Exploring the Change Theories in Nursing

Written by Brandon L.
February 22, 20249 min read

Change is a vital part of the healthcare industry. However, a lot of employees prefer the status quo over new projects; not all change is good. Studies show that a lot of projects fail because of poor planning, unmotivated employees, communication inefficiency, and excessive changes. Since change is inevitable, all healthcare professionals must ensure there are practical changes that lead to growth. This is where changing theories come in. These theories are instrumental in identifying weaknesses and problems that could inhibit changes, allowing those involved to develop ways that are beneficial to the organization.   As a nursing student, it is essential to understand these theories in nursing to understand how change occurs in healthcare institutions and how to write a change management paper.

In this guide, our nursing writers will explore the different types of change theories in nursing.

Why Use Change Model in Healthcare?

Even though change is a dynamic process that could cause resistance, it is necessary for any organization, particularly healthcare. Change is good because it does the following:

What are the Three Types of Change Theories in Nursing

Change theories provide opportunities for nurses and other healthcare workers to understand, manage, and adapt to changes that happen in the industry. They help solve common healthcare problems. While there are various theories of change in nursing school, the most common are three: Kurt Lewin's change theory, Ronald Lippitt's change theory, and Everett Rogers's change theory.

Kurt Lewin’s Change Theory

Kurt Lewin was a physicist and social scientist who developed change theory in the 1940s as a framework for understanding the process of change in an organization. He proposed that change occurs in three stages: Unfreeze, Change (Transition), and Freeze (Refreeze).

Before reaching the stage of stability or equilibrium, Lewin proposed that a lot of misunderstanding and transition occur in a person or organization. To explain this, he used the analogy of how an ice cube can be melted and refrozen to an entirely new shape.

Stage #1: Unfreeze (understanding change is needed)

As the first stage of Lewin's theory, unfreezing is one of the most essential parts of change theory. It aims to prepare an organization and the people in it for the change that's about to take place.

Lewin suggests that change only takes place when people are highly motivated to go through it. Otherwise, they will stick to the status quo.  So, leaders within the organization who want to make changes must persuade people and motivate them of the need for the change and how it will be beneficial both to the organization and to them as employees. For example, if the

To make the process much easier, Lewin suggests incorporating the following strategies:

When all parties are willing to make the changes and understand why it is essential, there will be a smooth transition.

Stage #2: Change (the process of initiating change)

When there is a disruption in the status quo, policymakers should address any uncertainty and come up with new ways to address issues and do things. This stage deals with the implementation of change. It involves moving from one place to another in terms of change in thoughts, feelings, and behavior because people believe that acting in new ways can support change.

However, moving from unfreeze to change doesn't happen overnight; it takes time for people to adjust from one stage to another. People need time to embrace the new direction so that change can happen.

According to Lewin, three actions can cause change to happen:

  1. Convince others that the status quo is not helpful to anyone, including the company, and that they should have a new perspective on the change.
  2. Embrace the opportunity of working with others to find new ways of encouraging the desired change to happen.
  3. Connect with influential people who have the same thoughts of supporting change.

Lewins agrees that the second stage in the change process is the most difficult because people are facing uncertainty and fear. Thus, leaders and change-makers need to have supportive programs and clear communication strategies in place to encourage people to press on.  Clear communication should happen at every stage, from planning to implementation. People need to know what is happening at each stage. In other words, inform people of the changes, why they are happening, and what they should expect afterward.

Additionally, it is important to dispel any rumors which are likely to spread. One way to do this is to ensure those involved answer questions clearly and honestly. Time is also a critical component to have at this stage. This is because convincing people is challenging.

Stage #3: Refreeze

At this stage, changes have already taken effect, and people are beginning to embrace the new transformation; thus, the organization is ready for refreeze. Therefore, the organization will be said to have attained equilibrium when the desired changes have occurred.

The refreeze stage is necessary to ensure the desired changes have been implemented, and when this happens, one can say that the changes are the new norm.

Lewin suggested that this stage is essential in the change process; otherwise, people will be caught in the transition phase. In addition, in the absence of the refreeze stage, it will be hard to convince people of the new change initiatives. How else will you persuade people of recent changes when you did not allow for the previous ones to sink in? Thus, for this stage to be successful, an organization must put the following into place, according to Lewin:


Lewin's change theory has been successfully applied in healthcare settings to improve patient care and simplify nurses’ jobs. For instance, to reduce medication errors, the theory has been used in the implementation of bar-coded medication administration.

Everett Roger’s Change Theory

While Lewin’s theory is more widely used in the healthcare system, it has been continuously criticized for being too simplistic. For this reason, it was expounded and modified by Everett Rogers. So, what is Rogers' change theory in nursing? Roger's theory is referred to as the diffusion of innovation theory. He seeks to explain how new ideas for innovation are adopted and implemented for change to take place.

Roger describes five phases that happen for planned change to take place: awareness, interest, evaluation, trial, and adoption.

  1. Awareness/ knowledge- at this point, a person becomes aware of an innovation but lacks the correct information about it. In an organization, a person trying to implement change will have to inform the rest of why change is necessary, what can be done, how it will occur, and who will be involved.
  2. Interest- a person develops an interest in innovation and actively seeks to find out more about it. The correct information is relayed to the employees so they can understand and gain interest in the desired change. At this point, attitudes, both favorable and unfavorable, begin to form.
  3. Evaluation- change is considered by weighing the pros and cons. An organization can conduct a pilot study to see whether the main project will succeed or fail.
  4. Trial- the change is implemented as the organization tries to adjust to fit with it. At this point, the organization or individual trying to make the changes can learn more about the innovation and determine whether it is functional.
  5. Adoption- At this stage, the organization decides whether to continue with the innovation by recognizing its value.

