# Military nursing in tactical pre-hospital care: structure, action, and challenges in high-risk contexts

## TL;DR

This study explores how military nurses operate in high-risk tactical pre-hospital care settings, emphasizing their training, resource management, and challenges.

## Contribution

The study applies Giddens’ Structuring Theory to analyze military nursing practices in high-risk environments, revealing new insights into their adaptive agency.

## Key findings

- Military nurses adapt practices and innovate despite rigid hierarchies.
- Key challenges include communication issues and scarcity of supplies in hostile environments.
- Institutionalizing tactical pre-hospital care requires investment in training and technology.

## Abstract

to understand, in light of Anthony Giddens’ Structuring Theory, how military nursing professionals act in tactical pre-hospital care, highlighting training, management, and care practices in risk contexts, and structural challenges that put pressure on their practice.

a qualitative, descriptive study with 15 participants recruited through chain sampling. Data collection took place between March 2023 and January 2024 using semi-structured interviews. The corpus was processed in Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires and analyzed using Descending Hierarchical Classification.

four classes emerged, organized into three axes: leadership in training; resource management in hostile environments; challenges related to communication and scarcity of supplies.

military nursing demonstrates agency by adapting practices and producing innovation even in the face of rigid hierarchical structures. Tactical pre-hospital care must be institutionalized, investing in training, technologies, and scientific production that consolidate this field as strategic for operational health.

compreender, à luz da Teoria da Estruturação de Anthony Giddens, como profissionais de enfermagem militar atuam no atendimento pré-hospitalar tático, evidenciando práticas formativas, gerenciais e assistenciais em contextos de risco, e desafios estruturais que tensionam sua prática.

estudo qualitativo, descritivo, com 15 participantes recrutados por amostragem em cadeia. Coleta ocorreu entre março/2023 e janeiro/2024 utilizando entrevistas semiestruturadas. O corpus foi processado no Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires e analisado por Classificação Hierárquica Descendente.

emergiram quatro classes, organizadas em três eixos: protagonismo na formação; gestão de recursos em ambientes hostis; desafios relacionados à comunicação e escassez de insumos.

a enfermagem militar demonstra agência ao adaptar práticas e produzir inovação mesmo diante de estruturas hierárquicas rígidas. Há necessidade de institucionalização do atendimento pré-hospitalar tático, investindo em formação, tecnologias e produção científica que consolidem esse campo como estratégico para a saúde operacional.