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Area of Science:

  • Healthcare Management
  • Nursing Studies
  • Organizational Behavior

Background:

  • Healthcare organizations face continuous and rapid change due to external pressures.
  • Nurse resistance is frequently cited as a cause of change failure in healthcare.
  • Existing literature on organizational change predominantly reflects administrative perspectives, with limited insight into nurses' experiences.

Purpose of the Study:

  • To explore the lived experiences of frontline nurses navigating rapid and continuous organizational change.
  • To understand the nature and motivations behind nurse resistance in healthcare settings.
  • To provide a nursing-centric perspective on the challenges and dynamics of organizational change.

Main Methods:

  • Qualitative critical hermeneutic design.
  • Face-to-face interviews with 14 Registered Nurses at an urban pediatric teaching hospital in Canada.
  • Open-ended questions and member reflections to ensure accurate portrayal of participant experiences.

Main Results:

  • Nurse resistance to change is characterized by covert behaviors in micro-ethical moments, rather than overt actions.
  • Nurses utilize resistance as a strategy to provide morally authentic care at the bedside.
  • These acts of resistance serve to reclaim professional power amidst feelings of powerlessness within change initiatives.

Conclusions:

  • Findings offer novel insights into nurse resistance, reframing it as ethical action and political agency.
  • Understanding the covert, ethically-driven nature of resistance is crucial for navigating change in dynamic healthcare institutions.
  • This research highlights the ethical dimensions of nursing practice within rapidly evolving healthcare environments.