Ideological tensions amidst rapid and continuous organizational change in healthcare

Abstract

PurposeThe aim of this study was to explore the nature of frontline nurses' experiences of living with rapid and continuous organizational change.Design/methodology/approachA critical hermeneutic approach was utilized. This was a qualitative inquiry theoretically guided by critical management studies.FindingsParticipants recognized that many change initiatives reflected an ideological shift in healthcare that supported a culture of service, whilst sacrificing a culture of care. A culture of service prioritized cost-savings and efficiency, which saw nurses lose the time and resources required to provide quality, safe care.Practical implicationsNurses felt morally responsible to uphold a culture of care, which proved challenging and at times unobtainable. The inability to provide quality, safe care in light of organizational changes resulted in a multitude of negative emotional repercussions, which fostered moral distress.Originality/valueThe findings from this study bring to light ideological tensions that negatively impact nurses. This study supports the conclusion that the planning, implementation and evaluation of organizational change initiatives must reflect a culture of care in order to alleviate the many negative experiences of organizational change noted in this study.