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We are changing our model of care and meeting with resistance. Do you think 36 hours of cross training in a new and unfamiliar unit is appropriate?

Wednesday June 12, 2013
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Dear Donna,

We are changing our model of care to couplet care. The facility has been very traditional, and now we are meeting with a great deal of resistance. Change is difficult, especially in an organization that has not held nurses accountable or promoted any growth. Nurses have the opportunity to work side by side for 36 hours in the unit in which they are not as comfortable, have a skills assessment checklist and a one-on-one preceptor. These are maternity nurses going to nursery and nursery nurses going to postpartum. They have been given health stream modules to do, and we have a director and educator available to them at all times. We have made it clear there is no time frame, and each nurse will be assessed daily moving forward. Do you think 36 hours of cross training in the unfamiliar unit is appropriate? They want four weeks. Is this unrealistic?

Meeting Resistance

Dear Donna replies:

Dear Meeting Resistance,

Whether the change is perceived as good or not, no one likes change, especially when it is thrust upon them and not their choice. Change is necessary for growth of the organization, the department and the individual.

It also is normal for those who are being required to do things differently to resist. It sounds like you have developed a comprehensive program to assist the staff in the transition. Nurses often underestimate their own ability to adapt to a new area. In some cases, the longer time frame just allows more procrastination.

You can check with colleagues in a related specialty through your local or state chapter of the Association of Women's Health, Obstetric and Neonatal Nurses (www.awhonn.org) to see if they have gone through a similar transition and what worked for them. This is where your professional associations can be particularly helpful. Call educators and managers in other facilities and as the education or practice representative at the state and national level of AWHONN for additional ideas, advice, support and information.

If you can negotiate something that both parties are comfortable with, that would be ideal. You also can try it out with a few staff members — choose those who are more positive and open to the change —and see how it goes for them. Then they can spread the word that it is possible, before the others are required to comply.

Best wishes,

Donna Cardillo, RN, MA, well-known career guru, is Nurse.com’s “Dear Donna” and author of “Your First Year as a Nurse: Making the Transition from Total Novice to Successful Professional” and “The ULTIMATE Career Guide for Nurses: Practical Advice for Thriving at Every Stage of Your Career.” Information about the books is available at www.Nurse.com/CE/7010 and www.Nurse.com/CE/7250, respectively. To ask Donna your question, go to www.Nurse.com/Asktheexperts/Deardonna. Find a “Dear Donna” seminar near you: Call 800-866-0919 or visit http://Events.nursingspectrum.com/Seminar.