforts that fail are usually not because of unneeded changes or poorly thought out changes, but because of a lack of due diligence during preliminary planning. If your team members are low on the change-readiness continuum, there will be a longer lead time to prepare them. Some activities that will need to be completed prior to implementation to help improve readiness are:

  • Establish a group to lead the change on your unit. Kotter (1996) calls this the "guiding coalition." This group will lead the change on your unit. The group may be just a few people, depending on the magnitude of the project, but it should include staff with credibility, leadership skills, and informal influence abilities.
  • Create a communication plan. The more ingrained the practice and the more emotionally bound to the practice, the bigger the need for abundant communication. This should come from you, the manager, as well as the guiding team. Identify "what's in it for me" (WIIFM.) Let them know how this will help them and communicate this frequently. They need to know how this will, in the end, make their lives better. Your communication plan should include who you will communicate to, the vehicle (meeting, personal, e-mail, poster, etc.), timing (dates), and the responsible party (who is in charge of the communication).
  • Address resistance. Not everyone will overtly express resistance. Watch body language. Keep your ears open. Invite them to talk to you about it. Talk with them privately if needed since some may not want to verbalize their fears or concerns in front of others. Listen to feelings behind the content. Coach your guiding team on how to listen to concerns and get input. Your staff may have some great ideas on how to make the change easier or more effective.
  • Get their input into how the change will transpire. The more input you get into any change, the more buy-in you are likely to have.
  • Create and communicate the vision (Kotter, 1996). Paint the picture of what the future will look like. Make it appealing to your staff. The change team should create the vision and be ready to articulate it.
  • Provide skills training and the time and opportunity to practice. This is a crucial step if the change requires new skills. Be sure the training is thorough and practice time is adequate.

- Patty Kubus, RN, MBA, PhD

(April 2012)