Advances in medical and technological procedures, together with changes in demography, demand structural changes in the Nordic health care systems. Few studies have focused on employee perceptions of these structural changes. This study aims to describe employee reactions following a merger between two Norwegian hospitals. A Grounded theory approach has been used in this study. The theoretical model is based on empirical data collected from employees directly affected by the structural change process. Employee resistance was found to be the core category. Three categories were found in relation to this core category; goal uncertainty, organizational culture and individual insecurity. Different perceptions and interpretations of vaguely formulated goals lead to employee resistance. The difference between the organizational cultures in the two hospitals impeded the merger according to the project plan, and very few positive results could be seen. Individual insecurity regarding the future was experienced in connection with the implementation of structural change. The authors propose a strategy to counteract resistance in similar mergers.