Making sense of a new nursing role: a phenomenological study of an organizational change

Although health care organizational change is a constant phenomenon, little is understood as to how staff experience this change. Unsuccessful change efforts have suggested the possible important relationship between understanding staff's experience and improved results. The purpose of this phenomenological study was to describe what staff on a medical-surgical unit experience during the initial phase of the implementation of a nursing care coordinator position, a first step in a broad organizational change. A purposeful sample of 11 nursing and non-nursing staff, considered unit experts, were interviewed using broad, open-ended questions designed to solicit their experience. Additionally, observations and document abstraction were used to add depth and clarification to the interviews. Analysis of data was conducted using a combination of Giorgi's and Colaizzi's procedures. Contextual elements framing staff's experiences included introduction of a new role with no organizational history into an increasingly demanding environment that staff perceived as constantly changing. Major themes of "experiencing the effect" and "struggling to make sense" were revealed. These findings suggest that the introduction of a new role can create turmoil and job insecurity in the current health care environment. Recommendations to support staff's efforts to "make sense" are provided.