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The Role of Nurse Leader in the Change Initiative

Nurse leaders act as change agents to implement changes that will enhance nursing and
improve the working conditions of floor nurses. In the present change initiative, the nurse leaders
will play a fundamental role in implementing improved interpersonal relationships with new
nurses during interviews and orientation. Moreover, the nurse leaders will ensure the formulation
effective communication concerning the reorganization of the growth opportunities for existing
nurses and how they align with organizational objectives (Nelson‐Brantley & Ford, 2017). In
order to ensure that nurses remain with the facility for a long time, nurse leaders will explain to
them the need to observe organizational culture and how the change initiative will impact the
nurses going forward. In other words, nurse leaders will ensure the implementation of the various
facets of the change initiative.
The Lippit’s seven step change theory will play an instrumental role in the change
initiative at the UMTB medical-surgical unit. Using this theory, the present author will diagnose
the issue of nurse burnout and evaluate the capability and motivation for change. Moreover, the
author will assess the motivation of the change agent and available resources as well as elect
progressive change objectives. Further, explaining the role of the change agent to the employees
by ensuring clarity in their expectation and sustaining the change through feedback, effective
communication and coordination regarding the effects of the change will occur (Burke, 2017).
Lastly, the Lippit’s seven step change theory will allow the author to terminate the helping
association of the change agent gradually.


Change Agents and their Roles

Change agents play crucial roles in managing the change process. As such, the
identification of these change agents and clearly outlining their roles becomes an important facet
of a change initiative. In the present project, the chief financial officer, as part of the
management, will need to support the project. Their role will entail providing resources for the
project by convincing the management of the business essence of the change initiative (Jones-
Schenk, 2017). Further, a quality improvement adviser will need to participate in the project and
their main role will entail convincing the administrative leadership of the impact of the project
on quality parameters.
Moreover, the nurse manager will work as a change advocate for the project. The role of
the nurse manager as a change advocate will entail showing commitment to the objectives of the
project and then influence others to become active (Kodama & Fukahori, 2017). The author will
also identify a nurse from the remaining nurses to also act as a change advocate. The role of the
nurse will entail convincing other nurses of the essence of the project and communicating the
leadership’s objective to them.

Application of the Change Theory to Develop Strategies

The change initiative related to the reduction of nurse turnover rates will occur based on
Lewin’s Change Model. The adoption of the change model occurs due to its premise that seeks
to influence organizational behavior (Shani & Noumair, 2017). The model will facilitate the
acquisition of driving forces that will push the UMTB employees at the medical-surgical unit
towards the desired direction by the unit’s leadership. Moreover, the theory will enable the

leadership of the unit to determine the potency of the forces leading to a high nurse turnover and
prescribe the requisite intervention to halt the same.
The first step of the model entails unfreezing, which encompasses altering the existing
behavior so as to achieve equilibrium, conformity, and overcome resistance. During the phase,
the unit leadership and change agents will undertake an examination of internal and external
factors to support the need for change. Regarding internal factors, parameters such as nurse
burnout, enhanced readmission rates, failing quality indicators, and high levels of mortality will
convince the leadership of the need to have the change initiative and recruit change advocates
from amongst them (Halter et al., 2017), Similarly, the management will need convincing using
external parameters such as failing patronage, reduced patient satisfaction statistics, and failing
revenues. The presence of information concerning the need for change will lead to the
identification of a team that will oversee the improvement of interpersonal relationship through
effective communication and other stratagem to improve change within the medical-surgical unit
at UMTB.
The second phase of the change initiative based on Lewin’s model entails the change
process. During this phase the change, the presence of effective communication strategies will
play a significant role in institution change. The nurse leadership at the unit will adopt an
informal communication strategy so as to take advantage of informal social dependencies, paths,
and connections to improve interprofessional relationships between leadership and nurses at the
medical-surgical unit (Zbieg, Batorski, & Żak, 2016). However, a form of formal communication
known as the cascade strategy will also occur wherein nurse managers will train nurse leaders,
who will in turn train the nurse advocates, who will pass the information to their peers. The

unfreezing process will entail the implementation of the change initiative wherein proper
interpersonal relationships starting with interviews will occur.
Overcoming Barriers to Change

The success of the change initiative will depend on the stakeholder support that will exist
from the leadership and personnel of the organization. Potential barriers may include lack of
support from the leadership and limited financial resources from the administration. Moreover,
ineffective communication could also hamper the initiative. To address the challenges, the
advocates of change initiatives will lobby for enough funding while they will use data to
convince the administration of the necessity for the project (Clayton, 2019). Moreover,
formulation of an effective communication strategy to communicate the objectives of the
initiative to the leadership and outline the roles of various change agents will overcome the
barriers. Monitoring the implementation process will allow the change team wo address
unforeseen circumstances and address it in timely fashion and intelligently.

Evaluation Methods

The evaluation methods of the change initiative will focus on the quality parameters and
the improvement of the wellbeing of nurses. One of the most significant determinants of the
success of the project will entail a reduction of the mortality rates, improved patient satisfaction,
and the cost of care per patient. Moreover, other parameters such as the financial position of the
unit, the rate of turnover and the nurse to patient ratio after the implementation of the initiative
will also demonstrate the effectiveness of the project (Nelson‐Brantley & Ford, 2017). The
evaluation of the change initiative will occur based on comparative data before the change

initiative and after the implementation of the same. The analysis of the data will reveal whether
the project will have succeeded or not based on individual parameters.
Strategies for Sustaining Change

To sustain change, identification of the threats to the project will become foundational
and it will occur using the The National Health Service Sustainability Model. Afterwards, the
UTMB will adopt the usage of tools such as such as process control boards, performance board,
improvement hurdles, as well as standard work to guarantee change sustainability. Whereas
process control and performance board will help the change agents to review the project to the
leadership, the standard work will visually communicate to the nurses the best practices
supported by the organization as a result of the change initiative (Silver et al., 2016). The
improvement hurdles will assess the project through meetings between the leadership and the
nurses, which facilitates the improvement of interpersonal relationships.
Overall Effectiveness of Change Plan

The mission statement of the UTMB entails the provision of highest quality patient care.
The fact that reduced turnover of nurses will improve quality parameters implies that the change
initiative aligns with the mission statement of the facility and its goals. The change initiatives
address stakeholder concerns by ensuring that the hospital’s patronage will improve, patient
satisfaction will increase and other quality parameters of the facility will also improve. As relates
to the community, the improvement of services through improving the nurse to patient ratio will
ensure that the people of Texas benefit from quality healthcare as promised by the facility.



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