A Grounded Theory of Nursing Resilience in Conflict-Affected Healthcare Settings in North East Nigeria

Background: Nurses in conflict-affected regions of Nigeria's North East operate under extreme duress including displacement, resource scarcity, and occupational trauma. A theoretical understanding of how nursing resilience is constructed and sustained in these conditions is absent from the literature. Aim: This study developed a substantive grounded theory of nursing resilience in conflict-affected healthcare settings in Borno and Adamawa States. Methods: A constructivist grounded theory design used theoretical sampling to recruit 32 nurses practising in displaced persons camp clinics and conflict-zone hospitals. Concurrent data collection through in-depth interviews and observation, constant comparative analysis, and theoretical saturation guided the inquiry. Results: The core category identified was adaptive professional re-anchoring, describing nurses' iterative process of reconstructing professional identity and purpose through communal solidarity, spiritual grounding, role flexibility, and selective disengagement. Three interacting conditions, namely institutional abandonment, community reliance, and moral witnessing, were identified as context-specific resilience shapers. Conclusion: This grounded theory offers the first formal theoretical model of nursing resilience under conflict conditions in Nigeria. Implications include conflict nursing education modules, peer support policy frameworks, and recognition of community-embedded resilience in nursing workforce policy. Keywords: nursing resilience, grounded theory, conflict, North East Nigeria, occupational trauma.