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Chaos Change Theory in Nursing


A report indicates a steady increase in nurses’ resignations. Identifying resources and retaining staff. Hiring new nurses and retaining personnel. Analyzing the reasons why nurses leave their workplace (exit interviews) and acting on them. Applying chaos theory to improve communication and interaction at the hospital. Developing a program of peer supervision to retain new nurses.

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Chaos Change Theory in Nursing

People’s attempts to understand and explain chaos goes back to ancient civilizations. The unpredictable, complex, dynamic environment of the healthcare system. Chaos is generally perceived as something wrong or harmful. Chaos is a system that is too dynamic to be predicted. Chaos is a system in which small changes lead to greater changes in the process. The non-linear theory challenges the linear way of thinking. Attractors influence the behaviors of actors and facilitate the change.

SWOT Analysis

Problem: high number of nurses leaving the workplace. General scarce of human resources. Goal: retain staff and hire new personnel. Strengths: high level of expertise, technological capacity, experienced personnel. Weaknesses: stressful and unpredictable environment, lack of cooperation. Opportunities: educating new leaders, and fostering communication. Threats: low government budget, patient load, the possibility of conflict at work.

Why Do Nurses Leave?

Excessive workload, stressful environment. Changes in patient load in the past 6 months. The multicultural background of some nurses is not reflected in the hospital’s policy. Nurses don’t feel appreciated at work. Pre-existed a shortage of nurses. Lack of interprofessional collaboration and support from management.

Action Plan

Programs to train nurses in leadership qualities. Facilitating communication and interprofessional collaboration via new channels. Communication and education as the main instruments for change. Training programs for newly hired nurses. Celebrating the multicultural background of staff. Stimulating communication in and outside the hospital. Improving working spaces to promote well-being.

Applying Chaos Change Theory

The problem requires improving communication between staff. Training personnel about the unpredictability of change is in line with general implications for the healthcare system. Nurses or managers act as attractors, who drive the change. Fostering leadership skills among nurses. Peer program and supervision for new personnel. Everyone is involved in the change through communication.

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Designing Steps to Prevent Staff Shortages

Interviewing current employees and nurses, who resigned to know their motivation. Has the resignation procedure been managed effectively? Tracking the management’s missteps. Analyzing the necessary education and training. Dealing with issues that employees find unsatisfactory at the workplace. Developing a program to retain new nursing staff (peer supervision).

Processes That Make Up the Change

Chaos theory in action: the general change occurs with numerous small changes. Small changes are unpredictable but can be controlled. Renouncing excessive control and standardization. Promoting trust, creativity, freedom, integration, and mutual support. The process of implementing changes is as meaningful as the desirable outcome. Everyone directs the process, but there is no systemic control over people. Accelerating communication through leaders. Creating an environment that encourages new nurses to stay.

New Practices to Encourage Effective Change

Leadership training for experienced nurses. Peer support program for new nurses. Reorganization of collective working spaces. Developing new digital channels for practice and communication. Organizing interprofessional groups to share information and knowledge. Developing and implementing new conflict management programs.

Leadership and Management

Hospital management must oversee staff shortenings and act on them. Encouraging transformational and democratic leadership styles to develop. Leaders, who motivate and inspire others. Leaders act as attractors, who drive the change throughout the system. Training in leadership and understanding Chaos theory should be provided. Encouraging critical thinking and challenging linear thinking in the workplace. Nursing leaders are encouraged to take part in policy-making.

Management Functions

Nursing leadership is about critical thinking, action, and advocacy. Responsibility and accountability for managing day-to-day operations. Providing inspiration and guidance, being an example to others. Supervising nurses’ professional practice. Managing resources (budget and personnel). Navigating the complex and dynamic working environment.

Budget Requirements

Changes are needed to address human and financial constraints. Applying chaos theory to implement change saves money. Investing in human capital. Ensuring retaining staff for the long-term period is crucial for stability. The overall budget for training and reorganization should not exceed 30000 USD.

Steps to Assure Staff Compliance

Peer program for new nurses to help them to adapt to a new environment. Systemic interviews with staff members to ensure they embrace new policies and rules. Providing written documentation for decisions and policies for new practices. Chaos model: all working processes and interactions exist within a system. Encouraging staff to participate in new processes. Remuneration system for those who comply/take an active part in new practices.

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Decision-making Process

Prior linear models proved to be ineffective. Applying qualitative research methods to understand the reasons for staff shortenings. Interviewing new employees to learn their satisfaction with the new environment. Selecting a change model suitable for the concrete situation. Educating strong leaders in the hospital’s nursing community. Evaluating how the environment should be adjusted to staff’s needs.


Demir, M., S.,Karaman, A., Oztekin, S. D. (2019). Chaos theory and nursing. International journal of caring sciences, 12(2), 1-4.

Mangiarotti, S., Peyre, M., Zhang, Y., Huc, M., Roger, F., & Kerr, Y. (2020). Chaos theory applied to the outbreak of COVID-19: An ancillary approach to decision making in pandemic context. Epidemiology and infection, 148, e95-e95. Web.

Wagner, J. (2018). Leadership and Influencing Change in Nursing. University of Regina Press.

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