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Serving as a Change Agent (Nursing)

by Christy Hennessey (Davidson), DNP, RNC-OB

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    00:00 Welcome back everyone. As the landscape of healthcare is ever evolving, it's important that nurses remain ready to support change and serve as change agents. A change agent is a person or thing that encourages people to change their behavior or their opinions. One important thing to remember about change in healthcare is that it is inevitable. It will happen all of the time.

    00:24 Now change in healthcare occurs for several reasons. Advances in medical care and technology, increasing demands and expectations from patients actively involved in their own health and well-being, and finally evolving reimbursement models that emphasize value rather than volume.

    00:41 Due to continuous change, transformational leadership can help with the process and prepare nurses to become change agents. Transformational leaders assume accountability for patient care outcomes through the assimilation and application of evidence-based information to design, implement, and evaluate patient care processes and models of care delivery. They also act as providers and managers of care at the point of care to patients anywhere healthcare is delivered. And they also use these unit competencies in a variety of healthcare settings to improve outcomes.

    01:12 So when you think about the role of change agents, they really have 2 primary responsibilities; to change oneself and to build capacity in others. They really serve as a change coach through several ways. First, guidance. The leader uses guidance to set behavioral expectations for staff performance and provides feedback on performance in the change project. Second, facilitation.

    01:37 Now as a facilitator, the change coach encourages staff to share in decision-making thereby creating and nurturing a culture that supports ____ from others, facilitates creative thinking, and enhances the process of finding the best solutions to address challenges. And finally, inspiration.

    01:54 The leader takes on an inspirational role really expressing confidence in recognizing staff as providing meaningful contributions to the change process. Now there are several skills needed to be an effective change agent. First, effective communication. Second, you need to build trusting relationships. You need to remain aware of change fatigue. Now change fatigue is a condition experienced by individuals subjected to unrelenting and overwhelming change in their work environments and sometimes this happens in healthcare. And finally, you need to have organizational agility.

    02:30 This is the ability of an organization to change rapidly depending on the situation. There are 3 primary change strategies. First, power coercive. Power coercive strategies are based on the application of power through legitimate authority. Little effort is used by the nurse leader to enforce change and the staff has no ability to alter the course of the change process. Power coercive strategies can be used when change is critical, time is limited, and there are high levels of resistance or there may be little or no chance of reaching organizational consensus. The second is empirical rational. Empirical rational strategies assume that providing knowledge is the most powerful requirement for change. This strategy assumes that people are rational and will act in their own self interest when they understand that the change will actually benefit them.

    03:20 It can work well if the change is perceived as reasonable or beneficial to the individual. And finally, normative-reeducative. Normative-reeducative strategies assume that individuals act in accordance with social norms and values that influence their acceptance of change. The nurse leader focuses on individual's behavior or motivator such as roles, attitudes, feelings, and their interpersonal relationships as an effective way to implement change in the healthcare environment. Sometimes, there is resistance to change so here's some strategies that will help. Understand that resistance is a natural part of the process. You want to learn why an individual is resisting the change. We linked some of the old ways of working with some of the new change as a way to really bridge the old with the new. You want to identify people who are willing to try the new practices and use them as champions. You want to assist staff in identifying with and valuing how the change will affect their practice. And finally, communicate a clear vision of the benefits to be gained from the change. So remember, by recognizing that change is inevitable in healthcare, organizations can focus on achieving effective change management including the use of nurses as change agents to smooth the way for change and to work to ensure positive outcomes.

    04:40 So when thinking of everything we've learned today, I would like you to consider this question.

    04:45 When serving as effective change agents, what are the critical skills needed to be successful? They are effectivce communicatioin, building trusting relationships, remaining aware of change fatigue, and organizational agility. I hope you've enjoyed today's video on serving as change agents. Thank you so much for watching.


    About the Lecture

    The lecture Serving as a Change Agent (Nursing) by Christy Hennessey (Davidson), DNP, RNC-OB is from the course Leadership and Management (Nursing).


    Included Quiz Questions

    1. To change oneself and to build capacity in others
    2. To identify opportunities and to engage others to change
    3. To motivate others to change and help form solutions
    4. To develop a safe place for creativity and inspire others to change
    1. Understanding that resistance is a natural part of the process
    2. Recognizing the key supporters and resistors
    3. Identifying the main source of resistance
    4. Communicating the clear goal of change to deal with resistance
    1. Empirical-rational
    2. Power-coercive
    3. Normative-reeducative
    4. Laissez-faire

    Author of lecture Serving as a Change Agent (Nursing)

     Christy Hennessey (Davidson), DNP, RNC-OB

    Christy Hennessey (Davidson), DNP, RNC-OB


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