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How can nurses participate in or lead in change management?

  • Comments (25)
  • Article: Kerridge J (2012) Leading change: 1 - identifying the issue. Nursing Times; 108: 4, 12-15.
  • Author: Joanna Kerridge is practice educator at Sue Ryder Nettlebed Hospice and associate lecturer at the University of West London.

Key points

  1. There is a pressing need for nurses to participate in or lead change management projects
  2. Staff need to be encouraged to develop the knowledge and skills to influence change
  3. The first step is to identify what exactly needs to change and why
  4. Several tools exist to help this process, including root cause analysis and process mapping
  5. Stakeholders need to be identified and involved in the process of change for it to be successful

Let’s discuss

The NHS Leadership Framework (NLC, 2011) recognises the potential of all staff to change practice. It is important that change is planned to ensure that it is effective and sustained.

Think about something in your clinical area that you would like to change.

  • What process did you use to identify the problem?
  • Are there barriers to making a change?
  • How could these be overcome?
  • Who should you involve in the process?
  • Comments (25)

Readers' comments (25)

  • Anonymous

    First you need to know what is the duty of a doctor and what service they offer before you can implement changes. It looks as if the public have been brain washed by media to beleive "Nurses Save Lives" and the duty of a nurse is to prevent doctors killing patients.

    I could not stand and ignore what goes on in the NHS and how nurses treat fellow human. Unfortunately doctors are helpless and so people who come to get help from professionals like me are made to suffer due to lack of proper education. As doctors we work under constant supervision (often humiliated by our seniors) for almost ten years yet we cannot claim to be perfect.

    So how do you think your members getting trained for six months and certificate by a nurse offer diagnosis, advice or treatment ? They are not only bringing shame to your profession but making a mockery of our moral and ethical responsibility.

    Please advice these nurses who are keen to help bring in changes in the NHS to join the medical school and be trained to work as a doctor. As a nurse you will not know what goes on behind the scene when a junior doctor makes a mistake and so they will maintain the high standard of care and compassion.

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  • Anonymous

    the government and particularly Lansley do not appear to understand the basic principles of the management of change and especially point no. 5 above! how can the acceptance of radical reforms and change be successful if such principles are not skillfully applied.

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  • Anonymous

    Anonymous | 23-Jan-2012 1:20 pm


    "First you need to know what is the duty of a doctor and what service they offer ..."

    your facts about the role and qualifications of nurses appear rather confused.

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  • michael stone

    Before this debate gets 'nasty' re doctors v nurses, what is this concept of 'change management' ?

    If nurses come across things they believe could be improved 'if we did 'X' instead', then it is simply a case of properly elaborating your proposal and reasoning, to whomever could implement the change.

    Which would be similarly true for something a doctor beleived could be improved, or a cleaner believed could be improved.

    Why is the world, so over-complicated: whatever happened to 'sense' !

    If the contention is just that nurses could effect changes which are within their normal working role and have already been decided upon, then surely this is simply stating that the people whose behaviour is to alter, are the people who are involved in altering their own behaviour (something so trivial, as to not need pointing out).

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  • Anonymous

    michael stone | 23-Jan-2012 3:10 pm

    before you mess up yet another debate, how about going and reading something about modern management theory and the management of change which can, as suggested in this article and the one in the link, be very usefully applied to nursing. it is not as simple as you make out. we are now managing a health service in the 21st century and no longer one in previous eras!

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  • michael stone

    Anonymous | 23-Jan-2012 3:26 pm

    You (I assume it is the same anonymous) have again commented that I have commented, but not commented about the topic - persistent behaviour on your part.

    If you disagree with the points I make, then by all means provide a reasoned critique of them - you don't do that, do you !

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  • Anonymous

    michael stone | 24-Jan-2012 11:12 am

    i really do not wish to enter into any further discussions with you but my answer to your above comment, last para, is no because as I have said before, I am interested in commenting on nursing matters with other nursing colleagues and change management is a topic I am particularly interested in from a nursing point of view.

    there is a large body of knowledge on this important subject which is important to the future of nursing and which I suggested you look at before introducing your own reductionist views and I fear you may block further debate and learning as you have done many times now.

    having seen you pattern of commenting behaviour now for a considerable time I tend not to read your comments in any great detail unless I find they are obstructing the discussion in which case I have, initially politely, pointed this out to you, as have quite a few others, but in your own interest, and in lack of respect for other commentators you chose to ignore any polite requests, even those which gave some justification. I also note there have been quite a few that were far less polite than mine, although I point out mine have also become less polite (although unlike some, mine do not contain personal or unreasonable attacks) as this seems to no avail.

    comments from anyone are normally welcome at any time and especially those from outside the profession which offer different perspectives essential to nursing but you overstep the boundaries and comment where issues need debate from a nursing perspective within the theory of nursing which you know nothing about and contribute nothing to the body of nursing knowledge essential for learners.

    I do not wish to waste any more of my time communicating with you on this matter and if you cannot adhere more respectfully to the etiquette of online commenting I will again take this up with NT.

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  • Anonymous

    "You (I assume it is the same anonymous) have again commented that I have commented, but not commented about the topic - persistent behaviour on your part."

    furthermore I reject you statement above as I do not come on the site to comment about your comments, but to comment on the issues under discussion which I have do regularly.

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  • Mertha Nyamande RMN

    Pardon my ignorance on this debate, but i am not sure how this became a Doctors vs Nurses debate. As i understand, this is about how Nurses can participate or lead in change management. You surely do not have to be a Doctor to participate in change management, even a janitor can.

    Nurses and doctors however, are not on opposing sides and therefore should not be working against each other, but compliment each other. In my experience, as a senior nurse, you often get junior doctors coming into a specialised environments and would not have an understanding or experience of how the systems work, nor understanding of the patient's history, background or complex medical/care needs. So we have to work together to guide each other, most importantly understand each other's limitations. Gone are the days where the doctor said and the nurses do. we are professionals in our own rights and have the right to disagree or question a course of treatment prescribed.

    This discussion has taken a different/wrong turn. It would be helpful if people commenting focus on the topics rather that taking this as an opportunity to have a rant about what they are not happy with.

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  • The debate has went out of the subject. Nurse has achieved a stage of being in charge of the care they are providing, they should have their say on patient's care matters, but there is a gap, experience is great, still we need the skills and the knowledge to provide the change. From experience some nursing adminstrators they are static about what they know, and they only see from one side, nurses who are on the wards they still lack the skills to implement change, good luck

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