Phelp LPNtoRN 6e

CHAPTER 3 • Adapting to Change 71

room for new beginnings. Role conflict may increase as both you and others around you work to put old roles behind you to prepare for new ones. Often, there is a sense of loss for the role left behind. REFREEZING Lewin’s last stage is called refreezing. The change has occurred and is now part of the individual, group, or organization. Refreezing requires a commitment to change and the stabilization of restraining and driving forces. There is a change of behaviors and attitudes within the change process. In continuing with the same example, as you reenter school, one change has already occurred: You are a student nurse again. You have internalized the value of continuing your education and have made the commitment to become an RN. This change is part of who you are. Your family, friends, and coworkers have also made adjustments to this change. You are now working through the internali zation of this new identity that you will be assuming. THINKING CRITICALLY Recall a planned change with which you were recently involved. Critique your change as viewed through the three stages of planned change described by Lewin. What steps were taken to initiate the change? What were the restraining and driving forces? What was your role in the planned change? What role conflict did you experience? When did you become aware that the change was causing a major transition for you? How did you manage the three phases of the transition? What was the impact on those around you? What would you do differently if you could to better manage the transition? EFFECTS OF CHANGE Change can have many effects. Some are expected, and some are not. As previously stated, individuals cope with and adapt to change in unique ways. STRESS, DISTRESS, AND EUSTRESS Stress, distress, and eustress are terms defined by Hans Selye (1976) to describe various conditions that humans experience. Stress is a universal response to any situation or factor that disturbs a person’s equilibrium. It has become a familiar term to all of us and may be a term that you will use frequently while in nursing school. Selye called the side effects of stress distress and eustress. Distress is the negative or maladaptive effects of change or stress, whereas eustress represents normal or moderate stress, which is more beneficial to the experiencer. With any stress or change, nonspecific bodily changes occur. If a person is able to cope effectively with change, the side effects will be kept to a minimum, but poor adaptation to stress or change results in damaging side effects, or distress. Physical signs of distress can include prolonged elevated blood pressure, increased gastric acid secretions, and decreased urine output. Emotional signs may include insomnia and hyperexcitability. There also may be behavioral changes such as depression or anger. Selye (1976) believed that some conditions (e.g., hypertension, ulcers, certain emo tional disturbances) represent diseases of adaptation. Although many researchers and

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