Case Study

A Newborn Nursery unit shows resistance to a practice change introduced by the Nurse Manager. The use of glucose gel, intended to improve the management of neonatal hypoglycemia, created additional work for the nurses along with confusion and questions. The intended focus of this case is change management, employee engagement, and leadership.

Major Problem and Secondary Issues

Change management and resistance to change: The Nurse Manager did not prepare and engage staff through each step of the change. The use of a change theory could be explored.

The nurses in the case study had many complaints and questions about the practice change and gel administration technique. The project was perceived negatively as something that just caused more work. However, as indicated in the case, other projects to support exclusive breastfeeding had been successfully implemented with the same group of nurses, illustrating their previous willingness to participate in change.

Employee engagement: The employee engagement scores were dropping in the case study unit and could be explored as a problem impacting change. Also, the Nurse Manager did not include nurses in the development of the project, missing the opportunity to engage the staff. The unit was busy and potentially understaffed due to a high census, vacations, and illnesses. Working short-staffed could cause exhaustion and frustration. Implementing change at a time when nurses may be depleted of their resilience resources may trigger resistance to change.

Leadership: Providing the preparation needed to engage staff and overcome resistance to change is the responsibility of leadership, so the major problem in the case could be a failure of leadership to engage staff in change, resulting in resistance and frustration. The manager did not use transformational leadership skills to create a vision and bring the team together through the project.

Role

The Nurse Manager is a possible role to solve the problem. Although part of the cause of the problem, this person has a relationship and history with the staff and has previously engaged the staff in the implementation of successful projects to support breastfeeding. Challenges could be the difficulty in moving past the poorly planned and implemented project and changing the negative perception of the staff. Other possible roles are a member of the unit leadership team working as a liaison between the Manager and the staff or a higher-level leader who can oversee strategies to move the project towards success.

Answer in detail the following questions.

Organizational Strengths and Weaknesses

Strengths include:

Weaknesses include:

Alternatives and Recommended Solutions

• Change management and overcoming resistance to change:
• Employee engagement:
• Leadership:

Evaluation

Change Management:

• Employee Engagement:
• Leadership: