“The general purpose of diagnosing a system is to determine the readiness or maturity level of the system regarding the system’s ability to carry out the goal or to solve the problem…The system’s diagnosis, therefore is the most important assessment made by managers. Accurate assessment results in the selection of the most appropriate leader behavior, which is theoretically based, and increases the probability for success in solving the problem” (Rigolosi 2005, p.62).
I currently work in a 69-bed rural regional hospital. They have had a lot of changes recently and are still in the process of implementing more. Therefore, more change at this juncture would not be wise. Instead, a good leader would help support the staff through the current change so that staff will not have “innovation fatigue.” The leader should focus on generating and supporting short term wins, analyze pros and cons, and reward those who help (Thomsen, 2013). Following that, the leader should help to anchor the new approaches into the culture. If the leader is new to the position, he/she should be very positive about the change and former employees. Keeping the culture a positive one is very important to keep satisfaction high, turnover low, and improving patient outcomes (Kennerly, Yap, Hemmings, Beckett, Schafer, & Borchers, 2012).
I used Maslow’s hierarchy to assess the organization. Currently they have physiological needs met but a part of the security section is stability and predictability. The current change needs to solidify, become a stable environment before anchoring of the present change can take place. Once more employees or the entire subculture of nursing moves on toward self-actualization, that would be the ideal time to identify those individuals and train them as leaders and change agents for the next change to come (Rigolosi, 2005 p.66).
Kennerly, S.M.,Yap, T.L.,Hemmings,A., Beckett, G.,Schafer, J., & Borchers, A. (2012).
Development and Psychometric Testing of the Nursing Culture Assessment Tool.
Clinical Nursing Research. 21(4). Retrieved from http://journals.sagepub.com.ezproxy.fhsu.edu:2048/doi/pdf/10.1177/1054773812440810
Rigolosi, E.L.M.E.J. (2005). Management and leadership in nursing and health care: an experiential
approach, 2nd edition. Retrieved from http://ebookcentral.proquest.com.
In all my years of nursing I found very few mangers to be good leaders. Instead of leading they micro mange employees. Instead being proactive to situation they are reactive. Leaders see the long term goal where as mangers see the short term goal. A good leader takes responsibility instead of assigning blame. Leadership keeps a positive environment through out the change processes.
I feel that all too often, when there is change, many of those individuals experiencing the change are either a) the last to know, and b) expected to just deal with it. I too have not had the best leader experience either. Change is definitely something that requires a leader to step up and help employees adjust and I truly hope that your changes begin to smooth out for you soon!
What I have noticed is that once a person steps into a position that has the responsibility of implementing change, even when they feel that they have a good grasp on the work flow of patient care, these leaders tend to loose sight of the patients and become focused on the expected outcomes of these changes. Recently transitioning into a leadership position where I have limited patient care exposure, but I am responsible for implementing changes within our facility, I believe that I know what is happening in our facility and how the changes that I am making is really going to affect staff and the patients but by not being out on the floor everyday I just don’t really know how the change is going to affect people.
All of you have such great points. It is hard in middle management/leadership. I imagine that sometimes change is forced on management and leaders as much as change feels forced onto bedside nurses. In the facility I am working at now, the changes come with a lot of backing research. These are changes that many hospitals have made close to a decade ago. I think that is an important fact to consider as well. For example, if I didn’t have experience with hourly rounding it would sound like just one more thing added to a list of things that never get done anyway. Seeing the evidence that it REDUCES the dreaded call lights and decreases the incidents of falls, would help persuade me to give it a good try. Miranda, the facility that I work at now has a system of “rounding” on employees. I feel that practice helps to keep managers/leaders in the loop about how change effects bedside staff. Perhaps that could be a solution to your problem? Thank you everyone for your feedback.