Nursing is a profession of change. The environment a nurse works in changes, technology is updated to provide the best patient care and nurses are learning about the updates to best evidence the field is relies on. Additional environmental changes for nurses include restructuring of the organization, quality improvement and employee retention (Marquis & Huston, 2012). These types of changes are typically planned (Marquis & Huston, 2012). Planned change is a purposeful, calculated and collaborative effort to bring about improvements with the assistance of a change agent (Roussel, 2006 as cited in Mitchell, 2013). However, attempts at change may fail when change agents take an unstructured approach (Wright 1998 as cited in Mitchell, 2013). Therefore, the change agent needs to be a leader or manager skilled in the implementation of planned change (Marquis & Huston, 2012).
The intent of this paper is to evaluate a problem or concern that is an impetus for change and utilize a theoretical model to implement the change. For purpose of this paper, the impetus for change stems from observations of a newly hired unit manager that there is dissatisfaction among newly hired nurses due to lack of a standardized orientation program. The lack of satisfaction is also contributing to high new hire turnover. The goal for the nurse manager will be to improve satisfaction by developing and standardizing a new hire orientation program using Kurt Lewin’s Development of Change Theory (Marquis & Huston, 2012).
Poor training to the unit and lack of encouragement are two of the major factors causing nurses to leave during their first year of employment (Marcum & West, 2004, as cited in Ward, 2009). Orientation programs should be in place to provide new RNs with necessary information in order to be successful on the unit as well as retain them in the organization (Ward, 2009). Best practices guidelines show when managers advocate for resources to support new graduates retention is a likely outcome (Morrow, 2009). Forms of supports shown to be best practice include formal orientation programs, peer mentoring, and orientation schedules and calendars so new hires are lined up with experienced nursing staff (Morrow, 2009).
Description of the health care setting and communication networks. The hospital environment is a non-profit critical access hospital in a rural area. The nursing unit within the hospital is medical surgical specialty unit. There are18 beds in this unit that manage acute medical surgical patients and swing bed patients with a vast range of diagnoses and care requirements. The medical-surgical unit also serves as a specialty unit for the management of acute care ventilator patients. There 50 medical surgical employees reporting to the unit manager including RN’s, nursing assistants and health unit coordinators.
Since this is a smaller hospital, there is a simpler organizational structure than what is seen in a large hospital. ...