Background The indispensable role of nurses in the healthcare system is evident as they contribute significantly to the effectiveness of healthcare delivery. However, nurse attrition, especially in countries like Somalia, is a growing concern. This research explores the reasons behind nurse attrition and its implications for healthcare systems.Methodology A qualitative research study was conducted in the Benadir region, involving 42 former nurses and 8 healthcare administrators. In-depth interviews were conducted with the former nurses to understand their motivations for entering the nursing profession, their experiences within the field, and the factors leading to their attrition. For healthcare administrators, semi-structured interviews were employed to explore the implications of nurse attrition on the healthcare system. Thematic analysis was used to identify and analyze the central themes that emerged from these interviews.Results Nurses often enter the profession driven by compassion and the desire to impact patient lives positively. However, disparities between initial expectations and realities of nursing practice, including inadequate compensation, burnout, unfavorable working conditions, job dissatisfaction, strained nurse-doctor relationships, and community misconceptions about the nursing role, contribute to nurse attrition. This phenomenon has several negative consequences, including a shortage of nurses, reduced care quality, increased workload for remaining nurses, longer patient wait times, limited access to healthcare services, higher operational expenses, added responsibilities for doctors, and lasting effects on public health.Conclusion & recommendations Nurse attrition is a complex process influenced by various factors. To mitigate its impact on healthcare systems, policymakers and healthcare administrators must allocate resources strategically, focus on comprehensive planning, and prioritize the recognition, support, and retention of nurses within the healthcare framework.