Change Resistance as Practicing Moral Authenticity: A Qualitative Study.
Organizational change
change resistance
concept development
nurse
political agency
power
Journal
Research and theory for nursing practice
ISSN: 1541-6577
Titre abrégé: Res Theory Nurs Pract
Pays: United States
ID NLM: 101146940
Informations de publication
Date de publication:
05 Mar 2021
05 Mar 2021
Historique:
entrez:
6
3
2021
pubmed:
7
3
2021
medline:
7
3
2021
Statut:
aheadofprint
Résumé
Organizational changes are increasingly rapid and continuous in health care as organizations strive to meet multiple external pressures. Much change in health care fails and nurse resistance is commonly blamed for such failure. Nurse resistance to organizational change is often described as overt behaviours and are deemed destructive to the change process. Much of the literature describing organizational change comes from the perspectives of administrators, there is little known about nurses' experiences of organizational change. The purpose of this inquiry was to explore the nature of frontline nurses' experiences of rapid and continuous change. A qualitative critical hermeneutic design was applied. 14 Registered Nurses participated in face-to-face interviews. Openended questions were used. The setting was an urban pediatric teaching hospital located in Canada. Research ethics board approval was obtained as required. Member reflections ensured accurate portrayals of participant's experiences. The findings from this study suggest that acts of resistance to change are not overt, but rather covert behaviors in micro-ethical moments. Nurses engaged in resistance as means to provide morally authentic care at the bedside. These acts were utilized to take back power over their practice amidst feelings of powerlessness, however, paradoxically, when participants described the concept of power, they understood it solely in the context of feeling powerless within the planning, implementation and evaluation of organizational change initiatives. Nurses engagement with resistant behaviours in the context of organizational change demonstrated ethical action and political agency that enabled morally authentic nursing practice. The findings from this study offer new understandings of a well-established concept in nursing and can be used when considering the ethical dimensions of nursing work amidst rapidly changing health care institutions.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
Organizational changes are increasingly rapid and continuous in health care as organizations strive to meet multiple external pressures. Much change in health care fails and nurse resistance is commonly blamed for such failure. Nurse resistance to organizational change is often described as overt behaviours and are deemed destructive to the change process. Much of the literature describing organizational change comes from the perspectives of administrators, there is little known about nurses' experiences of organizational change. The purpose of this inquiry was to explore the nature of frontline nurses' experiences of rapid and continuous change.
METHODS
METHODS
A qualitative critical hermeneutic design was applied. 14 Registered Nurses participated in face-to-face interviews. Openended questions were used. The setting was an urban pediatric teaching hospital located in Canada. Research ethics board approval was obtained as required. Member reflections ensured accurate portrayals of participant's experiences.
RESULTS
RESULTS
The findings from this study suggest that acts of resistance to change are not overt, but rather covert behaviors in micro-ethical moments. Nurses engaged in resistance as means to provide morally authentic care at the bedside. These acts were utilized to take back power over their practice amidst feelings of powerlessness, however, paradoxically, when participants described the concept of power, they understood it solely in the context of feeling powerless within the planning, implementation and evaluation of organizational change initiatives. Nurses engagement with resistant behaviours in the context of organizational change demonstrated ethical action and political agency that enabled morally authentic nursing practice.
IMPLICATIONS FOR PRACTICE
CONCLUSIONS
The findings from this study offer new understandings of a well-established concept in nursing and can be used when considering the ethical dimensions of nursing work amidst rapidly changing health care institutions.
Identifiants
pubmed: 33674454
pii: RTNP-D-20-00078
doi: 10.1891/RTNP-D-20-00078
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Copyright 2021 Springer Publishing Company, LLC.