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Master a Healthcare Merger

How Nurses Can Get Through the Transition with Their Careers on Track

Master a Healthcare Merger

Is your hospital about to merge with another facility? If so, you're probably experiencing a roller coaster of emotions, including fear, uncertainty and anxiety. Three merger-veteran nurses share their stories and offer the insights they gained during those white-knuckle moments. Follow their advice not only to get through the transition but also to make the most of the change and the new possibilities.

Stage One: Letting Go

Mergers mean change -- and lots of it. Karen Boardman, RN, MS, CS, saw this firsthand when her employer, an academic medical center with a state university, joined forces with a private, nonprofit community facility.

"We had very different cultures, different care management systems, different methods of documentation and different policies and procedures," says Boardman, now an assistant professor with Creighton University School of Nursing. Each hospital's nursing staff took pride in the care it provided and feared losing its standards of practice.

Through workshops at a staff retreat, Boardman came to better understand the three stages of change author William Bridges describes in Managing Transitions: Making the Most of Change. The first involves ending and letting go. "A lot of what is termed as resistance to change is actually a grieving process, or letting go," Boardman says.

Boardman and her peers faced down their fears and let go of the things they were losing: identity, security, relationships and familiarity.

Stage Two: Neutral Zone

Information gathering is a key activity of the chaotic second stage of transition, which Bridges terms the neutral zone.

When academic medical center George Washington University Hospital (GWUH) joined the for-profit Universal Health Services, clinical supervisor Joyce Pauig, RN, and her colleagues wondered how the merger would affect their work environment: Would they be able to choose their department? Would they lose seniority and favorable shift assignments? What was the new company like?

Pauig's solution was to absorb everything about the merger that she could. She attended all the merger-related meetings and read every memo and bulletin. "Don't let your fears take over," advises Pauig, who quickly learned to rely on official information sources rather than the hospital grapevine and rumor mill. "If I didn't understand something, I asked my boss, ‘Is this really true?'"

Handling the unknown also becomes easier when you banish feelings of helplessness and hopelessness. Take time to assess what others control and what's under your command, Boardman says. "Recognize that you do have some control and some choices."

Stage two is also an opportune time to assess your career values and goals.

Stage Three: New Beginnings

Once you've banished your fears, stopped mourning your losses and gotten the facts, you can start to see and celebrate what you're gaining in the third stage of transition.

At GWUH, Pauig saw many post-merger improvements, including raises based on performance rather than seniority, greater appreciation of employees, a stronger work ethic and approachable management.

It was a similar story at Highland Park Hospital in Illinois after its merger with Evanston Northwestern Healthcare (ENH). ENH, a larger teaching facility, brought with it the financial resources to invest heavily in Highland Park Hospital's services and facilities. Within six months of the union, Highland Park began performing cardiac surgery and hip and knee replacements.

For Mary Ellen Mitchell, RN, the merger opened up career possibilities she had never imagined. Mitchell, who was a manager of case management at Highland Park Hospital before the merger, has since advanced to senior director of quality improvement and continuity of care for all three ENH hospitals.

Over time, Mitchell realized that the nurses in each organization were more alike than different: "We were all colleagues working toward the same goal." By comparing notes, they identified and adopted best practices that improved the quality of patient care.

Another merger upside? Once they were part of the larger ENH health system, some nurses shortened their commutes by transferring to ENH facilities closer to home.

"Try to stay and wait just a little bit before formulating a conclusion," Mitchell says. "See where there may be opportunities. It may actually be better for you."

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