A Framework for Managing Change

Nurses work together in a simulation.
Nurses work together in a simulation.

We live in the age of instability, which escalates change across many environments. The potential for change raises a variety of responses. Even beneficial change requires those involved to give something up. The greater the personal sacrifice, the more likely it is that people will drag their feet in making the change (Heath & Heath, 2010). The inevitability of change is particularly acute in nursing and health professions education, where faculty members are bombarded with changes in the healthcare environment. To be an effective educator in this environment, faculty must think of change in a different way.

Happiness Hypothesis by Haidt (2006) provides a metaphor that gives direction for moving positively through change. The author suggests that managing change can be compared to riding an elephant. The rider, who is very small compared to the elephant, represents the conscious, verbal, thinking component of a person undergoing change. The rider provides the necessary facts to drive the direction for change. In contrast, the elephant can be compared to the emotions stimulated by the potential change — huge, automatic, and verbal. These emotions provide the energy to respond either positively or negatively. Haidt (2006) suggests that when there is a conflict between the direction of the change (the rider) and the source of the energy (the elephant), the rider can only override the elephant for some period of time. Ultimately the rider becomes exhausted! As a result, unless emotions brought about by change are dealt with, the change will ultimately fail (Haidt, 2006),

Heath and Heath (2010) suggest that change is hard because people are reluctant to change habits that have previously been successful. When we believe that we are going to be required to change something we value, negative emotions are inevitable. In certain situations, these negative feelings may be helpful to confront problems and avoid risks. However, when there is a need to focus on a wide-spread change, positive emotions, such as hope, optimism, and excitement, are necessary to broaden our thinking. Learning to move toward positive emotions is critical in the adoption of a specific organizational change (Heath & Heath, 2010). The following strategies can be used to accomplish this positive approach:

  • Acknowledge the negative feelings privately and publicly. Recognize the influence of the elephant upon the faculty’s willingness to participate in change.
  • Make a commitment to grow, even at the risk of failure. Structuring an environment in which failure is an acceptable outcome makes this commitment more possible.
  • Stimulate positive emotions (hope, enthusiasm, excitement) by creating a picture of the future that is similar to people’s pre-existing inclinations. For example, a change that will reduce the faculty workload, yet improve student outcomes, typically meets the desires of the faculty and engages their emotions in a positive way.
  • Shrink the change. Break down the change into smaller pieces, so that the change no longer “spooks“ the elephant. This may mean rolling out the change as a “pilot study,” or focusing on implementing this change for a small initial group.


Haidt, J. (2006). Happiness Hypothesis: Finding Wisdom in Ancient Wisdom. New York: Basic Books: Perseus Books Group.

Heath, C., & Heath, D. (2010). Switch: How to Change Things When Change is Hard. New York: Broadway Books.