Lewin's Change Model and Staffing Issues in ICUs 2022

Running head: LEWIN’S CHANGE MODEL AND STAFFING ISSUES IN ICUS
Lewin’s Change Model and Staffing Issues in ICUs
Name
Institutional Affiliation

LEWIN’S CHANGE MODEL AND STAFFING ISSUES IN ICUS 2
Lewin’s Change Model and Staffing Issues in ICUs
Overview of the Area of Change and Impact on Patient Safety
Intensive care units (ICUs) and high dependent units (HDUs) play a significant role in
improving the quality of life and sustaining life for patients suffering from terminal diseases.
The clinical environment in ICUs and HDUs require continuous presence of specialists that are
experienced in handling critical care to patients with the goal of reducing mortality rates and
maximizing patient safety when administering medication and moving patients from one facility
to another. Newly recruited nurses find it difficult working in ICUs and this has an impact on the
quality of care administered. It is recommended that hospitals recruit retired ICU specialists to
work alongside the newly recruited graduate nurses and guide them in their new environment to
maximize the quality of care. This can be done by applying Lewin’s three-step model of change.
In the “unfreeze” stage, the organization prepares its members for change. The “change” stage
entails introducing the desired change by recruiting retired nurses, and the “refreeze” stage
entails making change the part of the organization. This paper discusses how Lewin’s model of
change could be used to introduce changes in ICUs by addressing patient safety issues as a
factor linked to the recruitment of graduate nurses in ICUs.
How Implementation of Change could be influenced by:
Staff experiencing reality shock
Reality shock is the leading cause of staff turnovers and stress for young employees in
their work environment. According to Kodama (2017), graduate nurses find it difficult to transit
to the new work environment as they strive to strike a balance between the work environment
and the school environment. Using Lewin’s change model at this stage, the “unfreeze” approach
will applied by explaining to the management team and employees why change is necessary. The

LEWIN’S CHANGE MODEL AND STAFFING ISSUES IN ICUS 3
views and fears of staff experiencing reality shock will also be considered to make them feel part
of the organization. Scully (2015) explains that staff experiencing reality shock need nurse
leaders to guide and help them in the transition process as they adjust to the new environment.
The initial approach will start at the core of the organization and challenging the views and
attitudes to convince them to accept that there is a need for change.
Organizational culture and models of healthcare
Organizational culture can be a facilitator or a hindrance to successful career success and
job satisfaction. According to Courtright and Kerlyn (2014), young employees experience work
distress in their new environment, making it difficult for them to respond to critical issues in
ICUs. However, with proper application of Lewin’s change model, it is possible to resolve the
conflicts created at the “unfreeze” stage for effective changes. During the “change” stage, the
desired change of introducing retired nurse specialists in ICUs to guide the newly recruited
employees is implemented. However, some organizations may shun from this responsibility due
to their culture and also because they are profit-oriented without taking into consideration the
risk they pose to patients as discussed in Lee, Cheung, Joynt, Wong, and Gomersal (2017).
When young nurses are exposed to work overload in ICUs, they are demotivated and end up
quitting the profession due to lack of support.
Expectations from employers for continuous quality improvement
The expectation of the employer is that any change in the work environment is intended
to improve the quality of life, reduce operational costs, and increase work output. According to
Sartori, Costantini, Ceschi, and Tommasi (2018), presence of nurse leaders in the ICUs increase
patient safety and reduce mortality rates while increasing the quality of life. Leilan (2019)
further explains that graduate nurses find job satisfaction in their profession when guided by