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Retrospective Analysis of a Change in the Psychiatric ICU - Essay Example

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This essay analyses a recent change that took place in the challenging behavior ward (intensive care unit) of a forensic mental health care center, where I am currently employed as a Clinical Nurse Manager. The essay begins with a review of literature on change management followed by a summary of the change in the ICU, its implementation and analysis of the situation in light of the literature studied…
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Retrospective Analysis of a Change in the Psychiatric ICU
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There are several change management theories that have been proposed and almost all theories concur, that the success and failure of any change is related to the people factor. It is largely the emotional reactions of people involved in the change process that needs to be managed. Partnership, participation and commitment of staff responsible to implement new processes becomes critical, else any plan is likely to fail. Change management also emphasizes that people's fears need to be managed and trust needs to be built hence communication becomes critical.

Researchers have highlighted that involving staff in the planning of change, facilitating communication between departments and backing of senior management can go a long way in ensuring desired outcomes. Any new idea or change in existing practice, is often met with resistance by people who are involved in such transformations. Disruption in expectation is considered as loss of control (cited by, Brck, 2002). Resistance could be higher if people are not given clarity on the goals of new processes and the benefits that one hopes to achieve by implementing the change (Doppler and Lauterburg, 2000).

The reaction is triggered by the psychological need for security and predictability. Fear of the unknown holds people back from embracing any change in process or structure. As noted by (Block, 1981, p. 113), "typical forms of resistance, or bettersymptoms of resistance, beside the most obvious form of attacking, are: Silence, debating unimportant things, staying away, coming to late to meetings, flooding with detail, intrigues, rumours etc.".This can be counter productive as has been proven by Kotter (1995) who shows that two thirds of the changes end in failure.

Theorists agree that resistance is a natural reaction to change which need not be explained away with logic or ignored, it needs to be dealt with as soon as it encountered, acknowledging that people are humans with a bundle of emotions that need to be tackled. It therefore becomes important to elicit people's responses to change and address their concerns. The techniques available to change leaders for combating resistance abound in literature. Being participative (Coch & French, 1948, 512-532), using transition management (Ackerman, 1982, P. 46-66), making use of political diagnostic tools (Cobb, 1986, p.482-496), following an one to one approach (Coghlan, 1993), fostering a learning organization (Garratt, 1994), using the seven keys for successful change (Carr, 1994,55-58), or working as transformational leaders (Parry, 1996) are all helpful starting points for change leaders.

The task however is challenging since it involves complex emotions. However, it is also true that when people are asked to participate and their ideas respected, their commitment to the change process will increase (Armenakis & Bedeian, 1999).Final success can well depend on the maturity of change leaders (McClelland, 1975).It is also worth pointing out as noted by Chapman (2005), "certain types of people - the reliable/dependable/steady/habitual/process-oriented types - often find change very unsettling.

People who welcome change are not generally

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