Organizational change fatigue among nurses and its impact on work engagement: A qualitative study

Abstract

Aim

To explore how organizational change fatigue influences nurses' work engagement based on their lived experiences in tertiary hospitals in China.

Background

Organizational change fatigue undermines nurse engagement, a factor consistently linked to patient safety and workforce retention. Nurses are frequently positioned at the center of hospital reforms and must adapt to structural, technological, and policy-driven changes. These transitions often create cumulative stress, yet little is known about how nurses subjectively experience change fatigue or how it shapes their professional engagement. Addressing this gap is essential, as understanding lived experiences can inform leadership and policy strategies to sustain nurse well-being and ensure safe, high-quality patient care.

Methods

A descriptive phenomenological design was employed. Semi-structured interviews were conducted with 12 registered nurses from three tertiary hospitals using purposive sampling. Data were analyzed using Colaizzi's seven-step method, and reporting followed the Consolidated Criteria for Reporting Qualitative Research.

Results

Four themes were identified: perceptions of organizational change, emotional and behavioral responses, coping strategies and perceived support, and impact on work engagement. Nurses described a cyclical trajectory from emotional fatigue to disengagement, with the potential for re-engagement when supported by psychologically safe and inclusive environments.

Conclusions

Organizational change fatigue erodes nurses' motivation, professional commitment, and care quality. However, recovery is possible through relational leadership, transparent communication, and recognition of emotional labor. These findings highlight the need for human-centered change strategies to maintain engagement and ensure workforce sustainability during continuous healthcare reform.