12/01/2022
According to the International Council of Nurses, there could be a shortage of 13 million registered nurses (RNs) by 2030. Nursing Solutions, Inc. reports that RN turnover in 2021 increased by 8.4% which resulted in a national average of 27.1%. How can this be happening to arguably the glue to high-quality patient care? One factor contributing to this complex issue can be attributed to change fatigue. As a consultant, I aimed to understand the underlining symptoms causing this phenomenon and the cure to solve the well-known problem hitting hospital systems globally.
The Doctor Visit
A few months ago, I went to my bi-annual doctor’s visit. In typical fashion, I sat in the waiting area watching the latest episode of Fixer Upper until my name was called by my nurse. The door swung open, “Jeff, we are ready for you.” As I walked back to get my vitals taken, I sensed my nurse’s frustration. I asked her if everything was okay and she quickly gasped in an agitated tone, “No, we have another new toy (tablet) to learn, just after I got used to the old one and it’s not going well.” As I eluded to, the data is real and nurses are getting stressed, tired, and burned out and much of this can be attributed to change fatigue.
So, what is Change Fatigue?
Change fatigue occurs when a plethora of changes keep coming with little to no recognition of the impact those changes have on their constituents. Therefore, the affected parties become tired and resistant to the exorbitant amount of change they are experiencing, leading to slower adoption or in some cases, no adoption at all. This quickly leads to a lack of engagement, a decrease in productivity and, in some cases, increased attrition. Sticking with our example of change fatigue impacting RNs, let’s walk through the symptoms.
The Symptoms
1. Attrition is rising at a rapid rate. As previously mentioned, RN retention is a real problem hospital systems are faced with and it is only getting worse. The rapid change coming their way is leading to significant burnout and departures to more stable working environments. More importantly, the hours invested in training these RNs come at a high cost to the hospital system contributing to poor financial health.
2. There are too many tools that do the same thing. When it comes to new technology, systems, and processes, hospital systems are aiming to become first adopters. This can be referred to as the “shiny new toy syndrome” where administrators, doctors, and other providers are looking for an immediate sensation of the latest and greatest technological advancement. Unfortunately, this symptom is temporary and the thrill and happiness wear off before moving on to the next big thing.
3. Hours of training is increasing. The number of training hours for hospital staff has increased significantly over the past 10 years. In particular, RNs have increased their amount of new technology training on top of their existing standard procedural training. Constantly learning new tools and technology is creating a never-ending loop of catch-up. Additionally, the more hours RNs spend in training, the less time they are spending with patients.
The Cure
1. Bring them along on the journey. Before the change impacts the RNs, get them involved in what is coming. For example, conduct surveys or focus groups to understand the wants and needs of RNs before they get new technology thrown at them. The more they know about the change early, the more likely they are to adopt it.
2. Communicate the “Why” early and often. It is critical to clearly define the “Why” you are changing upfront so that stakeholders can choose to adopt the change or be left behind. Be purposeful in defining it and create a sense of urgency amongst the group that if the change does not occur, it could impact them and the hospital system negatively.
3. Give them a break. Just as you give RNs periodic work breaks during shifts, follow the same mantra when it comes to rolling out changes. Spread them out and bundle those that are aligned together. If an RN knows changes are coming throughout the year at similar times, they are much more receptive to that change leading to higher adoption rates.
4. Learn and adjust. Providing adequate feedback channels as changes get pushed out, demonstrates that the RN has a voice and is being heard. Take feedback and take action on those high-value areas for continuous improvement. Communicate when some changes were killed altogether because of timing, too many, or it was just the right thing to do. This process also instills trust in your hospital system leaders.
5. Build a social network. Building a network of change champions who are supportive and bought into the change, lessens angst and concern when changes are communicated and deployed. A stakeholder, in this case, an RN, typically thinks, “if a change champion I trust is supportive, I better be.”
According to The AHA 2021 AHA Health Care Talent Scan, the projected demand for nurses by 2026 is 2,000,000 with the projected increase in supply to be only 500,000. As you can see, the retention of nurses is a problem and they are leaving in droves. They are growing tired of change and are ready to have normal shifts, appropriate feedback channels, and be champions of change.
I urge hospital systems to step up now and lead the way to battle the change fatigue disease. We are here to help you combat this systemic issue with a cure.
