The grieving process in cultural change.

A real sense of loss is experienced by many middle managers as hospitals change their cultures and evolve toward participatory management. To work through the loss involved, managers need time and resources to grieve for the old as they learn the new. Although the grieving process is relatively straightforward, difficulty arises because the need to talk and grieve for the old occurs precisely when all attention and effort focuses on the new. Administrative groups may feel threatened by middle management's expression of grief. Unwillingness to acknowledge and support that grief may provoke greater anger and resistance, increasing the problems associated with change. In the long run, time spent grieving for the old will make the transition to the new that much smoother. Organizations will see a positive return from time spent in the grieving process. Inability to let go of the old is often at the root of the uneasiness, resistance, and lack of visible commitment to the new. Why should we not spend the required time appreciating and then letting go of the old even as we teach the new? As we progress to the learning organization, to a staff empowered to resolve problems and seize opportunities, let it be known that expressions of the staff's humanity will be tolerated. Mistakes will be much more acceptable than lack of effort for fear of error. In working together, better patient care can be attained along with personal and organizational strength. Recognizing Annette's, or any manager's or staff member's, loss and allowing the grief necessary to resolve that loss will benefit all.(ABSTRACT TRUNCATED AT 250 WORDS)