Learning Activity 9:
Nurses as Change Agents
"If you don't like something change it. If you can't change it, change your attitude. Don't Complain." - Maya Angelou
"Nearly all men can stand adversity, but if you want to test a man's character, give him power."" - unknown
Overview
A change agent is the person who seeks to cause or create change. This person may originate the ideas for change or may be an individual who recognizes the value of new ideas originated by others. Nurses may need to be change agents in regard to themselves, their clients, the institutions in which they practice and at a societal level at large. When one understands the process of change and how best to adapt to it, they are more likely to become an agent of change rather than a target of change. All those affected by a change are called the targets or stakeholders. The various models studied earlier in this course provide a framework for enabling change, e.g. Lewin's Force Field model or Virginia Satir's Chaos Model.
Effective change agents have a repertoire of applicable skills, (Nickols, 2000) particularly:
- Political skills
- Analytical Skills
- People Skills
- System Skills
- Business Skills
Ends In View
This learning activity is intended to provide learners with the opportunity to:- Apply an understanding of change to initiating change in health and societal contexts.
- Identify key factors in enabling change and overcoming resistance to change.
- Develop change management skills and change agent abilities.
In Practice
1. The readings outline a number of skills, abilities and process components needed to become an effective change agent. Brainstorm in small groups how nurses could develop these skills to apply in the workplace and in the health-social arena. Share your ideas with the class.
2. The Prosci Change Management Maturity Model offers a useful framework for assessing and developing planned change in a variety of organizational settings. Think of the setting where your practice experience is occurring currently. Where does this setting fit in the Prosci Model? What sort of change model/plan did you choose to implement?
3. The NHS publication provides a brief overview of a number of different approaches and models for change management. Which of these approaches would be suitable for the following planned changes? Where does the content in the Dooley reading fit in?
- Switching from a paper based medication administration record to a computerized MAR system.
- Changing organizational governance structures (administration, support clinicians, ward management, human resource personnel).
- You join three colleagues who all wish to lose 20 pounds of body weight within the next six months.
- You wish to spearhead a group who aim to lobby for skateboarding helmet and body pad legislation for all age groups.
- A group you belong to wishes to stop animal testing by drug and vitamin companies.
4. In pairs or triads, write down one change that you would like to work on this year. Select a change model that would fit this proposed change.
In Reflection
1.What skills and attitudes do you personally need to develop to be able to function as an effective change agent?
2.How do these skills differ when acting as a change agent for an institution or societal group versus a personal change, or a client change?
References
Dooley, J. (1995). Cultural aspects of systemic change management. Proceedings of ASQC Conference, QC95.
NCCSDO (2001). Managing Change in the NHS: Key points for health care managers and professionals. NHS Service Delivery and Organization R & D Programme. London, UK: London School of Hygiene and Tropical Medicine.
Nickols, F. (2004). Change Management 101: A Primer.
President's Advisory Commission on Consumer Protection and Quality in the Health care industry. Adapting Organizations for Change. Building the Capacity to improve Quality, Chapter 12. Quality First: Better Health Care for all Americans.
Prosci (1996). Change Management Maturity Model. Change Management Tutorial Series.
IN PREPARATION:
