Exploring the Mediating Role of Employee Engagement in the Relationship Between Nursing Resilience, Emotional Intelligence, and Work Efficiency: A Qualitative Study in Saudi Arabia

<ns5:p>Abstract* Background Psychological resources are increasingly recognized as important determinants of nursing performance and healthcare quality. Although emotional intelligence and nursing resilience have been associated with positive work outcomes, limited qualitative evidence has explored how these resources influence nursing work efficiency through employee engagement. This study explored the mediating role of employee engagement in the relationship between nursing resilience, emotional intelligence, and nursing work efficiency among nurses in a tertiary healthcare setting in Saudi Arabia. Methods A qualitative study using thematic analysis was conducted among 25 registered nurses at King Fahad Specialist Hospital, Qassim Health Cluster, Saudi Arabia. Participants were purposively recruited from intensive care, emergency, medical, surgical, and outpatient departments. Data were collected through semi-structured in-depth interviews, supported by limited observations and document review. Interview transcripts were analysed manually using thematic analysis with the assistance of NVivo version 14. Trustworthiness was established through methodological triangulation and Lincoln and Guba’s criteria. Results Four interconnected themes emerged: emotional intelligence as a psychological resource for effective nursing practice, nursing resilience as an adaptive psychological capacity, employee engagement as the motivational pathway linking psychological resources to work performance, and nursing work efficiency as the outcome of strengthened psychological resources. Participants consistently described emotional intelligence and resilience as essential for managing workplace challenges and sustaining high-quality patient care. Employee engagement emerged as the key mechanism through which these psychological resources enhanced nurses’ motivation, adaptability, and work efficiency. Conclusions Employee engagement plays a central mediating role in translating emotional intelligence and nursing resilience into improved nursing work efficiency. Healthcare organizations should strengthen psychological resources through supportive leadership, resilience-building initiatives, emotional intelligence training, and strategies that foster employee engagement to enhance nursing performance and healthcare quality.</ns5:p>