Many hospital epidemiologists (HE) and infection control practitioners (ICPs) find criticism a product of controlling infection because as change agents, these healthcare workers are often perceived as being highly critical. Criticism of epidemiologists and ICPs may appear in a number of ways. Staff may perceive the HE/ICP in a criticizing role because monitoring duties usually require investigative behavior that can be misinterpreted as spying. Staff may feel that epidemiologists do not understand the real work situation, because HEs and ICPs often do not actively care for patients and sometimes dictate that familiar routines be replaced by new procedures. This is especially true when the new procedures appear to take more time and effort than the familiar routine. In addition, the HE/ICP may be seen as picking on certain staff members when follow-up evaluation flags staff deficiencies that must be corrected.

Criticism is a subjective perception, but staff who perceive the change agent as critical may impede the change process. All too often, staff who feel criticized get angry and defensive, and become less willing to cooperate. Instead of quickly being able to modify unacceptable staff behavior, the HE/ICP may find that staff resistance and negativism will obstruct the implementation of even a minor change. Staff energy will be spent justifying the undesired behavior. Some staff even fantasize about eliminating the roles of the epidemiologist and ICPs, and may be heard to say, “We got our work done before they came. Besides, how does all this monitoring really help patient care? With this nursing shortage, the ICP could help us more by taking part in real patient care.” The ICP and HE do not generate known income for the hospital and many times they create additional work and advocate that extra monies be spent. Consequently, even an administrator might become critical of these change agents.