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Learn more: PMC Disclaimer | PMC Copyright Notice Int Nurs Rev . 2026 Apr 12;73:e70177. doi: 10.1111/inr.70177 Search in PMC Search in PubMed View in NLM Catalog Add to search Health and Well‐Being of Military Nurses in High‐Reliability, High‐Stress Environments: A Qualitative Study in the Slovenian Armed Forces Zlatko Kvržić Zlatko Kvržić 1 Department of Nursing, Slovenian Armed Forces, Military Medical Unit, Šentvid, Ljubljana, Slovenia Find articles by Zlatko Kvržić 1 , Mirko Prosen Mirko Prosen 2 University of Primorska, Faculty of Health Sciences, Izola, Slovenia Find articles by Mirko Prosen 2, ✉ Author information Article notes Copyright and License information 1 Department of Nursing, Slovenian Armed Forces, Military Medical Unit, Šentvid, Ljubljana, Slovenia 2 University of Primorska, Faculty of Health Sciences, Izola, Slovenia ✉ Corresponding author. Received 2025 Nov 28; Accepted 2026 Mar 18; Issue date 2026 Jun. © 2026 The Author(s). International Nursing Review published by John Wiley & Sons Ltd on behalf of International Council of Nurses. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. PMC Copyright notice PMCID: PMC13071344 PMID: 41968623 ABSTRACT Aim To investigate how female military nurses experience high‐reliability, high‐stress environments and how these conditions shape their well‐being. Background Military nursing involves complex demands that extend beyond clinical care, including dual professional roles, operational unpredictability, and gendered expectations. These pressures can undermine physical, psychological, and social well‐being, yet the lived experiences of military nurses, particularly women, remain underexplored. Design A qualitative descriptive design was used. Methods Ten female military nurses were recruited through purposive sampling and interviewed individually in semi‐structured online interviews. Data were analysed using qualitative content analysis. Trustworthiness was ensured through reflexive coding, an audit trail, and adherence to COREQ guidelines. Results Five overarching categories captured the factors shaping well‐being: organisational and structural demands; high‐stress operational environments; emotional and psychological burden; coping and resilience; and gendered identity and work–family balance. Participants described constrained autonomy, communication gaps, and role ambiguity within hierarchical structures. Psychological pressures were heightened by moral tensions, responsibility for colleagues, and expectations of emotional control. Coping relied mainly on informal peer support, as formal services were rarely used due to stigma. Gendered norms and family responsibilities further influenced well‐being and career decisions. Conclusion Military nurse well‐being is shaped less by individual resilience and more by organisational culture, operational demands, and gendered expectations. Addressing these systemic factors is essential for sustaining the military nursing workforce. Implication for Nursing Strengthening leadership support, communication, psychological safety, and professional autonomy may improve working conditions and support nurses’ well‐being in demanding operational contexts. Implications for Health Policy Policies should promote supportive organisational cultures, reduce stigma around help‐seeking, and facilitate work–family reconciliation to sustain and retain the military nursing workforce. Keywords: military medicine, occupational health, psychological stress, qualitative research, work–family conflict, work environment 1. Introduction Nurses working in high‐risk, rapidly changing environments face increasing pressures that threaten their physical, psychological, and social well‐being. Global research consistently shows rising levels of burnout, compassion fatigue, and workforce attrition linked to excessive workloads, chronic understaffing, and emotionally demanding patient care (Jin et al. 2025 ). These challenges are intensified in settings where clinical decision‐making carries heightened operational consequences, errors are less tolerated, and organisational cultures demand constant vigilance and uninterrupted readiness. In such contexts, nurse well‐being has become both a professional priority and a strategic concern, directly affecting quality of care, patient safety, and workforce sustainability (Flood and Keegan 2022 ; Jin et al. 2025 ). Military nursing represents one of the most demanding and high‐reliability environments in contemporary healthcare. In this study, the term high reliability refers to healthcare work carried out in complex, high‐risk settings where errors have serious consequences and sustained performance under pressure is essential. High‐reliability organisations are typically characterised by continuous risk awareness, sensitivity to operations, and a strong emphasis on safety and error prevention (Murray et al. 2024 ; Duplechan 2024 ). Although military systems, as a whole, may not fully exhibit all characteristics of high‐reliability organisations, such as organisational flexibility, deference to expertise, or a learning‐oriented safety culture, the concept is applied here specifically to the healthcare functions within military structures, where healthcare is delivered under conditions of high uncertainty, operational risk, and limited resources. In this study, the concept of high‐reliability is used as an analytical lens to examine the nature of healthcare work within the military context, rather than as a formal organisational classification of the Slovenian