At the intersection of care and command: A thematic analysis of military nurses’ experiences in a compact national defense structure

Abstract

Background Military nursing operates at the intersection of healthcare and defense, requiring nurses to balance professional ethics with military discipline, operational readiness, and organizational hierarchy. Purpose To explore how military nurses in a small defense system construct and sustain professional identities and how organizational structures and military culture shape their autonomy, competence, well-being, and family life. Methods A qualitative design using reflexive thematic analysis was employed. Nineteen individual semistructured interviews were conducted with military nurses serving in the armed forces. Discussion Seven interrelated themes demonstrated that professional identity in military nursing is dynamic, adaptive, and morally grounded, and is continuously negotiated at the intersection of care and command. Organizational hierarchy, autonomy, professional development, emotional resilience, family responsibilities, and institutional recognition shaped participants' professional experiences. Conclusion Empathetic leadership, realistic training, and policies that support work-life balance and equitable recognition are vital for well-being and operational readiness. Stronger organizational support and clearer leadership communication may enhance retention, resilience, and the quality of military healthcare.