The aim of this paper was to explore nurses' stress experiences of working under the current health care system in Taiwan using a qualitative approach. A grounded theory approach was used to collect the data from a sample of 28 critical care nurses from seven hospitals in Taiwan. Data were analysed using a multii-step analytic procedure, based on the approaches of Glaser, Chesler and Strauss and Corbin. The health care system changes were found to increase critical care nurses' occupational stress and work dilemmas. For the purpose of this study, two categories that emerged in the context component of the paradigm model are investigated. They were hospital reorganisation and cultural burden of the nurses' role. The findings indicated that hospital organisational changes and people's own belief of the nurse's role were recognised as the environmental pressures which increase critical care nurses' occupational stress. Cultural background may play an important role in influencing nurses' work atmosphere and their ways of being seen.