1. Gould, Kathleen Ahern PhD, RN

Article Content

Johnson S. Who Moved My Cheese (1988) G. P. Putnam's Sons.

Random House Group Ltd., Vermilion, United Kingdom


ISBN 0 09 181 697 1


Dr Spencer Johnson, coauthor of The One Minute Manager, wrote Who Moved My Cheese, an amusing and thought-provoking story about change. This book is an easy read and one that stimulates discussion and personal reflection. Johnson guides the reader through a serious of events and illustrates the vital importance of being able to deal with unexpected change.

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In this book, cheese is a metaphor for what many consider security, safety, or comfort, the things that constitute contentment. This may include a career, relationship, financial security, or inner peace. Four characters in this delightful parable represent individual responses whenever humans are confronted with change.


The characters live in a maze and look for cheese in their search for security and happiness. The maze may represent an organization, relationships, community, or family.


Who Moved My Cheese is often used as a discussion tool in times of uncertainty or change. The title reflects the anxiety that occurs with unexpected change, a constant challenge in the health care environment. Although this text is not new, its lessons are timeless.


The book can be used as a tool for personal growth and awareness, a motivational tool, or as a conversation starter for group projects. Discussion can unite groups and help providers deal creatively with the disruption often felt in health care settings.


Lessons learned through the characters include the following:


* The quicker you let go of old cheese, the sooner you find new cheese.


* When you change what you believe, you change what you do.


* The fear you let build up in your mind is worse than the situation that actually exists.


* Some characters moved with the cheese as they realized: The mistakes made in the past can be used to plan for the future.


* Notice the little changes so you are better prepared for the big change that might be coming.


* The biggest inhibitor of change lies within yourself. Nothing gets better until you change.



Dr Johnson's education includes a psychology degree from the University of Southern California, an MD from the Royal College of Surgeons and medical clerkships at Harvard Medical School and the Mayo Clinic.


Kotter J, Rathgeber H. Our Iceberg is Melting: Change and Succeeding Under Any Conditions. (2005 Reed Elsevier Inc)

This book is also used to help people manage change. The proverbial melting icebergs are organizations, jobs, or services. The story imparts an important lesson; even in adverse conditions, change can be managed successfully.

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Melting icebergs come in many forms; hospitals close, organizations merge, leadership changes. Each individual must choose to be a champion of change or an obstructionist.


Harvard Business School professor John Kotter, author of the bestselling Leading Change (1996), teams up with executive Holger Rathgeber to create a business fable.


Kotter and Rathgeber introduce a framework for a change initiative through a community of Antarctic penguins facing a very real threat; their home, an iceberg, is melting.


This paperback, a quick read, may facilitate group discussions about organizational culture, group dynamics, and the challenges of change.


The authors use a fable about a penguin colony in Antarctica that has lived on the same iceberg for many years. However, one day, a curious penguin discovers problem signs in the iceberg, but few penguins want to listen to him. Like many of us, they do not want to acknowledge a problem, especially one that may create change. The story is analogous to the common challenge, facing difficult problems at home or at work.


Once the small group of penguins came to understand that their iceberg actually was melting, they demonstrated how to create a course toward successful change. These steps are the basis for what Kotter and Rathgeber describe as an 8-step process.


The 8-Step Process of Successful Change


Set the Stage


1. Create a sense of urgency.



Help others see the need for change and the importance of acting immediately.


2. Pull together the guiding team.



Make sure there is a powerful group guiding the change, one with leadership skills, credibility, communications ability, authority, analytical skills, and a sense of urgency.


Decide What to Do


3. Develop the change vision and strategy.



Clarify how the future will be different from the past and how you can make that future a reality.


Make It Happen


4. Communicate for understanding and buy-in.



Make sure as many others as possible understand and accept the vision and the strategy.


5. Empower others to act.



Remove as many barriers as possible so that those who want to make the vision a reality can do so.


6. Produce short-term wins.



Create some visible, unambiguous successes as soon as possible.


7. Don't let up.



Press harder and faster after the first successes. Be relentless with initiating change after change until the vision is a reality.


Make It Stick


8. Create a new culture.



Hold on to the new ways of behaving, and make sure they succeed, until they become strong enough to replace old traditions.


Kotter and Rathgeber also explain that thinking and feeling differently can help change behavior and lead to better results. To expedite the process they encourage groups to


* Collect data, analyze it.


* Present the information logically to change people's thinking.


* Changed thinking, in turn, can change behavior.



Feeling differently can change behavior more and lead to even better results in many ways:


* Create surprising, compelling, and, if possible, visual experiences.


* The experiences change how people feel about a situation.


* A change in feelings can lead to a significant change in behavior.