title: Breakpoints and continuities: a case study of reactive change.
abstract: In 1987, nursing administrators effected radical changes on a pediatric psychiatry ward: A bachelor's degree in nursing science became mandatory for nursing staff, family systems nursing was introduced, and postdischarge nursing follow-up was instituted. To convey how they accomplished the changes, a case history of change on the ward is presented. It suggests that there were many driving forces. Factors most important to nursing's success included a strong vision of nursing, sufficient pain or discomfort to motivate change, the ability to recognize and seize opportunities, and the linking of change to existing institutional practices, policies, and values.
authors.forename: J
authors.initials: J
authors.lastname: Stelling
authors.forename: J
authors.initials: J
authors.lastname: Milne-Smith
mesh_terms: D002648:Child; D002675:Child, Preschool; D006757:Hospital Units / Q000458:organization & administration / Q000639:trends*; D006801:Humans; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000639:trends; D009936:Organizational Innovation; D010372:Pediatrics / Q000458:organization & administration / Q000639:trends*; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration / Q000639:trends; D011570:Psychiatry / Q000458:organization & administration / Q000639:trends*; D011792:Quebec