Background: Healthcare environments expose workers and patients to hazardous substances, leading to sickness and death. Nurses play a critical role in maintaining patient health and managing occupational risks, including biological, physical, chemical, and psychological hazards, highlighting the need for significant commitment. This study aims to explore the occupational health hazards and control measures among nurses and nurse managers in Saudi Arabia. Methods: A descriptive, cross‐sectional study was conducted using a convenience sample of 222 nurses and nurse managers in Northern Border Hospitals. A Google survey questionnaire was utilized for capturing data, including demographic information, occupational health hazards, and control measures. Results: Of the 222 nurses surveyed, 20.3% experienced high ergonomic hazards, 14.4% experienced physical hazards, 14.9% experienced chemical hazards, 17.1% experienced biological hazards, and 34.2% experienced moderate psychological hazards. Regarding safety measures, 86.0% of participants reported high levels of control, 80.6% took proactive safety precautions, and 87.8% adhered to comprehensive control measures. There was little correlation between demographic characteristics, occupational hazards, and control measures. A significant negative association was found between control measures and occupational hazards ( p value ≤ 0.001). Conclusion: Nurses face a range of occupational hazards, including ergonomic, physical, chemical, biological, and psychological risks. Addressing these hazards is essential for the well‐being of nurses, the quality of patient care, and the creation of a healthier work environment. While control measures are generally effective, some healthcare workers lack access to adequate safety protocols. The results indicated a negative correlation between exposure to occupational health hazards and the implementation of control measures.

Background: One of the key priorities of Saudi Vision 2030 is to ensure that all Saudi citizens have access to high‐quality healthcare, but this goal is constrained by international and domestic nursing staff shortages. Nursing directors have recommended introducing a professional career path focused on developing nurses’ leadership skills. Despite recognition of nurse managers’ key role in recruiting, retaining, and engaging nurses, few studies have explored how Saudi managers acquire and deploy leadership skills. This study explores how nurse managers view and experience workplace leadership. Methods: This ethnographic study examined nurse managers’ perceptions and experiences of leadership development in a Saudi hospital affiliated with the Ministry of Health. Qualitative data were collected during periodic visits over eight months, including workplace and continuing medical education observations, document examinations, and informal and semistructured interviews with 21 nurse managers. A framework analysis approach was used to interpret and summarize the data. Findings: The data were organized into four major themes: imbalanced power dynamics, no shared vision, workplace rituals and behaviors, and the need for learning. The findings indicated a power imbalance, consistent with international studies. The hospital had hierarchical and transactional management structures and a culturally pervasive leadership approach framed by wasta (“middleman” or “go‐between” in Arabic) . Such nepotism, normalized in Saudi business practice, is officially recognized and condemned as corrupt by state legislators. The Saudi government is rigorously combating this practice through strict regulations and enforcement. A climate encouraging adherence with the directorate’s guidelines led managers to comply, even though they employed strategies to subvert some of its authority. Conclusion: Wasta was used to enhance performance, obtain rewards, secure favorable work assignments, gain meritless promotions, and allocate staff arbitrarily. Paradoxically, while managers criticized the capricious use of wasta, they also employed it to secure what they believed they deserved, sometimes at the expense of their colleagues’ careers.

Aim: This study explored how nurses perceive and navigate professional autonomy in Saudi hospital settings, with particular attention to the organisational and cultural barriers that shape autonomous practice. Background: Vision 2030 provides the strategic framework for transforming healthcare systems in Saudi Arabia, placing nursing autonomy at the centre of efforts to deliver safe, patient‐centred care. Nursing autonomy influences clinical decision‐making, job satisfaction and workforce retention. Methods: A qualitative descriptive design was employed across two referral hospitals in northern Saudi Arabia. Purposive sampling was used to recruit staff nurses and nurse managers with direct experience of clinical autonomy in practice. Twenty‐four semistructured interviews were conducted in Arabic with staff nurses ( n = 16) and nurse managers ( n = 8). Data were analysed using Braun and Clarke’s reflexive thematic analysis. Results: Three themes were constructed through analysis: (1) structured dependency, reflecting how hierarchical systems restrict independent decision‐making; (2) navigating interprofessional dynamics, addressing collaborative practice and role negotiation and (3) communication and professional identity, capturing how nurses’ sense of agency is shaped by confidence, visibility and perceived professional status. Discussion: The findings indicate that nursing autonomy is variably supported and is shaped by the interplay of hierarchical structures, interprofessional dynamics and communication‐based professional identity work. Conclusions: A substantive misalignment exists between the strategic aims of Vision 2030 and nurses’ day‐to‐day experiences of hierarchical control and structured dependency. Addressing this gap requires targeted interventions, including leadership development and sustained institutional commitment to shared governance models.

