The study, which screened records through September 2026, identified fifteen primary studies conducted between 2019 and 2026. These studies were conducted in various regions, including Aseer, Dammam, Hail, Riyadh, and Jazan. The central finding of the review is that the existing evidence is methodologically uneven and heterogeneous, precluding the creation of a single, reliable national prevalence estimate for burnout in this specific workforce.
The review focused on registered nurses employed in hospital emergency departments within Saudi Arabia. It excluded studies that pooled nurses with other professionals unless nurse-specific data could be extracted. The researchers sought to understand which studies met this eligibility rule, what outcomes and measures were reported, and what gaps remain in the literature. This focused approach was necessary because previous reviews of critical care nurses could not be assumed to apply to emergency departments, which have distinct patient flow, triage demands, and exposure to episodic trauma.
The methodology followed the Arksey and O’Malley framework with subsequent refinements, and reporting was informed by PRISMA-ScR guidelines. A systematic search was conducted across five electronic databases, including PubMed/MEDLINE and CINAHL Complete. The search combined controlled vocabulary and free-text terms to capture studies on burnout, occupational fatigue, stress, anxiety, depression, and sleep disturbance. The review did not register its protocol prospectively, a limitation the authors acknowledge, meaning methodological decisions may have evolved during the conduct of the review.
Among the fifteen included studies, ten used cross-sectional survey designs, one used a cross-sectional predictive analysis, two were qualitative, and two used sequential mixed-methods designs. No record evaluated a workplace intervention or followed a cohort over time. The studies varied significantly in their sampling frames, with some recruiting only emergency nurses and others reporting nurse-specific findings within mixed-professional samples. This variation in design and sample composition is a primary reason why the results cannot be easily compared or pooled.
The instruments used to measure outcomes were also inconsistent. Quantitative reports used the Maslach Burnout Inventory or the Copenhagen Burnout Inventory, while fatigue was measured with the Occupational Fatigue Exhaustion/Recovery Scale or single direct items. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale or the Depression Anxiety Stress Scales. This lack of standardization means that a 15% overall burnout rate in one study is not directly comparable to a 65.4% high burnout rate in another, as they arise from different constructs, thresholds, and denominators.
Specific findings highlighted the variability in the data. For instance, a 2019 study in Aseer reported a nurse-specific overall burnout rate of 15.0%, while a 2024 study in Riyadh reported a 65.4% high overall burnout estimate. The Riyadh study had inconsistent instrument labeling, which the review notes as a caution for interpretation. Another study in Dammam classified 28 out of 37 nursing staff as burned out. These figures illustrate the difficulty of establishing a baseline for nursing management without standardized measurement tools.
Beyond burnout, the review identified studies on related constructs such as occupational stress and secondary traumatic stress. A 2022 mixed-methods study identified excessive paperwork, staff shortage, and high patient load as leading reported stressors. A 2024 study reported secondary traumatic stress symptoms in 95% of participating emergency nurses, with more than half classified as high-to-severe. However, the review explicitly states that these outcomes are distinct from burnout and should not be relabeled as such, preserving the integrity of the different psychological constructs.
The discussion emphasizes that the apparent spread of reported values is itself a methodological finding. The heterogeneity in measures and reporting formats means that the existing studies cannot support like-for-like comparisons. This lack of comparability is a significant barrier for nursing managers who might otherwise use these data to benchmark one hospital or region against another. The review argues that the central implication is not a single burden estimate, but the need for clearer, comparable measurement and stronger, locally grounded research.
International literature provides context but not a substitute for Saudi-specific data. Meta-analyses of emergency nurse studies elsewhere have also reported heterogeneous estimates, suggesting that measurement variability is a global issue. However, importing international prevalence figures into Saudi policy is discouraged. The review notes that while nurse burnout is associated with poorer patient safety and satisfaction outcomes in broader literature, this association should not be converted into a causal claim for Saudi emergency departments without local evidence.
The review identifies several critical gaps in the Saudi evidence base, including the absence of intervention evaluations, longitudinal analyses, and national sampling frames. This leaves nursing managers with a reason to investigate local conditions but not with a defensible estimate for benchmarking. The authors suggest that actions should be designed as evaluable improvement work rather than as a response to an assumed national prevalence. This approach aligns with international benchmarks that recommend organizational interventions and manager training over individual resilience programs alone.
For nursing practice, the review recommends treating burnout, fatigue, anxiety, and depression as distinct concerns using construct-specific instruments. At the unit level, findings support routine review of workload, recovery opportunities, team support, and safety. These are evidence-informed priorities for local testing and monitoring, not interventions proven to reduce burnout in Saudi emergency departments. The review underscores the importance of confidential access to occupational health or mental health support where indicated.
