Human resource for health, especially nurses, is the greatest challenge worldwide for most of the countries. This shortage has compelled hospital’s management and leadership to identify its causes and strategize interventions to overcome the deficit in order to improve and sustain quality health care for patients. This paper identifies issues affecting nurses’ retention and suggests recommendations for creating job enrichment and enhancing retention at a private university hospital in Karachi Pakistan. A contextual secondary data analysis of M.Sc. Nursing thesis, exit interviews and external evaluators’ report (2004) of a private university hospital in Karachi Pakistan along with review national and international studies published during 2001- 2013 on the factors affecting and strategies to improve nurses’ retention, attrition and job satisfaction. The contextual secondary analysis identifies the 5Ms including “management, migration, marriage, money and mother in law” to be the reasons of resignations identified among nurses. Whereas global literature highlighted two sets of reasons one is related to work life including higher education opportunities for career advancement, personal reasons, marriage, family commitment, and relocation for better prospects. The other set of reasons are work environment including overwork, lack of collegiality with co-workers, and lack of recognition from management. Moreover a model for nurses’ retention was developed to suggest ways to protect health human capital investment in a private university hospital. With prevailing country security situation in Pakistan, high cost impact of retention, sponsorship and escalating overseas demand, turnover will continue to remain a constant challenge. Healthcare organizations are strongly advised to invest in talent management practices that will have the greatest value for ensuring a steady workforce of qualified and engaged nurses.
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