Nursing is pretty lean. I suspect it will be made leaner. In other departments, there are a lot of management people; there could be some streamlining done there. In nursing, we have always bit the bullet and found out later that other departments haven’t reduced their personnel. Any type of reform is scary right now; my job could be affected. –Margo, Nurse Manager
Reengineering, TQM, horizontal structures, redesigning, virtual teams — welcome to the wide world of buzzwords and management’s latest, and greatest pet fads. Think back…what was your workplace like five years ago? Three? How about last year? Stable…Calm…Tranquil? Definitely not. No one in today’s workplace has been untouched by the amount of significant change woven in every organization, at every level. Most people will say that their workloads and stress levels have increased over the past three years. Attribute it to change.
Change is here to stay. And, the only thing that will change change, is that it will accelerate — its rate will continue to increase. Futurists believe that the amount of change to be encountered in the next ten years will be equivalent to the amount of change experienced during the past seventy-five. Think exponentially, not incrementally. Because of technology and communication capabilities, any changes in the future will come up a faster, even explosive pace. You may feel you’re caught in a shock wave.
Change is a unique, and not so unique, process that will invade the rest of your life. Without it, nothing could exist, and life, as present generations currently know it, would cease to exist. Anyone over 30 knows when reflecting back to early childhood that microwaves and VCR’s did not exist then.
Since 1940, the personal computer, penicillin, the Pill, artificial hearts, organ transplants, radar, television, FM radios, credit cards, frozen foods, ball point pens and pantyhose only scratch the surface of debuted items and procedures. Can you imagine today’s society without any of them? In 1997, the ability to clone was officially announced, guaranteeing a heated debate — to clone, or not to clone.
Change is inevitable. Without it, there is no growth, nil or little improvement and little opportunity. How dreadful, how scary, and…how exciting.
>From Non-Shifting to Shift Shaper
In 1981, I published my first book. At that time, I thought it would be the only book that I would ever produce and really didn’t pay much attention to the process of how it was created. After all, why bother when it’s a one-time shot. Well, the one-time shot turned into multi-books with no end in sight today. I’ve just finished my eighteenth. The process that takes any work to publication has changed significantly since 1981, just as the changes in healthcare’s delivery and management has.
I did not really tune into the changes that were going on in the book business until I began work on my second book. New technology was rapidly coming on the scene. In 1979, when my first manuscript of was sent to publishers, the concept of word processing as we know it today, was unheard of by most. It would be a few years before the upstart kid, Apple Computer, broke into headlines, and the workplace.
When I started to work on the second book in 1982, I was aware that there were some new gimmicks and gadgets out there. But, I resisted jumping in and trying one of those new gadgets — the computer. They weren’t cheap, so I didn’t get one. Contrary to popular belief, most authors don’t make a lot of money — the average income from their work is less than $10,000 a year, even today.
My secretary’s typewriter was good enough. Mine was impressive for its time. It had the capability of remembering 50 pages of material. In the early 80s, it was IBM’s state of the art for small businesses. Granted, they were not used for writing books at that time. They were primarily for storing letters that would be sent to my clients, reused or slightly modified. In the old days, from 1979 to 1986, my articles and books were written on a typewriter with each page retyped as changes were made. As I look back, I was in the Stone Age.
The Five Stages of Change
When you are faced with the change process, you experience multiple stages. They include:
* RESISTANCE — being stubborn and denying the benefits and need of an item, process or concept. Fear is an underlying ingredient when resistance is in play — fear of the unknown, fear of failure, and sometimes, fear of success.
* SKEPTICISM — willing to try, but still doubting the benefit and use of an item, process or concept, clinging to the past.
* ADAPTATION — moving past reluctance and fully accepting that the item, process or concept can be integrated into your personal or professional life.
* SHIFTING — opening up to “what if” scenarios; your transition from being stubborn to shift shaper is almost complete.
* COHESIVENESS — the ways of the past are the past; your new attitude becomes, “Why didn’t I do this sooner” or “What took me (or my group, team, facility, organization or company) so long to…change?” You are a shift-shaper — you can’t understand why others are not on the band wagon and why they are still resisting change.
While in the process of producing my second book, I experienced both resistance and great skepticism. I knew there was another way to do it, but the old way — the typewriter — was good enough. And I wasn’t sure or convinced of the validity of the new equipment available that would supposedly speed up a writer’s work.
It only takes an author a couple of times to realize there has got to be a better way than rewriting an entire manuscript every time a paragraph needs to be moved or a few more typos are uncovered. In fact, back in the Stone Age of the 80s, it was quite common to turn in manuscripts with typos and crossed out sentences and paragraphs. We authors knew the publisher’s typesetter would “clean it up.” Today, clean manuscripts from author to publisher are the rule!
Finally, we rented a computer for a month, just to give it a trial run. As Louie, my secretary, embraced the genius of it, I still resisted. I was both skeptical and hesitant, still viewing it as a new-fangled device. Since Louie was taking my dictation, transferring my spoken words to paper, I let her have her way. It soon became obvious to me that her speed and efficiency levels were enhanced.
