Change Management in Transcultural Nursing: A Step-by-Step Guide
This paper examines change management in a healthcare setting, focusing on the implementation of a transcultural nursing care model among registered nurses. It outlines the psychological and sociological challenges nurses face when adapting to cultural competency expectations, explains why stakeholder readiness is essential to success, and demonstrates how change agents can bridge gaps between resistant and accepting staff. Drawing on Kotter's 8-step change model and supporting scholarly sources, the paper argues that involving stakeholders early, communicating a clear rationale, and modeling desired behaviors are the most effective strategies for sustaining meaningful organizational change in healthcare environments.
- Introduction to Transcultural Care and Change: RNs face cultural competency challenges requiring dual perspectives
- The Change Management Process: Preparation and Implementation: Three-phase model: preparation, management, and reinforcement
- Resistance to Change and the Role of Leadership: Leadership failures cause 70% of change initiatives to fail
- Readiness for Change and Kotter's 8-Step Model: Eight steps build unified readiness across mixed-opinion groups
- Change Agents and Stakeholder Engagement: Change agents align nurses and physicians with new practices
- Managing Diverse Perspectives and Agendas: Stakeholder feedback merges differing agendas into shared vision
- Conclusion: Early stakeholder inclusion reduces later resistance to change
✍️ How to write this paper — guide, tools & examples ▾
What makes this paper effective
- Anchors abstract concepts in a concrete clinical scenario — transcultural nursing implementation — which gives theoretical frameworks practical grounding throughout.
- Uses a well-known change framework (Kotter's 8-step model) systematically, working through its steps in sequence to structure the argument rather than merely citing it in passing.
- Balances multiple scholarly sources with applied reasoning, connecting each citation directly to the nursing context rather than dropping references without integration.
Key academic technique demonstrated
The paper demonstrates applied framework analysis: it introduces Kotter's 8-step model as a theoretical lens and then maps each step to the specific challenges of implementing transcultural nursing, showing how a general management framework can be adapted to a domain-specific problem. This technique — selecting an established model and testing it against a real scenario — is a core competency in graduate-level health administration and nursing leadership writing.
Structure breakdown
The paper opens by establishing the clinical change context (transcultural care for RNs), then defines change management's three-phase process (preparation, management, reinforcement). It moves into the causes of resistance and leadership accountability, introduces Kotter's model as the solution framework, explains the role of change agents, addresses perspective and agenda differences, and closes with a synthesis conclusion linking all elements back to the healthcare setting. Each section builds logically on the one before it.
Introduction to Transcultural Care and Change
A major challenge for registered nurses (RNs) involves implementing a transcultural care model — one that requires nurses to become more educated about different cultures and how to respond appropriately to patients from a variety of cultural backgrounds. This demands that nurses maintain two distinct perspectives and sets of beliefs simultaneously: their own personal beliefs and an empathetic understanding of the beliefs held by patients from different cultural backgrounds. As Kodama and Fukahori (2017) noted, the main challenge for RNs tasked with a change of this nature is to develop respect and empathy for others while holding both a micro and a macro perspective.
This paper describes the different perspectives on change held by those who welcome it and those who dread it, explains why readiness for change is crucial to its success, shows how change agents are essential for employee engagement, discusses how differing perspectives and agendas impact the change process, and explains how change can best be managed.
The Change Management Process: Preparation and Implementation
Change management is a process that proceeds in steps, which generally consist of preparation, management, and reinforcement (NHS, 2011). The first of these steps — preparation — requires that the change manager gain a sense of what stakeholders think about the current environment and about the proposed change. As Doll, Cornelison, Rath, and Syme (2017) explain, actualizing change depends upon involving stakeholders and obtaining their input and feedback on various proposals and change ideas. The more involved stakeholders are from the beginning of the process, the more likely they are to embrace the change during the implementation stage.
The management stage, where implementation goes live, requires managers to use change agents — stakeholders (generally employees) who are supportive of the change and can promote it among their colleagues. Resistance to change occurs when management has failed to identify all the perspectives and opposing points of view toward the change.
Resistance to Change and the Role of Leadership
To promote change effectively, the manager must explain rationally why the change is needed, present a vision of the benefits it will bring, and demonstrate personal supportiveness. Not everyone is going to welcome the change, but that does not mean they must resist it. Resistance is frequently a consequence of a failure of communication — and it is the change manager's responsibility to communicate the vision to those who are skeptical of change.
The primary reason resistance occurs and change fails is that managers are unable to adapt to the problem areas they encounter. Tobias (2015) points out that "the brutal fact is that about 70% of all change initiatives fail. The failure of leaders to challenge themselves to change, and then model the behavior they seek in others, may be a large contributor to these failures" (p. 35). In other words, change managers must be equipped with the ability to model the type of behavior they want their employees to demonstrate. In the case of transcultural nursing, they must be able to logically explain why the new behavior is needed. Modeling desired behavior is also an excellent method for reinforcing changes once they have been implemented.
Readiness for Change and Kotter's 8-Step Model
Readiness for change within a group that mixes those who welcome and those who resist change requires a deliberate approach: having change agents in place who can demonstrate empathy for those with opposing views while also explaining the importance of the change and why it is necessary (Joshi, 2014). One way to help develop readiness for change among a diverse group is to apply Kotter's change model, which is comprised of eight steps:
1) Create a sense of urgency
2) Create a guiding coalition
3) Create a vision for change
4) Communicate the vision
5) Remove obstacles
6) Create short-term wins
7) Consolidate improvements
8) Anchor the changes (Kotter's 8 Step Change Model, 2018).
To bring a group together, one must first create a sense of the urgent need for change. This helps break down barriers among employees who are reluctant to change and aligns them with those who are more accepting of it. Second, a guiding coalition must be formed to ensure that the group stays on the right track rather than shifting aimlessly between competing viewpoints. The coalition embraces the rationale for change and guides the rest of the group through the implementation process.
Conclusion
Change is a process that has numerous psychological and sociological components: managers must be aware of the risk of resistance and of ways to mitigate that risk. If managers in a healthcare setting can incorporate the views of nurses and physicians into the change process, they will benefit from involving stakeholders at the earliest stages and reduce the risk of obstacles emerging later. Change agents and a guiding coalition made up of workers who are both supportive of and knowledgeable about the change should be utilized by change managers to facilitate the overall process. A clear rationale for the change should always be provided as the foundational explanation for why the change is required.
References
Doll, G. A., Cornelison, L. J., Rath, H., & Syme, M. L. (2017). Actualizing culture change: The Promoting Excellent Alternatives in Kansas Nursing Homes (PEAK 2.0) program. Psychological Services, 14(3), 307.
Joshi. (2014). Change is constant, but improvement is rapid. H&HN: Hospitals and Health Networks.
Kodama, Y., & Fukahori, H. (2017). Nurse managers' attributes to promote change in their wards: A qualitative study. Nursing Open, 4(4), 209–217.
Kotter's 8 Step Change Model. (2018). Retrieved from https://www.toolshero.com/change-management/8-step-change-model-kotter/
NHS. (2011). Overview – Change management – the systems and tools for managing change. Retrieved from https://www.england.nhs.uk/improvement-hub/wp-content/uploads/sites/44/2017/11/Overview-Change-management.pdf
Tobias, R. M. (2015). Why do so many organizational change efforts fail? Public Manager, 44(1), 35.
Create your account
Always verify citation format against your institution’s current style guide requirements.