Armed Forces. Nurses in the armed forces must function within rigid hierarchical structures, frequently operate in unpredictable conditions, and provide care in situations of acute trauma, mass casualties, and resource scarcity (Mani et al. 2024 ). The pressures of deployment, the emotional toll of exposure to conflict‐related injuries, and the continuous need to transition between civilian and military roles contribute to a uniquely complex psychological landscape. Sadhaan et al. ( 2022 ) found that military and conflict‐related nurses experience significant emotional and physical strain both before and after deployment, characterised by stress, anxiety, grief, and long‐term mental health difficulties. These strains are not episodic; rather, they accumulate across repeated cycles of readiness, deployment, and reintegration, creating an enduring burden on well‐being (Ma et al. 2021a ). Within military structures, the pressures affecting nurses are shaped not only by clinical demands but also by the operational culture and organisational expectations of the armed forces. Jin et al. ( 2025 ) demonstrate that strict military management, limited autonomy, and ‘serious’ organisational climates undermine psychological empowerment and contribute to burnout among military hospital nurses. Positive work environments and supportive leadership, by contrast, strengthen empowerment and significantly improve intent to stay, suggesting that organisational support is a critical determinant of well‐being (Chargualaf et al. 2025 ; Ein et al. 2024 ; Jin et al. 2025 ). Similarly, Sadhaan et al. ( 2022 ) emphasise that nurses’ capacity to cope with deployment‐related stress depends greatly on pre‐deployment preparation, access to equipment and training, and the availability of debriefing and post‐deployment psychological support. The gendered nature of military institutions adds another layer of complexity. Although women are increasingly represented in the armed forces, they remain a minority in many military health units and often navigate expectations stemming from historically male‐dominated structures. Roche et al. ( 2020 ), for example, reported that female military officers experience pronounced psychological distress arising from the dual pressures of leadership and caregiving roles, often describing a ‘double bind’ in which professional demands collide with expectations associated with motherhood and family life. Spanner ( 2020 ) argues that military cultures continue to rely on traditional gender norms, both within the organisation and in surrounding military family structures, reinforcing forms of invisible emotional and domestic labour that disproportionately fall on women. In the context of military nursing, where most nurses are women but the institutional hierarchy is predominantly male, this creates unique tensions between professional identity, operational expectations, and personal well‐being. Despite growing recognition of these challenges, the lived experiences of military nurses, particularly women, remain under‐represented in empirical research. Existing studies tend to focus on professional domains such as competency development, psychological preparedness, and workforce outcomes (Flood and Keegan 2022 ; Jin et al. 2025 ; Mani et al. 2024 ; Ma et al. 2020 , 2021a , 2021b , 2022 ), leaving limited insight into how military nurses themselves understand and manage the pressures embedded in everyday high‐reliability military settings. Little is known about how organisational culture, gendered expectations, and operational demands intersect to shape women's well‐being, or how nurses mobilise coping strategies and support networks within the constraints of military structures. This gap is particularly notable given that well‐being is closely linked not only to individual resilience but also to collective practices, leadership approaches, and institutional conditions. The purpose of this study was to explore how military nurses experience and manage the pressures of high‐reliability, high‐stress environments. By examining organisational demands, operational unpredictability, and emotional burdens, the study aimed to identify the factors shaping nurses’ physical, psychological, and moral well‐being. It also examined coping strategies and support systems that foster resilience. The main research question guiding the study was: How do military nurses experience and navigate the challenges that affect their health and well‐being in high‐reliability, high‐stress military environments? 2. Methods 2.1. Study Design A qualitative descriptive design was used, as it provides a pragmatic and low‐inference approach suitable for studies aiming to present a clear and direct account of participants’ experiences (Neergaard et al. 2009 ; Sandelowski 2000 ). This design was appropriate because the study aimed to describe how military nurses understand and manage pressures in high‐reliability, high‐stress environments without imposing a priori theoretical interpretations. In line with qualitative description, data were collected through in‐depth semi‐structured interviews, which allow participants to recount events in their own words and enable the researcher to explore emerging issues in detail (Kim et al. 2017 ; Sandelowski 2000 ). 