Ideological tensions amidst rapid and continuous organizational change in healthcare

Purpose The aim of this study was to explore the nature of frontline nurses' experiences of living with rapid and continuous organizational change. Design/methodology/approach A critical hermeneutic approach was utilized. This was a qualitative inquiry theoretically guided by critical management studies. Findings Participants 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 implications Nurses 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/value The 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.