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

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.