2.2. Study Setting and Recruitment The defence system of the Republic of Slovenia consists of the Slovenian Armed Forces (SAF) and the non‐military component, which provides civil capabilities and support to the SAF and allied forces. As of November 2025, the SAF comprises 6,492 active personnel. Women represent 17.8% of the force, reflecting the organisation's commitment to gender equality. Military nursing in Slovenia is primarily embedded within the Military Medical Unit (MMU), the central structure responsible for delivering medical and veterinary support across the SAF. The MMU operates according to the principles of military medicine and provides first‐level medical care, emergency support, preventive health services, training, medical logistics, and deployable capabilities such as the Role 2 Basic Land military treatment facility. Through its medical, logistical, epidemiological, and veterinary components, the MMU ensures health protection and operational medical support for SAF personnel at home and during international deployments (Slovenian Army 2025 ). Although the total number of military nurses within the SAF is relatively small, the study sample represents a substantial proportion of nurses with active operational experience within the MMU. Given the gendered nature of military institutions and the historical under‐representation of women in uniformed structures, the study focused exclusively on female military nurses to explore their specific experiences and highlight gender‐specific challenges within military healthcare environments. Participants were recruited through purposive sampling, ensuring that all interviewees met predefined inclusion criteria related to gender (woman), role (nurse), experience (at least one year), and service (actively serving) within the SAF medical system. Before data collection, all participants were fully informed of the study's aims and objectives and gave consent to participate. A total of ten female military nurses were interviewed. Recruitment was guided by the concept of information power rather than by saturation. Data collection was continuously evaluated, and recruitment ended when the sample provided sufficient information power, as reflected in the richness, relevance, and specificity of the data in relation to the study aim (Malterud et al. 2016 ). This was supported by the participants’ high level of sample specificity and extensive professional experience, which yielded in‐depth, information‐rich accounts. 2.3. Data Collection Data were collected between April and May 2025 through individual semi‐structured interviews conducted online via Zoom. All interviews were conducted by the second author, who is a civilian researcher, a trained nurse specialising in women's health, and a sociologist by education. The second author holds a PhD and is not employed by the SAF, nor does he have any formal or hierarchical relationship with the participants, which supported an independent and non‐military interviewing position. Before each interview, participants received written information about the study and provided written informed consent. They also completed a short questionnaire capturing demographic and service‐related characteristics. The interview guide ( Supplement S2 ) was developed based on relevant literature, the central aim of the study, and contextual insights provided by the first author, who holds a Master's degree in nursing and is employed within the MMU of the SAF. The first author did not participate in data collection and had no direct contact with participants during the interview phase. Interviews lasted between 30 and 47 minutes, depending on the depth of participants’ narratives. All interviews were audio‐recorded and transcribed verbatim immediately after completion. No participants withdrew from the study. 2.4. Data Analysis Data were analysed using qualitative content analysis, guided by Bengtsson ( 2016 ) and Graneheim et al. ( 2017 ). All interviews were transcribed verbatim and analysed in Slovenian, enabling the researchers to work closely with participants’ original expressions. The analysis was conducted in NVivo 1.7.2 (QSR International) to support systematic organisation of codes and categories. Both authors independently read the transcripts several times to familiarise themselves with the material before identifying and coding meaning units inductively. During coding, repeated cycles of comparison and refinement ensured that the categories accurately reflected the data. Codes with similar content were condensed and organised into subcategories and broader categories, with attention to internal consistency and clear distinctions between categories (Graneheim et al. 2017 ). The authors then jointly reviewed and discussed the developing analytical framework until they reached agreement on the structure and interpretation of categories and themes. Once consensus was achieved, the final conceptual model was translated into English for reporting. 2.5. Rigour and Trustworthiness To ensure the rigour and trustworthiness of the study, we followed Lincoln and Guba's ( 1989 ) criteria of credibility, dependability, confirmability, authenticity, and transferability throughout the research process. Credibility was supported through purposive sampling of participants with direct and relevant experience, careful development and piloting of the interview guide, and prolonged engagement with the data. Credibility and reflexivity were further strengthened by deliberately separating the military organisational structure from the data collection process, which reduced the likelihood of hierarchical influence, coercion, or socially desirable responses in a rigid military context. Researcher positionality and potential power dynamics were continuously reflected upon during data collection and analysis. As the first author is employed within the military medical