Brain Drain and Retention Strategies: Lived Experience of Expatriate Nurses in Saudi Arabia: Challenges and Implications.

This study explored the lived experiences of expatriate nurses in Saudi Arabia, examining the factors driving migration and brain drain and identifying retention strategies from their perspectives. The brain drain phenomenon, marked by the migration of skilled nurses from developing to wealthier countries for better career opportunities and living conditions, remains a global healthcare concern. Despite growing attention, research on factors driving expatriate nurses' migration to Saudi Arabia is limited. Understanding these factors is crucial for developing effective retention strategies. A phenomenological qualitative approach was used with a purposive sample of 36 expatriate nurses from diverse nationalities such as Filipino, Indian, South African, Malaysian, Jordanian, and the United Kingdom. Data were collected through semistructured interviews and analyzed thematically. Four themes were identified shaping the brain drain phenomenon among expatriate nurses in Saudi Arabia: push factors, pull factors, challenges, and retention strategies. Within these, 15 subthemes and 31 related factors emerged. Economic hardship, limited career growth, and poor working conditions drove migration, while higher salaries, career advancement, and better work environments attracted nurses. Challenges included high patient loads, restricted leadership roles, social adaptation difficulties, and work-life imbalance. Most expatriate nurses (86.1%,  = 31) intended to remain in Saudi Arabia. Findings underscore the complicated connection between push and pull factors and challenges influencing expatriate nurse's migration and retention. This study contributes new insights into nursing workforce management in Saudi Arabia and offers policy-driven recommendations to enhance nurse retention strategies, supporting the Saudi Vision 2030 healthcare transformation. Addressing these challenges requires a multifaceted approach that includes financial incentives, structured career development programs, leadership inclusion, work--life balance policies, and expatriate support systems.