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(Nursing profession studied) This is clearly not very high, and there does not seem to be a high impact of the change in technology on nurses and their employment.
This leads to a dichotomy in the view about nurses - they are viewed as targets of change rather than the force which leads to changes through proposals, leadership and implementation. This often causes them difficulty in carrying on with their jobs when there are rapid changes within the organization. To save their own position, it is important that nurses learn about change theory, change strategies and methods of anticipation and managing change. This may take place in organizations which wants to change its staff mix so that it can save on costs through inclusion of more unlicensed assistive personnel. These personnel will generally try to maintain their position through direct assertion, but there have to be an analysis of the driving and restraining forces before any decision is finally taken. (The Power of Change)
The driving reasons for the proposed change may be an increase in patient care hours that the hospital has to face, decreased charges that can be levied, elimination of non-professional tasks that are carried out by the registered nurses and additional time that has to be spent by them for teaching patients and their families. On the other side, there may be restrictions due to the lack of control over care for patients, concerns and worries about the supervision of unlicensed staff, the desire of maintaining the present situation and getting into any changes, and the conflict between the new staff and the old. Their may be conflicts in many cases between the new group and the old group, and the group planning the change may have their own views. These generally lead to a halt to the entire process till the conflicts are resolved. This is also the situation when the process of education and usage of technology among nurses start in any organization.
In general the policy adopted is to have a strategy of re-education so that creativity is stimulated and resistance is reduced. At the same time, the process involves more time for the change and a resultant higher cost. In a certain instance this situation was faced by two nurse managers. One of them adopted a policy of directly telling the staff about the change and the positive effects the change will bring within the organization. The feelings of the staff were not taken care of and this resulted in a near rebellion of the staff when the implementation dates and new staffing plans were put up. The entire group wanted to resign. Another manager had the same problem and selected a normative re-educative strategy. When the changes were introduced, he wanted to know from the staff their reactions. The opinions of the staff were listened to and further suggestions were made by the manager so that the problems of the staff were attended to. (The Power of Change)
The problems of the staff are quite easy to understand. A nurse may have developed competence with an existing documentation system, but have to start again when a computerized documentation system is introduced. There are many reasons for resistance to change - poor timing of the change, fear of loss of control, lack of trust, comfort with the existing situation, less certainty about the effects of change and the feeling that there will be extra efforts required to meet the change. At the same time, the nurse are capable of solving problems of changes and in a hospital in Wisconsin a nurse changed the frequency and timing of activated clotting time for patients with a particular type of coronary intervention. The result was a savings to the hospital of $5,000 in nursing time. (The Power of Change) Thus the introduction of changes based on technology has to be introduced in collaboration with the group which is going to implement the concept.
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