system, reflexive discussion was maintained throughout the analytic process to consider how professional familiarity with the context might shape interpretation of the data. Dependability was strengthened by maintaining a transparent decision trail and involving both authors in the iterative coding, categorisation, and theme refinement process to enhance interpretive consistency. Confirmability was ensured by grounding all analytical decisions in participants’ accounts, systematically linking interpretations to data excerpts, and documenting analytic decisions in NVivo as memos. Transferability was enabled by providing a rich description of the SAF context, participant characteristics, and the study setting, allowing readers to assess applicability to other contexts. Authenticity was promoted by presenting diverse perspectives and retaining the nuance of participants’ voices throughout the narrative. The reporting of findings followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) to ensure transparency and methodological rigour (Tong et al. 2007 ). 3. Findings The study included ten female military nurses serving in the SAF. Their average age was 43.5 years, and all were mothers. Three participants had one child, six had two children, and one had three children. Regarding educational background, four had completed vocational nursing education, four held a Bachelor's degree in nursing, and two had completed a Master's degree. Participants reported long professional careers in healthcare, with an average of 22 years of clinical experience and an average of 17 years of service within the SAF. All had completed additional training within the military system or the broader healthcare sector. In addition to their nursing duties, all held an official military rank and performed roles within the organisational structure of the SAF medical system. They were employed across different military healthcare settings, and all were active‐duty personnel at the time of data collection. Operational experience was a defining feature of the sample. All had been deployed at least once, and most had extensive experience with shift work, field duties, emergency activations, and other forms of irregular or high‐demand work inherent to military service. The content analysis identified five central categories (Figure 1 ). These categories reflect the structural, operational, psychological, supportive, and identity‐related dimensions of their work ( Supplement S1 ). The concept of categories and subcategories indicates that well‐being is not determined by any single factor but results from the cumulative influence of institutional conditions, the nature of military work, and the personal and social contexts in which military nurses live and serve. FIGURE 1. Open in a new tab Overview of categories and subcategories illustrating the interconnected domains shaping military nurses’ well‐being. Note. The figure represents a descriptive thematic overview and does not imply causal relationships. 3.1. Organisational and Structural Demands in Military Nursing Participants described the military system as a complex organisational environment that frequently constrained their autonomy and challenged their professional identity. Structural pressures were embedded in their daily work, particularly through fragmented communication, inconsistent procedures, and a command hierarchy that often overshadowed clinical judgement. Several participants highlighted how organisational processes created uncertainty and additional workload, noting that ‘everything moves through the chain of command, so decisions are slow, and you carry all the responsibility in the meantime’. These pressures were intensified by staffing shortages, administrative burden, and sudden changes in operational expectations, contributing to a sense of organisational strain. Alongside these structural demands, participants described the persistent tension of navigating dual professional identities. Many felt positioned ‘between two worlds’, expected to adhere simultaneously to military discipline and nursing standards. As one participant put it, ‘Being in two structures at once creates grey areas. I'm not always clear where my responsibilities begin or end’. This ambiguity complicated their ability to advocate for nursing practice within a system that prioritised hierarchy over clinical expertise. Participants often struggled to justify professional decisions to non‐clinical superiors, describing situations where ‘you have to explain basic nursing logic to people who don't understand healthcare at all’. The dual‐role expectations also influenced their sense of professional visibility. Several participants felt that nursing was undervalued within the military structure, where they were ‘seen first as soldiers, and only then as nurses’. This invisibility reinforced perceptions of limited influence in organisational decision‐making, particularly when commanders with no clinical training made decisions affecting patient care and service processes. Despite functioning as specialists and educators within their units, many participants described inconsistent recognition of their expertise across commands and units, further intensifying role conflict. 