PLEASE RESPOND TO THIS PEER DISCUSSION POST BELOW 

A successful change requires a person who is well developed in leadership and planning as well a functioning as a change agent (Angel-Sveda, 2012). A change agent is skilled in theory and implementing change. I witnessed this with an educational leader. This educational leader is in charge of most of the department’s education but mostly involved with the orientation portion of education, when candidates are first hired and during their probation period. I was part of a change process, including going into the field (patient home) during orientation observing patient care, documenting, time spent in home, and then coming back to report and review the charting. The change model was implemented to help familiarize ne employees to the work environment as well as reinforce policies for existing employees.

Using one of the change theories in the book or one that you have researched, analyze the change effort that you presented.

The Lewin’s Change Theory: This model describes the change process in three steps; described as “Unfreeze-Change-Refreeze”.

The Unfreeze stage is when the change is anticipated to happen or initialing began; involves supporting staff, feedback, empowerment, and freedom for independent thinking (Coghlan & Brannick, 2003)..  In the case for me the unfreeze stage was when the new employees shadowed the existing employees on their home visits. The existing employees were very apprehensive about this training but reluctantly participated.

The Change stage is when  all the employees are expected to adapt the change and adhere to rules (Coghlan & Brannick, 2003). During this stage many employees reverted back to their old ways, not charting in the home or tracking their miles at the time of the visit; leaving room for error in documentation.

The Refreeze stage is when the change is expected to be followed and evaluation of adherence is need to ensure change is effective (Coghlan & Brannick, 2003). After a few weeks the employees did comply with the change the educator presented but some employees did not and were retrained by having to attend a class reiterating the company policies.  

What went well?

The new employees got hands on experience during orientation, which included, real-time charting, on point questions, and engaging with clients. They also had the opportunity to navigate through the portable computer system before diving into the field alone. Another good outcome was the employees were able to get to know one another during this time and a mentor relationship is usually developed. 

What didn’t go well?

Some existing employees thought the change model was a way to ‘spy’ on them or track their amount of time spent in the home. There was a lot of resistance from employees or many of them declined to participate in the new orientation/training process. 

What would you have done differently if you had been in a leadership position?

I would have explained the need for the change model in the first place.  The educator introduced the change model but did not explain its need or rationale thoroughly. I also would have included high positional workers into the conversation and implementation so other employees knew this was important and required for compliance.

 Discuss the importance of advocacy as it pertains to patient care. What is the nurse’s role in patient advocacy? Describe a situation in which you were involved with patient advocacy. Explain what the advocacy accomplished for the patient, and what the repercussions would have been if the patient would not have had an advocate.