Applying the concepts of William Bridges in a Nursing & Healthcare environment. Managing Transition, Managing Change, Leadership.

1. Change Theory in
Nursing Leadership
Kris Mailepors
Director of Organizational Development
Catholic Medical Center
Ph 603-663-1961
kmailepo@cmc-nh.org
Tw: @krismailepors

2. WHAT DOES THIS TELL YOU ABOUT CHANGE?

3. Three Things to Consider
1. What makes handling change so challenging?
2. What does this quote mean to you:
“I’ve been in this business 36 years, I’ve learned a
lot—most of it doesn’t apply anymore”

4. Changes just keep coming!!!
From outside…
• Market conditions
From inside…
• New technologies
• New team structures
• New software
• New regulations
• New Managers
• New policies
• Reduced budgets
• New or unclear expectations

5. Change is good…is it?
…Change usually benefits the organization by
solving a problem or creating greater efficiency
however…
…It pays much more attention to the finances,
strategy, and technology than to the people who
have to make it work
THERE IS THE ISSUE

6. Change vs. Transition
Change is …
– Situational; something starts or stops.
Transition is …
– The gradual process of psychological adjustment
that happens inside us as we adapt…
It is the TRANSITION, not the change, that people resist

7. The Three Phases of Transition

8. Why is transition resisted?
• People have a personal connection to how
they work; people are giving up a part of their
personality
• Fear of the unknown; doing and being what
they have never done or been before

9. The Three Phases of Transition

10. What has ended…what is lost?
•
•
•
•
•
•
•
Turf
Status
Power/influence
Autonomy
Relationships
Memberships
Routine/structure
•
•
•
•
•
Meaningful work
Control of work
Personal Identity
Competence
Personal Future

11. Doing a Loss Analysis
Note on the grid who is losing what

12. Dealing with an ending?
Denial
Sadness/
Anxiety
Depression
Bargaining
Anger

13. Handling those dealing with endings
and loses
Behaviors: Flip attitude, evasion, skepticism,
refusal to accept the reality of the situation
Actions:
– explain the change and the reasons
– Give examples of peers who are changing or
learning
– Give examples of the need for this new
(system/approach/technology)

14. Handling those dealing with endings
and loses
Behaviors: Resentment, rumor mongering,
nervousness or stress, decreased productivity
and effectiveness
Actions:
– Encourage talking and listen carefully
– Don’t talk them out of feelings; offer a different point
of view if you have one
– Give positive feedback on their progress, if genuine
– Offer accurate information to dispel rumors

15. Handling those dealing with endings
and loses
Behaviors: Grumbling, irritation, rage, mistakes,
aggressiveness, foot dragging, vandalism,
indignation
Actions:
–
–
–
–
–
Listen and acknowledge anger
Don’t talk them out of it
Don’t assume blame for their anger
Don’t collude/agree with them
Recommend involving HR if extreme

16. Handling those dealing with endings
and loses
Behaviors: Attempts to get out of the situation, attempts
to make deals or promises relating to the old way,
negotiation
Actions:
–
–
–
–
–
Keep realistic plan in sight
Don’t be swayed by promises or negotiations
Reinforce situation as it is
Don’t get into problem solving or bargaining with them
Gently remind them of reality

17. Handling those dealing with endings
and loses
Behaviors: Silence, “down,” or disheartened, tearfulness
Actions:
– Acknowledge, sympathize and reach out.
– Initiate conversation and ask questions to draw them out
– Encourage talking and sharing feelings either one-on-one
or in small supportive groups
– Promote supportive group events, interaction, or
impromptu fun
– Recommend to HR if appropriate

18. The Three Phases of Transition

19. Critical part: THE NEUTRAL ZONE
Emotions of the Neutral Zone:
–
–
–
–
Confusion
Apprehension
Detachment
Interest/Eagerness

20. Communication during transition feels risky…
There cannot be too much communication during
the Neutral Zone.
It is the difference between a bearable situation
and a disaster.
Two main kinds of communication in this zone:

21. 1. Communication designed to show
CONNECTION and CONCERN.
2. Communication that clarifies the PURPOSE,
the PICTURE, the PLAN, and the PART.

22. 1. Communication designed to show CONNECTION and
CONCERN
MANAGERS and leaders must keep
communicating not just for more information
but to show that they care. Isolation can be
easily amplified during a time of transition.

23. 2. Communication that clarifies the PURPOSE, the
PICTURE, the PLAN, and the PART.
Purpose
The “why’s” of the change. Purpose can serve to
clear up confusion.
Picture
Vision of the outcome; the light at the end of the
tunnel, a destination. (use an analogy—1st day)

24. 2. Communication that clarifies the PURPOSE, the
PICTURE, the PLAN, and the PART.
Plan
beyond just the destination, this is the roadmap that
leads there. These are step-by-step actions to get
through the Neutral Zone.
Part
Successful transition depends on the people involved.
They all play a part. Know yours, know theirs, make
sure they know theirs.

25. The Three Phases of Transition

26. Creativity & Learning
1. Encourage experimentation and risk taking
2. Enhance trust
3. Expose individuals and groups to diverse
perspectives
4. Provide the workforce with stimulating and
interactive settings
5. Use feedback mechanisms
6. If appropriate, help people revise their career
plan within the new change

27. The Three Phases of Transition

28. Getting to the
…
1. Translate the changes into activity that has
real meaning to the people doing it
2. Provide people with the opportunity to
practice or gain familiarity
3. Work collaboratively
4. Focus on efforts and achieve a few “quick
successes”
5. Build RESPONSIVENESS and FLEXIBILITY into
your routine

29. 7 things to remember!
1. You have to end before you begin
2. Between the end and the new beginning,
there is a hiatus
3. That hiatus can be creative
4. People go through transition at different
speeds, and may be affected by different
things
5. *Most* organizations are running a deficit in
transition management

30. People May Hate Change…
…But they love
Progress
Reference: www.wmbridges.com; www.linkageinc.com