3.2. Demands of High‐Reliability and High‐Stress Operational Environments Participants repeatedly emphasised the physical intensity of fieldwork, describing conditions that require both endurance and improvisation. Working environments were often harsh and unpredictable, marked by extreme weather, unstable terrain, and limited resources. As one participant explained, ‘In the field you can't rely on ideal conditions, so flexibility becomes part of your routine’. Others noted that compared to civilian healthcare, military settings require sustained physical strength: carrying heavy gear, walking long distances, and performing complex procedures under demanding conditions. The weight of equipment, the pace of activities, and the constant movement contributed to cumulative fatigue, yet participants viewed this as an inseparable part of the profession. Accompanied by these physical pressures, nurses faced operational unpredictability, where routine tasks could shift suddenly into emergency care. Several participants described abrupt activations, unexpected deployments, and rapid transitions from administrative duties to crisis response. One participant recalled being called with minimal notice to relocate an entire mobile hospital: ‘On Saturday they called … by five in the afternoon we all had to be at the barracks. By Monday the hospital was ready for the first patient’. Such scenarios reflect how readiness is not a theoretical expectation but a lived and recurring reality. Nurses must function effectively even when information is incomplete, resources are scarce, or structures are still being assembled. Training helped prepare them, yet many emphasised that simulations fall short of real‐world complexity. ‘Training is predictable, while the real world isn't. Out there, situations fall apart in ways drills never prepare you for’, one participant observed. This gap between rehearsed crises and actual field conditions generated both uncertainty and motivation to seek continuous learning. Experiences on missions were widely described as transformational, building independence and strengthening clinical judgement. As another nurse put it, ‘When I'm on a mission, the boundaries of my job shift. I act more autonomously and feel a greater sense of responsibility’. Despite these pressures, participants regarded high‐stress operational environments as central to their professional identity. The expectation of readiness, the capacity to respond under pressure, and the ability to adapt to diverse and sometimes dangerous settings were seen as markers of competence and pride. For many, the unpredictability of military work was not only a challenge but also a source of meaning: a reminder that their role carries weight, responsibility, and purpose beyond routine healthcare provision. 3.3. Emotional and Psychological Burden of Military Nursing Participants described the emotional and psychological burden of military nursing as a constant undercurrent shaping their daily work and overall well‐being. Rather than arising solely from clinical situations, strain emerged from the interplay of organisational pressures, operational unpredictability, moral responsibility, and the expectations embedded in military culture. Many nurses spoke of cumulative emotional fatigue, noting that stress did not necessarily come from providing care but from the broader institutional environment. As one participant explained, ‘It's not the scope of the healthcare that exhausts me […] it's everything around it’. This sense of overload was intensified by the need to maintain alertness and composure, even when facing administrative unpredictability, shifting responsibilities, or prolonged periods of high demand. Several noted that emotional recovery became increasingly difficult over time, describing how repeated pressures left lasting effects. One participant reflected, ‘When stress comes in waves, it takes me longer to recover each time’. In addition, participants described deep moral tensions stemming from navigating the values of nursing within the discipline of the armed forces. Situations in which clinical judgement conflicted with military command were particularly challenging, prompting feelings of discomfort, frustration, or ethical uncertainty. A participant summarised: ‘Medically, the right action is obvious, but the directives we get don't always follow that logic’. The weight of responsibility, especially in life‐and‐death situations or when caring for injured colleagues, added another layer to this burden. Nurses often felt personally accountable for outcomes, even when circumstances were beyond their control. Personal identity and emotional investment also contributed to this complexity. For many, the sense of duty towards the team coexisted with responsibilities at home, leading to internal conflict and guilt during deployments or extended absences. As one participant shared, ‘My family expects me to be present, my unit relies on me too, and being stretched between the two is emotionally exhausting’. Emotional withdrawal, numbness, or a deliberate effort to ‘switch off’ were described as protective strategies used to cope with the intensity of these experiences. Yet, despite these challenges, participants remained deeply committed to their role, drawing meaning and strength from their contribution to military service. 