[Sharon]

Think of a time of difficult change in an organization that you were part of or affected you. What was the reason for the change?  Did you resist the change? Where did you see yourself during that change – as an innovator, early adopter, early majority, late majority, laggard or a rejecter?

Using the above questions as a guide, reflect on a change that happened in your work environment.

[Stephanie]

A difficult change within my organization that affected me was when my surgical unit stopped receiving our regular elective surgeries. During the covid 19 pandemic, are hospital was starting to have a high increase in patient admissions and with that was pushing back regular elective surgeries. With this they came to see the elective surgeries no longer required an overnight/extended stay in hospital and they could be admitted to day surgery post operatively and sent home the same evening. This was a significant change because now my unit was experiencing more medical/ALC admission that we were not use to causing a heavier work load. I was very resistive to the change as were others because we were now being expected to provide care outside of are specialty and it was causing difficulty as are unit was not fully equipped to manage the change at this time. I saw myself during this change as a late Majority i followed the direction of my team lead accepted the admissions and cared for them the best way i knew how however i expressed my negative concerns and what this would do to are unit. As shown we ended up loosing a majority of are staff because they could no longer handle the workload. However are management later on did bring Bariatric surgery to are unit allowing us to have more surgical admissions again.

[Jessica]

Hi Stephanie, I am so sorry you had to experience that. The pandemic resulted in a lot of change in healthcare and unfortunately many suffered because of those changes. Although you may not have been using your specialty skills, the Patients are lucky to have had you there to care for them. We lost a lot of valuable health care professionals during that time. It wasn’t easy, but we are better and stronger because of it. Thank you for sharing.

[Anastasia]

The pandemic changed a lot of things we experienced this at our hospital with all the ALC patients. We lost a lot of great nurses during these difficult times

[Kayla]

Hi stephanie,
thanks for sharing that, covid 19 definitely had a huge impact on patients and nurses, and all healthcare workers

[Jessica]

A difficult change in my organization occurred when we transitioned to an automated medication dispensing system. Some of the reasons for the change were to enhance efficiency, minimize medication errors, and ensure timely access to medications. Although the new system was going to bring improvements to the organization, staff seemed scared of change. Sometimes we get used to doing things a certain way that we are reluctant to change or fail to see the full potential of something.
Although I thought the change would be positive, I did feel some resistance because I was on maternity leave when the project was being rolled out. I was worried that I wouldn’t receive thorough training on the system upon my return and was nervous for the change. Typically, I am an innovator but because of the timeline and not being present for the initial rollout it took a bit longer for me to feel comfortable with the change. I would say I was more of a late majority in this situation.
When I returned from maternity leave the staff were already familiar with the new system. I was surrounded by super users and staff who were confident so I felt comfortable and supported if I had any questions. I made the transition smoother than expected as many of the challenges that come with change were already figured out.

[Katherine]

I really relate to your reflection about how being away during a major change can make it harder to adjust. It’s great that you were honest about feeling nervous but still open to learning once you returned. Having supportive coworkers and “super users” around makes such a big difference — it shows how strong teamwork and peer influence can make transitions smoother. I like how you recognized your shift from being an innovator to a late majority in this situation — it really highlights how our comfort with change can depend on timing and circumstances.

[Tina]

Jessica,
I remember when our unit in the hospital also rolled out the new automatic dispensing medication unit. It was stressful and such a big change. I had mixed feelings of this change, the back and forth, no longer being able to push the medication cart around. But liked the idea of less medication errors. Thanks for sharing.

[Donna]

A recent change i experienced was when our staffing assignments were modified and I had to cover two floors instead of one due to staff shortages. This was difficult adjustment because it increased my work load and required constant prioritization to ensure every resident received safe and timely care. At first, it felt overwhelming, especially during medication passes and when residents on both floors needed assistance at the same time. However, I would describe myself as part of the early majority, once i understood the need for the change, I adapted to staying organized ,communicating effectively with PSW’s and managing my time carefully. This experience taught me resilience, flexibility and the importance of teamwork in maintaining quality care even during challenging transitions.

[Amit Kaur]

Hi Donna
Thank you for sharing your experience.You managed by staying organised and communicating with team members effectively and you also expressed a positive change.Learning from challenging experience and providing quality care.I really liked your professionalism.