The limitations of the review are substantial, including searches limited to four sources and English-language terms, as well as incomplete metadata in some source exports. The synthesis is described as hypothesis-generating rather than causal or nationally representative. Despite these limitations, the review provides a transparent map of the current evidence, highlighting the need for a coordinated Saudi research agenda. This agenda should prioritize multicentre prospective studies, validated Arabic-appropriate measures, and complete reporting of response and missing data.
In conclusion, the scoping review reveals that while there is a growing body of evidence on Saudi emergency nurse wellbeing, it is too fragmented to support definitive conclusions about national burden. The heterogeneity in study design, sampling, and measurement tools prevents the pooling of prevalence estimates. Future research must focus on standardizing methods and evaluating organizational interventions to create a defensible baseline for nursing management and patient care in Saudi emergency departments.
The review’s eligibility criteria required that studies report findings specifically for registered nurses in Saudi emergency departments. Records that pooled nurses with physicians or other clinicians were excluded unless nurse-specific data could be extracted separately. This distinction is critical because the review notes that a nursing group nested within a mixed professional sample is not equivalent to a nurse-only sample. For example, one study reported an overall burnout value of 16.3% that pooled nurses and physicians, a figure the review explicitly did not use as a nurse-specific estimate. Instead, the review relied on the 15.0% nurse-specific overall burnout rate reported in the same Aseer study. This careful separation prevents the exaggeration or obscuring of the problem that can occur when different instruments and reporting formats are treated as interchangeable.
Among the fifteen included studies, only two earlier quantitative reports supplied a clear nurse-specific numerator and denominator for the selected overall burnout outcome. The remaining studies provided results in various forms, such as mean scores, correlations, subgroup values, or qualitative themes. For instance, a 2022 study in Hail reported a mean Copenhagen Burnout Inventory score of 39 ± 10, which the review clarifies is not a prevalence estimate. Similarly, a 2023 study in a Saudi military hospital reported mean depression and anxiety scores for an emergency nurse subgroup, which cannot be interpreted as prevalence rates. This variety in evidentiary strength and form is why the review records each result with its original denominator and interpretive context rather than reducing the evidence base to a single summary percentage.
The review also highlights the importance of distinguishing burnout from related but distinct constructs such as occupational fatigue, moral distress, and secondary traumatic stress. A 2022 study in Hail and Al-Qassim used the Occupational Fatigue Exhaustion/Recovery Scale to assess fatigue and reported a burnout correlate, but the review emphasizes that this is a correlate, not a burnout prevalence estimate. Another study in Riyadh used a single direct question about fatigue during a night shift, which is a direct measure but not a validated burnout score. By keeping these constructs separate, the review avoids the error of treating them as synonyms, which can lead to misleading conclusions about the nature and extent of the workforce issue.
The qualitative studies included in the review provided narrative evidence of burnout-related experiences, such as emotional exhaustion, depersonalization, and resilience mechanisms. A 2026 study in Riyadh described five themes related to emotional labor demands and organizational influence, while a 2026 study in Al-Ahsa focused on trauma-informed care and included themes of accumulated emotional toll and moral injury. These studies do not provide prevalence estimates but offer insight into the lived experiences of emergency nurses. The review includes them as relevant narrative evidence, noting that they do not substitute for quantitative measures of burnout prevalence.
The review’s synthesis was descriptive, grouping findings by construct and reporting them with the original instrument and denominator wherever available. Meta-analysis was not planned because the constructs, measures, thresholds, and reporting formats were materially heterogeneous. This approach allows for a transparent mapping of the evidence base, highlighting the specific gaps and inconsistencies that need to be addressed in future research. The review’s focus on relevance and direct fit with the research question ensures that the findings are grounded in the specific context of Saudi emergency nursing, rather than relying on international figures that may not be applicable.
Subject of Research: Scoping review of burnout and psychological outcomes in Saudi emergency nurses
Article Title: Burnout and Related Occupational and Psychological Outcomes Among Emergency Nurses in Saudi Arabia: A Scoping Review
Article References: Mani, Z. A., Farasani, M. M., Elagi, A. A., Ogdi, A. M., & Manni, A. A. (2026). Burnout and Related Occupational and Psychological Outcomes Among Emergency Nurses in Saudi Arabia: A Scoping Review. Nursing Open, 13(11), Article e71020. https://doi.org/10.1002/nop2.71020
Image Credits: AI Generated
DOI: 10.1002/nop2.71020
Keywords: burnout, emergency nurses, Saudi Arabia, scoping review, occupational health, psychological outcomes, nursing management, healthcare workforce, Related, Occupational, Psychological, Outcomes
News Source: Ophelia Keating. (November 10, 2026). Saudi Emergency Nurse Burnout Data Remains Fragmented. Scienmag.
