Nursing professionalisation in Saudi Arabia: a scoping review of education, gender, regulation, and workforce transformation

Professionalisation is the process by which an occupation gains control over knowledge, standards, credentialing and work; professional authority is demonstrated when members exercise legitimate decision rights. Recent Saudi nursing expansion in education, recruitment, nationalisation and regulation may enable professionalisation but does not alone establish enacted authority. This review mapped whether institutional development was accompanied by evidence of nurses’ enacted professional authority. Following JBI guidance and PRISMA-ScR, PubMed/MEDLINE and OpenAlex were searched from 1948 to 18 July 2026. Official-site and citation searches supplemented database searching. Eligible sources provided Saudi-specific evidence across five prespecified domains. No risk-of-bias score was applied; the evidential basis and limitations of each claim were reported. From 3,758 database records, 1,209 duplicates were removed, 2,549 records screened, 85 reports assessed and 79 sources included. These comprised 25 cross-sectional and 18 qualitative studies; 46 sources were published from 2020 to 18 July 2026. Education and credential pathways expanded, but this constituted enabling evidence rather than proof of professionalisation or enacted authority. The 2023 national scope-of-practice document defined formal expectations, whereas enacted scope, advanced practice, autonomy and policy participation were inconsistently documented. Public-image, family and gender evidence was mainly cross-sectional or qualitative. Official 2024 statistics recorded an overall workforce of 243,336 nurses, including 106,145 Saudi-national nurses (43.6%); 179,177 nurses (73.6%) were women, with midwives reported separately. Evidence supported workforce growth alongside maldistribution, but did not establish a Vision 2030 effect. Evidence is stronger for educational and credential development, formal regulation and workforce development than for enacted professional authority. Education, regulation and workforce planning should therefore measure implementation and longitudinal nursing-sensitive outcomes using stable population definitions.