Transformational Leadership and Leadership

Applying Change Theory to Nursing Operations

In response to a request from a nurse manager to select a team of nurses to assist in implementing a long-needed change to existing policy, it will be necessary to change the manner in which the nursing staff performs shift-to-shift reporting. At present, nurses report to each other in the break room and the nurse manager has decided that in the next 2 weeks the nursing unit will transition to report being endorsed at the bedside. This paper describes how a project manager should approach this change project using a transformational leadership style to guide the process as well as how Kurt Lewin's change theory can be used support the change implementation process. Finally, a summary of the research and important findings concerning transformational leadership and Lewin's change theory in this context are provided in the conclusion.

Discussion concerning the selected leadership style and supporting rationale

Transformational leadership style was selected to implement the change to shift -to-shift nursing report at the bedside. As the term connotes, transformational leaders "transform" their organizations from their existing state to a desired state (Bass, 1998), making this leadership style especially appropriate for the change in shift-to-shift reporting. For instance, Avolio and Bass (2002) point out that in general, transformational leaders "motivate their associates, colleagues, followers, clients, and even their bosses to go beyond their individual self-interests for the good of the group, organization, or society" (p. 2). Because people naturally tend to resist change, it is important for any leadership style to reinforce the need for change in order to motivate others to make the personal investments in time and effort that are required to accomplish it, making transformational leadership an optimal approach. One of the best strategies for achieving this outcome is the active and enthusiastic solicitation of feedback from those who will be most impacted by the change initiative (Bass, 2002).

2. Discussion concerning the change theorist selected to implement this change and supporting rationale

Kurt Lewin's change theory can be summed up by the now-famous dictum, "Unfreeze - Change -- Refreeze" (Rosch, 2002, p. 8). Although it is reasonable to posit that most managers recognize the challenges that are involved in implanting any change to their subordinates' day-to-day routine because this is a natural reaction. Most people truly hate changes to their daily routine because it requires a personal investment in time and effort that may have dubious results. Therefore, Lewin's change theory maintains that the current shift-to-shift reporting regimen must be unfrozen, a meaningful change implemented and this change formally adopted and codified.

Notwithstanding a change manager's best efforts to the contrary, empirical observations and painful experience confirm that implementing and sustaining meaningful changes in organizations of any size or type is fraught with unexpected views from stakeholders that may not have even have been readily apparent at the outset. For instance, Rosch (2002) emphasizes that, "While someone may start out with a plan to implement a change in an organization, it rapidly becomes subject to and changed by the unfolding situation. As the process unfolds, new actors emerge, and known ones may wax and wane in significance" (p. 9). Some of the variables that can play an especially pivotal role may not have even occurred to the change manager, but Lewin and like-minded organizational behavioral theorists maintain that it is essential to overcome this initial reluctance to change by emphasizing the "what's in it for me" aspects of the proposed changes (Rosch, 2002).

3. Apply this theory to the implementation of this shift-to-shift reporting at the bedside

At the situation now stands, the shift-to-shift reporting in their break room is clearly untenable for a number of reasons, most especially the lack of continuity of nursing care that such an approach provides. It does not take a stretch of imagination to readily understand how the noisy and hectic environment of a nursing unit break room is enormously unconducive to the communication of vitally important nursing data about patients, and even the slightest lapse in communications can spell the difference between life and death. Given that the vast majority of professional nurses pursue the profession from the outset, it only makes good sense that most nurses want the best for their patients. In sum, tt is this aspect of current shift-to-shift transfer of nursing responsibility that is most lacking, and bedside reporting has a number of clear advantages that make this initiative "easier to sell" to the numerous stakeholders that are involved (e.g,, accrediting agencies, other professional nurses, their patients and healthcare organizations).