WEEK 5 SCHOOL RESOURSESRole Concepts in Healthcare Role theory is the product of interdisciplinary theory development that includes anthropology, sociology, and social psychology. It contains concepts and propositional statements that address specific aspects of social behavior, the goal of which is the understanding and explanation of social order. Role theory seeks to predict how individuals will perform in a given role. Nursing role can be interpreted as a normative structure learned and internalized during the process of professional socialization in nursing. Socialization occurs as role occupants interact with others in related positions. Socialization is the process by which individuals acquire the knowledge, skills, attitudes, values, motivations, and patterns that shape their adaptation to the setting in which they live and work. It is viewed as an interactional-reciprocal process in which the person being socialized and the socializer are mutually influenced. The process includes the learning of motor and language skills, social roles, moral norms and values, affective and cognitive modes of functioning. The goal is attainment of competence in performance of the role in order to be accepted by society. Socializing agents are family, authority figures, peers, and institutions, and the process is a means of transmitting learning to the person being socialized. The primary focus is on occupational, marital, and parental roles. Socialization is a continuous and cumulative process. Nursing professionals are constantly dealing with staff members, patients, and their families. The nature of their work calls for a certain amount of socialization in order to be able to interact effectively with colleagues, patients and their families. For example, the improved technical skills and competencies of a new nurse is the result of socialization. A nurse, who is not comfortable with electrocardiographic interpretations or handling pulmonary catheters, gains confidence after getting some assistance from experienced staff nurses. Similarly, changes in the affective domain are also the result of socialization. Sources of Role Strain in Nursing: From typology, let's move on to examine some of the assumptions of the role theory: · People seek problematic, challenging situations in which they may use their skills and knowledge. · People are predisposed to actualizing their own potential. · Conflict is necessary for progress and the development of consensus in a social system. · Conflict and challenge facilitate individual growth. · Role difficulties and problems are neither abnormal nor undesirable. In the light of these assumptions, consider some of conditions that contribute to role strain in the nursing profession: · Socialization deficit—lack of adequate socialization for the role or for status changes within the role, such as promotions · Role differentiation—changes in the role due to changing technology, increased organizational complexity, change ...

1. WEEK 5 SCHOOL RESOURSESRole Concepts in Healthcare
Role theory is the product of interdisciplinary theory
development that includes anthropology, sociology, and social
psychology. It contains concepts and propositional statements
that address specific aspects of social behavior, the goal of
which is the understanding and explanation of social order. Role
theory seeks to predict how individuals will perform in a given
role. Nursing role can be interpreted as a normative structure
learned and internalized during the process of professional
socialization in nursing. Socialization occurs as role occupants
interact with others in related positions.
Socialization is the process by which individuals acquire the
knowledge, skills, attitudes, values, motivations, and patterns
that shape their adaptation to the setting in which they live and
work. It is viewed as an interactional-reciprocal process in
which the person being socialized and the socializer are
mutually influenced. The process includes the learning of motor
and language skills, social roles, moral norms and values,
affective and cognitive modes of functioning. The goal is
attainment of competence in performance of the role in order to
be accepted by society. Socializing agents are family, authority
figures, peers, and institutions, and the process is a means of
transmitting learning to the person being socialized. The
primary focus is on occupational, marital, and parental roles.
Socialization is a continuous and cumulative process. Nursing
professionals are constantly dealing with staff members,
patients, and their families. The nature of their work calls for a
certain amount of socialization in order to be able to interact
effectively with colleagues, patients and their families. For
example, the improved technical skills and competencies of a
new nurse is the result of socialization. A nurse, who is not
comfortable with electrocardiographic interpretations or
handling pulmonary catheters, gains confidence after getting
some assistance from experienced staff nurses. Similarly,
changes in the affective domain are also the result of

2. socialization.
Sources of Role Strain in Nursing:
From typology, let's move on to examine some of the
assumptions of the role theory:
· People seek problematic, challenging situations in which they
may use their skills and knowledge.
· People are predisposed to actualizing their own potential.
· Conflict is necessary for progress and the development of
consensus in a social system.
· Conflict and challenge facilitate individual growth.
· Role difficulties and problems are neither abnormal nor
undesirable.
In the light of these assumptions, consider some of conditions
that contribute to role strain in the nursing profession:
· Socialization deficit—lack of adequate socialization for the
role or for status changes within the role, such as promotions
· Role differentiation—changes in the role due to changing
technology, increased organizational complexity, change in
output expected by the organization
· Role transition—movement from old roles to newly
developing roles
The primary sources of role strain for nurses include role
conflict and role ambiguity.
Role conflict
· The role occupant is confronted with conflicting expectations
that are mutually exclusive and therefore impossible to carry
out.
· The role occupant is a member of different groups and has a
different role in each, the expectations for which may be
mutually exclusive.
· Role partners may have different expectations for role
occupant.
· Role expectations of subroles may be incompatible.
· Conflict is inevitable in organizations.

