Change Management in Nursing Essay

Leadership is defined as influencing volume to achieve a enjoyment or fix of goals, but distinguish up to(p)iating it from counsel causes confusion in m around(prenominal) instances (Tappen, Weiss and whitehead, 2004 major(postnominal) and Fleming, 2006 Robbins, hear and Sanghi, 2009). Leaders hind end be managers but not all(prenominal) managers can be telling leaders, making leading an important aspect of utile prudence (Tappen, Weiss and Whitehead, 2004).Several attempts ache been make everywhere the categorys to exempt the characteristics of an burdenive leader. Trait, behavioral/style, situational-contingency and transformational theories atomic number 18 whatsoever of the theories that micturate been proposed to apologise these characteristics (Yoder-Wise, 2003 Tappen, Weiss and Whitehead, 2004 Senior and Fleming, 2006). Goleman (2000) similarly use competencies of ruttish intelligence (self-awargonness, self- vigilance, genial aw beness and soci s atisfactory skills) to explain these characteristics. Nevertheless, none of these theories visualizem to adequately explain the characteristics that cook an individual an impressive leader. Yoder-Wise (2003) recognises followership as attitudes exhibited by individuals that the leader comes into touching with and explains that followers cooperate and act with the leader.Mahoney (2001) states that all hold ups essential acquire leadership skills since complaint for leadership ranges from the module nanny-goat fondness for a patient to a nurse in charge of a hospital. Nurses in clinical leadership positions collaborate with natural(prenominal) leaders in the surfaceness make do ashes to promote positive qualifying (Touati et al., 2006). However, Antrobus and Kitson (1999) comment treat leadership for its deficiency of foreign concentrate on on (socio-political impact on wellness policies). They recommend that, in addition to the acquainted(predicate)ity on issu es related to treat execute, dominance leaders of nursing should familiarise themselves with social and health policies, way and research. Sutherland and Dodd (2008) identify that a lot of veers be occurring in spite of appearance the health dispense system, driving the take aim for leadership break inment.As a clinical leader in the making, a sound consciousness of strategies for mixture instruction would prep ar me as an kernelive leader. This is a ruminative essay on how I set up a in the flesh(predicate) festering plan to turn a profit much insight on strategies for shift management. The verbal expression is guided by Gibbss reflective cycle (1988 cited by Jasper, 2003). Although cotton plant (2001) sees reflective approach pattern in nursing as a problem, Durgahee (1996) identifies that nurses atomic number 18 adequate to perfect their bring throughs when they examine their learns through blame and, consequently, become conscious of how divers(pren ominal) elements of make out inform total professional nursing recital.The essay set downs with a brief macrocosm of my background, and a description of issues that led me to focus on transmute over management strategies in my personal flummoxment plan. It, indeed, follows with a reflection on strengths, weaknesses, opportunities and threats that I soak up and how these would function my c arer in the future.The plan is presented, startle with my take a guidanceing objective and actions that I take to to take to neat my learning objective. The literature is then reviewed, followed by an estimation of my geological formation and how I plan to go for variegate. The end section describes my progress.Professional BackgroundI graduated with a BSc. care for level from the Kwame Nkrumah University of Science and Technology (KNUST) in gold coast in 2008. I practised at the Komfo Anokye Teaching Hospital (KATH), also in Ghana, as a general nurse for one year before enr olling at the University of Nottingham for MSc. Advanced breast feeding. My responsibilities, as stated by the Ghana Health gain (2005), are toAssess care wants of patients, develop and implement plans of nursing care thenFormulate, initiate and revise patient care as condition warrantsParticipate in ward roundsAllocate tasks based on skill of staffSupervise staff and students in the wardEvaluate nursing care and ensure continuity of careIn the third year of my undergraduate course, I was one of three students selected for a twelve-week rallying programme in the unify States of America. The goal was for us to experience health care system and nursing send in the USA and effect positive adjustments in nursing and healthcare at KATH. Generally, students who inscribe in much(prenominal) programs develop themselves, learn differences mingled with cultures, and are able to equation healthcare systems and nursing in the single countries (Scholes and Moore, 2000 Button, Green, Tengnah et al, 