Caught Between Care and Collapse: An Interpretive Qualitative Exploration of Burnout and Resilience Among Respiratory Therapists in Saudi Arabia.

BACKGROUND

Although burnout among respiratory therapists (RTs) is well documented, qualitative insights into their lived experiences in Saudi Arabia remain limited. This study explored RTs' experiences of burnout, systemic and organisational drivers of professional strain, and strategies for resilience and retention within Saudi hospitals.

METHODS

A qualitative descriptive design was employed. Purposive sampling was used to recruit 11 RTs from diverse regions across Saudi Arabia. Semi-structured interviews were conducted in Arabic between September and November 2025, audio-recorded, and transcribed verbatim. Data management and analysis followed a hybrid approach using NVivo 12 software alongside manual coding to support deep immersion in the data. Analysis was guided by Braun and Clarke's reflexive thematic analysis. Methodological rigour was enhanced through reflexive memoing, peer debriefing, and adherence to a 15-point trustworthiness checklist.

RESULTS

Analysis generated one overarching theme, "Caught Between Care and Collapse: The Human Cost of Institutional Burnout," alongside three interrelated themes. Participants described (1) "Living within a system that drains the self," highlighting sustained physical and emotional exhaustion driven by understaffing and extended shifts; (2) "Losing meaning and recognition," illustrating how organisational neglect eroded professional passion and replaced it with obligation and frustration; and (3) "Coping strategies and informal support," reflecting quiet resilience through self-regulation, peer solidarity, and humane leadership. Many participants framed their endurance as an act of moral defiance rather than passive resignation.

CONCLUSIONS

These findings suggest that RT burnout reflects not individual failure but a structural outcome of sustained strain and deficits in reciprocity. Burnout emerges as an institutional crisis in which therapists remain deeply committed to patient care while being pushed toward professional collapse by systemic neglect. Culturally informed, system-level interventions are urgently needed to preserve this essential workforce.