Change is a regular occurrence within the healthcare system. As nurses, we are so resistant to change within our organization. If unplanned or accidental change happens, we as human beings have no choice but to accept the change as it was not anticipated and out of our control. Planned change on the other hand is “the direct result of a conscious effort between the individual who works to bring about the change and those on whom the change has a direct impact.” (Bozak, 2003) Lewin’s Change Theory Model was designed to alleviate feelings of uneasiness, uncertainty, and loss of control during times of planned change.
At Midstate Medical Center we are experiencing planned change daily within the ever changing framework of our institution. Many nurses are in a state of panic, not willing to accept change. They resist it by allowing the evolving change to shift their attitude from one of positive to one of negative within the hospital. Within the last five years at Midstate, we have undergone a tremendous change in our documentation. We changed from paper charting to computer charting and computer physicians order entry (CPOE). In speaking with my educational resource nurse and coordinator of the computerized base charting, I discovered that it was Lewin’s Change Theory Model that guided improved behavior and an effective implementation of change in my hospital. By utilizing his three step process of unfreezing the current level, moving to a new level, and refreezing or freezing at the new level, Midstate was able to “successfully strengthen the driving forces in favor of the change while weakening or eliminating the restraining forces.” (Bozak, 2003)
Examples of Driving Forces:
- Commitment by management
- Adequate financial resources
- Educational/training needs provided for
- High level of autonomy in organizational culture
Examples of Restraining Forces:
- Aversion by staff to learning a new system
- Lack of prior computer experience
- Negative past experience with change
- Low level of commitment by staff
When applying Lewin’s Change Model Theory to current practice nurses should know:
- His theory of change provides structure to understand nurses behavior
- His theory can guide and analyze the process of change and assist in identifying the adapt to forces that can move the change forward or create barrier to weaken the change
- His theory will help those in the organization realize that change is necessary and valuable to the success of the organization
- His theory will ensure continued support and assistance to people in the organization at all levels to help them continue to adapt to the change
Application of Lewin’s Change Model Theory to my anticipated practice as a masters-prepared nurse:
Leaders in today’s healthcare environment must be prepared to efficiently and effectively adapt to change. Power in many organizations has shifted from upper management and administration to their staff workers and employees. “Empowerment is consistent with the contemporary views of leadership (i.e., transformational, visionary, etc.).” (McEwen & Wills 2011) It is important to note here that, “in today’s competitive economic environment, organizations that have been successful from an economic and quality standpoint, are those that have empowered employees to “get the job done.” (McEwen & Wills 2011) Mastered-prepared nurses must be knowledgeable in new ways to deliver care, new therapies and new technology. They need to develop skills necessary to evaluate therapies and be ready to implement change in practice when indicated.
“According to the American Association of Colleges of Nursing (AACN, 1996) nurses in advanced practice should be prepared to critique, evaluate and use theory.” (McEwen & Wills 2011) It is not enough just to use any theory. As masters-prepared nurses, we must be able to identify and use the appropriate theories from nursing that apply to the particular area or field of nursing we are in. We must be able to utilize the chosen theory to provide the highest quality of care possible to all of our clients. This goal can be achieved by understanding the organizational structure or healthcare delivery system in which we practice.
As a masters-prepared nurse, the ability of understanding theory enhances knowledge within an organization. The application of Lewin’s Change Model Theory would be a suitable nursing theory in organizations today. Healthcare is faced with constant change in; technology, governmental laws, policies and procedures and empowerment of hospital staff. Utilizing Lewin’s 3 stage, Changed Model Theory, would spare the environment from chaos, and aide in maintain equilibrium among the staff during a planned change. “Leaders in today’s environments of continual change must be prepared to efficiently and effectively adapt to change and must be able to manage all aspects of change-from both external and internal forces.” (McEwen & Wills 2011)