3.4. Coping, Resilience, and Support Systems Participants described coping and resilience as essential to functioning within the demanding and unpredictable environment of military nursing. Their narratives indicated that well‐being was maintained through a combination of personal coping strategies, informal support networks, and selective use of organisational resources. These approaches were often interwoven, reflecting a flexible and pragmatic approach to managing stress in a system where emotional control, physical readiness, and reliability are highly valued. Many participants identified personal coping strategies as their primary means of maintaining balance. Physical activity, time outdoors, and structured routines were commonly mentioned as grounding practices. One participant emphasised the restorative effect of movement, noting, ‘For me, nature is the best medicine. I calm down as soon as I go for a walk’. Others described the importance of disconnecting from military obligations during off‐duty hours, using rest or solitude to re‐establish emotional stability. At times, coping involved intentionally withdrawing from distressing stimuli or limiting exposure to tension at work. As another participant explained, ‘Sometimes you just distance yourself because you have to protect your own nerves’. These strategies were not signs of disengagement but deliberate efforts to preserve energy and remain effective in high‐pressure situations. Alongside these individual practices, social and collegial support emerged as a central protective factor. Participants consistently described peers as the most reliable and trusted source of emotional relief. Everyday conversations, humour, and shared reflection created a sense of safety and understanding that was difficult to find elsewhere. One participant expressed this openly: ‘We open up to one another when it gets heavy; that's how we cope’. Team cohesion was described as both an emotional anchor and a practical necessity, helping nurses manage the intensity of their responsibilities while strengthening their sense of belonging. Informal peer support provided an immediate response to stress, in contrast to formal services, which were often considered less accessible or less aligned with military culture. Although psychological services were available within the organisation, participants expressed mixed feelings about using them. Some appreciated the presence of trained professionals, while many voiced concerns about privacy, trust, or potential stigma. As one participant noted, ‘There's a hotline for support, but I hesitate to use it. I'm not certain how protected my privacy really is’. Instead, nurses tended to rely on colleagues or family members, especially partners, who were frequently described as important emotional buffers. The interplay between institutional structures and informal relationships shaped a coping culture that prioritised collective strength but often placed the burden of emotional support on peers rather than formal systems. 3.5. Gendered Identity, Work–Family Balance, and Professional Meaning Across interviews, participants described a subtle but persistent need to validate their competence in environments where military culture still operates through masculine norms. Women frequently felt judged by gendered assumptions. As one participant put it plainly, ‘When a woman joins the army, they don't see the middle ground—either you're ‘one of the boys’ or you're looking for a boyfriend’. Some spoke of being initially tested or underestimated, noting that credibility had to be earned through stamina, communication, and professional capability. Yet they also emphasised that once accepted, the team dynamic was strong, and mutual respect grew from shared hardship and responsibility. Work–family balance emerged as a central struggle, especially for those with young children or partners also employed in the armed forces. Participants described a lifestyle marked by constant coordination, unpredictability, and long absences. Missions, extended exercises, and irregular schedules placed pressure on household routines, emotional availability, and childcare. One participant explained the strain directly: ‘You get used to being alone for months, but the children don't understand why you're here one day and gone the next’. Several highlighted the emotional burden of maintaining stability at home while remaining operationally ready, noting that guilt was a pervasive undercurrent: guilt for leaving, guilt for missing milestones, and guilt for not being fully present even when physically at home. Despite these tensions, many participants described military nursing as a source of deep purpose, pride, and identity. The uniform itself was seen as a symbol of service, discipline, and contribution to national safety. One participant stated, ‘I enjoy my work and teammates, and serving is something that genuinely makes me proud’. Others stressed the ethical dimension of their work, blending their humanitarian commitment with loyalty to the defence system. Deployment, in particular, was described as transformative, enhancing confidence, independence, and professional meaning. As one participant reflected, ‘During deployments I often have to take initiative on my own, and that responsibility strengthens my skills and confidence in a way that regular duties never could’. While participants described these challenges from a gendered perspective, it is recognised that experiences such as work–family strain, guilt related to absence, and missed milestones may also occur among male military nurses. However, participants’ accounts emphasise how these experiences are shaped and intensified by gendered expectations and norms within a predominantly male military culture. 