Burnout and engagement profiles of emergency nurses: the role of job insecurity appraisal and capabilities

Emergency nurses are particularly vulnerable to burnout (a state of extreme tiredness, reduced ability to regulate cognitive and emotional processes, and mental distancing) with far-reaching consequences for individuals, healthcare systems, and society. Working in high-pressure environments marked by traumatic events, intense workloads, irregular shifts, and emotionally charged encounters, emergency nurses must sustain their performance and well-being amid growing job insecurity. This study examined the roles of work capabilities (enabled and achieved work values), burnout, work engagement, and job insecurity appraisals (as either a hindrance or a challenge) in shaping emergency nurses' sustainable employability. A quantitative, cross-sectional survey design was used, and data were collected via convenience sampling from 204 emergency nurses across 13 hospitals in South Africa. Structural equation modeling, latent profile analysis, and Bolck-Croon-Hagenaars analysis were employed to examine associations, subpopulations, and profile differences. Findings indicated that appraising job insecurity as a challenge positively affected emergency nurses' capabilities and engagement, while hindrance appraisals were associated with elevated levels of mental distance, cognitive impairment, and emotional impairment. Capabilities were negatively associated with exhaustion and mental distance, and positively associated with engagement. Latent profile analysis identified four distinct burnout and engagement profiles: moderately burned-out (35%), slightly disengaged (38%), healthy engaged (15%), and burned-out (12%). Emergency nurses in the moderately burned-out profile reported significantly lower challenge appraisals than those in the slightly disengaged group. Additionally, the burned-out and moderately burned-out groups reported lower capability scores than the slightly disengaged and healthy engaged profiles, with the healthy engaged group reporting the highest scores overall. These findings underscore the importance of interventions that build work capabilities and support adaptive interpretations of job insecurity. Such efforts are critical for reducing burnout, enhancing engagement, and promoting the sustainable employability of emergency nurses.