1. Baker, Kathy A. PhD, RN, ACNS-BC, FAAN

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I don't like change. Maybe it is because it is the end of the day and I am exhausted, but I just can't shake my frustration. I don't like change. My office building at the university is undergoing change. We are adding a huge extension to the building. I had to move out of my office into a temporary office with four other colleagues, all of them dear friends, but I don't like change. My files are in boxes stacked around my desk. I reach for a simple office tool like a stapler, but I don't know where it is now. I don't have any drawers in my "desk." It's really just a flat table with wheels. I don't like change.

Kathy A. Baker, PhD,... - Click to enlarge in new windowKathy A. Baker, PhD, RN, ACNS-BC, FAAN

When I come or leave my office building now, I can't use the sidewalk. The convenient entry door by the parking lot and elevator is blocked off as well. The sidewalk is impassable with a fence across the walk because the renovation materials from the third floor of the old building have to be dumped out a window on that side of the building. I am supposed to walk through the building next door, swing west of our building, and then come back east to avoid the blocked sidewalk. The elevator is off limits so I can't take anything heavy to work in my rolling backpack because there is only stair access to my office. Do you know of any academician who doesn't need to carry heavy papers and books back and forth from their office to home? Seriously, I don't like change.


I did enjoy the change of our new format for the SGNA Annual Course. I liked that we went three full days with Wednesday now flexible for travelling. We don't all bolt for the airport at the same time and it's easier to get a cab. Plus, those of you who know me know how I hate getting up early. Now I can have a leisure morning before heading home after a fantastic meeting with my gastroenterology nursing colleagues from across the United States and abroad. So, maybe I do like some change.


In the practice setting, I always love when the new gastroenterology fellows start. It's exciting getting to know them, their personalities, professional goals, and idiosyncrasies. I love how they change over time from excited novices to calm, confident practitioners. And when I think about it, I do enjoy the beginning of a new semester in academia. A fresh start with different students, new revisions to my courses, new textbooks, new formats... change.


I guess the real truth is sometimes I don't like change, and yet sometimes I do. Unexpected change seems to get old quickly. Spending energy to adapt to things I didn't ask for or expect is a drain. Planned change, on the other hand, I perceive as fun or exciting. Usually my planned change leads to an expected outcome, whereas unplanned change results in an outcome that is unknown or unwanted.


I also have to admit that one of the reasons I have always loved nursing is that there is, well ... constant change. I am never bored. I am always learning. Gastroenterology endoscopy is like that-new procedures, new patients, new therapies. There is never a dull moment. There is always something new to learn and master. I suppose this does sound as if I like change.


So how do I manage the unplanned change that I don't like? How do any of us adapt to the change that constantly invades our space and diverts our attention from the things we want to enjoy? Baber ( identified eight tips for coping positively with unplanned change that I find helpful.


1. Acknowledge the change. In particular, I acknowledge what I like and don't like.


2. Confess your feelings about the change. Right now, I hate not having my old office all to myself with a beautiful view of the trees and birds. I hate having to take conference calls out in the parking lot in my car so I have privacy and a calm environment.


3. Decide when to accept and when to reject the change. My office on the third floor was being demolished so the "when" was decided for me. I put that into action when I packed up and moved down to my temporary office on the second floor at the same time I was managing graduation events for my department (great timing).


4. Adopt an attitude of anticipation. Welcome change as an opportunity. Find the benefit somewhere in the change. Touring the new addition to the building and seeing where my new office will be are helping me ignore the present and focus on the not-too-distant future.


5. Choose your thoughts and attitudes about each change. Negative thoughts block your creativity and problem-solving abilities. Positive thoughts build bridges to possibilities and opportunities. My office mates and I constantly tell each other we can do this for just a few months. We do have fun sharing an office and there is great laughter when we are all present. Of course, that means there may not be much productivity, either. I'm just saying!


6. Learn to relax (more). I am being much more deliberate this summer about when I am in my office at the university and when I am working from home. At home, I can burn a deliciously scented candle, watch the birds out my window while I work, and take a quick walk through the garden to clear my head. And I always get more work done because I can focus without interruptions.


7. Set smart goals so you can consciously guide the change. My goals for this temporary move are to be as efficient and effective as possible. I deliberately plan when I need to be in the office at the university and when it makes more sense for me to work from home. I have meetings with colleagues scheduled at my home office so we have a quiet place to work and relax during the renovation and building. That saves me time driving and helps avoid the frustration of all the noise when trying to host a meeting.


8. Communicate with supportive people who can help you deal with stress. I'll confess-I'm a whiner. If I can whine, I can cope. My closest colleagues and friends know this about me and patiently listen while I whine. They may join in (remember, misery loves company) or steer me to a more positive perspective ("just think how fabulous our new space will be"). Knowing I am not alone is often one of the best coping strategies I can utilize when dealing with change. And just as important is my willingness to support someone else when they are dealing with stress. It goes both ways.



So while it is definitely true that I do not like some aspects of change, especially unplanned change, it is also true that I do love other facets of change. New people, experiences, processes.... I tend to enjoy and savor these aspects of change.


Our patients need our help just as we need help adapting to unplanned change. Like us, they will exhibit healthy and unhealthy coping strategies in response to the need for change. Use the key points Baber proposed to support your patients just as you support yourself. Encourage them to talk about the change in their life as a result of their alteration in health. Let your patients know it is safe to be honest about their feelings and discuss their plans or fears for living with the change. Be sure your patient has someone who can help them put perspective on the changes forced on them by alterations in their health. For some that may be a friend or family member, and for others it may be a counselor or social worker.


Change is inevitable, sometimes welcomed and sometimes disliked. Most of us can agree; we don't like change 100% of the time. But for those of us in healthcare, change is a constant. For our patients, change may not be their norm. Patients don't have to like change, but they do need to learn to navigate through change to have as positive an experience as possible while they cope with the changes of altered health. Our expertise in navigating change, both planned and unplanned, can make the difference in coaching and supporting our patients through unwanted diagnoses, unexpected procedures, and uncertain outcomes. So while I don't like change, or at least unplanned change, as a nurse, I am an expert at dealing with change and I suspect you are as well. Let's put that expertise to good work. Change isn't going away.