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This research aims to understand how Generation Z emergency nurses in China experience organisational silence and its effects on patient safety.

February 21, 2026BMC Nursing0 citationsOpen Access

The organisational silence experiences of Generation Z nurses in emergency department: a qualitative descriptive phenomenological research study in Shanghai, China

JJJinxia JiangShanghai Tenth People's Hospital YLYue LiuTongji University YLYi LiuTongji University

Key Points

This research aims to understand how Generation Z emergency nurses in China experience organisational silence and its effects on patient safety.
Qualitative descriptive phenomenological approach
Semi-structured, in-depth interviews with 21 Generation Z emergency nurses
Data analysis based on Colaizzi’s seven-step phenomenological method
Identified three main themes related to organisational silence: competency limitations, reasons for silence, and outcomes
Moderate silence can have some benefits, but prolonged silence negatively affects employees and patient safety
Healthcare managers are encouraged to create tailored strategies to reduce organisational silence among nurses

Abstract

Patient safety is a fundamental objective for healthcare systems worldwide and a prerequisite for high-quality nursing care. Growing evidence indicates that organisational silence among nurses not only undermines job satisfaction and performance but also stifles innovation and impedes decision-making within healthcare organisations, thereby jeopardising patient safety. In China, Generation Z emergency nurses exhibit distinct characteristics compared to previous generations, which may shape their experiences of organisational silence. However, the precise influence of these generational traits on their propensity for silence remains unclear. This study aimed to explore the organisational silence experiences of Generation Z emergency nurses within China’s distinctive sociocultural context. A phenomenological qualitative approach was adopted for this study. Semi-structured, in-depth face-to-face interviews were conducted with 21 Generation Z emergency nurses from a tertiary hospital in Shanghai between January and February 2025. The collected data were analysed using Colaizzi’s seven-step phenomenological analysis method. The analysis revealed three primary themes with twelve associated subthemes: (a) competency limitations among those maintaining silence, (b) underlying reasons for organisational silence, and (c) outcomes of silence. While moderate silence may yield certain benefits, prolonged organisational silence can have detrimental effects on employees, teams and organisations. As different types of organisational silence operate through distinct mechanisms, healthcare managers should develop targeted intervention strategies based on careful assessment of both the motivations behind silence and its extent. The ultimate objectives are to reduce organisational silence among Generation Z emergency nurses, enhance staff retention, and improve patient safety outcomes.

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