Change Theory in Nursing Leadership

Kris Mailepors Director of Organizational Development

Catholic Medical CenterPh 603-663-1961

kmailepo@cmc-nh.orgTw: @krismailepors

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CHANGE Three Things to Consider

1. What makes handling change so challenging?

2. What does this quote mean to you:“I’ve been in this business 36 years, I’ve learned a lot

—most of it doesn’t apply anymore”

Changes just keep coming!!!

From outside…• Market conditions

• New technologies

• New software

• New regulations

From inside…• New Managers

• New team structures

• New policies

• Reduced budgets

• New or unclear expectations

Change is good…is it?

…Change usually benefits the organization by solving a problem or creating greater efficiency

however…

…It pays much more attention to the finances, strategy, and technology than to the people who have to make it work

THERE IS THE ISSUE

Change vs. Transition

Change is …– Situational; something starts or stops.

Transition is …– The gradual process of psychological adjustment

that happens inside us as we adapt…

It is the TRANSITION, not the change, that people resist

The Three Phases of Transition

Why is transition resisted?

• People have a personal connection to how they work; people are giving up a part of their personality

• Fear of the unknown; doing and being what they have never done or been before

The Three Phases of Transition

What has ended…what is lost?

• Turf• Status• Power/influence• Autonomy• Relationships• Memberships• Routine/structure

• Meaningful work• Control of work• Personal Identity• Competence• Personal Future

Doing a Loss Analysis

Note on the grid who is losing what

Dealing with an ending?

Denial

Anxiety

AngerBargaining

Sadness/Depression

Handling those dealing with endings and loses

DENIALBehaviors: Flip attitude, evasion, skepticism,

refusal to accept the reality of the situationActions: – explain the change and the reasons– Give examples of peers who are changing or learning– Give examples of the need for this new

(system/approach/technology)

Handling those dealing with endings and loses

ANXIETYBehaviors: Resentment, rumor mongering, nervousness

or stress, decreased productivity and effectivenessActions:– Encourage talking and listen carefully– Don’t talk them out of feelings; offer a different point of

view if you have one– Give positive feedback on their progress, if genuine– Offer accurate information to dispel rumors

Handling those dealing with endings and loses

ANGERBehaviors: Grumbling, irritation, rage, mistakes,

aggressiveness, foot dragging, vandalism, indignationActions:– Listen and acknowledge anger– Don’t talk them out of it– Don’t assume blame for their anger– Don’t collude/agree with them– Recommend involving HR if extreme

Handling those dealing with endings and loses

BARGAININGBehaviors: Attempts to get out of the situation, attempts

to make deals or promises relating to the old way, negotiation

Actions:– Keep realistic plan in sight– Don’t be swayed by promises or negotiations– Reinforce situation as it is– Don’t get into problem solving or bargaining with them– Gently remind them of reality

Handling those dealing with endings and loses

SADNESS/DEPRESSIONBehaviors: Silence, “down,” or disheartened, tearfulness

Actions:– Acknowledge, sympathize and reach out.– Initiate conversation and ask questions to draw them out– Encourage talking and sharing feelings either one-on-one or in

small supportive groups– Promote supportive group events, interaction, or impromptu

fun– Recommend to HR if appropriate

The Three Phases of Transition

Critical part: THE NEUTRAL ZONE

Emotions of the Neutral Zone:– Confusion– Apprehension– Detachment– Interest/Eagerness

CommunicationCommunication during transition feels risky…

There cannot be too much communication during the Neutral Zone.

It is the difference between a bearable situation and a disaster.

Two main kinds of communication in this zone:

Communication1. Communication designed to show

CONNECTION and CONCERN.

2. Communication that clarifies the PURPOSE, the PICTURE, the PLAN, and the PART.

Communication1. Communication designed to show CONNECTION and

CONCERN

MANAGERS and leaders must keep communicating not just for more information but to show that they care. Isolation can be easily amplified during a time of transition.

Communication2. Communication that clarifies the PURPOSE, the

PICTURE, the PLAN, and the PART.

PurposeThe “why’s” of the change. Purpose can serve to clear up confusion.

PictureVision of the outcome; the light at the end of the tunnel, a destination. (use an analogy—1st day)

Communication2. Communication that clarifies the PURPOSE, the PICTURE,

the PLAN, and the PART.

Planbeyond just the destination, this is the roadmap that leads there. These are step-by-step actions to get through the Neutral Zone.

PartSuccessful transition depends on the people involved. They all play a part. Know yours, know theirs, make sure they know theirs.

The Three Phases of Transition

NEUTRAL ZONE IS ALSO KNOWN FOR…

Creativity & Learning1. Encourage experimentation and risk taking2. Enhance trust3. Expose individuals and groups to diverse

perspectives4. Provide the workforce with stimulating and

interactive settings5. Use feedback mechanisms6. If appropriate, help people revise their career

plan within the new change

The Three Phases of Transition

Getting to the NEW BEGINNING…

1. Translate the changes into activity that has real meaning to the people doing it

2. Provide people with the opportunity to practice or gain familiarity

3. Work collaboratively4. Focus on efforts and achieve a few “quick

successes”5. Build RESPONSIVENESS and FLEXIBILITY into

your routine

7 things to remember!

1. You have to end before you begin2. Between the end and the new beginning,

there is a hiatus3. That hiatus can be creative4. People go through transition at different

speeds, and may be affected by different things

5. *Most* organizations are running a deficit in transition management

People May Hate Change…

…But they love Progress

Reference: www.wmbridges.com; www.linkageinc.com