A new manager discovers that their unit still follows outdated procedures. You are aware of the evidence against this practice and are eager to make a rapid change on your unit. In terms of Lewin’s Stages of Change, which stage are you in?

Choice A Reason:

Follower implies that the nurse manager is taking direction from others rather than leading the situation. In this context, the nurse manager is actively addressing an issue, proposing solutions, and seeking input from the staff, which are leadership behaviors. Therefore, the role of a follower does not accurately describe the nurse manager’s actions in this scenario.

Choice B Reason:

Leader is the most appropriate role for the nurse manager in this situation. By calling a staff meeting, proposing a solution, and asking for input, the nurse manager is demonstrating leadership qualities. Effective leaders engage their team in problem-solving, encourage collaboration, and guide the team towards a resolution. This approach helps in addressing the issue effectively while fostering a supportive and inclusive work environment.

Choice C Reason:

Manager refers to the administrative and organizational responsibilities of the nurse manager. While the nurse manager is indeed managing the situation, the emphasis in this scenario is on leadership. The actions described—proposing a solution and seeking staff input—highlight the nurse manager’s role as a leader rather than just a manager. Leadership involves inspiring and motivating the team, which is crucial in handling complex situations like this.

Choice D Reason:

Regulator implies a role focused on enforcing rules and policies. While maintaining standards and policies is part of a nurse manager’s responsibilities, the scenario described involves more than just regulation. The nurse manager is actively engaging with the staff to find a solution, which is a leadership activity. Therefore, the role of a regulator does not fully capture the nurse manager’s actions in this context.

Choice A Reason:

Focusing the assessment on the unit and ignoring the needs of the hospital as a whole is not a viable approach. While it is important to address the specific needs of the unit, it is equally crucial to consider the broader context of the hospital. Ignoring the hospital’s overall needs can lead to fragmented care and inefficiencies. A holistic approach ensures that changes in the unit align with the hospital’s goals and resources.

Choice B Reason:

Hiring an outside consultant to oversee and manage the project can provide specialized expertise and an external perspective. However, this approach may not fully leverage the insights and experiences of the staff who are directly involved in patient care. Consultants can be valuable, but their role should complement, not replace, the active involvement of the unit’s staff.

Choice C Reason:

Engaging involved staff at all levels in the decision-making process is the best approach. This strategy aligns with complexity principles, which emphasize the importance of collaboration, shared decision-making, and leveraging the collective expertise of the team. Involving staff fosters a sense of ownership and commitment to the changes, leading to more effective and sustainable implementation. It also ensures that the adaptations are practical and directly address the needs of both patients and staff.

Choice D Reason:

Seeking a resolution from upper management may be necessary for securing resources and support, but it should not be the primary approach. Top-down directives can overlook the nuanced understanding and practical insights of frontline staff. Effective change management requires a bottom-up approach that engages those who are most familiar with the day-to-day operations and challenges of the unit.