[Tina]

A Change that is being made as we speak in LTC, is the Med-Cert of PSWs. Though this has been legislated for some time by the government, It is now being implemented at my work. Some of the reasons for the change were to enhance efficiency of the nurse. By having a PSW doing the majority of the medications, this then leaves more time for the nurses to spend time, doing other duties. Things such as treatments, wound care, assessments of the residents. The nurse will still have the responsibility of narcotic, injectables, contacting the doctors and orders to name a few.
In this current change, I would say I am a early adopter. To me this is a welcome change, though I am not aways welcome to change, I see this as a plus side. It benefits all involved and the efficiency of the neighbourhood at my work.

[Stephanie]

Hi Tina, Wow this would defiantly be a big change I also agree that i could see the benefits to this especially if nurses are being responsible for more then one unit of LTC residents due to short staffing ect.. and having the PSW’s be able to assist with simple med pass this would allow more time for the nursing team to focus on updating care plans, wound care, and better assessment of LTC residents. I can see how some may be a rejector to this change due to senior staff who don’t feel comfortable with administering medications ect.. however i feel there is always room for everyone’s scope to improve.

[Viatcheslav]

Tina, it is a big change in your scope of practice. While on one hand it does offer more freedom to practice nursing skills and focus on more specific tasks, I can also see how it can be intimidating leaving the established routine behind. I think I would also be an early adopter, as potential to grow our skills and be more useful is that much greater.

[Katherine]

A big change I went through at work was when we switched from paper charting to electronic documentation. The idea was to make things more efficient and accurate, but at first it just felt stressful and time-consuming. I definitely resisted it in the beginning because it felt like too much change all at once, especially with an already busy workload.

Looking back, I’d say I was part of the early majority — not one of the first to jump in, but I came around once I saw others getting the hang of it. Like Patterson et al. mention, it wasn’t that I didn’t want the change, I just didn’t feel confident using the new system at first. Once we had more training and support from leadership, it got a lot easier.

This experience showed me that resistance is normal, and good communication and patience from leaders can really make all the difference when change happens.

[Mauei Caela]

Hi Katherine,

I am glad that you were given appropriate resources to give you more confidence in adapting to the new change. I understand you as we had some equipment changes every year and it always feels like learning adds up to the workload as you are still navigating while doing the job. I also agree with what you said that resistance is normal, and having supportive and understanding leaders is necessary to implement a successful change.

[Amit Kaur]

A big change that had influenced me during the Covid emergency time,Govt had mandated the Covid vaccine for all health care workers that situation was like” my way or highway”.
I did not resist.I am an early adopter, I accepted this as the same as other vaccines we take for job requirements like Hepatitis A,B.,Tetanus,TB test etc.
But this impacted me, not only a health vise but also other co-workers who decided not to take the vaccine and left the job .That brought a big work load with a shortage of staff.

[Donna]

That’s a great reflection Amit. I completely agree, mandated vaccination during the covid emergency created a huge shift for all of us in healthcare. Like you, i also accepted it as part of our professional responsibility, similar to other required immunizations. It was definitely challenging to see many colleagues leave, which increased workload and pressure on those who stayed. But it also showed how adaptable and resilient healthcare workers can be in times of crisis.

[Anastasia]

When the COVID-19 pandemic began, our organization underwent a rapid and difficult change to respond to the overwhelming number of patients. A field hospital was opened to manage the overflow, and I was redeployed there. The reason for this change was clear — our existing facilities could not handle the volume of critically ill patients, and we needed additional space and resources to provide care.
At the time, I resisted the change. I was anxious about leaving my familiar work environment and colleagues to join a new team in an unfamiliar setting. More than that, I knew the field hospital would be a place of immense emotional strain. Many patients were critically ill, and because families weren’t allowed to visit, people were dying alone. This reality made the transition even more difficult to accept.
Looking back, I would place myself in the late majority category. I eventually adapted and accepted the change, but it took time. Initially, I struggled with fear, uncertainty, and emotional overwhelm. However, once I settled in, I understood the importance of the role we were playing and grew more comfortable working alongside new colleagues in such a challenging environment.
This experience taught me how difficult organizational change can be, especially in crisis situations. It also showed me that even when initial resistance is strong, support, teamwork, and time can help individuals adjust and contribute meaningfully to the change.

[Stephanie]

Thank you for sharing this story. It is definitely hard to change and I probably would have resisted it too.
I really liked that you were in the late majority category and are able to see that it was a positive outcome as the result. You were able to grow with that change.

