Nursing

From the staff development bookshelf: Transforming nursing practice through change remapping

Staff Development Weekly: Insight on Evidence-Based Practice in Education, June 17, 2011

Leading strategic change in transforming professional nursing practice through shared governance requires organizations to channel efforts in training, educating, and empowering others to get ahead of the change curve to master anticipatory change rather than subject themselves constantly to reactionary or crisis change.

So how exactly does remapping change work? Black and Gregersen (2003) discuss three primary brain barriers leading to failed change and the keys to successfully overcoming those barriers and delivering strategic change in healthy organizations.

  1. Brain barrier: Failure to see the need for change when what they have already been doing seems to still be working for them
    • Contrast. Look at key contrasts at how strategies, structures, cultural values, processes, technologies, practice models, and approaches to nursing leadership that worked in the past are no longer effective in the present or appropriate for the future.
    • Confrontation. Leaders may have to confront nurses with clear and compelling evidences between past, present, and future contrasts to help them see before they can move to change. They cannot—they will not—change if they do not see the need to do so.
  2. Brain barrier: Failure to move after they see the need to change because they do not believe in the new path, their ability to walk it, or the rewarding outcomes of the journey and destination.
    • Destinations. Make sure everyone sees the destination clearly to gain belief in the move to shared governance. People cannot change if they do not see the destination clearly or understand where they are going.
    • Resources. Give them the skills, resources, and tools they need to reach the destination and participate in shared governance.
    • Rewards. Deliver valuable rewards along the journey that have meaning to the employee.
  3. Brain barrier: Failure to finish because they are tired and lost
    • Champions. Trained and motivated change champions are needed close to the action in every practice setting from the moment that the decision to change is implemented.
    • Charting. Progress must be measured at all levels in the organization and reported. Performance—good, bad, or indifferent—needs to be communicated to staff members. Successful change requires monitoring and communicating at the individual level.


Source: Book excerpt adapted from Shared Governance: A Practical Approach to Transform Professional Nursing Practice, Second Edition, by Diana Swihart, PhD, Dmin, MSN, CS, RN-BC.

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