NUR5123 Module 5 change communication plan example

One Nurse, One Job, One Waveform: Announcing Dedicated Sedation Nurses and Capnography in Interventional Radiology to Eight Audiences in the Right Order

Student Name

American College of Education

NUR5123: Relationships Through Communication

Module 5 Assignment

Instructor Name

August 3, 2027

The Change and Why

In the interventional radiology department followed in this course, the nurse who monitors a sedated patient also circulates: opening supplies, handing equipment, answering the phone and documenting. Pulse oximetry is used for every sedated patient; capnography, which measures exhaled carbon dioxide and detects slowed or absent breathing before oxygen saturation falls, is used only when the nurse chooses. In the past year the department had four episodes of oversedation requiring reversal agents, two of them discovered when an oxygen saturation alarm sounded while the nurse was retrieving a catheter from the supply room.

The current practice guideline for moderate procedural sedation recommends continuous monitoring of ventilation with capnography in addition to observation and pulse oximetry, and calls for an individual other than the person performing the procedure to monitor the patient throughout, taking on only minor tasks that can be interrupted once the patient is stable (American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, 2018). The department will adopt both. Beginning September 1, every patient under moderate sedation will have a nurse assigned only to monitoring and continuous capnography. Because this requires a second nurse in each room, the department will run three rooms instead of four on days when it cannot staff the fourth, until three new nurse positions are filled, expected by December.

What the Research Says About Communicating Change

Change creates uncertainty, and communication is the main tool leaders have to reduce it. In a study of employees in an organization undergoing change, Allen et al. (2007) found that the quality and timing of communication shaped how uncertain employees felt, and that employees preferred to hear about strategic matters from senior leaders and about how the change would affect their own jobs from their immediate supervisors. Johansson and Heide (2008), reviewing research on communication in organizational change, distinguished treating communication as a tool for announcing decisions from treating it as the process through which people make sense of change together, and argued that the second view better explains why changes succeed or fail.

Both findings shape this plan. The department's leaders will explain why the change is happening; supervisors and charge nurses will explain what it means for each person's day. And the plan builds in conversations, not only announcements. People who first hear about a change that affects their work from an email sent to everyone will spend the next week interpreting it without the people who could explain it.

Audiences and Their Concerns

Eight audiences are affected. Interventional radiology nurses will ask whether they will be sedation nurses all day, whether the change implies they were unsafe before and who will fill the new positions. Interventional radiologists will ask whether fewer rooms means longer waits and lost cases, and whether they can still start without the second nurse when the schedule is tight. Radiologic technologists will take on some circulating tasks and will ask what exactly those are. Schedulers must rebuild the calendar and will ask which days run three rooms. Referring services, especially oncology, surgery and nephrology, will ask how long their patients will wait. The dialysis clinics from the Module 4 partnership will ask whether urgent access procedures are protected. Patients scheduled on reduced days may be moved and need to be told why. And the hospital's senior leaders will ask about cost, volume and risk.

Sequence, Messengers and Channels

The sequence runs from those most affected and most able to shape the change outward. First, in week one, the nurse manager meets the department's charge nurses and the medical director meets the interventional radiologists, each in person, to explain the change, the guideline behind it and the staffing plan, and to hear objections before anyone else is told. These two groups will carry the message to their colleagues, so they must hear it first and have a chance to improve it. Second, in week two, the nurse manager and the charge nurses hold two staff meetings, one early and one late, for all nurses and technologists, followed the same day by a written summary; technologists also receive a one-page task list agreed with their supervisor. Third, in week two, the scheduling supervisor meets schedulers in person with the new template.

Fourth, in week three, the medical director writes to the chiefs of the referring services, and the nurse manager calls the three dialysis clinic managers directly, because the partnership agreed that changes affecting urgent access would be discussed by phone rather than announced. Fifth, patients affected on reduced days are called by schedulers using a short script that explains the change as an added safety measure, offers the earliest alternative and names a contact. Senior leaders receive a brief written summary from the director of nursing in week one, before any external audience is told, so that they are not surprised by questions from physicians in other departments.

The Core Message and Its Questions

Every messenger will use the same core message, adapted in length: "Starting September 1, every patient who receives moderate sedation in interventional radiology will have a nurse whose only job is to watch them, with continuous monitoring of their breathing. National guidelines recommend this, and it will catch problems earlier than we can now. Until we hire three more nurses, we will sometimes run three rooms instead of four. Urgent cases, including dialysis access, will not be delayed."

The department's intranet will carry a running list of questions and answers, refreshed every week. It answers the questions identified for each audience, including the one nurses are most likely to ask but least likely to say aloud: whether the change means they did something wrong. The answer is plain. The change reflects a national standard the department had not yet met, not a judgment on any nurse, and the oversedation events were caught because nurses responded to alarms while doing two jobs at once.

Feedback and Adjustment

Communication does not end at launch. The charge nurses will collect questions and concerns at every morning huddle for the first month and pass them to the nurse manager, who will answer them on the intranet page within two days. The nurse manager will check with the three dialysis clinics and the oncology service after the first two weeks, and the department will report the number of procedures postponed because of reduced rooms each week to the referring chiefs until the new nurses start. If postponements exceed ten a week, the medical director and director of nursing will meet to decide whether to fund temporary staff. At the end of the third month, the nurse manager will ask a sample of nurses, technologists and physicians two questions: how they first heard about the change, and whether anything about it still confuses them. Their answers will show whether the planned sequence actually reached people in the intended order, and they will shape how the department announces its next change.

References

Allen, J., Jimmieson, N. L., Bordia, P., & Irmer, B. E. (2007). Uncertainty during organizational change: Managing perceptions through communication. Journal of Change Management, 7(2), 187-210. https://doi.org/10.1080/14697010701563379

American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia. (2018). Practice guidelines for moderate procedural sedation and analgesia 2018. Anesthesiology, 128(3), 437-479. https://doi.org/10.1097/ALN.0000000000002043

Johansson, C., & Heide, M. (2008). Speaking of change: Three communication approaches in studies of organizational change. Corporate Communications: An International Journal, 13(3), 288-305. https://doi.org/10.1108/13563280810893661