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Recent advancements in the field of organizational psychology have transformed the employees’ perceptions related to the reactions of the employment relationship. The main aim of the study is to explore the consequences of psychological contracts among the nursing staff and how to provide better patient care and quality service in the health-care system as nurses play a pivotal role in the context of Pakistan. Significantly, this study attempts to bridge the research gap by exploring consequences of psychological contracts. Drawing on the social exchange theory, this study examined the psychological contracts of nurses and their reactions to the perceived violation.

This research adopted a qualitative method and was based on an exploratory approach. Data were collected through in-depth semi-structured interviews from 21 nurses working in public, private and charity hospitals in Karachi, Pakistan. The thematic content analysis is employed for the analysis of data by using NVivo software.

The study identified the relational and transactional elements related to the psychological contract of nurses who predominantly consisted of supervisor support, autonomy, tangible/intangible rewards and trust. The intrinsic motivation which relates to their devotion to work was found as an additional element to balance their psychological contract. This research also establishes that the psychological contract of nurses is being violated in their work settings.

By highlighting the importance of psychological contract breach, the findings demonstrate that health-care institutions should take measures to cope with psychological contract breach issues at the workplace.

This study contributes to the body of knowledge by exploring psychological contract breach. Substantially, there are rare studies conducted on psychological contract breach among nurses in developing country context (Pakistan). However, this study adds to the previous studies related to the psychological contract of nurses in the context of Pakistan by using social exchange theories. Finally, this study enables the management of healthcare to balance the psychological contract issues effectively.