A large healthcare corporation recently purchased a small, 50-bed rural nursing home. Â A new director of nursing was brought in to replace the former one, who had retired after 30 years. Â The new director addressed the staff members at the reception held to welcome him. Â â€œMy philosophy is that you cannot manage anything that you havenâ€™t measured. Â Everyone tells me that you have all been doing an excellent job here. Â With my measurement approach, we will be able to analyze everything you do and become more efficient than ever.â€
The nursing staff members soon found out what the new director meant by his measurement approach. Â Every bath, episode of incontinence care, feeding of a resident, or trip off the unit had to be counted, and the amount of time each activity required had to be recorded. Â Nurse managers were required to review these data with staff members every week, questioning any time that was not accounted for. Â Time spent talking with families or consulting with other staff members was considered time wasted unless the staff member could justify the â€œinterruptionâ€ in his or her work.
No one complained openly about the change, but absenteeism rates increased rapidly. Â Personal day and vacation time requests soared. Staff members nearing retirement crowded the tiny personnel office, overwhelming the single staff member with their requests to â€œtell me how soon I can retire with full benefits.â€ Â The director of nursing found that shortage of staff was becoming a serious problem and that no new applications were coming in, despite the fact that this rural area offered few good job opportunities.
Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Instructions
In your textbook, Leading and Managing in Nursing, read Chapter 18, “Leading Change”.Â
Read the case study background information.
Prepare to discuss the following prompts:
- What is the perceived problem? Â Is a change needed? Â What evidence of resistance to change can you find in this case study? Â Support your answer by citing and referencing one current reliable source other than your textbook.
If you were a staff nurse, how do you think you would have reacted to this change in administration?
- Discuss the nature of change in this scenario. Â What change management approaches will probably be needed? Â What could the director of nursing do to increase acceptance of this change? Â What could the nurse managers and staff nurses do? Â Justify your selections.