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Making changes in a healthcare organisation is a process complicated by resistance. Elizabeth Curtis and Patricia White examine some of the factors that lead to resistance to change and strategies for overcoming it
CHANGE IN healthcare occurs at a rapid pace and all nurses, whatever their grade, must be knowledgeable and skilled in the change process (White 1998). Reasons for change include restructuring in the workplace, advances in technology, a greater need for efficiency and the growth of new services (White 1998).
White (1998) suggests that `change itself is neither good or bad, it is inevitable... Change will, must and should occur'. Change can affect people in different ways regardless of its type. For example, people may experience feelings of achievement, loss, pride and stress (Marquis and Huston 2000). Change also brings uncertainty, ambiguity and a loss of control and predictability (Muchinsky 2000).
Marquis and Huston (2000) argue that because change can disrupt the `homeostasis, or balance, within a group resistance should always be expected'. The level of resistance will depend on the type of change. There is less resistance to technological change than there is to social change or to change that is not consistent with established customs or norms. For example, nurses are more likely to accept a change in the type of intravenous pump used than a change regarding who is able to administer intravenous therapy.
Harvey (1995) believes that `change without resistance is no change at all - it is an illusion of change'. Therefore, it is important that nurses are able to recognise resistance and plan and implement strategies to reduce or prevent it.
Resistance to change refers to any employee behaviours that discredit, delay or prevent the implementation of a work change (Newstrom and Davis 1997). Employees may resist change for several reasons, and understanding them may help change leaders or agents to implement change more effectively (Daft 2000). According to Dent and Galloway-- Goldberg (1999) resistance to change has become 'a standard part of management vocabulary' (indeed, as a topic, resistance to change was discussed in the majority of texts reviewed for this article).
Resistance as a concept came into the literature on organisational change through psychoanalysis and the human relations movement. In examining this concept in...