Call the Midwife…

…lessons in managing change

If you’ve been watching Call the Midwife you’ll notice that Management and Leadership have become a hot topic for this series.

In case you’ve not seen it (I really do recommend it) midwifery and district nursing to the population of Poplar is delivered by the nuns, midwives and nurses from Nonnatus House, led by Sister Julienne. Sister Julienne was a respected leader with a team who are committed to the needs of their patients, always putting their patient first and often going beyond the call of duty.

At the beginning of this series we see Sister Julienne having to take a step down from leadership as she is told Sister Ursula would be taking the role of leading Nonnatus House. Sister Ursula is focused on taking Nonnatus into the “modern world”, with efficiency as a priority.

Sister Ursula starts by implementing new rules, including limiting appointments to 20 minutes, “biscuits only for fainters”, not going over and above the remit of the service (the relationship between Nonnatus and the community goes far beyond midwifery services). The midwives are left feeling they are being denied the opportunity to do their best for their patients.

The result of the new rules is the team of midwives are finding ways to cover for each other and get around the rules, they don’t see any value in the news rules and see the service they can give their patients (many in significant need) is being reduced without need or explanation. Any attempt to raise their concerns with Sister Ursula are closed down quickly, resulting in almost no communication between Sister Ursula and her team, in either direction.

The world is changing for the nuns, midwives and nurses at Nonnatus, we can however see the errors in Sister Ursula’s way, she has turned up new with no introduction to herself and she has heard no introduction from the individuals who report to her. With this she has lost the respect of her team, who have assumed she has no knowledge or expertise and feel their professional opinions have been ignored.  As a result the team is pushed together in defiance, finding ways to avoid the rules, Sister Ursula’s credibility is reduced further.  Sister Ursula ignores the feedback she is receiving and pushes on with her change regime.  We see a team united in distrust of their leader, feeling stress in their jobs as they feel they are being prevented from giving the care their patients need and anxiety as they don’t know what is coming next.  We only see their views begin to be heard when a baby is left unconscious as a result of the 20 minute appointment.

Sister Ursula would have been advised to spend time listening to the members of Nonnatus House and getting to know them whilst letting them get to know her before implementing her changes. In implementing changes she needed to discuss with her team, hear their concerns and demonstrate she continues to value the team, whilst at the same time demonstrating why the changes are needed and the benefits they can bring.  Change is never an easy time, but communication could have helped overcome the issues being faced by Sister Ursula.

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