"My Colleagues Are the Ones Who Taught Me Everything": Navigating Workplace Integration Through Organizational...

Background/Objectives: International recruitment is used to address nursing workforce shortages, yet recruitment alone does not ensure successful integration into destination healthcare systems. This study aimed to explore how internationally recruited nurses (IRNs) experience and make sense of workplace integration in Saudi Arabia, with attention to the organizational, relational, and experiential processes that shape integration over time. Methods: A qualitative descriptive study with reflexive thematic analysis was conducted with 19 IRNs in three tertiary hospitals in southern Saudi Arabia. Participants were purposively recruited, and data were generated through semi-structured interviews. Organizational Socialization Theory (OST) was used as a sensitizing theoretical framework rather than a predetermined coding structure. Data were analyzed using Braun and Clarke's six-phase reflexive thematic analysis. Results: Four interrelated themes captured participants' integration experiences: (1) Entering the Workplace with Limited Organizational Preparation; (2) Becoming Integrated Through Workplace Relationships; (3) Learning the Unwritten Workplace Through Experience; and (4) Integration as an Uneven Trajectory Over Time. Formal preparation and orientation were often limited, shifting substantial responsibility for workplace learning to peers, supervisors, and experiential exposure. Supportive relationships facilitated learning and belonging, whereas harsh interactions, perceived inequities, and variable organizational support complicated integration. Conclusions: Workplace integration was experienced as a gradual, relational, and uneven process rather than a discrete orientation event. Healthcare organizations have a central responsibility for supporting integration, while informal peer learning should complement rather than replace structured organizational support.