Week 10: Change Theory

Lewin’s Change Management Model could be applied to the ACA 40 hours is full time employment definition policy. Normandin (2012) explains the three stages of this model. The first is the unfreeze stage, the second is the transition stage and, the third is the refreezing stage. As it applies to the policy, those employees affected, would have to disassociate the definition of full time employment as they have always understood it and realize that full-time employment had never been defined through the government but was always to be determined by the employer (www.dol.gov, n.d.). The transition stage would then involve every employer’s policy and procedures regarding full-time employment to be updated to state that full-time employment is defined as working 40 hours a week and employees beginning to work 40 hours, where perhaps they never had to, and the refreezing stage would be this new definition sticking and becoming the culture for all organizations. The problem with this is that a lot of employers’ already defined full-time employment as working 40 hours a week so this change management model would apply more to those professions and employers/organizations where the definition of full-time employment was not 40 hours per week. Normandin (2012) discusses other change management models but acknowledges that other models may be helpful as they all provide a guide to assist in making the changes needed but, ultimately, change is difficult to implement and manage.

Forti (2012) explains that a good theory of change should address some major concerns: who would benefit, what would be the benefit, over what period of time with the benefits be achieved, how these benefits would be achieved and, work circumstances will need to be addressed. Interestingly, some of these concerns have been raised in previous weeks throughout the course of this blog. These are all important concerns as they may be representative of the needs of society and especially those affected by this policy. Is it really necessary to define full-time employment and why? Not defining fulltime employment may not be a perfect way to function but it has worked so far. The possibility that employers could use the policy to avoid having to offer health insurance coverage benefits to employees is very concerning and more than that the fact that Medicaid might have to bear the burden of providing healthcare benefits to these employees should be considered. The publics’ opinion should be sought through polls and other means to better gain some insight into how this might affect everyone and not just some sectors of the economy and maybe the change would not be so difficult.

Forti, M. (2012). Six Theory of Change Pitfalls to Avoid. Retrieved from http://www.ssireview.org/blog/entry/six_theory_of_change_pitfalls_to_avoid

Normandin, B. (2012). Three Types of Change Management Models. Retrieved from http://quickbase.intuit.com/blog/2012/08/28/three-types-of-change-management-models/

United States Department of Labor. (n.d.). Work Hours: Full-Time Employment. Retrieved from http://www.dol.gov/dol/topic/workhours/full-time.htm


6 thoughts on “Week 10: Change Theory

  1. This was a very well written post on change theory in regards to the ACA 40 hours full time employment definition policy. Knowing that nursing is a field that is 2.8 million RNs and 690,000 LPNs strong, this alone shows the impact that such change in policy would have (U.S. Department of Health and Human Services, 2013). Hopefully, RNs involved in public policy and representatives familiar with other workforces that would be affected by this change would be able to come together to make their voices heard in Washington.

    It’s also interesting to note that this change in policy probably has roots in trying to protect the people from being taken advantage of by their employers, yet large groups of these people may lose coverage and/or be unable to pay for their own as a result of the change. I also think you bring up a great point that there is the potential for an increasing amount of individuals who require Medicaid or other programs causing more of an economic burden on the already strained economy.

    U.S. Department of Health and Human Services. (2013). The U.S. nursing workforce: Trends in supply and education. Retrieved from: http://bhpr.hrsa.gov/healthworkforce/reports/nursingworkforce/nursingworkforcefullreport.pdf


    1. Yes, it seems there were good intentions with the creation of this policy as pointed out in an earlier post on this blog but now we have to consider if it is doing more harm than good to the millions of professions, organizations and individuals who have relied upon being able to define fulltime employment and meet their professional and career obligations whilst not working a mandatory 40 hours a week schedule.


  2. This is a topic where one might wonder whether participating in a change is worthwhile. Are there times when making a change is worse than doing nothing? Lewin’s Change Management model can be applied to re-definition of the American work week under the ACA quite simply as you described. A study published by the Commonwealth Fund (Glied & Solis-Roman, 2014) found that about 27 million Americans work a 40 hour week. A reduction of just one hour per week could result in lost insurance benefits for this population. Regardless of your political leanings its clear this may cause problems, economically and socially. There are interesting business and ethical principles in play as well. If we utilize Forti’s (2012) assessment of a ‘good change’ as you mentioned, this policy does not appear to make the cut.

    Forti, M. (2012). Six Theory of Change Pitfalls to Avoid. Retrieved from http://www.ssireview.org/blog/entry/six_theory_of_change_pitfalls_to_avoid

    Glied, S. A. and Solis-Roman, C. (2014). Why Changing the Definition of Full-Time Work Under the ACA Will Put More Workers at Risk and Increase Federal Spending. The Commonwealth Fund Blog. Retrieved from http://www.commonwealthfund.org/publications/blog/2014/jan/changing-the-definition-of-full-time-work


    1. You asked a question which should be considered, “Are there times when making a change is worse than doing nothing?” In this case full time employment has never been defined and things worked even though they could be improved upon. Let the new policies being made reflect those improvements and not break something else that never needed fixing, or did it?


  3. Ifi I agree that public polling would be a great way for legislators to gain insight. For our field we could be an even bigger force if each hospital system did their own polls and combined them into one large poll because hospitals see the most 12 hour shifts and seem to have the most to loose. what do you think?


    1. Thanks for your comment, Kelly. I was actually thinking about how a poll would need to be conducted to be truly representative of the population – those who do not have to work 40 hours to be full-time employees and those who already do. I admit that I am not an expert at these things so I’ll leave it to those who conduct polls to develop one. That being said, your idea of polling employees/nurses from different hospitals may be a valid way to gain the information we seek. Hopefully it would not be considered biased – again, I am not an expert – but the governments decisions needs to reflect the wants and needs of the majority. The American Nurses Association (ANA) is requesting letters through emails being sent to nurses to let the legislators know how this policy would affect them and the profession of nursing as a whole (www.rnaction.org, 2014). This is not listed as a poll but it is a way of collecting information on the effects of this policy.


      American Nurses Association (ANA). (2014). When Nurses Talk…Washington Listens. Retrieved from http://www.rnaction.org/site/MessageViewer?dlv_id=12121&em_id=15681.0


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