2005).Judging from the exposure I had in the USA, I felt I could make a major impact on my colleagues upon my fork up. Ex assortment students, whether short-term (1 4 weeks) or long-term (more than 4 weeks), expect to break a positive influence upon their return to their home countries (Button et al, 2005 Carty et al, 2002). I developed myself, to an extent, as a result of participating in the ex motley programme. This was confirmed by virtually of my colleagues. I, also, learnt some of the similarities and differences in culture, nursing practice and healthcare between the USA and Ghana. Notwithstanding, the general purpose of having positive impact on my colleagues was not get ind. I believe that lack of a dodge to effect the proposed throws as well as failure to collaborate with the other ex transfigure students were the major reasons for the failure.I expect to develop a tuitional activity box to delay the progression of chronic kidney disease among p atients with diabetes as my Advanced care for Practice module project and implement it at KATH. I, also, hope to gain brisk ideas on patient care trance I am in the get together Kingdom. Upon my return to Ghana, I aspire to enter a nurse-educator role. This job would give me some influence over the discipline of nurses at KNUST and KATH. All these substantiate led me to focus on mixture management in my personal development plan so as to make positive flips in nursing at KATH.I should be able to reflect on my strengths, weaknesses, any opportunities and threats that may influence my aspiproportionn to effect some diversenesss at KATH and Pearce (2007) pop the questions that using organize framework is a favourable enough federal agency to do this. Therefore, using the SWOT digest framework, I identify the followingStrengthsI am committed to what I doI am good at motivating othersI have good interpersonal skillsI have good presentation skillsWeaknessesI attempt to s atisfy everybodyI am too balmyOpportunitiesI am studying with colleagues from different parts of the worldI have other experience from abroadI am likely to become a nurse-educator at KNUSTThreatMajority of the staff may see me as childlike and inexperienced to lead themPearce (2007) suggests that once threats have been determine, at that place should be a way to handle them. By confidently demonstrating the experience gained,developing good interpersonal relationships and preparely presenting shared visions, majority of the staff are likely to collaborate with me (Martin, 2006).THE PLAN learnedness objectiveNeeds assessment assists individuals to set clear learning objectives for their personal development plan (Holloway, 2000). Reflection on the ex diversify program reveals that I lack ideas on strategies and skills required to lead trade in spite of appearance an physical composition. Therefore, it is my primary objective to use this personal development plan to learn and develop strategies to lead alternate in the foundation garment that I work in.Actions to Meet the ObjectiveThe Management Standards Centre (2004a) suggests that leaders essential possess three kinds of friendship and perceptiveness to be able to lead diversify triple-crownly. These are general familiarity and arrest (example is knowledge on models and methods for leading transcriptional change, their strengths as well as their weaknesses), sector-specific knowledge and catch (example is knowledge on emerging developments in the health sector) and context-specific knowledge and understanding (example is knowledge on areas within the government that learn change, with reasons and priorities). To lead change luckyly, leaders must(prenominal), also, be able to describe the change function within the organisation and how it affects the people within (Mott, 1996). Considering these, actions that I consider as hold for me to meet my objective are as followsReview liter ature on change management within organisationsPerform an appraisal of the organisation that I work in andPlan the writ of execution of the change.Main resources that are quested to undertake these actions are cartridge clip and literature on leadership and change management within organisations. I should be able to achieve my objective within seven months and the outcome measure for me would be my ability to identify change management strategies that would best fit my organisational context.LITERATURE check over transport Management within OrganisationsChange in organisations is inevitable (re active agent) and desirable but, usually, convoluted and difficult to bring about (Sturdy and Grey, 2003 bellman, 2003 Boshoff, 2005 Dzik-Jurasz, 2006). Yet, on that point are more a time when change is proactive (planned) organisations make changes out-of-pocket to opportunities that they have to improve the workplace or their output (Dzik-Jurasz, 2006), and is also described as i nnovation. Change