Background: Vision 2030, which aims to provide all Saudi citizens with high-quality healthcare, is constrained by international and domestic shortages of nursing staff. Therefore, nursing directors have recommended the introduction of a professional career path, focusing on developing nurses’ leadership skills. However, despite widespread recognition of nurse managers’ key role in recruiting, retaining and engaging nurses, few studies have explored how Saudi managers are trained and acquire leadership skills and how they deploy them. This study aimed to explore how nurse managers view and experience leadership within their workplace. Methods: An ethnographic study into the perceptions and experiences of nurse managers regarding their leadership development was undertaken in a Saudi hospital affiliated with the Ministry of Health. Periodic study visits to the hospital over 8 months were undertaken to collect qualitative data. They involved workplace and continuing medical education observations, an examination of relevant documents, informal interviews/discussions, and semistructured interviews with 21 nurse managers. A framework approach analysis was used to interpret and summarise the data. Findings: The data were organised into four major themes: imbalanced power dynamics, no shared vision, workplace rituals and behaviours, and the need for learning. This paper discusses the imbalance of power, which was also in line with other international studies. The hospital had hierarchical and transactional management structures and processes and a culturally pervasive and normalised capricious leadership approach that was framed by Wasta. This is aform of nepotism normalised to Saudi business practice but now officially recognised and condemned as corrupt by state legislators. A climate of fear and intimidation induced compliance, conformity, and adaptation by managers to the directorate diktats. However, they also used other strategies to subvert and avoid some of the directorate’s authority. Conclusion: The notion that wasta was everywhere was pervasive within the hospital organisation and reported to be the root cause behind most of the dubious directorate decisions. It was used to enhance performance, obtain financial rewards, secure favourable work assignments, obtain meritless leadership promotions, and allocate staff arbitrarily. Paradoxically, while managers disparaged their experiences of the capricious use of wasta, some more vehemently than others, they also used it to get what was they assumed should be their due and occasionally at the expense of their colleagues.

Background: The healthcare industry demands nurses with both clinical proficiency and leadership skills. However, formal leadership training remains limited among undergraduate nursing students, underscoring the need for clinical mentorship to support leadership development. Purpose: This study investigated the association between clinical mentorship quality and leadership competencies among undergraduate nursing students enrolled at a public university in northern Saudi Arabia. Methods: Data were collected using a cross-sectional design from 224 nursing students through a self-administered online survey, which comprised three sections: demographic information, students’ perceptions of clinical mentorship quality, and a standardized assessment of leadership competencies. Results: Students reported positive perceptions of their leadership competencies, with an average score of 2.82. A strong positive correlation was observed between mentorship quality and leadership competencies, particularly in strategic thinking, emotional intelligence, influence, and teamwork. Differences were observed based on sex and academic performance, with female students and those with higher GPAs exhibiting stronger leadership competencies. Regression analysis revealed mentorship quality (β = 0.642, p < 0.001) and academic performance (β = 0.131, p = 0.013) as significant predictors of leadership competencies, while gender and academic year were not statistically significant. Conclusions: High-quality clinical mentorship substantially contributes to the development of leadership competencies among nursing students, with academic performance providing additional support. Integrating structured mentorship programs into nursing curricula may enhance preparedness for leadership roles within healthcare settings.

Background: Leadership skills on the part of nursing managers are expected to improve care for patients under the care of registered nurses. To do so also requires all Saudi hospital nursing leaders to attract and retain qualified nursing staff during a time of global shortages. Aim: The purpose of this study is to explore and identify the staff nurse perceptions of the barriers to and facilitators of effective nurse leadership for a major Saudi hospital and make recommendations for change. Methods: An interpretative methodology guided by John Kotter’s change theory. Qualitative data were collected from 14 participants using semi-structured interviews in 2016 and analysed using content analysis. Results: Two main categories have been identified through the data analysis process. The first category was barriers to effective leadership, comprising an inadequate leadership education and skills development; a limited authority and clinical empowerment; an unawareness of the need for change; and poor communication. The second category was facilitators of effective leadership, encapsulated engaging and listening to staff and seeking their ideas; recognizing staff performance, and motivational strategies. Conclusion: Even though the staff nurses who participated in this study were dissatisfied with the quality of leadership shown by their nurse managers, nevertheless they proffered an abundance of data during the study which accentuated the variety of organizational obstacles encountered by their nursing managers. They also voiced opinions on the workplace factors which might serve to assist nurse managers to improve the efficacy of their guidance. These were included in the study recommendations which were forwarded to all nursing managers employed at the hospital.