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This ethnographic revisit of a general hospital aims to critically explore and describe the mechanisms of corporate culture change and how institutional excellence is facilitated and constrained by everyday management practices between 1996/1997 and 2014/2015.

A five-month field study of day-to-day life in the hospital's nursing division was conducted by means of an ethnographic revisit, using participant-observation, semi-structured interviews, free conversations and documentary material.

Using labour process analysis with ethnographic data from a general hospital, the corporate culture is represented as faceted, complex and sophisticated, lending little support to the managerial claims that if corporate objectives are realised, they are achieved through some combination of shared values, beliefs and managerial practices. The findings tend to support the critical view in labour process writing that modern managerial initiatives lead to tightened corporate control, advanced employee subjection and extensive effort intensification. The findings demonstrate the way in which the nursing employees enthusiastically embrace many aspects of the managerial message and yet, at the same time, still remain suspicious and distance themselves from it through misbehaviour and adaptation, and, in some cases, use the rhetoric against management for their own ends.

What are the implications for clinical and managerial practitioners? The recommendations are to (1) develop managerial practitioners who are capable of managing change combined with the professional autonomy of clinical practitioners, (2) take care to practise what you preach in clinical and managerial reality, as commitment, consent, compliance and difference of opinion are signs of a healthy corporate culture and (3) consider the implications between social structures and human actions with different work behaviours on different levels involved.

This ethnographic revisit considers data from a labour process analysis of corporate culture change in a general hospital and revisits the ways in which contradictory expectations and pressures are experienced by nursing employees and management practitioners spread 17 years apart.

Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.

This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.

The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.

Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.

The purpose of this article is to report on case study research conducted in a German hospital and describe the implications that the “Management by walking about” approach had on healthcare employees. “Management by walking about” is widely seen as one of the favoured procedures for increasing employee commitment and shared understanding as well as supporting high trust work relations.

This case study set out to examine the actual labour processes and the concrete experiences of healthcare employees behind the “Management by walking about” approach in a German hospital. This was achieved by means of a six month field study of day‐to‐day life in the hospital's nursing division.

In this case study, the popular initiative of “Management by walking about” was used as a means of managerial control and, as such, the internal promotion of soaring values and path‐finding visions was met with both scepticism and cynicism.

Pre‐commitment and motivation levels were high among healthcare employees, they were passionate about their healthcare work and they actively engaged in open communication and organisational development. But all this had little to do with “Management by walking about”, and its implications raise questions about its influence on high trust work relations more generally.

The paper concludes that a more critical analysis is necessary to challenge the way in which “Management by walking about” is examined by healthcare management academics and practitioners.

This ethnographic investigation of a general hospital aims to critically analyse a much lauded corporate culture. Rather than accepting the managerial and academic claims concerning the mobilisation of corporate culture at face value, this study builds upon a labour process analysis and takes a close look at how it actually seems to work.

The paper explores and describes how executive managers seek to design and impose corporate culture change and how it affects the nursing employees of this organisation. This was achieved by means of a six month field study of day‐to‐day life in the hospital's nursing division.

The results lend little support to the official claims that, if managerial objectives are realised, they are achieved through some combination of shared values and employee participation. The evidence lends more support to the critical view in labour process writing that modern cultural strategies lead to increased corporate control, greater employee subjection and extensive effort intensification. The contradiction this brings into the working lives of the employees leads to the conclusion that the rhetoric of corporate culture change does not affect the pre‐existing attitudes and value orientations of nursing employees. However, there were considerable variations in how employees received the managerial message and thus, by their degree of misbehaviour and adaptation, affected the organisation itself as well as using the cultural rhetoric against the management for their own ends.

The paper concludes that an extended labour process analysis is necessary to challenge the way in which corporate culture change is explored and described by management academics and practitioners.