I then moved into the third stage of change — adaptation. My attitude became, “Well, we’ll keep it, but we won’t get rid of the typewriters” — we had three. After all, we would always need a typewriter if we needed to do something in a hurry. I resisted diving into learning how to use computer — I didn’t want to turn on the computer, much less know how to operate it. To me, “booting up” was what a woman did with her fall/winter footwear. I didn’t have a clue that it meant turning on the computer and opening a file.
In 1986, Louie went on a well-earned holiday leaving me with written and detailed instructions on how to turn on the computer and access certain files that I might need during her absence. At that time, I had begun my research for the book that was published the following year, Woman to Woman and was working on my doctorate.
My agent had asked me to make a few changes in the book proposal. The change seemed simple, that of converting some single spaced items to double spacing. With the magic of technology, I booted-up the computer, opened the appropriate file and proceeded to give it the commands to change from single to double spacing using the instructions Louie had left for me. Wah-la — I deleted 51 pages of manuscript!
For three days, I had experts try to retrieve the lost material — no success. My emotions ran the gamut — from disbelief, to denial, then anger. Because of Louie’s absence, I had no choice but to do it over — on a computer! I had to sit down and recreate what had been lost. Initially, I rebelled. I was in the “pits,” ticked. Being stubborn and resisting was my motto. Finally, I threw in the towel and guess what? I really liked using this marvelous new gadget. The computer had the ability to erase, delete, edit, to move phrases, sentences and paragraphs around with a tap of a finger. Unbelievable. My “gadget,” was a writer’s dream.
By the end of the day, I went from adaptation to the fourth stage, shifting. I began to wonder what else could I do with the computer and the word processing programs. What types of overheads for workshops could be produced? What about cartoons to be used during lectures? How about pasting graphs into articles? I was sold. In a nano-second, the fifth stage of cohesiveness hit. Within the year, three Macintoshes found new homes in my office.
I was hooked, almost becoming evangelistic is my pronouncements of awe in what my “Macs” could do. Today, a dozen plus years later, I am still in awe in what these machines can do. I became a shift-shaper for anyone who was contemplating a computer for home or office use.
Today, I openly and loudly say that I couldn’t imagine not having a computer. There is no way that I could produce what I do if these machines weren’t an integral part of my office team. Those original three have been upgraded, replaced and added to. From one typewriter to five computers. What happened to our state of the art, $3500 IBM Memory Typewriter? I gave it away!
Some people take forever to move beyond resistance. They will do whatever they can to ward off changes when the only reality is change. Not only do they practice the glorious art of self-sabotage, they assist in the sabotage of others on their team, departments, even organization. Fear, and denial, feed their resistance.
Organizations buy all the latest equipment and technology for bringing change to their environments, change that will enable them to be competitive in today’s, and tomorrow’s, markets. Consultants and trainers are brought in to execute the latest “latest.” Management believes it has done its part — now it’s the employees turn to implement and transition, the sooner, the better. Management only has it half right. Yes, the tools are there — but, it’s the people who are the gatekeepers. If the people — employees — don’t buy in, the “latest” is sabotaged.
The adage, “Try it, you might like it,” isn’t an instant fit. It takes time, practice, training. Rarely an overnight process. As I began to familiarize myself with the “assets” of the computer, I realized that there was a better way at my fingertips. It didn’t happen overnight. Rather, it crept up on me.
It is not uncommon for a huge percentage of the individuals in an organization, even a failing organization, to truly feel that any change is not necessary. The prevailing attitude is “If we just hang on (and do nothing), it will all settle down and everything will be back to normal.” Fat chance. Look at your own organization. How many departments are thriving (or still exist) that decided to do zip and wait the changing healthcare winds out?
In working through to the fourth stage, shifting, you may still feel uneasy or uncomfortable. Sometimes the “good old days” seem simpler. They may be, but today, technology changes almost daily for the home and workplace. You can’t turn back, you can only go forward. It seems as soon as you learn something new, it’s time to learn something else. There is always a fear that you might crash or fail when change is thrown at you. But over time, confidence builds up and you begin to wonder what took you so long.
When you arrive at the final stage of cohesiveness, you find that you’ve accepted the change and you can work with it comfortably, whatever “it” is. There will be times when you’ll think back and won’t be able to remember what it was really like before the change was in place. You feel confident and in control, wondering how you ever managed before the changes were put in place.
The VCR Way
Usually, there are three reactions to change: reactive, non-active and proactive.
REACTIVES jump out of the way. They’d rather not get involved. Uncertainty or lack of confidence tells them they’d be safer to step aside and see what evolves. Put a VCR in their hands and they would push the “pause” button. In time they may find that the change was exactly what they wanted, but they are too late to get on the band wagon. They paused too long.
