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Bedside End-of-Shift Report as a Healthcare Change

Change is inevitable and it is like a train, if one stands in its way it crushes the individual. In a health care organization there occurs change just like in any other organization. A situation in need of change in a healthcare organization is the old technology used in those organizations which should be discarded. Adoption of new technology is thus what health care needs so as to improve the efficiency of service delivery.

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In an attempt to make and implement change in an organization there always exist driving and restraining forces. The driving forces are those that affect a situation and they push the participants in the desired direction, they initiate a change and they keep it on track. These forces are useful in increasing and improving productivity. In adopting new technology in a health care organization the driving forces may be competition, efficiency in delivering services, and pressure from a higher authority like the government.

On the other hand, restraining forces are those that act against the driving forces, they decrease or restrain the driving forces and push them in the opposite direction in addition to trying to maintain the status quo. Nurses who prefer the status quo, improperly trained nurses who lack ins kills of operating the new technology that is to be adopted, poor maintenance of equipment, and insufficient funds are examples of restraining forces against the adoption of new technology in a health organization. In an event where the two forces are equal, change hardly takes place because no movement to or away from change is taking place thus change is said to be at the equilibrium.

The empirical rational strategy asserts that people will follow their rational self-interest once it is made known to them (Benne et al. 1976) this implies that a change will be accepted by an individual, a group, or an organization when it appears desirable and is in line with the interests of those affected. Reason and knowledge are stressed in this strategy as it is used primarily for technological changes. Here the recipients do not play an active role in planning the change. On the other hand, the change agent educates the targets of change so that they embrace the benefits of altering the status quo.

Using this strategy, an automated medication-dispensing machine can be introduced in the nursing unit and the manager explained to the nurse that he/she could learn to use the machine in less than thirty minutes and would never have to count the narcotics each shift making patient charges automatic, then the change is quickly seen as desirable since it saves time. The manager succeeds because the right information is transferred in an engaging and convincing manner to the nurse.

Since in empirical rational strategy the transfer of information is a one-way process, senior representatives like the manager communicate the facts to the recipients and help them understand. It would be aligned to the self-interests of the nurse who is rational and knows that this would help him/her getting finished with a shift on time. Here change would proceed easily and quickly.

In using rational empirical strategy, the technological approach to change is important because it can help members of an organization access new information as it becomes available; therefore with a sufficient information system, it is easy for the members to support logical changes.

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Kurt Lewin’s force field model describes the process of a dynamic balance of driving and restraining forces that work in opposing directions. This theory captures the relationship of those forces in three steps. (Sullivan, Decker, Jamison, et al 2004) therefore one must shift the balance in the direction of change through those three basic steps. The first step is known as unfreezing which is to unfreeze the existing situation or status quo which is the equilibrium state.

Here individuals become aware of the importance of change. It is also the stage where the strains of individual resistance and group conformity are overcome. It is done by increasing the driving forces that act on behavior away from the existing situation, motivating participants and preparing them for change, overcoming inertia, and dismantling the mindset that exists

The second step is known as the Moving stage. This is the stage where actual change occurs. People are encouraged to embrace new ideas and new ways of working. At this stage information is gathered, participants view the problem from a more liberal perspective and agree that the status quo is not desirable and that there is a need for change. This stage helps the organization to move on as new organizational attitudes, values, and behaviors are developed.

Refreezing is the last stage in this model. It is a process of crystallizing the newly adopted ideas in the minds of the employees and managers. It involves stabilizing the organization after the changes have been implemented so that a new equilibrium is formed. The managers and employees get used to the change and they practice it as it gets ingrained into their systems. When this has taken place we say that the process of change in an organization has been successful.


Baulcomb, Jean Sandra. Management of change through force field analysis: Journal of Nursing Management; 2003, Vol. 11 Issue 4, p. 275-280, 6p.

Bernstein, W. M. (2003). “Empowerment”: A task for the self, not the organization. Organization Development Journal, 21, 75 – 80.

Sullivan, Decker, Jamison, et al Effective Leadership and Management in Nursing, (6th Ed) Prentice Hall publishers, 2004.

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StudyCorgi. (2021, October 21). Bedside End-of-Shift Report as a Healthcare Change.

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"Bedside End-of-Shift Report as a Healthcare Change." StudyCorgi, 21 Oct. 2021,

1. StudyCorgi. "Bedside End-of-Shift Report as a Healthcare Change." October 21, 2021.


StudyCorgi. "Bedside End-of-Shift Report as a Healthcare Change." October 21, 2021.


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StudyCorgi. (2021) 'Bedside End-of-Shift Report as a Healthcare Change'. 21 October.

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