The Experiences and Perceptions of Organizational Support Among Chinese Nurses Following Work-Related Musculoskeletal Disorders: A Qualitative Descriptive Study.

backgroundWork-related musculoskeletal disorders (WMSDs) are highly prevalent among nurses in China and can affect nurses' health, work ability, professional identity, and retention. Although Organizational Support Theory suggests that perceived organizational support shapes employees' post-injury attitudes and behaviours, little qualitative evidence explains how Chinese nurses interpret organizational responses after WMSDs, especially in the context of high clinical workloads and staffing pressure. OBJECTIVE(S): To explore and describe the experiences and perceptions of organizational support among Chinese nurses following WMSDs.

designA qualitative descriptive study.

methodsTwenty-four Chinese registered nurses from five tertiary hospitals who had taken sick leave or sought medical care for WMSDs in the past two years were recruited via purposive sampling. Data were collected through semi-structured, one-on-one, in-depth interviews, with each participant completing one interview between January and June 2025. Data were analysed using Braun and Clarke's six-stage thematic analysis.

resultsThree core themes emerged: (1) Navigating between ambiguous formal systems and crucial informal support, which revealed nurses' struggles between indifferent official procedures and a reliance on personal networks; (2) The chasm between perceived value and organizational actions, which highlighted the discrepancy between the organization's professed 'care' and the transactional, punitive measures nurses actually experienced; and (3) Long-term ramifications of inadequate support on professional identity and career trajectory, which illustrated how poor support experiences eroded organizational loyalty, fostered turnover intentions, and ultimately destabilized their professional foundation.

conclusionsOrganizational support for Chinese nurses following WMSDs was fragmented, reactive, and insufficient, with formal procedures often failing to match the responsiveness of informal peer and manager support. These findings emphasize the need for nursing leaders and hospital administrators to develop structured return-to-work pathways, protect injured nurses from financial and career penalties, and strengthen ergonomic prevention as part of workforce retention strategy. PATIENT OR PUBLIC CONTRIBUTION: No patients or members of the public were involved in the design or conduct of this study. The research focused on the professional experiences of registered nurses, who contributed as participants through one-on-one interviews and assisted in the validation of findings through member checking. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study clarifies how nurses' post-injury experiences are shaped by the gap between informal relational support and formal organizational systems. For nursing practice and management, the findings suggest that reliance on informal peer support is unsustainable and may intensify guilt, presenteeism, and risk to patient care. Standardized phased return-to-work programmes, protection from punitive performance-pay consequences, nurse-manager training, and investment in ergonomic equipment are practical steps for maintaining a healthy and stable nursing workforce. IMPACT: What problem did the study address? This study addressed the lack of in-depth qualitative evidence regarding how Chinese nurses experience and perceive organizational support following WMSDs, particularly within the context of systemic nursing shortages. What were the main findings? The study identified a 'fractured' support system where formal bureaucratic procedures often fail to recognize individual suffering, forcing nurses to rely on precarious informal networks. This inadequacy severely erodes organizational loyalty, professional identity, and significantly increases turnover intentions. Where and on whom will the research have an impact? These findings will impact hospital administrators and nursing leaders by providing a roadmap for reforming occupational health policies. It also serves as a critical reference for health policymakers to develop national guidelines for managing occupational injuries in healthcare settings.