Kotter presents eight critical steps to implementing transformational change in an organization. In order to seamlessly launch and implement the transformational change, Kotter emphasizes on the significance of 1) establishing a sense of urgency, 2) forming a guiding coalition, 3&4) developing and communicating a vision to help employees better understand the objectives and expectations of the change. Also, 5) empowering others to act on the vision, 6) planning and creating short term wins help the change to be successful. The last two steps which are 7) consolidating improvements and 8) institutionalizing new approaches that will ensures effectiveness of the change (Kotter, 1996). According to Kotter, 70% of changes fail if any of the steps are skipped. Skipping any of these steps can cause mishaps to the transformational change. Instigating a change in an organization is essential but it is the most difficult task and can be met with resistant.
Based on personal experience with a recent change at my workplace, I think establishing sense of urgency and communicating the vision for change should have played a critical role in implementing change. Because within the hospital I work it was crucial to identify the need for change and establishing sense of urgency that’s why the change happened. Our hospital used to have its own PEDS floor but due to lack of PEDS patients throughout the years and budget cuts, PEDS unit has be transferred to our floor. So, our unit which is 5th surgical has 40 rooms and out of those 40 rooms 7 rooms are turned into PEDS rooms. Now the PEDS nurses and our floor nurses have to cross-train so nurses can take care of both PEDS patient as well as adult patients. The only problem with this change is that due to excessive number of staff, most of the floor nurses are being floated to different floor often rather than every 4-6 months like before and PEDS nurses are not allowed to float. A lot of nurses are also quitting because it is becoming mandatory to cross-train with PEDS patients, if not now then later on. The biggest complaint from the nurses who have already quit and are about to quit is due to the fact that they did not sign up to take care of PEDS patient and if they wanted to then they would have applied on the PEDS floor in first place. I somewhat agree with the whole situation because not everyone is good with kids and have to be very observant when taking care of kids especially on medication part.
I believe all these 8 steps are critical to overcome change challenges in an organization. I understand change is difficult and sometimes it has to happen for something good to come out of it but it would have been better for the management to notify about change via mandatory meeting rather than via email and ask for everyone’s opinions before implementing the change.
Thomsen, S. (2013, February 17). Kotter’s 8 Step Organizational Change Model FC. Retrieved March 23, 2017 from https;//www.youtube.com/watch?v=LxtF4OXhy1#action=share
I can definitely see where that can be an issue. I sometimes feel that those who aren’t in clinical care or have never worked peds don’t realize the major difference in caring for a pediatric patient and an adult patient. Everything from how you dose medications to how differently you need to interact and explain things at age appropriate levels. Developmentally, it’s also very different to care for a 6 month old versus a 17 year old and most pediatric nurses are trained on proper development and stages of life in this field and know what the norms should be. I wholeheartedly agree with you that peds is not for everyone. I feel that we all have a passion for something in nursing and that is why we work in the departments we do. I absolutely love kids and working in pediatrics but I know I would never be a good hospice, home health or burn nurse. I understand floating is necessary at times but do think it makes a lot of nurses feel uncomfortable and anxious. I felt many of us could relate to this statement, “Working with an unfamiliar patient population can ultimately threaten patient safety. Interventions may be within the nurse’s scope of practice, but not within his or her acquired skill set” (O’Connar & Dugan, 2017, p.57).
O’Connor, K., & Dugan, J. L. (2017). Addressing floating and patient safety. Nursing2018: The Peer-Reviewed Journal of Clinical Excellence, 47(2), 57-58. doi:10.1097/01.NURSE.0000511820.95903.78
Hi,
I enjoyed reading your post. I can see why nurses on your floor are not happy with taking care of peds patients. I know that I would not like doing it for a number of different reasons. If your facility had employed Kotter’s theory the change would have been smoother and perhaps another solution would have been found. In my opinion, the guiding coalition made up of staff nurses who advocate and explain the change would help tremendously in your case.
I can see where this circumstance would definitely cause issues! It is not fun to constantly be floated to another unit where things are unfamiliar. After a while, it will wear on your staff. Bitanga (2017) discusses how floating can impact patient care. Errors are commonly made among float staff because they are unfamiliar with the population.
Reference
Bitanga, M. (2017). What are the effects of floating to nurses and patient care. RN Journal. Retrieved from http://rn-journal.com/journal-of-nursing/effects-of-floating-to-nurses-and-patient-care