Amazon has nearly 20,000 books to help managers deal with change. Popular titles include Switch: How to Change Things When Change is Hard, Leading Change, and Change or Die. Change is inevitable, constant and difficult. At least, that's what middle managers are told.

As a bench tech, your job is simpler: do the work. But the realities of change and how your management imposes it creates turmoil, uncertainty, and stress that makes this harder. By understanding what to look for and how to react, you'll learn how to not just survive but thrive in today's changing environment.

Signs of Change
There's a lot of buzz about change in healthcare: public reporting of quality data, online ratings of doctors and hospitals, compliance with "meaningful use" measures, and changes in reimbursement. Much of this is linked to the new Patient Care and Affordable Care Act signed in 2010, often called Obamacare. The PCACA promises to overhaul much of the reimbursement, collection, and coverage in order to lower costs and increase the number of insured Americans, creating sweeping reform.

Your organization will deal with these changes in the way all change is handled: locally. Your leaders will respond based on cultural norms, expectations, and available resources using local history (e.g. what worked in the past) as a guide. Generally, change in an organization is expected or unexpected; the PCACA is both; your organization may not quite know what to expect of this inevitable change.

Local decisions eventually trickle down to affect the laboratory. These include changes to the organizational structure, products or services, management, and technology. Such changes may be accompanied by staffing plan revisions, demands for cost reduction, and a need for new skills, training, or credentials.¹

Effects of Change
Whether the change is external and largely beyond your control (e.g. Obamacare) or internal and requiring teamwork and shared sacrifice (staffing changes, conflicts, romance, etc.), the fear, uncertainty, and doubt of outcomes creates stress. While some stress is beneficial, it becomes a problem when demands for performance exceed an individual's capabilities. It's easy to feel like your life is spinning out of control.

Emotional symptoms may include: negative or depressed feelings, heightened sensitivity or aggression, feelings of withdrawal, mood swings, changes in eating or sleeping habits, increased alcohol or tobacco consumption, and absenteeism. While stress symptoms can certainly be caused by work conditions, it's important to have long-term stress evaluated by your physician; symptoms could be caused by something other than work.²

A failure to recognize signs and symptoms of stress can lead to personal changes beyond insubordination and depression. It can put your health at risk. Our bodies are programmed with a "fight or flight" endocrine response to selectively respond to danger in the short term, not day after day. Stress changes to look for are summarized in Table 2.

Dealing With Change
Management may be dealing with change, but as a bench tech you get the stress. Whatever is happening is too fast or too abrupt, leaving you feeling unprepared to cope, affecting what one business web site calls "the workplace within."³ A loss of control and fear of losing your job naturally triggers job stress and emotional changes.

And there is a real possibility of organization-wide failure: while it depends on the type, most change initiatives are doomed to fail. (A 2002 study found that cultural change fails more often than redesign projects, for example.) One psychologist cites pessimism, paralysis, and wrong decisions.⁴ Knowing you'll suffer for nothing adds fuel to the fire.

Here's how to cope, as suggested by author Vicki Bell:⁵

• Develop a support network. Having a group of friends you can rely on during the period of change reduces feelings of isolation, negativity, and contributes to well-being.
• Take care of yourself. As the above points out, the effects of long-term stress are significant. It's important to eat a balanced diet, exercise regularly, and rest. Take time to be with friends, family, or alone time with hobbies to recharge your batteries. Removing yourself from negative influences will clarify your perspective on the changes that are happening at work.
• Be flexible. Most of us settle into comfort zones, expecting that part of our life to run on auto-pilot. Change is often disruptive or threatening to these zones, so it's important to be flexible. Be willing to change and do something different.
• Be optimistic. While the worst may happen, it also may not. Whatever happens, you can see it as a positive opportunity to grow in your position or seek a new one. It's easier in the long run -- and healthier -- to be positive.

The Mayo Clinic web site suggests keeping a stress inventory, which can help manage all stressors. For one week write down situations, events, people, and other triggers that caused a negative emotional or physical response. Record the details of the incidents, including the setting and how you responded. This will give you information to look for ways to resolve stress.⁶

Finally, because the effects of stress are cumulative, it's best to remove any work stressors that contribute. You can take an inventory in your workplace of all the things that drive you crazy day in and out: broken equipment, expired supplies, messy storage areas, poorly written or incomplete procedures, and teamwork issues. Many of these issues can be dealt with immediately or in teams. Cleaning, organizing, and retooling processes can "wipe the slate" and give you more energy to deal with substantive change. You may find your coworkers are happy to get rid of stressors, too.

Acknowledging stress signs and symptoms, as well as the reality that people tend to react differently in stressful situations, can help you respond appropriately before your health and well-being are adversely affected. Making sure your stress is managed with a support network and healthy habits will leave you ready to cope with any change, leading to a positive contribution to your team and better patient care.

Scott Warner is lab manager at Penobscot Valley Hospital, Lincoln, ME.

References

1. Reference For Business. Managing change. Available at: www.referenceforbusiness.com/management/Log-Mar/Managing-Change.html. Last accessed Sept. 23, 2012.
2. Health and Safety Executive. Signs and symptoms. Available at: www.hse.gov.uk/stress/furtheradvice/signsandsymptoms.htm. Last accessed Sept. 23, 2012.
3. Covi I. Coping with change in the workplace. Available at: www.businessknowhow.com/manage/leadwithin.htm. Last accessed Sept. 23, 2012.
4. Visser C. Why do 80% of organizational change initiatives fail? Or do they? Available at: http://solutionfocusedchange.blogspot.com/2009/08/why-do-80-of-organizational-change.html. Last accessed Sept. 23, 2012.
5. Bell V. Coping with change in the workplace. Available at: www.thefabricator.com/article/trainingretention/coping-with-change-in-the-workplace. Last accessed Sept. 23, 2012.
6. The Mayo Clinic. Tips for coping with stress at work. Available at: www.mayoclinic.com/health/coping-with-stress/SR00030. Last accessed Sept. 23, 2012.
7. WebMD. Stress management -- effects of stress. Available at: www.webmd.com/balance/stress-management/stress-management-effects-of-stress. Last accessed Sept. 23, 2012.