RESISTANCE TO CHANGE: FORGET IT! Mabel Crawford, R.N.

Sometimes, the hectic pace of our fast-chang ing world makes us wish that we could bring things to a halt just long enough to catch our breath. We are part of the jet age, the nu- clear age, the space a g e t h e age where we feel that intimate knowledge of our entire universe is at our fingertips. Most of us be- come swept up in the changing times, but now and again it is not unusual for us to feel that we have lost touch and we wonder about all the changes. A little voice inside us cries out, “Stop the world, I want to get on!”

But change is the law of life, and in our time, it moves along a little faster than usual. The growth of a world or an individual de- pends upon progress, introduction of new

Mabel Crawford, R.N., is a graduate of the Bishop Johnson College of Nursing in Los Angeles, Calif., and has been associated with the Immaculate Heart College in Los Angeles. Miss Crawford is presently operating room supervisor at The Hospital of the Good Samaritan, Los Angeles, where she has served as staff and head nurse. She was the first president of AORN of Los Angeles, and chairman of the chapter’s Research Committee since its inception.

ideas, new methods and social adjustments. Most of us can accept change when things are not going well. When the need is desperate we’ll try any new idea, feeling that anything would be an improvement. But when we seem to have a top-notch situation going, as in our OR’S, we pull up short and hesitate to insti- tute new ideas for fear of upsetting a satis- factory arrangement. If we like something, if we are happy and satisfied with the way it is going, why change it? The fact is that the alternative to change is not to remain the same; it is to stagnate and decay. Anything- a person, a business, a department-that does not move and grow will eventually dis- integrate.

In our hospitals, there must be change of some sort if we are to continue with good pa- tient care. But in the operating room, where every function directly affects human life, new ideas cannot be randomly accepted. A change that is not carefully conceived and well-planned can have disastrous results. We

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Three reactions to new ideas

cannot say, “Let’s give it a try, we’ve got nothing to lose.” We are faced with a pre- carious seesaw with a bonfire under either end. If we do not change, we become out- dated and ineffective. If we change too quick- ly without proper foundation, we can destroy what we already have. How do we strike the balance and bring about changes that are necessary for the growth and expansion of the hospital and vital for the well-being of the patient ?

Naturally, some changes come about as the result of outside pressures, economic condi- tions, changing needs, demands of surgeons, technical improvements, introduction of new policies, new materials and equipment, and addition or loss of personnel. But changes can also result from the constructive thinking of those within the hospital-from top adminis- tration, supervisor, head nurse, to any em- ployee interested enough to write and put a suggestion in the suggestion box. Some ex- cellent results can be obtained from “gripes” if heard by the people who can bring about the changes.

The person who is responsible for changes on any level, usually the supervisor in the OR suite, must be successful in getting personnel to accept and put these ideas to work. She must evaluate individuals and have an under- standing not only of their reactions to change but also to suggested change. It is the human factor which inspires many people to put obstacles in the way of progress. This fre- quently is true even if the change may be to the person’s advantage. Often this first re- sponse to a changing situation is an emo- tional reaction. A person’s attitude is fre- quently affected by those things that most concern him personally ; habits of thinking, living, and routines. These may be hard to change, for the “status quo” brings with it feelings of security and pride. The intangi- ble aspects of change- the unknown, the un- expected, the something “diff erent”-can be very threatening to this state of well-being, and are often the reasons for strong resis- tance. If any change is to be accomplished, these anxieties and fears must be reduced.

Resistance can perform useful functions

40 AORN Journal

within a change effort. As previously indi- cated, any change can have unexpected con- sequences. Early detection of defects in the purpose of the change, communications or results to be achieved, can lead to a revision of plans. The results therefore obtained will be more desirable due to the challenge of a negative opinion. On the other hand, many a good idea has been discouraged because of negative thinking. One must be open-mind- ed, select important factors from the less important and come to a solution of the problem. There is always the possibility of error, but thoughtful comparison between the new and the old, a careful look at the ad- vantages and disadvantages, and a real aware- ness of the needs involved will reduce mistakes to a minimum. We all know the dire conse- quences of error in the OR, but also, the per- son who never makes a mistake probably isn’t doing anything.

The majority of people usually react with a willingness to accept new ideas. Most of us have been conditioned to change and simply

need to be “sold” on an idea. And then there is the small percentage who are willing to try anything and everything. All of these at- titudes contribute to the justification of change-providing security, economy and production.

The need to obtain the interest and willing ness of the employee in the need for change cannot be emphasized enough. Many times the grapevine has done the damage before the permission from administration has been obtained to even “fund” needed equipment, personnel or time. People usually like to get their information directly, to hear and give personal opinions on the anticipated needs and to have time to adjust to these future changes. It takes a person not easily dis- couraged to prepare her staff, keep com- munications true to fact, and still make prog- ress towards goals.

The fact is, if we are to maintain our present high professional standards and con- tinue to be innovators and leaders in a fast- moving world, we must all make the effort.

BIBLIOGRAPHY

1. Alexander, Burley, Ellison, Vallari, Planning of the Patient in Surgery, Chapter 2, “Administration of OR Nursing Services,” pp. 1444. 2. Looking into Nursing Leadership-Planning f o r

Change, Leadership Resources, Inc., 1%6, pp. 1-22. 3. Willingham, Jacqueline, Logic of Operating Room Nursing, Springer Publishing Co., Inc., New York, pp. 15-23.

“There is a rumor that trafic-dividing lines will be drawn in certain corridors of the building in order that the employees arriving late will not collide with those leaving early.”

Y Y Y

“lt hus been found unnecessary to provide trafic dividing lines in the corridors. Research reveals it is the same people arriving late who are leaving early.”

(AORN of Milwaukee newsletter)

August 1968 41