Unsurprisingly, personal qualities of the nurse who acts as a change agent are crucial in the implementation of change. If the self same nurse has a “track record of integrity,” the transition can be made smooth (White, “Change Strategies Make for Smooth Transitions”). McCarthy (2005) writes that the healthcare industry is constantly evolving, which is why change should be considered a certainty. For this reason, nurses who act as change agents must maintain track records of trustworthiness. They must not promise their subordinates more than they can deliver. McCarthy recommends small promises followed by big surprises of a positive nature.
In fact, this should be the personal philosophy of the change agent who must build rapport with his or her staff before change is proposed and implemented. If the nurse leader fails to keep promises, his or her staff is most likely to distrust the change being proposed. By making small promises and delivering big, on the other hand, the nurse leader provides evidence that the proposed positive change would, in fact, prove to be positive for all (McCarthy). Change may have been proposed through healthcare regulatory bodies, for example, state health departments.
The economic environment may similarly demand change. The nursing shortage serves as an illustration of the economic environment demanding change in healthcare organizations. New research may be another impetus to change. Regardless, the nurse leader asked to support implementation of a particular change in his or her department has control over the following: interpreting the change; reacting to it; identifying the expectations of staff in the given situation; planning the implementation of change; and also planning how to engage staff in the process of implementation (Cohen, 2006).
Interpretation of and reaction to change involve the incorporation of some of the characteristics of effective change agents already described. To understand the expectations of his or her subordinates, however, the nurse manager must determine the degree to which each of them is willing to accept change. It is only possible to involve the staff in the implementation of change after their reactions to change have been gauged. The Diffusion of Innovations Theory is very helpful for the nurse manager in this process. The Theory describes how staff members may differ in their adoption of change (White, “Anticipate Responses to Change,” 2004).