You work in an intensive care unit where there is an all-registered nurse (RN) staff.

Creating a Plan to Reduce Resistance. You work in an intensive care unit where there is an all-registered nurse (RN) staff. The staff work 12-hour shifts, and each nurse is assigned one or two patients, depending on the nursing needs of the patient. The unit has always used total patient care delivery assignments. Recently, your unit manager informed the staff that all patients in the unit would be assigned a case manager in an effort to maximize the use of resources and to reduce length of stay in the unit. Many of the unit staff resent the case manager and believe that this has reduced the RN’s autonomy and control of patient care. They are resistant to the need to document variances to the care multidisciplinary action plans and are generally uncooperative but not to the point that they are insubordinate. Although you feel some loss of autonomy, you also think that the case manager has been effective in coordinating care to speed patient discharge. You believe that at present, the atmosphere in the unit is very stressful. The unit manager and case manager have come to you and requested that you assist them in convincing the other staff to go along with this change.

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