Organizational Culture and Nurse Commitment in Conflict-Affected Hospitals: A Focus on Empowerment in Jerusalem

Introduction In conflict-affected regions such as Palestine, nurses' organizational commitment is critical for sustaining healthcare resilience. While organizational culture shapes such commitment, its dynamics remain understudied in settings marked by geopolitical strain. This study, the first in Palestine to empirically link empowerment to affective commitment using culturally adapted instruments, examines these relationships in Jerusalem hospitals, integrating geopolitical realities into organizational frameworks. Objective To assess how organizational culture dimensions (bureaucratic, innovative, supportive, empowerment) predict commitment types (affective, continuance, normative) in Palestinian hospitals, with a focus on empowerment's role in mitigating systemic challenges unique to conflict zones. Methods A cross-sectional study was conducted across five Jerusalem hospitals (October 2024–January 2025) using convenience sampling. Data from 302 nurses (94.4% response rate) were collected via validated scales culturally adapted through translation, back-translation, and pilot testing (N = 40). The 36-item Organizational Culture Scale and 24-item Organizational Commitment Scale employed 5-point Likert responses (1 = strongly disagree; 5 = strongly agree). Analyses included Pearson's correlations and regression modeling. Results Organizational culture significantly predicted commitment (B = 0.214, p = 0.001), explaining 57.8% of variance. Empowerment emerged as the strongest cultural driver of affective commitment (M = 3.63), while bureaucratic practices showed the weakest association (M = 3.38). Years of experience significantly predicted commitment (B = 0.570, p < 0.001), with mid-career nurses (6–15 years) exhibiting the strongest ties to workplace culture. Recommendations Hospitals should prioritize empowerment (e.g., autonomy in decision-making) and reduce bureaucratic barriers through digital tools to strengthen affective bonds. Retention strategies must address career-stage needs, particularly for mid-career nurses. These findings advocate for context-specific retention strategies tailored to the unique challenges of conflict-affected healthcare systems. Future studies should employ longitudinal designs to unravel causal pathways and validate conflict-specific adaptations of organizational frameworks.