I do agree that many nurses do resist changes. One change that was implemented on our unit was to incorporate our 4p rounding during bedside change of shift report. It was difficult to get the nurses buy-in and the process met great resistance by the majority. I think if nurses get the support needed and knew in detail the rationale for the changes that are being implemented then there would be very little resistance
Management and leaders should be more supportive of their staff with also building trust. This is very important to the needs of the staff in order create positivity. For example, staffing would be great for a couple of weeks, then back to square one (short staff), yet leadership expects 100% perfect rounding. I have experienced in the past where the staff was promised better nurse-patient ratio. They know that staff will view the change of including 4p rounds with change of shift bedside report more of a burden. Staffing issues sometimes cannot be controlled, because of staff calling in sick, staff leaving etc.. Our trend on 4p rounding and nurse-patient ratio have proven to have a positive when staffing is adequate. Monitoring call logs and staff assignments show that when nurse-patient is adequate, patients satisfaction increases.
I found the article, Hourly Rounding: Challenges with Implementation of an Evidence-Based Process interesting as it examines the problems with implementing hourly rounding on two hospital units and the results that are indicated. What drew my attention is the nurse’s attitude on the rounding process as it is described by the author, which found that nurses did not have a sense of ownership of the rounding process, so therefore they feel that this process is being inflicted upon them. If they knew the reasons for the 4p rounding process, they would see the benefits to both their patients and themselves. Yes, management should provide support and education regarding any process that is implemented, but nurses must be accountable for the kind of care they provide to their patients as well.
Lippincott Williams & Wilkins.(2012). Lippincott Nursing Center. Hourly Rounding: Challenges with Implementation of an Evidence-Based Process, Retrieved from