JHHSA Articles 
Mergers and the New Workplace: The Effects of a Merger of Two Emergency Departments on Nursing Staff
MARTIN LEES and GINA TAYLOR
JHHSA, Vol. 26 No. 4,
(2004)
Even small mergers have big consequences. This case study demon-
strates the complex nature of organizational change found even in small
organizational subunits and provides important insight for managers
and leaders who have completed or are considering such mergers. The
study examined the amalgamation of two emergency departments.
Quantitative and qualitative techniques were used to analyze the plan-
ning, implementation, and outcomes of this amalgamation on the
nursing staff. This case study draws upon the literature pertaining to
change survivor's syndrome, prescribed approaches to change, and the
difficulties in changing cultures and making complex decisions.
Change in hospitals has been shown to have negative consequences for
nurses. The goal of this study was to examine in greater detail what
aspects of change are associated with these effects. The findings
suggest that the planning of the amalgamation was consistent with
rational decision-making. The goals of changing to a single emergency
unit and cost savings were achieved. However, the nurses experienced
stress due to the pace of work and the physical layout of the newly
renovated department. The findings also suggest that personal-level
problems that the nurses experienced were consistent with the
consequences of survivor's syndrome, the psychological contract, and
communication issues. It was recommended that the organization
undertake initiative to alleviate these stresses.
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