Question 1

The nurse manager is facilitating change to a new documentation system in the unit. If the manager wants to use the most common method to overcome resistance to the change, which strategy would be chosen?
A) The manager distributes a handout explaining the new system and how to use it.
B) The manager creates a "quick tip" sheet about how to use the system and schedules practice sessions for each nurse.
C) The manager identifies a key supporter of the change and has that nurse act as mentor to the remaining staff.
D) The manager threatens to transfer anyone who resists the change.

Accepted Answer

1. Giving information is the most common method of changing individuals' perceptions, attitudes, and values.
2. Providing information and an opportunity to practice is called training. Training is not the most common method of changing perceptions, attitudes, and values.
3. While having a mentor may be a desirable method for the learner, it is not the most common method of changing perceptions, attitudes, and values.
4. Transferring or terminating those who resist change is a method of changing the perceptions, attitudes, and values of the remaining staff. It is not the most common method.

Question 2

The nurse manager is facing resistance to change from many staff nurses. Why should the manager work hard to address this resistance?
A) Resistance will keep the change from occurring at all.
B) Resistance from the late majority can keep others from accepting the change.
C) Resistance can negatively impact future client care.
D) Resistance allows others to take power from managers.

Accepted Answer

1. Resistance generally does not completely prevent change, but it may stall or delay it.
2. The late majority eventually does accept the change.
3. Client care is always the most important reason that nurses do what they do. If the change does not improve client care in some respect, is it worth the effort? If resisters interrupt the work of the unit or refuse to provide care as directed by the change, the quality of care may suffer.
4. Resistance is a normal part of change and does not mean that power has been diverted to the resisters.

Question 3

A nurse manager is faced with the task of introducing an unpopular change to a staff that includes several nurses who have acted as rejecters to previous changes. The manager expects resistance but hopes to identify these rejecters early in the process. The manager should be particularly alert to which statements?
A) "I don't care what they say; I'm not giving care that way."
B) "I don't think this is going to work, but I'll probably come around to it sooner or later."
C) "I'm not crazy about this idea, but we do need to change how we are providing care."
D) "I bet I can make it very difficult for this change to occur."
E) "It won't be so bad. I like change."

Accepted Answer

Statements A and D indicate a strong resistance to change and a potential for disruptive behavior. The nurse manager should pay close attention to these individuals and address their concerns or resistance early in the change process to avoid undermining the change effort. Statements B, C, and E indicate varying levels of openness or willingness to consider the change, and may be potential allies in supporting the change effort.

Question 4

The nurse manager has determined that changes are necessary in the way holiday shifts are assigned. When assessing the political climate surrounding this potential change, the nurse manager would ask which
A) Who is in control of the way holiday shifts are being assigned?
B) What communication technology is available to distribute information about the change in holiday shift assignments?
C) Who will lose when holiday shift assignments are changed?
D) Will changing holiday shift assignments affect the budget?
E) Who is benefiting the most from the way holiday shifts are currently assigned?

Accepted Answer

The nurse manager should assess who controls the current process, who might lose or be negatively impacted by the change, and who currently benefits from the existing system to understand the political dynamics and potential resistance to change.

Question 5

The staff is transitioning to a major change in the provision of nursing care in a large hospital. Which behaviors should the nurse manager watch for that would indicate possible problems?
A) Nurses are discussing the change at breaks and meals.
B) Nurses are doing both the old work and the new work.
C) A nurse says, "I guess everything we've done for years is wrong."
D) The provision of care with the new system takes longer than expected.
E) Nurses are doing parts of the old procedure and parts of the new procedure.

Accepted Answer

These behaviors indicate potential problems: doing both old and new work suggests confusion or resistance, expressing doubt about past practices can indicate low morale or resistance, and mixing old and new procedures shows a lack of clarity or training.

Question 6

A nursing supervisor would like the nurse manager to serve as change agent for a needed revision to unit policy. Which statements would alert the supervisor that this manager is not the best choice for this assignment?
A) "Well, we don't want to rock the boat too much."
B) "Do you think we can get enough support from the nurses to make this change?"
C) "We tried making a change like this before and it didn't work out well."
D) "To make this big change, we need to start making smaller changes now."
E) "There is going to be resistance, but I think it can be overcome."

