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chapter 8 | People and the Process of Change 105 CikguOnline
Whatever alternative they chose, the nurses were He suggests that a compelling story will increase
being challenged to find a solution that enabled them receptivity to a change more than a carefully
to move into a new comfort zone.To accomplish this, crafted analysis of the need for change. How is this
they would have to find a consistent, dependable done? The following are some examples of appeals
source of child care suited to their new schedule and to feelings.
to the needs of their children and then refreeze their
■ Instead of presenting statistics about the number
situation. If they did not find a satisfactory alterna-
of people who are re-admitted due to poor dis-
tive, they could remain in an unsettled state, in a
charge preparation, providing a story is more per-
discomfort zone, caught in a conflict between their
suasive: an older man collapsed at home the
personal and professional responsibilities.
evening after discharge because he had not been
As this example illustrates, even what seems to be a able to control his diabetes post surgery.Trying to
small change can greatly disturb the people break his fall, he fractured both wrists and is now
involved in it. The next section considers the many unable to return home or take care of himself.
reasons why change provokes resistance and how ■ Even better, videotape an interview with this
change can be unsettling. man, letting him tell his story and describe
the repercussions of poor preparation for
Resistance to Change discharge.
■ Drama may also be achieved through visual
People resist change for a variety of reasons that display. A culture plate of pathogens grown
vary from person to person and situation to situa- from swabs of ventilator equipment and patient
tion. You might find that one patient-care techni- room furniture is more attention-getting than an
cian is delighted with an increase in responsibility, infection control report. A display of disposables
whereas another is upset about it. Some people are with price tags attached used for just one surgi-
eager to risk change; others prefer the status quo cal patient is more memorable than an account-
(Hansten & Washburn, 1999). Managers may find ing sheet listing the costs.
that one change in routine provokes a storm of
The purpose of these activities is to present a
protest and that another is hardly noticed Why
compelling image that will affect people emotion-
does this happen?
ally, increasing their receptivity to change and
moving them into a state of readiness to change
Receptivity to Change
(Kotter, 1999).
Recognizing Different Information Processing
Styles
Sources of Resistance
An interesting research study suggests that nurse
Resistance to change comes from three major
managers are more receptive to change than their
sources: technical concerns, psychosocial needs,
staff members (Kalisch, 2007). Nurse managers
and threats to a person’s position and power
were found to be more innovative and decisive,
(Araujo Group).
whereas staff nurses preferred proven approaches,
thus being resistant to change. Nursing assistants, Technical Concerns
unit secretaries, and licensed practical nurses were
Some resistance to change is based on concerns
also unreceptive to change, adding layers of people
about whether the proposed change is a good idea.
who formed a “solid wall of resistance” to change.
The change itself may have design flaws.
Kalisch suggests that helping teams recognize their
preference for certainty (as opposed to change) will The Professional Practice Committee of a small hos-
increase their receptivity to necessary changes in pital, in order to save money, suggested replacing a
the workplace. commercial mouthwash with a mixture of hydrogen
peroxide and water. A staff nurse objected to this
Speaking to People’s Feelings proposed change, saying that she had read a research
Although both thinking and feeling responses to study several years ago that found peroxide solutions
change are important, Kotter (1999) says that the to be an irritant to the oral mucosa (Tombes &
heart of change lies in the emotions surrounding it. Gallucci, 1993). Fortunately, the chairperson of the