A nurse manager of a 40-bed newborn nursery unit attended the association of women health, obstertric and neonatal nurses national conference. one of the sessions introduced the buccal administration of glucose gel as a means to treat neonatal hypoglycemia. the gel showed a decrease in transfers to intensive care for glucose, it also showed a decrease in the need for formula supplements to normalize blood sugar levels, leading to an increase in breastfeeding. this would keep mothers with their babies and improve patient satisfaction. by reducing formula costs and lowering costs for nursery care. but resources were tight and some nurses were not always available because of other projects they were working on. The nurse manager began to work through the details of the gel alone. she got approval from the medical director for the medical pharmacy to create a protocol for dosing. She implemented the change and discussed it with staff, but it was a train-to-trainer approach. the project was a rocky start and the nurses complained about the administration of the gel and how much extra work it took. so sometimes they give the gel if they have time. they had a lot of complaints from the staff, but later the gel was implemented, it was the topic of discussion the project overall was perceived as a negative change that made more work for the nurses. case study: 

1. explain to the nurse manager why this seemingly easy change was met with such resistance.

2. Is there anything the nurse manager can do at this stage to address the issue? 3. make a recommendation to the manager on how to implement changes to go forward. provide a recommendation.