4. Discussion In this study, the concept of high reliability is used as an analytical lens to understand the pressures associated with healthcare work conducted within military structures, rather than as a formal organisational classification of the SAF. The findings indicate that nurse well‐being is shaped by a complex interplay of organisational structures, operational demands, psychological pressures, and gendered expectations. While several of these issues reflect challenges documented in civilian nursing, the military context amplifies their intensity and frequency, creating a distinctive set of risks to physical, psychological, and social well‐being. Participants described organisational systems that often constrained clinical autonomy, limited role clarity, and generated inefficiencies. Fragmented communication, slow decision‐making, and the dominance of command structures over clinical judgement produced ongoing strain and eroded nurses’ sense of control. These findings are consistent with a growing body of research demonstrating that structural factors, rather than individual resilience alone, play a central role in shaping nurse well‐being (Flood and Keegan 2022 ; Jin et al. 2025 ). Evidence shows that low empowerment, rigid organisational climates, and restricted decision‐making authority significantly contribute to burnout and emotional exhaustion among both military and civilian nurses (Loi et al. 2023 ; Şenol Çelik et al. 2024 ; Zhang et al. 2018 ). The high‐intensity nature of military operations also emerged as a major determinant of well‐being. Nurses described sudden deployments, rapid mobilisation, extended fieldwork, and unstable working conditions as routine aspects of their role. Such unpredictability required constant readiness and placed continuous strain on physical and emotional resources. Similar stressors have been identified in research on nurses’ health in trauma, disaster, and emergency settings, where operational unpredictability is associated with cumulative fatigue, sleep disturbance, and reduced psychological well‐being (Ein et al. 2024 ; Mani et al. 2024 ; Park et al. 2025 ; Shubayr 2025 ). Some participants viewed deployment as an opportunity for professional growth; however, the broader pattern reflected the health consequences of sustained high demand. The combination of heavy gear, harsh weather, and irregular working hours characterises the physical dimension of well‐being in the military workforce (Day et al. 2025 ), a dimension often overlooked in traditional well‐being frameworks. Psychological well‐being was significantly affected by the emotional and moral pressures inherent in military nursing (Park et al. 2025 ). Participants described cumulative stress arising not only from patient care but also from the wider institutional environment, administrative unpredictability, the weight of responsibility, and expectations of emotional control. These findings are similar to studies on military and humanitarian nurses, which show that repeated exposure to high‐stakes clinical situations and organisational instability increases the risk of stress, emotional fatigue, and reduced quality of life (Ma et al. 2021a ; Sadhaan et al. 2022 ; Zhang et al. 2018 ). Moral tension, particularly when military directives conflicted with nurses’ clinical or ethical judgement, emerged as a critical influence on well‐being. This aligns with evidence that moral injury and ethical strain are increasingly recognised as central threats to nurse mental health across settings, including disaster response, emergency care, and conflict zones (Day et al. 2025 ; Ein et al. 2024 ; Park et al. 2025 ). The present study demonstrates that such tensions are not isolated events but recurring stressors that shape nurses’ longer‐term psychological well‐being. Participants relied heavily on informal support from peers, described as the most accessible and trustworthy form of emotional protection. Collegial solidarity and shared humour played key roles in mitigating stress, consistent with literature identifying workplace social support as one of the strongest buffers against burnout in nursing (Chargualaf et al. 2025 ). However, reluctance to use formal psychological services due to stigma, confidentiality concerns, or cultural expectations highlights limitations in existing well‐being structures. This reflects broader evidence that formal mental health services remain under‐used in military settings, even when the need for support is high (Cramm et al. 2020 ). As the study focused on female military nurses, the findings illuminate how women's experiences of well‐being are shaped by their position within a traditionally male‐dominated military environment. Participants frequently encountered the need to prove competence in such environments, consistent with evidence that military women often navigate gendered assumptions affecting both psychological safety and career progression (Roche et al. 2020 ; Spanner 2020 ). In addition, work–family conflict was one of the most significant determinants of well‐being. Nurses described the emotional strain of balancing caregiving responsibilities with the unpredictability of military operations, reflecting patterns seen internationally among military women who disproportionately shoulder domestic labour (Cramm et al. 2020 ; Spanner 2020 ). These dual‐role expectations not only intensify stress but also shape decisions about career longevity and deployment willingness, issues central to workforce sustainability. 