Job satisfaction among Saudi and Non-Saudi critical care and emergency nurses: associations with psychological distress, turnover intention, and perceived retention strategies

Abstract

Critical care and emergency nurses work in complex and demanding environments that may affect their occupational well-being, psychological health, and job satisfaction. Although previous studies have examined nurse retention challenges, limited evidence exists regarding factors associated with job satisfaction among Saudi and non-Saudi nurses working in high-acuity clinical settings in Saudi Arabia. This study aimed to assess job satisfaction, psychological distress, turnover intention, and perceived organizational retention strategies among critical care and emergency nurses in Saudi Arabia and to identify factors statistically associated with higher job satisfaction. A descriptive cross-sectional correlational study was conducted among 494 critical care and emergency nurses recruited through convenience sampling from hospitals across five cities in northwestern Saudi Arabia. Data were collected using the McCloskey/Mueller Satisfaction Scale, Turnover Intention Scale, Patient Health Questionnaire-2, Generalized Anxiety Disorder-2, and a structured retention strategy questionnaire. Descriptive statistics, chi-square tests, Pearson correlation analysis, and multiple logistic regression analysis were performed. Overall, 57.9% of nurses reported moderate job satisfaction and 51.8% reported moderate turnover intention. Non-Saudi nurses reported higher perceived job distress and turnover intention compared with Saudi nurses. Job satisfaction was negatively associated with turnover intention ( r = − 0.435, p = 0.021). Multiple logistic regression analysis showed that salary ≥ 10,000 Saudi Riyals (OR = 2.68), employment in governmental hospitals (OR = 3.14), working in emergency departments (OR = 1.92), lower perceived job distress (OR = 2.62), absence of anxiety symptoms (OR = 2.47), lower back pain severity (OR = 1.86), and absence of depressive symptoms (OR = 1.58) were statistically associated with higher job satisfaction. Job satisfaction among critical care and emergency nurses was associated with workplace characteristics, physical health status, and psychological well-being. Although turnover intention was inversely correlated with job satisfaction, the cross-sectional design limits interpretation of temporal relationships. Organizational strategies focusing on supportive work environments, psychological well-being, equitable employment conditions, and professional development may contribute to improved nurse satisfaction and workforce stability. Not applicable.