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This assignment will look at how the change theory of Lewin can be applied to a clinical situation that has ethical, advocacy and legal ramifications

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Introduction

This assignment will look at how the change theory of Lewin can be applied to a clinical situation that has ethical, advocacy and legal ramifications. The elder care facility it will be applied to provides all staff with the same uniform regardless of their designation, also, within this facility all staff are referred to as nurse whether they are or not. This makes identification of staff designations very difficult. The change theory developed by Kurt Lewin in 1951 will be applied to change and improve this situation and an analysis of the situational factors that impact on change will be explored. The principals of change theory will be discussed and applied to the planned change and conclusions about determining the success of the change will be made. Whilst on clinical placement with first year students in an elder care facility it was noticed that all the staff members, except the nurse-manager who wore contemporary clothes, wore the same uniform. Only one nurse was seen to be wearing her badge and inquiries regarding the uniform were met with the response "we all want to look the same - no hierarchy here". Furthermore, all staff were referred to as "nurse" whether they were nurses or not. Being unfamiliar with the staff, students were further disadvantaged by being unable to rely on uniforms and badges to determine the staffing designations. It was also noticed that visitors to the facility had these same problems. Having staff designations identified by different uniforms would enable patients, visitors and other staff to instantly know whether they were talking to a registered nurse, a care associate or chatting to the cleaner. The theory of change was developed by Kurt Lewin, who identified three phases to accomplishing change (Marquis & Huston, 2003). The first of these phases is that of unfreezing, when "the change agent unfreezes forces that maintain the status quo" (Marquis & Huston, 2003, p. ...read more.

Middle

This proves to staff that they are trusted by the management and are considered a valuable part of the organisation. There are two aspects to this planned change. The first one is to introduce different uniforms for different staff designations and the second change is to ensure the only people who are referred to as "nurse" are those who are registered or enrolled nurses. It is anticipated that the introduction of a uniform change will be easier than changing the way people refer to each other because a uniform change can be done at a managerial and policy level, whereas ensuring people refer to each other correctly relies on the individuals themselves. According to Simms, Anderson, and Ervin (1994), a change that involves changing specific behaviors is easier to implement than one involving underlying beliefs and values. Many of the care associates at this elder care facility may like being called nurse, with all of the implications associated with being a nurse as opposed to being a care associate. Certainly none of them seem to correct anyone who does call them nurse, so the change agent could probably expect more resistance to this change than to the uniform change. The change agent in this facility would probably be the nurse manager, who appears to have a positive pro-active effect on this workplace. She would have to act as a role model and view the change positively. She would accept that there will be initial resistance from some members of the staff and this is a natural response (Clarke, 1994). As part of the unfreezing phase of this change the change agent would explain to the staff that there was a problem and because of this problem there was a need for change. According to Stephen (1999), staff wearing the same clothes is particularly unsettling to the elderly, and she goes on to say that it is important for nurses to identify their designation as registered nurses. ...read more.

Conclusion

The scope of the change is not big but it will impact on the staff. Nurses will be identified as such and other caregivers will not be identified as nurses. This change will empower patient's as they will know who is providing their care. Making this change will also encourage all the staff to accept more responsibility for providing a high standard of care within their scope of practice. By including staff in the change process, the change agent invite's them to become more attached to the organisation, which in turn leads to greater commitment, motivation and willingness to accept change (Hein & Nicholson, 1994). It will also allay any potential confusion from patients and their families about exactly who is performing cares for them or their loved ones. From a managerial perspective this gives the organisation a very professional public face. Anyone entering their premises will be able to easily identify the designations of staff by looking at their uniforms. Change is an essential factor in growth and development and while many people are initially resistant to change, others often feel empowered by it. Change involves three phases beginning with an idea and a change agent with vision and the ability to motivate and empower individuals will accomplish the change and ensure it is permanent. Excellent communication skills enable barriers and resistance to be overcome and allows those affected by change to have their say. All healthcare professionals work in an environment of constant change and must adapt to it. The right to be called "nurse" is one that is earned and carries legal, ethical and social obligations. While the practicalities of this change are not large, they will have a big impact on those affected by them. Nurses will be identified as nurses, and other staff who are not nurses, will not refer or be referred to as a nurse. Change is vital for development and empowerment, and whilst change is not always welcomed, without it there would be stagnation. . ...read more.

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