Aim The aim of this study was to analyze the effects of work alienation on organizational commitment, work effort and work-to-family enrichment. Background There is substantial research on the effects of work alienation on passive job performance, such as organizational commitment. However, studies analyzing work alienation on active performance, such as work effort, and outside work, such as work-to-family enrichment, are scarce. Method Two dimensions of work alienation are considered: powerlessness and meaninglessness. Hypotheses are tested using surveys collected among a national sample of midwives in the Netherlands (respondents: 790, response rate 61%). Results Findings indicate that work alienation (powerlessness and meaninglessness) influence organizational commitment, work effort and – to a lesser extent - work-to-family enrichment. High work meaninglessness, in particular, has negative effects on these outcomes. Conclusion When people feel that they have no influence in their work (hence, when they feel ‘powerless’) and especially when the feel that their work is not worthwhile (when they feel ‘meaningless’), this has substantial negative effects. Implications for nursing management Managers should increase the meaningfulness people attach to their work, thereby maintaining a high-quality workforce. Possible strategies include: 1.Improving person-job fit, 2. Developing high-quality relationships, 3. Better communicating the results people help deliver.