To explore job satisfaction of nurses during the Hajj season 2018 in Saudi Arabia, determine predictors of nurses' job satisfaction and inform future healthcare provision and policy. Mass gatherings of large numbers of people inevitably pose unique public health concerns and challenges for organizers. A mass gathering happens annually in Saudi Arabia during the Hajj pilgrimage. There wasa paucity of evidence regarding nurses' experiences during Hajj. This gap in knowledge needed to be addressed. A cross-sectional survey was conducted in 198 nurses across 12 healthcare settings along the Hajj pilgrimage route. A 24-item Nurses' Job Satisfaction Questionnaire was developed exploring six domains: supervision, nature of work, retention, communication, workload and co-workers. Nurses reported a high level of job satisfaction. All six domains were strong predictors of job satisfaction. Nurses reported the lowest level of job satisfaction when assessed against the items 'multiple policies and procedures that were perceived as complicating nursing work', 'incompetence of other people they work with' and 'too much burden at work'. Job satisfaction levels for nurses during Hajj 2018 appeared higher than during previous Hajj pilgrimages, probably influenced by the additional healthcare measures put in place during Hajj 2018, such as improved technology. Hajj-specific skills training must be designed to enhance the knowledge, competencies and capabilities of nurses. Policies and procedures must prevent heavy workloads and avoid complicating nurses' work during Hajj. Improvements to the nurse work environment should focus on evidence-based interventions promoting effective resource planning, interprofessional relationships and communication, for instance via innovative, technological approaches. These findings can be shared with organizers of other mass gatherings worldwide.
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