Question: How Would You Handle This Response to Change?

You are the unit manager of a cardiovascular surgical unit. The workstation on the unit is small, dated, and disorganized. The unit clerks have complained for some time that the chart racks on the counter above their desk are difficult to reach, that staff frequently impinge on the clerks' work space to discuss patients or to chart, that the call-light system is antiquated, and that supplies and forms need to be relocated. You ask all eight of your shift unit clerks to make a "wish list" of how they would like the workstation to be redesigned for optimum effi ciency and effectiveness. Construction is completed several months later. You are pleased that the new workstation incorporates what each unit clerk included in his or her top three priorities for change. There is a new revolving chart rack in the center of the workstation, with enhanced accessibility to both staff and unit clerks. A new state-of-the-art, call-light system has been installed. A small, quiet room has been created for nurses to chart and conference, and new cubbyholes and fi ling drawers now put forms within arm's reach of the charge nurse and unit clerk. Almost immediately, you begin to be barraged with complaints about the changes. Several of the unit clerks fi nd the new call-light system's computerized response system overwhelming and complain that patient lights are now going unanswered. Others complain that with the chart rack out of their immediate work area, charts can no longer be monitored and are being removed from the unit by physicians or left in the charting room by nurses.

One unit clerk has fi led a complaint that she was injured by a staff member who carelessly and rapidly turned the chart rack. She refuses to work again until the old chart racks are returned. The regular day-shift unit clerk complains that all the forms are fi led backward for left-handed people and that after 20 years, she should have the right to put them the way that she likes it. Several of the nurses are complaining that the workstation is "now the domain of the unit clerk" and that access to the telephones and desk supplies is limited by the unit clerks. There have been some rumblings that several staff members believe that you favored the requests of some employees over others. Today, when you make rounds at change of shift, you fi nd the day-shift unit clerk and charge nurse involved in a heated conversation with the evening-shift unit clerk and charge nurse. Each evening, the charge nurse and unit clerk reorganize the workstation in the manner that they believe is most effective, and each morning, the charge nurse and unit clerk put things back the way they had been the prior day. Both believe that the other shift is undermining their efforts to "fi x" the workstation organization and that their method of organization is the best. Both groups of workers turn to you and demand that you "make the other shift stop sabotaging our efforts to change things for the better."

ASSIGNMENT: Despite your intent to include subordinate input into this planned change, resistance is high and worker morale is decreasing. Is the level of resistance a normal and anticipated response to planned change? If so, would you intervene in this conflict? How? Was it possible to have reduced the likelihood of such a high degree of resistance?