[CHUNYAN]

A big change in my retirement home is at the time we changed pharmacy. A new EMAR system and a new HOGAN medication Cabinet. The benefit of Cabinet is it stored majority of the medication resident need .It can cover all the emergency medication .IF resident has UTI after doctor prescribe the antibiotic we can got from the Cabinet right away. Resident can get treatment on time. It is very convenient when the puff, insulin is finished you can take out from the machine very quick save time to order and deliver to us Also save time for nurses to count narcotic during shift change. No narcotic count .At this point I am adoptor for the new technology machine. But in another hand, the machine take time to dispend medication. We have to withdraw the narcotic every single time. If resident has pain need Tylenol PRN we have to running to machine and withdraw the medications and came back give to resident. Sometimes resident could not understand why it take so long to get PRN medications .in that case I stand on rejecter position As time goes on I find The more we use the machine the more we used to it and start to like it .

[Mauei Caela]

When our payroll system changed, I shifted from being an early adopter to part of the late majority. The new system was more complicated, with additional numbers and complexity. Issues arose, including missing vacation hours for a colleague, which remained unresolved for over a year. T4s had errors, with deductions/contributions not reflected accurately. Some staff had to redo their taxes due to corrections.

The transition was frustrating, with staff resistance and requests to revert to the old system. However, we were told the old system couldn’t be brought back. Despite challenges, the new system has benefits, like tracking staff time arrivals and encouraging punctuality. This aims to improve bedside turnover and allow staff to go home on time. Recently, pay stubs were simplified based on staff feedback, making them easier to read. While the transition was difficult, we’re adapting and seeing some positive changes, although unresolved problems remain.

[Trudy]

Hello Mauei,

That is so frustrating for all involved. Sometimes new systems do have their benefits once it is rolled out properly and staff get familiar with the program. The right training and education should always be done prior to getting rid of old programs. Hopefully, the kinks will be worked out, and it will be smoother for everyone. I would have been part of the late majority too, if I was in that situation.

[Trudy]

A big change in one organization I worked for was massive layoffs. I was employed as a full-time nurse as a new grad. Unfortunately, the hospital was undergoing some changes. A lot of lower seniority nurses, such as myself, were either laid off or asked to move into a part-time role on a different unit. I would say I was part of the late majority. I was very uncertain and fearful of the future. Initially, I resisted the change. I was eventually able to adapt to the changes made. I took the part-time job to stay within the organization. Within a year, I was able to apply for a full-time job back on my unit.

[Loubna]

Thank you Trudy for sharing your experience. It was a challenging time especially as a new graduate. It makes sense why you resisted to change first. However, your experience shows the importance of being flexible during difficult organizational changes.

[Stephanie]

The biggest change I have expereienced was when the organization switched from paper charting to electronic charting. It was to help improve charting and geared for the speciality of hospice. I was all for this change, along with majority of the employess, until I was in it. We all received training on the new system. Once the switch over happened, there was more difficulty with unexpected errors then originally expected. Many changes within had to be evaluated. Changes to improve the system are still ongoing.
It was a difficult change, immensely overwhelming and fustrating for everyone on the clinical team, and myself included.
It was interesting to witness that some people did not like the change, rejected it before it launched and some were innovators who improved the system right away.

[Loubna]

In my long term care workplace, we recently switched to using a new skin and wound application for skin documentation and weekly monitoring. The reason for this change was to ensure better tracking of resident’s wound care progress and healing and improve consistency and communication between nurses. At first, some nurses were hesitant because it required a new learning, but I was actually one of the earlier adopters. I saw its benefits right away. The system allowed us to easily review wound updates. Although it took some time to get comfortable with the system, I stayed positive and helped my coworkers who were finding it challenging to achieve smoother transition.

[Kayla]

At my cuurent job, there was a time where they restructured teams and joined my team with another managers portfolio and moved us to another floor. The reason for the change was internal redesign. At first alot of the team were hesistant and uhappy about the change, I tried to be an early adopter and go with the change instead of against it, as i knew it was happening regardless, I also saw some of the benefits despite the risk. I think being an early adopter helped some of the other team feel more comfortable with the change

[Viatcheslav]

A difficult change in an organization that has affected me was when our hospital underwent an update in OT scheduling process which involved upgrading to the new software and completely redesigning the flow.

The change was implemented to address staffing shortage issue and make the system more efficient; to improve the process of offering open and short shifts. While the idea sounded great, even during the “sales pitch” management was giving to staff it didn’t sound as something which would work very well for our organization. While I cannot say that I resisted this change, as it was not really an option if someone wanted to pick up a shift, I didn’t like it and didn’t believe that it would be effective. Late majority is a definition I would describe myself in this situation.

It has been few years new system has been running for and I find I still stay strong in my initial opinion about it. The old system was better, but I had to adopt and adapt to stay current and be able to continue making extra income through OT.

[Author]

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