NON-ACTIVES stand still. They’re paralyzed. Their VCR didn’t pause, it “stopped” and in some cases, rewound. Non-active posturing means you’re stuck. It is easy to end up being run over, ignored or viewed as invisible. Both reactives and non-actives usually fail to anticipate.
PROACTIVES will most likely win the race. They are not inclined to get out of the way or stand still. Their VCR is set at “play.” They get involved, ask questions and create their own future rather than have someone else make it for them. Proactives don’t fail to anticipate.
Each of us has the choice of pushing which button we set our VCR at. What’s yours?
Few enthusiastically jump in and wallow in change. The norm is to avoid it. For most change and shifting gears is scary business. Your fear factors rise. Denial matches fear’s level. It’s easy to become paralyzed. Welcome to changeophobia.
Change is usually messy. It’s destructive. Things get broken along the way — old beliefs, habits, traditions. Nay-sayers will issue warnings — take it slow or stop it. You tiptoe around, avoid them or try to be nice. After all, no one really wants someone to be hurt in the change process.
It doesn’t matter, toes will be bruised. If you, and your organization, are unwilling to break a few things along the change path, heavy baggage accumulates. Bad habits stay intact. By being careful and protecting the sacred cows, you sabotage the “could be” generation of events — your future. A caterpillar must shed its cocoon to become a butterfly. You and your organization must shed many of the old ways and habits to spread wings and fly.
Becoming A Shift-Shaper
Becoming a shift-shaper is usually brought about by one of two forces: external or internal. The first is external. Change is forced on you, by others from work, family or relationships. You are given no choice, so you make the change. You create the internal force of change. You will change on your own if you experience sufficient discontent — you feel the need for or see a better way. You decide that your style, methods, education or output need fine tuning. A shift-shaper you become. In either case, courage and confidence are needed.
I often ask participants in workshops to list the areas of change that they have experienced or observed. Some create an incredible list, others appear or act brain dead. What change? is their attitude. If “What change?” is your mantra, guaranteed, your tenure will indeed be short. You might as well write a will or your termination notice. Change is not invisible — it’s everywhere.
To survive and grow through a changing environment — whether it’s personal or professional — takes a commitment from you. For most people, the old saying, “One for the money, two for the show, three to get ready…,” is never completed with the final phase “four to go.” Most become stuck on getting ready; no one gets stuck on going. Change doesn’t wait until you are ready to deal with it. It just happens, it moves along quickly. The sooner you acknowledge it and get on board, the sooner you become a player.
As change evolves, it’s important to position yourself. Begin by making a commitment for on-going improvement, learn new things. Start a program that either enhances the current skills you have, or, expands them and let them take you into another field.
There is no question that positions have and are being eliminated as you read this. Windows close, but new doors open. Thousands, yes even millions, of new products, jobs and/or companies are created because of change. In-patient care has shifted to out-patient care. In the past, insurance companies, the government, even the medical communities have resisted home care. At least paying for it. Finally, that is changing.
Dramatic shifts in attitudes have emerged in the 90s. New professions will open, expanding opportunities for nurses, technicians, doctors and consultants serving this market.
Greater communication skills are urgently needed between care provider and patient. No longer will around-the-clock patient care be the norm. Rather, patients/clients must hear all instructions clearly in 10-20 minutes. From that mere fact, gadgets, and yes, gimmicks, will be produced and marketed to the home care industry — items to trigger memory, facilitate care, make life easier.
The evolving health care field must reinvent itself. It is, and will continue to be, one of the most important sectors of the economy. There is no question that many types of jobs have been and will be eliminated as you read this. Windows close, but new doors open. Thousands, yes even millions, of new products, jobs and/or companies are created because of the change you are in or will be going through.
As change occurs, it’s important to position yourself. Begin by making a commitment for on-going improvement, learn new things. Start a program that either enhances the current skills you have, or, expands them and let them take you into another field.
There is no question that positions have and are being eliminated as you read this. Windows close, but new doors open. Thousands, yes even millions, of new products, jobs and/or companies are created because of change. In-patient care has shifted to out-patient care. In the past, insurance companies, the government, even the medical communities have resisted home care. At least paying for it. And, that is changing.
Dramatic shifts in attitudes have emerged in the 90s. New professions will open, expanding opportunities for nurses, technicians, doctors and consultants serving this market. Greater communication skills are urgently needed between care provider and patient. No longer will around-the-clock patient care be the norm. Rather, patients/clients must hear all instructions clearly in 10-20 minutes. From that mere fact, gadgets, and yes, gimmicks, will be produced and marketed to the home care industry — items to trigger memory, facilitate care, make life easier.
Embracing change and being a shift-shaper enables you to take advantage of any opportunity that may catch your eye –opportunities that you had not previously envisioned or contemplated. In healthcare, there is a vast sea out there. Beyond, and within each sea, are shorelines and islands. And, better yet, new oceans for further discoveries.
To embrace…or not to embrace change? — there is only one answer. Are you ready?