Background: There is little disagreement that the shortage of nurses affects patients' outcomes globally. However, within the low and middle income country setting, there is minimal known about the perceptions of nurses on nursing shortages impact the health outcomes of their patients and what recruitment and retention strategies might be appropriate to address some of these challenges. This study explored the perceptions of nurses on the health outcomes of patient related to shortage of registered nurses and the strategies to retain nurses at a public hospital in Tanzania. Method: This qualitative descriptive study used semi-structured in-depth interviews with a select group of nurses in a large public hospital. Findings: Through an iterative coding process, a series of categories were derived which yielded three major themesfactors contributing to nursing shortage; compromised quality of care; and recruitment and retention strategies. Conclusion: A shortage of nurses affects the health outcomes of patients as it potentially hinders timely accomplishment of the optimal nursing. Efforts need to be proactive in recognizing the reasons for nursing shortages which are rooted in individual, institutional (agency), and organizational (systemic) issues. Within the LMIC context, such as where this study was conducted, it became apparent that the nurses wanted acknowledgement and opportunities to work collaboratively towards the resolution of workload issues for the benefit of the patients.
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