3. Role Ambiguity
· Role expectations are vague.
· There is disagreement on the expectations for a particular role.
· Goals of administration and professionals are often
significantly different.
· Some ambiguity is characteristic of all professional roles;
technical roles are more defined with clearer expectations.
· Professionals often do not deal with the uncertain and the
unexpected.
· Ambiguity is a challenge to professional skills and demands
creativity.
· Ambiguity is even more detrimental to role performance than
role conflict.
We have all experienced role stress and role strain in our work
lives. In your work environment, what do you feel are some the
contributing factors? How have these contributed to role strain
in your present work?
Change Theory:
The nature of organizations is such that success in one area
inevitably produces problems in another. Organizations,
whatever their specific purpose, facilitate the production of
dilemmas. Therefore, there is always a need for change and
change management to affect growth and profits. The goal is to
enhance change-facilitating forces while effectively diminishing
the restraining forces.
However, organizations change as little as they must, rather
than as much as they should.
Is planned change in complex organizations possible? Or do
enormous internal and external forces overcome any attempt to
control them?
There are limits to the potential for change.
· Not everyone has the power to effect change.
· Change cannot be ordered to happen.
· Conflicts of interests may resist change.
The need for change may make it harder to change.
· Adversity produces a sense of necessity for change that

4. promotes innovation.
· However, scarcity of resources creates a climate less likely to
utilize innovation than abundance.
· The ability of an organization to change significantly appears
greatest when inclination to change is least.
· In times of plenty, these are increased resources for change
but less necessity.
Meaning of Intentional/Planned Change
According to Kurt Lewin's change theory in the 1940s, change
was movement between discrete, fixed states. The classic model
was of the system unfreezing, changing, and refreezing. This is
no longer considered to be accurate, as systems and
organizations never freeze. They are dynamic, always in a state
of flux, and the stages of change constantly overlap.
What is the reality?
Organizations are always in motion. Change is always
occurring, whether guided by the leaders or not. Change is not
always planned nor desired. Those involved in controlling
events or guiding change must always be aware of the nature of
the networks within and around organizations. Forces that
prompt change include the relationship of the organization with
its environment, growth during its life cycle, and its internal
and external struggle for power.
Change is ubiquitous in healthcare as an industry and within our
organizations. Do you know what the big three model of change
is all about?
The Big Three Theory of Change:
The big three theory of change is the result of groundbreaking
efforts by Rosabeth Moss Kanter—professor at the Harvard
Business School. This theory focuses on various components
that institute change in organizations.
The Big Three Theory of Change comprises:
· Three kinds of movement
· Three forms of change

5. · Three action roles in the change process
Types of Movement
Movement can be:
· Macroevolutionary—historical, related to whole industries, the
movement of an organization as it relates to motion in its
environment. The environment is always shifting due to
geographical, political, economic, demographic, and social
realties.
· Microevolutionary—developmental, related to the movement
of parts of the organization as it grows, ages, and progresses
through its life cycle. Momentum is created in an organization
as it increases in size, and its members, values, and practices
change.
· Revolutionary—the manipulation and struggle for power and
control to make decisions or attain benefits from the
organization. Over time, different stakeholders advance their
own interests and make claims on the organization's resources.
Forms of Change
Change relates to:
· Identity—changes in the relationships between the
organization and its environment; its assets and market; its
relationships to customers and other organizations.
· Coordination—changes which involve the internal parts or
configuration of an organization; the problems of shape and
structure as it grows and ages.
· Control—changes that stress the political dimension; which
coalition is dominant in the organization, which set of interests
predominate, who governs and sets strategy; ownership.
Action Roles
Action roles can be as:
· Change strategists—concerned with the organization's
direction and the connection between the organization and its
environment; usually found in top leaders at the beginning of a

6. change sequence.
· Change implementers—responsible for the change effort itself,
concerned with internal organizational structure and
coordination; usually the mid-level managers in the middle of
the change sequence.
· Change recipients—those most strongly affected by the change
and its implementation but without the opportunity to influence
those effects; organizational staff at the end of the change
sequence.
Nursing professionals don't work in a vacuum. They create a
framework for change within their work environment. For
example, the culture change movement pioneered by Stephen
Shields—president and CEO of the Meadowlark Hills retirement
community in Manhattan, Kansas—has brought a radical
transformation in the way patients are treated in long-term care
facilities. This movement believes in moving away from the
assembly-line approach to treating patients; to that of warm
household community, where the patient and staff build a life
together. The big three theory of change can be an important
tool to affect change and influence certain health policy
decisions.The Future of Nursing
The future of nursing is rooted in the past and the two are
linked together by a number of events and trends. As you traced
the evolution of nursing theory from the philosophical
underpinnings of ways of knowing in nursing and various
nursing theoretical frameworks to the application of theory to
education, practice, and research, you will have noticed that a
number of trends have marked the different periods of the
history of nursing. Contemporary nursing has come a long way
since the era of Florence Nightingale who established the
foundation for modern nursing.
Though theories have often been accused of being vague and
lacking in simplicity and clarity, they have always been used by
professionals to prescribe and predict nursing practice. This
course on Advanced Theoretical Perspective sought to provide
you with a nursing perspective to examine clinical situations,

7. education, and research. Gaining an understanding of the
theoretical base of nursing, the process of theory development,
and its relation to empirical research will enable you to
structure your ideas as you interpret the connection between
theory and practice.
This course gave you an opportunity to work on a group
presentation, theory critique, and concept paper, which allowed
you to analyze and evaluate nursing conceptualizations. Your
group presentation helped you develop your skills in
collaborative work, while you tried to understand the scientific
nature of nursing concepts. The theory critique exercise
sharpened your analytical skills as you critically evaluated your
chosen nursing theory and examined its relevance to research,
practice, and education. Your concept paper furthered your
philosophical enquiry and gave you a better understanding of
the concepts that underlie your personal philosophy for
professional nursing practice.