Career advice

Showing leadership in a time of change

Change takes its toll on everyone. In the third and final part of our leadership series, Mandy Day-Calder looks at what you can do to help patients, colleagues and yourself to flourish in uncertain times.

Change takes its toll on everyone. In the third and final part of our leadership series, Mandy Day-Calder looks at what you can do to help patients, colleagues and yourself to flourish in uncertain times

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We all move through the stages of change at different speeds. Picture: iStock

Think back to any change within your clinical environment that has had a direct impact on your role. It may have been limited to your ward or something that was implemented across the whole of your NHS trust. Now think of all the emotions linked to this change, both positive and negative.

If you didn’t have any say in what was happening and felt the change was imposed on you, the balance of your emotions may be more negative.

If too many changes happened at once you may have just felt overwhelmed. You are more likely to feel positive about change that happened some time ago than about change that is current.

Ways of doing

Change involves going through a process of transition from one way of doing things to another. Change consultant William Bridges identified three important stages, known as the Transition Model:

  • Ending, losing and letting go. This is when you are confronted with the prospect of change and the realisation that you need to move away from something that is comfortable and familiar. Resistance, fear, frustration and uncertainty are often high.
  • The neutral zone. This is the in-between stage. What you were accustomed to is now the ‘old way’, but the ‘new way’ is still confusing and unknown.  
  • The new beginning. This is when when the ‘new way’ finally feels comfortable and becomes the norm. 

A good example of this transition was when 12-hour shifts were introduced. Many nurses who had been used to shorter shifts were resistant to this change, scared of the impact it would have both on and off duty. Yet now, some years later, many nurses are happy with 12-hour shifts and resist any efforts to shorten them. 

The American writer Mark Twain said: ‘A round man cannot be expected to fit into a square hole right away. He must have time to modify his shape.’

Faced with the same situation, a group of nurses or patients will all move through the transitional stages of change at different speeds.

Here are some things you can do to help:

Listen empathically If possible, try to offer space and time before the change is implemented so people can voice concerns. Remember that not everyone is comfortable speaking in public, so think of ways to be inclusive – for example, can you set up an online survey or put a feedback box in the ward?

Be open and honest If you expect someone to adapt in a certain way you will only alienate them. Explain the rationale behind the change and how it will be implemented, including what support is available, such as training and leaflets.

Acknowledge difficult feelings Don’t brush over these. Sometimes simply knowing that what you are feeling is ‘normal’ can help you cope during a period of uncertainty.

Offer a sense of direction Especially during the neutral phase, colleagues and patients may feel a bit lost, so try to think of ways to show encouragement and motivation.

One step at a time Keep things as simple as possible and don’t bombard anyone with too much information at any one time.

Be patient Adapting to change takes time and sometimes you may have to explain things more than once. Leading change can be stressful, so remember to look after yourself as well as others.


Mandy Day-Calder is a freelance writer and life/health coach

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