Sometimes Change is Hard

As an RNAO Best Practice Spotlight Organization, we take the opportunity to bring together our “Best Practice Champions” to learn and share experiences in working with Best Practice Guidelines. Recently, Irma Jean Bajnok, Director, International Affairs and Best Practice Guidelines Programs, Centre for Professional Nursing Excellence at the Registered Nurses Association of Ontario, spent some time with us sharing a practical and organized framework to address change based on the book, “SWITCH, How to change things when change is hard”. The analogy used in discussing change was an elephant, a rider and a path, a somewhat odd combination but when you think about it, it does make sense.

We are in a state of conflict and contradiction when it comes to change; our hearts and minds often disagree. The logical thinking part of you (The Rider) thinks that you should be able to muscle the heart (The Elephant) into making change against the elephant’s will or preference. The elephant is the emotional, more instinctive part of you. Switch suggests that if you grab their hearts, their minds will follow.

The elephant represents the group who are being asked to change. Elephants are big and very smart, but can be stubborn. Trying to direct them down a path simply because you want them to go that way won’t necessarily make them move. The path is the environment which may need some ‘tweaking’ to rally the group toward the change. The path or environment should have situations, tools, procedures, forms, and so on, that make it easy and intuitive to do the right thing and hard to do the wrong thing. Keep the switch (change) going by encouraging and celebrating steps taken toward the goal.

So the moral of the story is we need to ensure that there is good reason for the change we are making. Change needs to benefit our patients; the nurses and other healthcare providers need a clear understanding of the benefits, that will make the change valuable to them. Then as the rider or manager of the change we can move the elephant down the path.