The Role Emotions Play in the Change Process: Negative emotions associated with change

Negative emotions associated with change

A number of negative emotions specific to the health care environment are listed in the previous section.

Despite the emotional response being highly individual, there are 3 emotions that dominate:

Fear

Isolation

Stress

Most fear is not of the change itself but of the unknown associated with change and can be perpetuated by the proverbial grapevine.

Isolation, on the other hand, can be the result of the breaking up of either formal or informal support groups. It can also result from the perception of not having a say in the decisions surrounding change or from not being asked to share the wisdom that comes from experience.

Not surprisingly, stress is a common cause of sickness and absenteeism within health care organizations. Lokk and Arnetz (2002) cite organizational change as a significant stressor both mentally and physiologically, with stress related illnesses being a common side-effect of poorly managed change.

Debra

Debra Johnston is the Clinical Coordinator/ Enterostomal Therapy Nurse for Medical Oncology at teaching hospital in Toronto. Debra completed her diploma nursing from Georgian College in 1994, and obtained her Bachelor of Science in Nursing from Ryerson University in 2004. She completed her Enterostomal Therapy Education in 2005 and recently successfully achieved CNA certification in Enterostomal Therapy Nursing. She is presently pursuing a Masters in Nursing from Athabasca University. Her clinical practice involves complex wound and fistula management, and educating patients and their families who have new ostomies. Her corporate responsibilities include product evaluation, involvement in the Skin and Wound Care Nursing Clinical Leadership Team and the Interprofessional Pressure Ulcer Prevention and Management Committee.

Corinne

Cori Watson holds a Bachelor of Science Nursing degree from the University of Victoria and is currently pursuing a Masters of Nursing from Athabasca University.

Her past experience includes clinical nurse positions, as well as clinical education, nursing management and professional practice spanning the acute care as well as home and community care sectors.

Cori is certified in Hospice Palliative Care and Community Health Nursing through the Canadian Nurses Association. In her current role as Professional Practice Leader, Oncology at Thunder Bay Regional Health Sciences Centre, Cori supports the strategic direction for nursing and provides leadership and consultation for professional practice with the Regional Cancer Care Program.

Andrea

Andrea Jewell began her career in 1994 with a Diploma in Nursing from the CEGEP in Hull, Quebec, and then graduated with her BScN from the University of Ottawa in 1997. She is currently working on her Masters of Nursing through distance education from Athabasca University.
Andrea has over 16 years of experience in Nursing across the clinical and educational domains and has worked in the tertiary, public and primary health care sectors. For the past year, she has been working as an Education Consultant with the Inter-Professional Model of Patient CareÓ team at The Ottawa Hospital.

Maria

Maria has a Bachelor of Arts from University of Toronto. She obtained a Bachelor of Nursing degree from Athabasca University. Maria obtained a certificate in Perioperative nursing at George Brown College. Maria is currently almost half way through her Masters of Nursing at Athabasca University.

Maria has a twenty-year career as a Perioperative nurse specializing in Cardiovascular surgery. She has had some leadership experience as the Patient Care Coordinator for the Cardiac operating rooms. She is currently the Advance Practice Nurse –Educator in the operating room at busy downtown operating room.

Definitions of Change

Change means something different to everyone. The following is a small compilation from a very large selection of definitions of change:

Change is...

...an event that occurs when something passes from one state or phase to another

...to become different in some particular way, without permanently losing one's or its former characteristics or essence

...the act, process, or result of altering or modifying

...to cause to be different

...to give a completely different form or appearance to; transform

...a transformation or transition from one state, condition, or phase to another

Which definition do you most identify with?

Favorite Quotes on Change

Case Scenario 1

You are the manager of a busy emergency department that never seems to slow down. Staffing is constantly short and the workload extremely demanding at all hours. The department currently uses paper charting for all aspects of care, including doctors' orders. The senior management team has decided that the paper charting system is no longer functional for the department and to move forward into the future, an electronic documentation system is required. You are given a time frame of 1 year until the go live date.

At a staff meeting you make the staff aware of the coming change and many seem to be extremely disgruntled by the immensity of the change. As the discussion progresses, the staff seems to become more and more frustrated and stressed about the seemingly constant change within the department.

As the manager, what emotions can you anticipate from your staff during this change process?

What strategies can you use to help your staff through the change?

Case Scenario 2

The incidence of pressure ulcers within your institution has dramatically increased this year. Chart audits reveal nursing documentation on the presence of pressure ulcers (including the size, stage, location and wound healing trajectory) need to be improved. As well, nursing interventions in relation to pressure ulcer prevention need to be clearly identified within the charting.

In today’s busy healthcare environments, charting is rushed to keep up with the intense demands of patient care. Often appropriate patient care is provided, but this is not reflected sufficiently within the nursing documentation.

To help fulfil this documentation requirement (and also to legally protect nurses involved in patient care), new user friendly “Wound Care Documentation” and “Braden Plan of Care” tools are created to facilitate efficient, comprehensive charting.

During rollout to the pilot nursing units, you overhear some nurses who were not initially included in the brainstorming sessions for the tools complaining “here we go again- another piece of paper to be filled out”.

How would you handle this situation?

Discussion Questions

Please review the following discussion questions and post your response in the "Group Presentations" forum.

1. Caruso & Salovey (2004) identified 6 principles of emotional intelligence.

Can you give an example of how the conscious awareness of one or more of these principles has enhanced your personal or professional emotional health?

2. Rhee (2007) and Barsade (2002) both describe an emotional ripple effect which can occur in response to change. They believe that one individual or group’s emotional response can directly impact the emotions, moods and behaviors of another individual or group.

Have you witnessed an emotional ripple effect within your organization during a change process? What was its impact? What strategies were utilized to overcome it and move forward?

3. Liu & Perrewe (2005) write that a flood of information in any change results in “threat rigidity” because there are limits to the capacity of new information one can process.

Describe a situation in your personal or professional life where you encountered threat rigidity and how you coped with this information overload.

4. Garrety, Badham, Morrigan, Rifkin & Zanko (2003) suggest that cultural change within an organization “can only be achieved through personal transformation among managers.”

Can you provide an example of good management during an organizational change initiative? What characteristics did the manager role model that supported the resilience of the team and lead to successful change?