Nurses as Change Agents

Technological advancements and improvements to treatment have always brought change to healthcare. However, the rate of change has increased since the 1990s due to escalating healthcare costs, government regulations and new technology. As a result, nurses need to be multi-skilled and ready to lead the charge in helping the nursing profession keep pace.

A change agent is a person who leads or creates change. In nursing, change agents maintain high quality care, provide support to staff and limit the adverse effects of new developments.

Why Is There More Change Today?

Healthcare regulations constantly change. A nursing unit may finally adapt to new rules only to encounter new guidelines. Something is always changing with resident assessment instruments, care area assessments, minimum data sets, quality measures and quality indicators. Other forces leading to dramatic changes in healthcare include wearable devices and the growing demand for data-driven decision-making.

In Aging in the United States — Past, Present, and Future, the Census Bureau estimates there will be a 74 percent increase in the number of Americans age 65 or older. Americans under the age of 65 will increase by far less at only 24 percent. The sheer number of Baby Boomers entering retirement and relying on Medicare is leading to a shifting healthcare environment.

Are Nurses Involved in Change?

Nursing today involves more than caring for patients. In fact, the Institute of Medicine has issued a pivotal report — Future of Nursing: Leading Change, Advancing Health — that recommends nurses earn a Bachelor of Science in Nursing to meet healthcare’s rapidly evolving and complicated requirements.

With Baby Boomers approaching retirement, the healthcare industry will lose about one-third of its nurses to retirement over the next 10 years. This means units will lose a lot of experience and knowledge. Furthermore, the number of aging Baby Boomers will lead to an influx of people with illnesses and disabilities. Here, BSN coursework will help fill the knowledge gap.

The American Journal of Emergency Medicine has published a study that looked at the time physicians spend with patients and performing data entry. Titled 4000 Clicks, the study found that physicians spend an average of 28 percent of their time with patients. At 44 percent, however, the bulk of their time goes to data entry.

Nurses, on the other hand, spend more than one-third of their time with patients, according to How much time do nurses have for patients? They interact with physicians, family members, coworkers and office staff. They also update electronic health records and manage work flows.

Since nurses tend to be intermediaries for people and processes, it puts them in a good position to be change agents. Although nurse managers are typically the change agents for their units, any nurse can fulfill this role. They can identify areas for improvement and spot problems that need solutions.

How Nurses Can Help Drive Change

Change can be stressful for everyone. Getting support from a nursing unit for new guidelines and procedures will be harder without explanations for the change. Before change agents can convince others of the value of new approaches, they need to embrace the new idea themselves.

Since change can be a politically charged topic, effective change agents need to develop the following attributes:

  • Active listening skills.
  • Consistent communication.
  • Effective motivation.
  • Helpfulness.

The first and most important step in gathering support for change is communication. With a full plate, people can sometimes overlook communication. Change agents can increase staff participation by helping their unit understand the following:

  • Why is change necessary?
  • Who benefits?
  • What does it require?
  • What is a nurse’s role?
  • What are the positive and negative effects?

“Safe and respectful work environments for our staff and patients are critical priorities,” writes Boynton in Nurse leaders as change agents. “Role modeling effective communication, owning our contribution to problems, and providing transformational leadership is indeed, daunting. We need leaders who will help to slow things down and bring back a balance of caring and collaboration into healthcare.”

Learn more about Colorado Mesa University online RN to BSN program.


Boynton, B. (n.d.). Nurse leaders as change agents. Clinical Cafe

Fleece, J. and Houle, D. (2011). The New Health Age: The Future of Health Care in America.

Hill, R. G., Jr., Sears, L. M. and Melanson, S. W. (2013). 4000 Clicks: a productivity analysis of electronic medical records in a community hospital ED. The American Journal of Emergency Medicine.

(2010). The Future of Nursing: Leading Change, Advancing Health. The National Academies Press

(n.d.). Aging in the United States — Past, Present, and Future. United States Census Bureau

Westbrook, J. I., Duffield, C. and Li, L. (2011). How much time do nurses have for patients? A longitudinal study quantifying hospital nurses’ patterns of task time distribution and interactions with health professionals. National Center for Biotechnology Information

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