The increasing volume of unstructured textual data in healthcare, particularly in nursing care reports, presents both challenges and opportunities for enhancing patient care and operational efficiency. This study explores the application of Latent Dirichlet Allocation (LDA) topic modeling to analyze free-text nursing narratives from inpatient stays in three different clinics, aiming to uncover the latent thematic structures within. Utilizing the R programming environment and the visualization tool LDAvis, we identified three main themes: “Patient Well-being,” “Patient Mobility and Care Activities,” and “Treatment and Pain Management,” the latter combining two closely related but initially distinct topics due to their overlapping content. Our findings demonstrate the potential of LDA topic modeling in extracting meaningful insights from nursing narratives, which could inform patient care strategies and healthcare practices. However, the study also highlights significant challenges associated with the method, including the sensitivity to parameter settings, the lack of updates for key software packages, and concerns about reproducibility. These issues highlight the need for meticulous parameter validation and the exploration of alternative text analysis methodologies for future research. By addressing these methodological challenges and emphasizing the importance of comparative method analysis, this study contributes to the advancement of text analytics in healthcare. It opens avenues for further research aimed at developing more robust, efficient, and accessible tools for analyzing free-text data, thereby enhancing the ability of healthcare professionals to use unstructured data to improve decision making and patient outcomes.