Barbara Norris: Leading Change in the General Surgery Unit

BLDR Assignment

1. How well has Barbara Norris done in the first month as nurse manager of GSU? Was she a good choice for the position? Norris inherited the unit which was already in a mess with low employee morale, high stress levels, full of discontent and the highest employee turnover rate among all the departments of EMU. At this stage, the fact that she took up the challenging role of the GSU manager was in itself commendable. Although she did not bring about any radical changes within the first month of her taking position, she however took efforts to understand the root cause of the problem that doomed the unit; her running of the Off-site buttresses the same. There she could surely have taken a more dynamic leadership role which she did not mostly because she was not used to such hostile environment in her previous unit. Nevertheless, she at least had her objectives met at the end of the Off-site and that was having a list of items that most frustrated or demotivated her staff. With this in hand she chalked out her future plan of action. So according to us, Barbara did a good job in the first month of her joining GSU as a nurse manager. She was a good choice for the position as she possessed the initiative and grit to work for the betterment of the unit. The leadership competencies she demonstrated were: Empowering others Establishing focus Efforts to Manage Change & Manage Performance Given more time, she would surely prove to be a good leader. 2. What changes is she trying to make and why? Barbara is trying to institute: A transparent performance review system which would help acknowledge good performers for their work and contribution if not adjust their compensation accordingly. This would help boost their morale and reduce their discontent. A culture of mutual cooperation, collaboration and teamwork. This would bring the coworkers closer and make the work environment more enjoyable and lively to work in ultimately checking the attrition of the unit. Empowering others in every decision related to the unit. This is a very important step in any Change Management process as it gives the sense of inclusion and ownership of the business to every individual. With the sense of ownership comes the natural sense of taking initiative which helps resolve a lot of issues. Opportunities for the staff to learn and grow as it was complained by some of them in the Offsite that their job was becoming more administrative and less patient centred. Strong and effective leadership in order to build the sense of trust and respect in the unit.

3. What are the three obstacles that she should anticipate and how should she address them? Obstacle 1: Establishing a sense of urgency The major problem is crunch in human resources because of the hiring freeze at EMU. Barbara has to therefore convince her director to seek reprieve from the hiring freeze and get more staff for the unit by establishing the sense of urgency. In case that does not work out, she has to schedule the shifts of the existing nurses such that they do not feel over worked or ensure that the ones who put good amount of effort are not left unacknowledged. This would show how serious she is about getting things right and alleviate some of the grievances on an urgent basis. Obstacle 2: Generating short-term wins This can be done by instituting a transparent review process that links performance and pay. But because she does not possess the authority to do so, she can at least incorporate a system that rewards the good performers with non-monetary rewards such as verbal acknowledgement or certificates of merit or regular meetings where performers are identified and thanked for their valuable contribution by their peers and bosses. Obstacle 3: Creating a guiding coalition To bring about change, it would be imperative for Barbara to break the hostility between the nurses and build a healthier culture of cooperation and collaboration. She could consider holding weekly grievance redresser meets to resolve small issues. She could also institute a system wherein the nurses have to work as a team rather than individuals while attending to patients. This would create a friendly environment and make it easier for her to create a team of people who are ready to embrace change for the betterment of their unit. 4. Please device an action plan for Norris based on the Kotters 8 steps for change. Step 1: Establishing a Sense of Urgency Minutes of the meeting held with all the nurses could be presented as a report to the director. This would help create a sense of urgency for reforming the policies, especially the freeze on hiring. Step 2: Creating the Guiding Coalition It is advisable to pair an experienced nurse with a not-so-experienced nurse and allocate a portion of performance grading to the performance of the other nurse in the pair, that is, if nurse A and nurse B form a pair, then a component of performance grading of A would be how well B performs during that weak and vice versa. Step 3: Developing a Change Vision With the kind of current industry environment, it is inevitable that the nurses not only perform but also help others perform. Growth is a mandate in healthcare industry and it is imperative to provide them an environment conducive to coping with the pace. Step 4: Communicating the Vision for Buy-in The working pairs so formed should change every month. This would automate the buy-in process from the side of nurses. As far as the top management at GSU is concerned, they have to take their chances to survive and here it is much more than a calculated risk because they can no further

afford to lose their staff. Weekly meeting with the nurses where everyone can voice their experiences must be held. Step 5: Empowering Broad-based Action Since every pair would have one experienced and one amateur, the decision making can be handed over to every pair as one could learn from the mistakes in the past of the other and the scope of the decision going wrong is also reduced in such a teaming up method. Step 6: Generating Short-term Wins Recognition of best performer at the weekly meets and further acknowledgement of the other credentials followed by a best-practices journal entry every month would help embed a feeling of empowerment in the nurses. Step 7: Never Letting Up The community of nurses is undoubtedly very crucial to healthcare industry. The idea of bestpractices journal revolves around the fact that their efforts now would not just be recognised but also be in the records for future use. Step 8: Incorporating Changes into the Culture Pointer based feedback collection from the patients and awarding the most liked nurse of the year at an annual function would send across a positive message to all. Also, those who have served the hospital for 10, 20, 30 years and so on could be awarded at such functions.