Friday, April 15, 2016

Nurse Change Agents Can Mix It Up

Nurses, when you're at work, do you feel like there are things that need to change? Are there processes, policies, or nursing procedures that everyone follows but seem woefully inefficient or old school? Are people at work stuck doing things the same old way just because no one has taken the initiative to pivot and alter the pattern? That can be frustrating, especially if you're a natural born nurse change agent.

Change Agents 'R' Us

If you're not officially a nurse manager or leader, it can seem inappropriate or downright scary to attempt to initiate change in your workplace. However, change agents come in all shapes and sizes, and sometimes change needs to come from within the ranks, not from the "top" of the nursing/healthcare food chain.

Nurse change agents are assuredly intrapreneurs, but sometimes they're intrapreneurs on steroids! Episode 41 of The Nurse Keith Show is all about nurse intrapreneurship and why it's so important, so do your homework if you want to be one (or if you want to assess if you already are one!)

Some of us simply put our heads down and plow through the day, watching the clock and doing whatever we can just to survive the shift and get home to our lives and families. However, some of us aren't satisfied with just doing what we're told; we see how things could be different, and we can't sit back and watch inefficiency or poor practices run amok.

If you're the kind of nurse who notices things and sees how they could be better, you might very well be a nurse change agent. If you're the kind of nurse who isn't afraid to speak up in a team meeting and say, "You know, I've been thinking; we could do __________ so much more efficiently, and here's how I would do it." This might be a frightening thought for some of you, but there are likely some nurses reading this post who do this all the time. Face it; you're change agents, folks.

Making Change Happen

If you can't stay quiet, and you tend to speak your mind about how things could be different, good for you! We can easily fall into stagnation and a "that's just the way it's always been done" mentality in nursing; we need nurses like you who are courageous and forward-thinking enough to rouse us from our lethargy and ennui, cajoling us to think more creatively.

One way to make change happen is to speak up; raising your voice can be effective, and it can definitely get you somewhere. But remember, speaking up has risks, and some individuals may not be happy that you're using your outside voice.

Gather Your Allies

You also need allies in order to champion change. Look for natural allies who can feed your fire, have your back, and support you as you champion change. Your allies don't all have to be nurses or leaders, but having some members of leadership in your corner is helpful, and fellow nurses are definitely a plus.

If you can create a broad coalition of supporters (rather than just nurses), recruit that support from the physicians, the therapists, the mental health team, housekeeping, maintenance, administration, support staff, and whoever is willing to hop on board your train. 


As David Bowie once sang in his famous song, "Changes", we sometimes must "turn and face the strain," as painful as it may be. As a change agent, you may be forcing everyone to turn and face a strain they would rather not acknowledge the existence of; more power to you.

The caveat here is that change can be painful, and your championing of change could make you some enemies, as well as pin you to the wall in defense of your opinions and/or actions. But if you believe in change, nurses, stand up for the need for change, rail against stodgy, calcified ways of doing things, and fight for what you think is right.

Change isn't healthy for change's sake, but if it's for the good of the whole, here's to the power of change and change agents willing to make it happen.


Keith Carlson, RN, BSN, NC-BC, is the Board Certified Nurse Coach behind and the well-known blog, Digital Doorway.

Keith is co-host of, a wildly popular nursing podcast; he also hosts The Nurse Keith Show, his own podcast focused on career advice and inspiration for nurses. Keith is also the resident nursing career expert at

A widely published nurse writer, Keith is the author of "Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century." He has also contributed chapters to a number of books related to the nursing profession, and currently writes for MultiViews New Service,, StaffGarden, and Working Nurse Magazine.

Mr. Carlson brings a plethora of experience as a nurse thought leader, online nurse personality, holistic career coach, writer, and well-known successful nurse entrepreneur.

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