Globally, healthcare systems are undergoing rapid and often continuous transformation, driven by pressures to improve efficiency, accountability, and care quality. Hospitals, as central actors in these reforms, are introducing policy revisions, digital technologies, and structural realignments (Cohen et al., 2022; Liu et al., 2025; Zhang et al., 2023). Nurses, positioned at the frontline of patient care, are directly exposed to these transitions and are expected to adapt to evolving workflows, performance-based funding models, and new delivery systems (Zhang, Zhang, & Zhang, n.d.; Shan, Shang, Yan, & Ye, 2023). While such reforms aim to optimize health service delivery, they frequently generate unintended consequences, including increased workload, role conflict, and uncertainty. These pressures not only heighten operational strain but also erode nurses' psychological well-being and professional performance (Casey, 2021; Heikkila, Huhtala, Mauno, & Feldt, 2022). Collectively, these stressors contribute to what has been termed organizational change fatigue.

Organizational change fatigue refers to a state of psychological and emotional exhaustion arising from repeated and large-scale institutional transformations. In nursing contexts, it manifests through emotional disengagement, diminished professional vitality, and passive adaptation to change (Beaulieu, Seneviratne, & Nowell, 2023; Cao, Lin, Liang, & Qin, 2024). Evidence has increasingly linked change fatigue to job dissatisfaction, burnout, decreased organizational commitment, and compromised care quality (Brown, Wey, & Foland, 2018; Lotfi et al., 2024; McMillan & Perron, 2020; Sarigul & Ugurluoglu, 2023). Importantly, the implications of nurse disengagement extend far beyond individual well-being. International research shows that lower staff engagement is associated with weaker patient safety cultures and increased incidence of adverse events (Janes, Mills, Budworth, Johnson, & Lawton, 2021). Moreover, disengagement is a strong predictor of turnover intention, with engagement positively influencing nurse retention through the mediation of supportive organizational culture (Goyal & Kaur, 2023). A recent systematic review further underscores that sustaining engagement requires attention to multiple determinants spanning individual, organizational, and environmental levels (Aungsuroch, Gunawan, Juanamasta, & Montayre, 2024).

Despite these insights, much of the existing literature has focused on isolated stress outcomes or has employed quantitative designs, offering limited understanding of the subjective and contextual aspects of change fatigue (Lv et al., 2025). This gap is particularly salient in China, where reforms are typically rapid, top-down, and administratively driven. Within such hierarchical systems, nurses often encounter restricted decision-making autonomy and limited opportunities to provide feedback, conditions that intensify the impact of change and diminish professional voice (Gao & Zhang, 2021; Klundert, de Korne, Yuan, Wang, & van Wijngaarden, 2020). Against this backdrop, exploring nurses' lived experiences is essential to capturing the human dimensions of reform and developing strategies that sustain both professional engagement and system performance.