9.1: Introduction

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Page ID: 8954

Joan Wagner & Sonia A. Udod
University of Regina

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Learning Objectives

Explain why nurses have the opportunity to be change agents.
Identify how different theorists explain change.
Discuss how the nursing process is similar to the change process.
Discuss the medicine wheel as a change model.
Describe the nurse leader’s role in implementing change and the call to action.
Differentiate among change strategies.
Recognize how to handle resistance to change.

Leaders take us to places we’ve never been before. But there are no freeways to the future, no paved highways to unknown, unexplored destinations. There’s only wilderness. To step into the unknown, begin with the exploration of the inner territory. We continue to discover that the most critical knowledge for all of us—and for leaders especially—turns out to be self-knowledge. (Kouzes & Posner, 2007, p. 346)

Change is an essential component of nursing practice. Leading change is a challenge for nurse leaders amid the complexities and challenges of evolving health care environments in providing quality patient care. This chapter is designed to provide nurse leaders with guidance through various theories and frameworks to effectively support the change process in shaping healthy work environments. Additionally, you will learn about resistance to change and how to respond constructively to change. This chapter focuses on providing guidelines for nurse leaders on behaviours and practices for encouraging and facilitating change in the health care setting.

The rapid pace of change in Canada’s health care system provides opportunities for nurse leaders to refine and advance their leadership and management skills for advancing change. Various forces that drive change in health care include rising costs of treatment, new technologies, advances in science, workforce shortages, and an aging population. Change initiatives must always be implemented for good reason within the context of advancing institutional goals and objectives. Balancing change is a key challenge within a patient- and family-centred model to provide safe and reliable patient care (Stefancyk, Hancock, & Meadows, 2013; Saskatchewan Ministry of Health, 2011).