Accepted Answer

The answer of A nursing supervisor would like the nurse...

Question 7

Hospital administration is working with a university school of nursing to establish a nursing residency program. Why is this a desired action?
A) A residency program eliminates the hospital's liability if a novice nurse makes an error.
B) A residency program is established to make nursing education more like physician education.
C) The Institute of Medicine has proposed residency programs for nurses.
D) A residency program ensures that nurses participate in lifelong learning.

Accepted Answer

The Institute of Medicine has proposed residency programs for nurses as a way to improve the quality of patient care and increase the confidence and competence of new nurses. A nursing residency program provides a bridge from academic learning to clinical practice by offering mentored clinical experience and continuing education opportunities. It also helps to address the nursing shortage by providing additional support and training for novice nurses. Eliminating liability or making nursing education more like physician education are not the primary reasons for establishing a nursing residency program. While a residency program can promote lifelong learning, this is not its sole purpose.

Question 8

A major change has occurred in the governance of the hospital. How can the nurse manager help staff cope with this change?
A) Disperse information about the change as quickly as possible.
B) Discourage any negative discussion about the change.
C) Remind staff that change is part of the health care environment.
D) Talk about the change in positive terms.
E) Withdraw slightly from those who oppose the change.

Accepted Answer

The nurse manager can help staff cope with the major change in the governance of the hospital by dispersing information about the change as quickly as possible, reminding staff that change is part of the healthcare environment and talking about the change in positive terms. By providing timely and accurate information, the nurse manager can help staff understand the reasons behind the change and reduce anxiety and confusion. It is important to acknowledge that change can be difficult and disruptive, but emphasizing the positive aspects of the change can help staff see it as an opportunity for growth and improvement. Discouraging negative discussion about the change and withdrawing from those who oppose the change may further polarize staff and create resistance to the change.

Question 9

Which statements by a hospital executive reflect power-coercive strategies to implement change?
A) "We must follow the federal guidelines in the way we bill for our services."
B) "If we don't reduce our nosocomial infection rate, Medicare won't reimburse us."
C) "Administration has to make this change or our accreditation status will be at risk."
D) "This change is the only logical action we can take."
E) "All our sister institutions in the association have already made this change."

Accepted Answer

Power-coercive strategies involve using authority, threats, or mandates to enforce change. Statements A, B, and C reflect this by emphasizing compliance with external regulations, financial consequences, and accreditation risks.

Question 10

A nursing supervisor has introduced a needed change in policy to the nurse managers. The managers have met maximum resistance when attempting to gain support for the change. Which options reflect valid strategies for the nurse managers?
A) Meet with the supervisor and discuss modification of the proposed change.
B) Slow down the change process.
C) Meet with the supervisor and suggest abandoning the change.
D) Work together to identify strategies to overcome resistance.
E) Proceed with the change.

Accepted Answer

The answer of A nursing supervisor has introduced a needed...

Quiz 5: Initiating and Managing Change

The nurse manager is facilitating change to a new documentation system in the unit. If the manager wants to use the most common method to overcome resistance to the change, which strategy would be chosen?

The nurse manager is facing resistance to change from many staff nurses. Why should the manager work hard to address this resistance?

The nurse manager has determined that changes are necessary in the way holiday shifts are assigned. When assessing the political climate surrounding this potential change, the nurse manager would ask which

The staff is transitioning to a major change in the provision of nursing care in a large hospital. Which behaviors should the nurse manager watch for that would indicate possible problems?

A nursing supervisor would like the nurse manager to serve as change agent for a needed revision to unit policy. Which statements would alert the supervisor that this manager is not the best choice for this assignment?

Hospital administration is working with a university school of nursing to establish a nursing residency program. Why is this a desired action?

A major change has occurred in the governance of the hospital. How can the nurse manager help staff cope with this change?

Which statements by a hospital executive reflect power-coercive strategies to implement change?

A nursing supervisor has introduced a needed change in policy to the nurse managers. The managers have met maximum resistance when attempting to gain support for the change. Which options reflect valid strategies for the nurse managers?