This article aims to clarify the concept of change fatigue and deems further exploration of the concept within the discipline of nursing is relevant and necessary. The concept of change fatigue has evolved from the discipline of management as a means to explore organization change and its associated triumphs and failures. Change fatigue has typically been described as one and the same as change resistance, with very little literature acknowledging that they are in fact distinct concepts. Concept clarification has highlighted the striking differences and few similarities that exist between the concepts of change fatigue and change resistance. Further exploration and subsequent research on the concept of change fatigue is needed within the discipline of nursing. The concept not only presents new and alternative perspectives on the processes of organization change, but provides opportunity for theory development that recognizes the impact organizational change has on nurses' work lives.

Aims: To provide a conceptual update on change fatigue in nursing as it relates to rapid and continuous change implementation. This doctoral dissertation examined nurses' experiences of rapid and continuous organizational change, with a core component of the study examining the concept of change fatigue. Background: Change fatigue is understood as the overwhelming feelings of stress, exhaustion and burnout fuelled by feelings of ambivalence and powerlessness associated with rapid and continuous change in the workplace. Change fatigue may cause workers to become withdrawn and greatly influences their decision to leave the workplace and even their profession. Little research to date has explored change fatigue in nurses. Methods: Were qualitative in nature. Design: A critical hermeneutic approach was used. Face-to-face interviews were conducted with 14 Registered Nurses. Open-ended questions were used. Theoretical thematic analysis and inductive analysis of data were completed using Brown and Gilligan's voice-centred relational method. The study spanned from 2015-2018. Results: Nurses did experience many of the core elements of change fatigue noted in the non-nursing literature, including exhaustion, apathy, powerlessness, and burnout. Two additional themes emerged pertaining to nurses' understandings of why they were experiencing change fatigue. These themes included the intensification of nursing work and repeated and ongoing self-sacrifice. Conclusion: Participants offered important insight into an emergent concept in the discipline of nursing. Impact: The negative experiences associated with change fatigue are important for administrators and other stakeholders to recognize and acknowledge, as they must work to alleviate change fatigue in their institutions to preserve the well-being of the nursing workforce. This knowledge is also important to nursing scholars, who may further research the topic and embed it into nursing curricula.

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.

Efforts to curb spread of COVID-19 has led to restrictive visitor policies in healthcare, which disrupt social connection between patients and their families at end of life. We interviewed 17 Canadian nurses providing palliative care, to solicit their descriptions of, and responses to, ethical issues experienced as a result of COVID-19 related circumstances. Our analysis was inductive and scaffolded on notions of nurses’ moral agency, palliative care values, and our clinical practice in end-of-life care. Our findings reveal that while participants appreciated the need for pandemic measures, they found blanket policies separating patients and families to be antithetical to their philosophy of palliative care. In navigating this tension, nurses drew on the foundational values of their practice, engaging in ethical reasoning and action to integrate safety and humanity into their work. These findings underscore the epistemic agency of nurses and highlight the limits of a purely biomedical logic for guiding the nursing ethics of the pandemic response.

Change is inevitable, and increasingly rapid and continuous in healthcare as organizations strive to adapt, improve and innovate. Organizational change challenges healthcare providers because it restructures how and when patient care delivery is provided, changing ways in which nurses must carry out their work. The aim of this doctoral study was to explore frontline nurses’ experiences of living with rapid and continuous organizational change. A critical hermeneutic approach was utilized. Participants described feeling voiceless, powerless and apolitical amidst rapid and continuous organizational changes which fuelled apathy, cynicism and disengagement from the organization. However, critical analysis of the data showed that nurses actively engaged with power, voice and politics through resistant and transgressive behaviours in micro‐ethical moments of practice. There is a need to reconceptualize the concepts of voice, power and politics in nursing as there is dissonance between nurses’ beliefs about these concepts and what they are enacting in practice. Recognizing their enactment of power, voice and political agency at the micro‐level may empower nurses. Empowerment would mitigate the high levels of reports of powerlessness experienced in practice during organizational changes.