Sally, I appreciate your insightful post regarding beginning nurse led groups on an inpatient psychiatric unit. I know that this can be a challenging transition to go through and your assistance will be instrumental in its success.
Your assessment that the nursing staff appear frozen and lacking motivation to make the necessary adjustments in their work to begin leading groups seems accurate. You describe that the manager has been unsuccessful in unfreezing staff attitudes regarding this change for over two years (S. Rothacker-Peyton, personal communication, July 22, 2017). This speaks to a fair amount of resistance amongst the staff as well as a likelihood of significant barriers to implementing nurse-led groups. It will be important to determine what has failed with this change in the past, as well as what has worked in the successful implementation of change with the same team to determine the best path forward. Furthermore, it is concerning that the nurse manager’s past attempts at communicating regarding quality improvement have resulted in a lack of feedback. As you discussed, it will be very important to build an implementation plan based upon the work described by Middaugh (2017), Heuston
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As the nurse manager has been trying to implement this change for quite some time now it will likely be challenging to create a sense of urgency, the staff may be desensitized to hearing the message at this point. Furthermore, it appears from your description that the nurse manager has not been able to successfully empower the staff and fully implement change (S. Rothacker-Peyton, personal communication, July 22, 2017). Does she lack credibility with her staff? If so, a strong guiding team as described by Middaugh (2017) will be even more important. Perhaps, they will build the credibility that the nurse manager has been unable to successfully