Neurotransmitters, emotions, and well-being vs. burnout in nurses: a scoping review

Background Nursing practice is characterized by recurrent exposure to intense emotional fluctuations, both personally and in relation to patient care. Well-being among nurses is determined not only by external organizational factors—such as workload, staffing adequacy, and managerial support—but also by intrinsic neurobiological mechanisms. Neurotransmitters, including dopamine, serotonin, oxytocin, and cortisol, among others, play a pivotal role in regulating mood, motivation, stress responsivity, and overall emotional stability. These neurochemical systems exert a direct influence on nurses’ subjective well-being, happiness, and resilience. This scoping review seeks to synthesize existing evidence regarding the influence of neurotransmitters on nurses’ emotional experiences and emotional well-being within the clinical work environment. Methods The scoping review was conducted in accordance with the Joanna Briggs Institute methodology and its corresponding guidelines for the development of scoping review protocols. Results Cognitive empathy emerged across literature as a salient protective factor, diminishing vulnerability to compassion fatigue. Mindfulness-based interventions and meditation programs commonly incorporated strategies aimed at cultivating compassion-related competencies. Nevertheless, mindfulness did not demonstrate a statistically significant moderating effect on the association between work pressure and emotional exhaustion. Moreover, the associations among work pressure, empathic care, and work performance were found to be stronger when mindfulness was low rather than high, even in contexts where mindfulness training had been reinforced. Conclusions Health policies that integrate structured organizational support with targeted training in empathy development, cognitive reappraisal, emotional regulation, and peer-support mechanisms show potential for mitigating compassion fatigue. Empathy has been identified as a mediating variable in the relationship between compassion fatigue and burnout, whereas emotional intelligence appears to attenuate the deleterious effects of burnout on professional functioning. Additionally, workplace ostracism exerts an influence on deviant workplace behaviors among nurses through pathways involving emotional exhaustion and defensive silence.