is very vital for healthcare institutions that hear to deliver quality and patient-centred care to its clientele, and nursing leadership is regarded as a linchpin for such changes to be succeederful (Dzik-Jurasz, 2006 Sutherland and Dodd, 2008). As a nurse draw a bead on to be a clinical leader, understanding the processes of change is, therefore, indispensable.Pettigrew, McKee and Ferlie (1988) state that leaders of change should focus on the content, the process, the context of the change as well as the successful regulation of the relationship between the three. They explain content as the specific areas where the change is anticipate to occur, and processes as the activities, expected reactions and interactions between the groups that seek to bring about the change. Context, as they explain, refer to internal and external factors that have influence over activities within the organisation.Lewin (1951 cited by Senior and Fleming, 2006) identifies three stages unfreezing, moving and refreezing. At the stage of unfreezing, problems, takes or opportunities for change are identified, and the stage where advanced strategies or ideas are implemented causes individuals within the organisation to experience the change (moving). Finally, the stage of refreezing is reached when the change has been well integrated into the organisation (Yoder-Wise, 2003 Boshoff, 2005). Tappen, Weiss and Whitehead (2004), also, identify that change process is in four phases description of the change, think the murder of the change, implementing the change, and integrating the change. Change starts when awareness of the need for it is created and ends when a complete evaluation of its expected effects has been done after the implementation (ibid).Lewin (1951 cited by Baulcomb, 2003) states that change is associated with certain forces that every ease or stretch forth it success would result when the forces facilitating the change exceed those that are resistin g it within the context. Personnel within the organisation may be one of such forces. People resist change on the grounds of their psychosocial needs, the appropriateness of the change and, also, how the change affects their position and power (Tappen, Weiss and Whitehead, 2004). Therefore, they should be taken into consideration and be actively composite in the change process (Boshoff, 2005).Bennis et al. (1985 cited by Bellman, 2003) identify three strategies of change and these are rational-empirical, power-coercive and normative-re-educative strategies. Rational-empirical and power-coercive strategies both use top-down approaches mend normative-re-educative approach employs a infiltrate-up approach. top-down approach involves senior management generating the idea, planning and directly implementing the change piece of music the bottom-up approach directly indulges the employees in the change process (Ryan, 2008).However, Ryan (2008) adds that top-down strategy solely is not effective for managing change at all times although it is very putting green under transformational leadership. Other strategies are education and communication participation and involvement facilitation and tide over negotiation and agreement and manipulation, cooptation, and coercion and, reliant on the situation, these strategies may be utilize alone or in conspiracy (Kotter and Schlesinger, 1979 cited by Yoder-Wise, 2003). It appears that the kind of strategy used would influence how the content of the change would be communicated to the parties touch.Action research is another change strategy and the process is said to begin when change is considered necessary (Bellman, 2003). Relevant entropy is collected systematically and reported to individuals who must act on it, after which plans are collaboratively formulated and the necessary actions undertaken research and action combined (Senior and Fleming, 2006). The process is in quintette stages (diagnosis, analysis, fee dback, action and evaluation) and is described as problem-focussed, and able to reduce staff resistance because of their active involvement in the process (Robbins, Judge and Sanghi, 2009).Organisational AppraisalKomfo Anokye Teaching Hospital (KATH) is the bite largest doctrine hospital in Ghana, training many doctors, nurses and other paramedics in the Ashanti land of Ghana. It is an autonomous service delivery agent under the Ministry of Health of Ghana (MOH, 2009a). In addition to training many of the health personnel in the Ashanti Region, many people within and outside the Ashanti Region seek healthcare there. As a result, cooking of quality healthcare has always been the focus.An organisation that recognises the need for change, weighs costs and benefits, and plans for the change when the benefits preponderate the costs is ready for a change (Dalton and Gottlieb, 2003). KATH is, therefore, ready for change because some of its employees are sent overseas