| Summary: | <em>Research Aim</em> The chief aim of this Saudi-based study is to provide an in-depth understanding of how nurses and nurse managers perceive culture and effective and ineffective collaborative working in a highly multicultural healthcare setting. <em>Methods</em> A qualitative case study approach was used. Eighteen semi-structured interviews were conducted to better understand how nurses and nurse managers perceive culture and how this impacts effective and ineffective collaborative working in a large hospital in Riyadh in the Kingdom of Saudi Arabia (KSA). A literature review guided the development of an interview schedule, underpinned by the Purnell Competence Model (Purnell, 2002). The results of all interview data were collected, transcribed, and analysed inductively and deductively. <em>Principal Findings</em> Fourteen items in total from the in-depth semi-structured interview can help to identify the barriers and facilitators of multicultural nurses working together. The Purnell Model proved its efficiency to be used for multicultural nurses' collaboration in a Saudi hospital, but a further three themes emerged beyond the Purnell Model of Cultural Competence to better describe the current case study. <em>Conclusions </em> In order for optimal healthcare to be provided by multicultural nurses, it is essential that they collaborate effectively. This can be accomplished through appropriate practices, training, education, and research, as well as professional and self-awareness through cultural competence; publicising ethical guidelines and enacting regulation by the Ministry of Health in KSA. <em>Importance and Relevance</em> This study is the first study to describe the barriers and facilitators of multicultural nurses working together in any context and specifically in a KSA context. There have been no studies into the barriers and facilitators in a Saudi context. Therefore, the academic contribution of this thesis will help to fill the gap in knowledge. A few studies have previously been conducted in Saudi Arabia, but these focus on barriers to nurse-patient relationships, rather than multicultural nurses working together. The results of this thesis will inform the future multicultural nursing workforce collaboration strategies of the KSA Ministry of Health and ultimately impact on patient care through better working relationships.
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