This paper reviews the literature on the psychological effects of change and discusses the impact of an overarching organizational change on the staff nurses of a large oncology unit in the Midwest. Their reactions are compared with a grief-change framework synthesized from the literature. This framework was useful in explaining staff nurse behaviors and attitudes, and offered interventions specific to each stage of the change process useful to the CNS. Dissemination of this information is discussed, as well as implications for advanced nursing practice.