Rogers's change theory is mainly applied in organizations that require long-term projects. For instance, in healthcare industries where nurses have been adamant about accepting change but have of its success from those who have adopted it, the proposed change is likely to occur.

For a change to succeed, Rogers identified the kind of people and organization that will need to have:

Limitations of the Diffusion of Innovation Theory

Roger’s theory of diffusion of innovation has faced a lot of criticism, including the following:

Lippitt’s Seven-Step Change Theory

Lippitt’s theory expands on Lewin's theory by focusing on the role of the change agent. Change agents are referred to as people who have the power and skill to initiate, facilitate, and coordinate the efforts needed to make change happen. They can be from within or outside an organization. 

While external change agents are preferred because they bring a new perspective to the organization, they can be disadvantageous. This is because they lack the key facts and understanding of the organization's way of operation. 

The following are the seven steps of change according to Lippitt:

Step1: Diagnosis of a problem

Examining all possible consequences of the problem and how the change will affect essential personnel with the capabilities to fix the problem. Additionally, it also involves gathering essential data from those who will be affected and ensuring they are committed to the success of the transformation.

The client must recognize whether there are communication blockages between the client and practitioner that could impede the success of the change. If there are any, proper measures should be put in place to ensure they are eliminated. 

Step 2: Evaluate the motivation and capabilities

What will encourage change to happen? Think about the motivation and resources necessary to make this happen. Resources include both financial and human. It's also important to consider the structure of the organization.

Step 3: Assess the Motivations of the Change Agent

What does the change agent need to make the change happen? Think of their stamina, experiences, determinations, etc.

At this stage, a lot of problems that inhibit the success of the organization could be identified 

Step 4: Select the Objectives of the Progress Change

Define the change process and develop the plan of action as well as accompanying strategies. This plan must include clear steps, each with timelines.

Duties should be assigned to relevant parties. The main activities of change agents at this stage include coaching and training employees to impact them with skills that will help in their jobs.

Change agents could also consider broad change strategies such as:

Step 5: Explain the Change Agent’s Role

The role of the change agent should be explained to all employees and ensure that they understand what all the expectations are. This will avoid confusion, misunderstandings, and resentment.

Step 6: Maintain Change

The change agent is monitored to ensure that there is progress. At this point, it is essential to facilitate feedback, enhance communication, and coordinate the effects of change. All those involved in the process of change sit down to go through their tasks and monitor their progress.

Maintaining change corresponds to the nursing process implementation change. It involves maintaining change so that it becomes part of the organization.

Step 7: Terminate the Relationship of the Change Agent

Gradually, the helping relationship with the change agent is terminated. Eventually, the staff accepts the change, and stabilization happens.

Lippitt suggested that the key to ensuring change happens and empowering the process is by having the right person be the voice for change. The seven-step theory by Lippitt is effective because it gives employees a more effective role within the organization of driving and supporting change. The other theoretical models involved project people making employees do things differently when they were happy with the status quo.

Other Change Management Theories

As earlier indicated, change theories offer a framework for understanding, implementing, and managing changes in healthcare or clinical settings. Nurses and other healthcare professionals can navigate transitions using these change models, whether be it adopting new practices, technologies, behavior, or organizational structures. Apart from the theories of change that we have highlighted above, you can also consider:

Our expert nursing assignment helpers can come through for you if you want to hire someone to write your change management paper. They understand the theories of change that apply in clinical settings, and can write a perfect paper that will impress your professor and meet all your needs, place your order and get the best today!

How to Incorporate Change Theories into Nursing Education

Change theories play a vital role both in the nursing profession and education. The following are ways in which you can incorporate change theories in your nursing education.

Change theories can be useful when writing your capstone project. To do this, you must first understand the key principles of change theories and how they relate to the nursing project you want to work on. If you want to initiate a change within a given hospital, such as improving patient outcomes or reducing readmission cases, explore how the change theories can be applied to the project.

For instance, you can use Roger’s theory of diffusion to understand how best to disseminate information about the change to the relevant parties. Doing this ensures your project is evidence-based, effective, and patient-centered.

Besides capstone projects, change theories of management can also help you write nursing research papers or nursing essays.

The theories act as a theoretical framework guiding your research question and design. They guide researchers in understanding the complexities involved in nursing research.

Additionally, the change theories can help identify factors that are necessary for change to happen, such as the attitudes and beliefs of the employees.

For instance, researchers can use change theories to develop research questions for the context in which the change is happening. Consider the following research that was conducted to establish how to reduce low-value healthcare. The change theories were instrumental in guiding data collection strategies and analysis.

Theories of change are also instrumental in writing change management papers.

These theories can help you explore the complexities of running a healthcare system and provide a framework for which you can develop you're a well-thought-out research plan.

For example, if you want to write about the implementation of a new electronic health record system in a hospital, choose an appropriate change theory such as Lewin's, and then conduct a literature review.

The goal is to find research that has applied the same theory so that you can identify key concepts and variables for your research question.

Final Word

Change is a necessary part of any individual or company wishing to grow. To understand theories and how they can help healthcare organizations, one must understand the theoretical models about them. By following the guide to the most common change theories in nursing, you will understand the way healthcare systems evolves to improve patient's lives and well-being.

If you need help understanding or writing a capstone or research paper using any of the above change theories, our nursing writers can help. Contact us today for more information.

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