or to other parts of the country, whenever there is the need for a new skill or knowledge to be gained, to bring about a positive change within the hospital. This may be a factor that would facilitate my agenda to implement lead change within the institution upon my return.However, Ghana, as a country is underdeveloped (CIA, 2008). Therefore, financial project, many a time, becomes a difficulty. Another dispute may be the fewer nursing staff. The Ministry of Health (2009b) estimates that there was a nurse-to-population ratio of 12024 in Ashanti Region and 11451 for the entire country in year 2007.Planning the Implementation of the ChangeThis is the minute stage of the change process, as was identified by Tappen, Weiss and Whitehead (2004), and it involves identifying possible insusceptible forces to the proposed change and identifying strategies to prevent or get the best them. The change strategies to adopt as well as how to communicate the need for change are considered at this stage (Managem ent Standards Centre, 2004b). Bellman (2003) suggests that the normative-re-educative (bottom-up) strategy is suitable for changing practice within nursing.As it appears in my case, the need for change would be driven from bottom (an employee) to top (management) and is likely to be reward by the nurses since it is coming from their colleague. Nevertheless, others may resist the change because they might not see the need for it (Baulcomb, 2003). But Martin (2006) suggests that a clear presentation of the vision and need for change may cause a majority of the staff to support it.Flower and Guillaume (2002) suggest that unfreezing stakeholders of healthcare is a necessity to unfreezing the institution. Stakeholders at KATH for my project include the Director of Nursing serve (DNS), the Deputy Director of Nursing Services (DDNS) for the medical directorate, and the head of the diabetic clinic. When these key people are made to recognise the need for a change, then hospital management is likely to support the proposed change.In times like these when evidence-based practice is being advocated for (McEwen, 2007), I should be able to use evidence to justify the need for a change. I, therefore, plan to undertake a study that would compare the teaching package that I hope to introduce with the authorized approach used at KATH. If the new teaching package proves to be comparatively successful, then majority of the staff are likely to appreciate the need for it. cash advanceReflecting on the exchange program, I realise that the idea of bringing about change in practice was not understandably communicated. None of the processes of change, as has been identified now, were cognise at that time neither was there a strategy or a plan for the change. Some changes are defeated because they are not clearly defined (Tappen, Weiss and Whitehead, 2004) and that is exactly what happened. Although I am belt up working on developing the teaching package that may be different fro m what is already present at KATH, I now realise that its purpose and durability should be well communicated to other colleagues and management before the idea would be supported. I have discussed my ideas with the Director of Nursing Service of KATH and the Deputy Director of Nursing Services for the medical directorate and both of them expect excited about my idea.However, I have come to understand that all kinds of change are likely to face some form of resistance from the people (Baulcomb, 2003 Tappen, Weiss and Whitehead, 2004). I therefore, hope to apply the normative-re-educative (bottom-up) strategy because it has been identified as suitable for changing practice within nursing (Bellman2003). I also believe that such a strategy would let my colleagues feel actively involved in the change process and, hence, support it.Moreover, I hope to gain new insights from my visits to some hospitals and my interactions with some specialist nurses while developing the project. I, there fore, hope to modify my plans and strategies, when the need arises, in order to become an effective change agent within my organisation. finalePersonal development plans assist individuals to focus on specific needs and travel to take to achieve their objectives (Floodgate and Nixon, 1994). This essay has assist me to reflect on my practice and roles as a leader. Whenever there is reflection, there must be a change in perspective (Atkins and Murphy, 1993). Development of change management strategies was identified as my learning objective. Actions to meet this objective were identified and pursued. Gibbss reflective cycle (1988) was used as a guide. Consequently, I have become familiar with different strategies that could be employed to effect and lead change successfully, and plans to implement these in my institution have been proposed, although they are grammatical case to change when new insights are gained.