Cultural Cliques in Nursing: A Lewin's Change Model Approach
This paper examines the problem of cultural cliques among nurses in the clinical setting and their impact on communication, patient care, and workplace cohesion. Drawing on evidence-based practice and relational aggression research, the paper applies Lewin's three-stage change model — Unfreeze, Move/Action, and Re-Freeze — alongside transactional leadership principles to address the issue. Proposed interventions include cultural awareness training, ethics education, job rotations, performance evaluations, and anonymous staff surveys. The optimal outcome is increased cultural awareness and mutual respect among nurses, evidenced by a measurable reduction in clique-based behavior in the clinical environment.
- Introduction: Evidence-Based Practice and the Problem of Cultural Cliques: Evidence-based practice and nursing cultural clique problem
- Relational Aggression in the Nursing Environment: Relational aggression harms nurses and patients
- Lewin's Change Model: Stage One — Unfreeze: Problem identification initiates the change process
- Stage Two — Move/Action: Training, rotations, and evaluations drive change
- Stage Three — Re-Freeze: Standardizing effective practices sustains change
- Conclusion: Change is necessary in dynamic professional environments
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What makes this paper effective
- The paper clearly identifies a specific, real-world clinical problem — cultural cliques — and ties it directly to patient safety outcomes, strengthening the urgency of the argument.
- It applies a well-established theoretical framework (Lewin's three-stage change model) systematically, giving the proposed intervention a recognizable and credible structure.
- Each stage of the change process includes concrete, actionable steps (job rotations, anonymous surveys, performance evaluations), which move the paper beyond abstract theory into practical application.
Key academic technique demonstrated
The paper demonstrates applied theoretical analysis: it takes an organizational behavior framework (Lewin's change model) and maps it directly onto a specific nursing workplace problem. Rather than simply describing the theory, the author operationalizes each stage with specific interventions, showing how abstract models translate into clinical and administrative practice.
Structure breakdown
The paper opens with a rationale for evidence-based practice in nursing, then identifies the central problem (cultural cliques and relational aggression), supported by a cited source. The body is organized into the three stages of Lewin's change model, with Stage Two receiving the most detail as the action phase. A brief conclusion addresses the broader necessity of change management in professional settings. References follow APA format throughout.
Introduction: Evidence-Based Practice and the Problem of Cultural Cliques
Evidence-based practice holds great promise for the professional nurse in the clinical setting. Learning through continuing self-education and peer-group education from evidence-based studies enables the nurse to operate at optimal efficiency in their job functions. However, given the demands of the profession, it is not always easy to come together in a learning atmosphere (Krugman, 2009). The use of evidence-based practice can be both clinically important and professionally advantageous (Leasure, Stirlen, & Thompson, 2008).
The problem addressed in this paper is the clustering of cliques among nurses in the clinical setting based on their cultural background, thereby creating a potential for missed communication, lowered patient care, and interpersonal strife. The change application used to address this problem is based on Lewin's change model and applies transactional leadership to guide the necessary stages of change. The optimal outcome is increased cultural awareness and respect among nurses of different cultural backgrounds, as evidenced by a decrease in cultural cliques in the work environment.
Relational Aggression in the Nursing Environment
Dellasega (2009) reports on the relational aggression that occurs in the nursing environment. These types of aggression occur when two or more nurses band together and engage in aggression against other nurses. The forms of aggression are not physical — they are relational. These forms include gossiping, ostracizing nurses, and deliberately withholding information (Dellasega, 2009).
While all forms of relational aggression are psychologically distressing and contribute to disunity among nurses in the workplace, the deliberate withholding of information has the potential to harm not only the nurse being targeted, but also that nurse's patients. This is an unacceptable situation, as lives hang in the balance. Addressing this problem through a structured change process is therefore both an ethical and a professional imperative.
Lewin's Change Model: Stage One — Unfreeze
The first stage of Lewin's change model is the Unfreeze stage. In the context of this problem, this stage involves the clear identification of the issue: the formation of cultural cliques among nurses in the workplace. Recognizing and naming the problem is the essential starting point before any meaningful change can be implemented.
Stage Two — Move/Action
The second stage, Move/Action, encompasses the active interventions designed to address the identified problem. The following steps are proposed:
Conclusion
Change in the workplace can be a painful process for those who are resistant to it. However, change is a necessary process, as social, spatial, and temporal characteristics are dynamic and subject to multiple forces at any given moment. When a problem is clearly identified as a disruptive element in a professional setting such as a nursing work environment, there are several change model options for moving from problem to solution.
In this case, Lewin's three-stage model, guided by transactional leadership principles, provides a clear and actionable framework. By unfreezing the current state, implementing targeted interventions, and refreezing around improved norms, nurse leaders can effectively address cultural cliques, reduce relational aggression, and ultimately improve both the nursing work environment and patient care outcomes.
References
Dellasega, C. (2009). Bullying among nurses. American Journal of Nursing, 52–58.
Kritsonis, A. (2005). Comparison of change theories. International Journal of Scholarly Academic Intellectual Diversity, 1–7.
Krugman, M. (2009). Barriers to successful journal club outcomes. Journal for Nurses in Staff Development, 100–101.
Leasure, A., Stirlen, J., & Thompson, G. (2008). Barriers and facilitators to the use of evidence-based practice. Dimensions of Critical Care Nursing, 27(2), 74–84.
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