Nursing in Saudi Arabia : A Brief Overview

By M.D. Kavanwal

Nursing in Saudi Arabia poses many unforeseen challenges, and if you are not one who adapts to change readily, you think twice about going on assignment to this country.

There are several state-run hospitals, but I would advise against working in them. The hospitals originally owned and run by members of the royal family are much better run, safer, and claim to live up to JCHO standards.

(JCHO is an accreditation commission that certifies health care organizations and programs in the United States. JCHO measures performance standards, and works to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services.)

One of the problems with nursing in Saudi Arabia is that some of the hospitals are gigantic. The hospital I worked in was a three-quarter mile walk from the front door to the back entrance. The walk, I must add, is one long, straight hallway with arteries, just as long, leading to other areas of the hospital.

The enormity of the buildings is due to the desire of the royals to “out build” former princes or kings. It is easy to get lost, even if working in the hospital for years.

The danger of being so large is that in remote areas of some of the corridors that lead nowhere, unsuspecting women often are trapped by men, vandalized and raped.

During the day, the threat is less, but at night, with fewer visitors, women are at risk. It is always a good idea to know your route to the floor you work on, and walk quickly. It is always advisable to walk with one of your colleagues, and never explore areas unfamiliar to you.





Nursing in Saudi Arabia is different. The policies and Procedures are built around the whims of influential families. Sometimes medical treatments are curbed to adjust to the culture and Islamic practices, which are not always in the best interest of the patient.

Many fine physicians and nurses give up and break their contracts because patients dictate their care and tell you when it is time for an assessment or for treatments or for medications. It is almost impossible to care for people properly.

When a member of the Royal Family is admitted to a unit he/she is accompanied by a minimum of 3 and up to 14 , servants and sometimes includes a private nurse.

This private nurse often comes from another Third World country, where nursing and medical standards are not adhered to, and your nursing in Saudi Arabia is challenged.

Because the family trusts this privately hired nurse, all your work is coordinated through her. For example, often the administration of medications is given by this private nurse, and not yourself, even though you measured and poured out the dosages.

If however, you gain favor with the family, they may prefer that you become their private nurse or doctor, and offer you a contract.(the first one is fired, and often sent home in disgrace)

It is ill advised to accept nursing in Saudi Arabia under these circumstances because you then are at the mercy of the family, and you won’t be able to leave the country until the family is finished with your services. That can be a year…two years…five…

Sometimes Canadian and American nurses are offered royal assignments. If contracts are negotiated through the major hospitals, these contracts can be advantageous. The problem is, the nurse is then isolated from other Westerners, and being naïve about Saudi culture, she can get into trouble.

Such was the case when I took an assignment in Jeddah. The novel, Surreal in Saudi details the events of my nursing in Saudi Arabia.

Racial prejudice is open and persons from South African, East India, and especially those from the Philipines, are looked down on. (Within Saudi Arabia, people are ranked, and there is a distinct hierarchy of people, even amongst the Arab people themselves.)

Those who are not from Western nations are prohibited from working directly with an important Royal Family member. A white Western female nurse with an American, Canadian, Irish, Australian or English passport is highly sought after.

A “Do Not Resuscitate” order—meaning not to perform medical procedures that will increase the lifespan unnecessarily or artificially, does not exist for certain members of the Royal family, except on paper.

This means that the aged and/or infirm are kept alive by any and all means possible. It is common to see an entire wing of the hospital dedicated to royal patients who are in a persistent vegetative states or are on vents or other means of artificial life support.

As long as the patient lives, the younger family members have a closer link to the family funds and are eligible for bigger stipends. Nursing in Saudi Arabia, and working with the families of these patients on artificial life support is very hard, and the nurse often ends up working as a glorified maid, subservient to family caretakers, rather than working in her professional role.

It is true Canadians and Americans are paid greater salaries than those from other countries, but we do not earn five times the national average, as some nurses do who come from other countries.

The Saudis do a calculation based on the average salary of a general duty nurse in their home country, and offer a fair wage. As Canadians and Americans, the salary is a little more than the national average for nurses, but more dollars can certainly be earned in North America.

If you are willing to take travel nursing assignments, for example, you can make a lot more money than what you can earn in Saudi. The main advantage, monetarily for nursing in Saudi Arabia, is the tax savings.

There is no Saudi tax to pay and very few living expenses, since housing is provided. Uniforms are provided, and the trip, including flight, to Saudi Arabia, and the return trip home are also paid for.

When a female nurse is on duty, she does not have to wear an abaya if going outside of the hospital. She does have to cover if she is not actively on duty.

Nurses who come to work to Saudi are mostly single women, and they live on the hospital grounds, in furnished apartments. These apartments are like safe havens from the Saudi people, with huge protective walls to shield the foreigners from any threats, and to protect the Saudi nationals from immodesty and improper conduct on the part of the Westerners. These areas for Westerners are called compounds.

The compounds are clean, and have facilities such as gyms and swimming pools.

Taxis are available to provide transportation to leave the complex to go shopping or site-seeing.

The Saudis do not have a manufacturing industry, and they do not have textile industries. Most things are imported from India, the Philippines or China. Food, literally, is imported from all over the world. Fresh fruit comes from Northern Africa, and beef from Ireland and lamb from Australia.

One branch of the royal family owns a farm, and unlike North America, the farm owners are not confined to one area. Their farm is located in several regions throughout the country, providing fresh cow’s milk, goat’s milk, cheese and eggs to grocery stores and sooks throughout the nation.

You can spend hours just tasting special imports of the best honey, or 28 different kinds of olives on the olive counters. Figs and Arabic coffee made from a white beans are a mainstay in the Saudi diet.



This overview of nursing in Saudi Arabia gives a brief insight into some of the restrictions placed on professionals willing to travel and offer their skills.

For a more in-depth perspective on living and nursing in Saudi Arabia, the novel, Surreal in Saudi and its sequel, has accurate portrayals of life in Saudi, as does the information on these web pages.