Organizational Position and Structural Empowerment in Chinese Community Nursing: An Interpretive Case Study

Nurse empowerment is widely recognized for advancing professional development and job satisfaction, yet its structural dimensions remain underexplored in China's community nursing sector. Guided by Kanter's structural empowerment theory, this interpretive case study examines how formal hierarchies and informal organizational dynamics converge to shape community nurses' access to power in nonward settings. Drawing on 24 semistructured remote interviews and unstructured observations in Shenzhen, four interrelated themes were identified: (1) dual-function caregiving roles, (2) entitlement to formal power, (3) variation in informal roles, and (4) inequities in informal power. Each theme explicitly connects to core components of structural empowerment, access to supply, information, support, and opportunities, illustrating how organizational structures and interpersonal relationships jointly shape nurses' empowerment experiences. Findings reveal tensions between formal structures intended to promote empowerment and informal dynamics that sustain power asymmetries. By unpacking these layered power relations, the study offers critical insight into structural empowerment in decentralized nursing contexts and calls for both policy and managerial reforms to foster inclusive, ethically grounded organizational cultures.