4.1. Study Limitations This study has several limitations. The sample consisted only of female military nurses from a single national context, which may limit transferability to mixed‐gender settings or other armed forces. In addition, as all participants were mothers, findings related to work–family balance may reflect a specific life‐stage perspective and may not represent the experiences of women without children or of male military nurses. As participation was voluntary, the sample may reflect both self‐selection by those motivated to share their experiences and the absence of individuals experiencing the most severe levels of strain who may have lacked the capacity to participate. The study relied on self‐reported experiences, which may have been influenced by recall or social desirability. Although a qualitative descriptive approach allowed for detailed accounts, it offers a limited scope for deeper theoretical interpretation. Finally, the findings reflect a specific organisational period, and experiences may change with shifts in military structure, training, or deployment patterns. Although participants described moral strain, guilt, and emotional burden, the study did not aim to assess clinical post‐traumatic conditions such as PTSD or complex PTSD, and no diagnostic assessment of trauma‐related disorders was conducted. 4.2. Implications for Nursing and Health Policy The findings highlight the need for multi‐level organisational strategies to strengthen nurse well‐being in military settings by addressing clinical practice, leadership, and policy frameworks simultaneously. Implications for nursing practice include strengthening professional autonomy and role clarity within military healthcare structures. Clearer communication pathways between military nursing staff and military command, consistent leadership support, and protected opportunities for clinical decision‐making are essential to reduce role ambiguity and moral strain. Practice environments should facilitate structured peer support mechanisms, regular debriefings after high‐intensity operational activities, and access to confidential psychological support perceived as safe and non‐punitive. Recognising informal peer support as a key protective factor, organisations should legitimise and support team‐based coping practices rather than relying solely on individual resilience. Implications for nursing leadership and policy point to the importance of fostering psychologically safe organisational cultures within rigid hierarchical systems. Policies should explicitly address stigma related to help‐seeking, ensure confidentiality of mental health services, and clearly separate clinical evaluation from psychological support pathways. Leadership development programmes for military commanders and senior military nursing staff should include training in supportive leadership, ethical decision‐making, and interprofessional communication. Given the strong influence of work–family conflict on well‐being, workforce policies should incorporate work–family reconciliation measures, including predictable scheduling where operationally feasible, flexible deployment planning, and formal recognition of caregiving responsibilities, particularly for women in uniformed roles. Future recommendations and research directions include examining well‐being across different ranks, genders, professional roles, and service branches to better understand how organisational position and career stage shape experiences of strain and resilience. Longitudinal research is needed to explore how repeated cycles of readiness, deployment, and reintegration affect well‐being over time. Future studies should also evaluate the impact of organisational reforms, leadership interventions, and well‐being policies on nurse retention, psychological safety, and quality of care. These lines of inquiry could be further informed by established occupational health frameworks, such as the Job Demands–Resources model (Bakker and Demerouti 2017 ), to systematically examine the balance between organisational demands, available resources, and well‐being outcomes in military nursing contexts. Strengthening collaboration between military nursing management and military command structures may support more sustainable, ethically grounded, and health‐promoting working conditions for military nurses. 5. Conclusion This study provides new insight into how structural, operational, psychological, and cultural factors intersect to shape the well‐being of military nurses working in high‐risk environments. It demonstrates that well‐being is not a function of individual resilience alone, but is shaped by institutional conditions, organisational culture, gendered norms, and the nature of the work itself. These insights support international calls for system‐level interventions, leadership development, and structural reform to improve nurse well‐being and workforce retention across diverse care settings, including military health systems. Author Contributions Zlatko Kvržić : Conceptualisation, data collection, methodology, data analysis, data curation, validation, writing – review and editing. Mirko Prosen : Conceptualisation, data collection, data analysis, data curation, writing – original draft. Funding The authors have nothing to report. Ethics Approval Ethical approval was obtained from the Commission of the University of Primorska for Ethics in Human Subjects Research (Approval No: 4264‐16‐3/2022). In addition, the permission to conduct the study within the Slovenian Armed Forces was granted by the Ministry of Defence of the Republic of Slovenia, Command for Doctrine, Development, Education and Training (Document No: 603–58/2025‐28, 31 March 2025). Participation was voluntary, and all participants received information about the study before providing written informed consent. Confidentiality and anonymity were ensured, and participants were free to withdraw at any time. Conflicts of Interest The authors declare no competing interests. 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