The Relationship Among Change Fatigue, Resilience, and Job Satisfaction of Hospital Staff Nurses

Health care is typified by change. Organizational changes have a negative impact on nurses and the effects of organizational change is being overlooked and under researched (Delmatoff & Lazarus, 2014; McMillian & Perron, 2013). Change in an organization leads to increased sick time, work disability, loss of productivity, organizational commitment, increased turnover rates (Bernerth, Walker, & Harris, 2011), stress (McMillian & Perron, 2013), emotional exhaustion (Manzano Garcio & Ayale Calvo, 2012), and change fatigue (Bernerth et al., 2011; McMillan & Perron, 2013). Change fatigue is a result of constant organizational change and has not been researched with nurses. Majority of the research on organizational change is associated with change resistance. Differences exist between change fatigue and change resistance. Resistant behaviors are intentional actions, but change fatigue is when staff become disengaged, apathetic, and passive about the changes. Because of these passive behaviors, change fatigue is unnoticed by nurse managers and under researched (McMillian & Perron, 2013).

Resilience is a personal quality that enables one to thrive in the face of adversity, such as with organizational change. Resilient nurses are better able to cope with stress and have lower levels of emotional exhaustion (Manzano Garcia & Ayala Calvo, 2012). Resilience reduces the risk of burnout, improves the retention and mental health of nurses (Shin, Taylor, & Seo, 2012), and has a positive correlation to years of work experience (Lee et al., 2015). 

A study was conducted to determine if hospital staff nurses experience change fatigue and if there are differences in levels of change fatigue of novice an experienced hospital staff nurses. The Transactional Model of Stress and Coping developed by Lazarus and Folkman (1984) was used as the theoretical framework. The model proposes that stressors and ways individuals cope with stress need to be considered jointly in explaining the stress and coping process because they are interdependent. Organizational change is a frequent stressor experienced by nurses that causes stress, a decrease in job satisfaction, and change fatigue. Resilience is personal quality that can be used to adapt to the stress of organizational change.

The study assessed the relationship among change fatigue, resilience, and job satisfaction of hospital staff nurses. Participants completed an online survey, using three tools: Change Fatigue Scale, Connor-Davidson Resilience Scale (CD-RISC), and McCloskey/Mueller Satisfaction Scale (MMSS). The participants were 535 staff nurses employed in a rural or urban hospital. The study reported a significant difference between novice and experienced staff nurses in change fatigue (t= -2.9, p = .003), resilience (t= -2.3, p = .01), and job satisfaction (t = -2.0, p = .04). Experienced nurses had higher change fatigue, resilience, and job satisfaction. The study also reported a significant negative association between change fatigue and job satisfaction (r = -.295, p = .000) and change fatigue and resilience (r = -.145, p =.002). A significant positive association was found between resilience and job satisfaction (r = .251, p = .000). Multiple regression found education, gender, and hospital size are predictor variables of change fatigue. Linear trend found as size of facility and number of beds increases, change fatigue increases and as educational level increases, change fatigue decreases.