According to Meru County government CIDP (2013-2017), the department of health mission statement is geared towards rendering quality health services to the citizens. Three major indicators suggested the likelihood of ultimate low delivery of quality health services by the nursing professionals. These indicators included the following: Strikes, work boycotts and go slow. The extent of such industrial actions by the nurses would definitely compromise the realization of the above mentioned mission statement where aspect of quality performance was very key. Therefore, the study addressed this problem by investigating the effect of reward system on job performance of nursing professionals working in Meru County government hospitals. The study was guided by the following specific objectives: One, to determine the effect of employee financial compensation on job performance of nursing professionals working in Meru County Government hospitals. Secondly, to find out the effect of employee promotion on job performance of nursing professionals working in Meru County Government hospitals, and lastly, to determine the effect of employee recognition on job performance of nursing professionals working in Meru County Government hospitals. This study was done in Meru County targeting a population of 275 nurses working in fifteen (15) level four hospitals, whose sample size was 83. Stratified random sampling was used. The study used primary method of data collection where questionnaire and interview schedule were used as tools of collecting data. Secondary method was also used to collect data whose purpose was to enrich the background information. Descriptive and inferential statistics was used for data analysis. The study established that employee financial compensation, employee promotion and employee recognition all affected job performance of nursing professionals working in Meru County government level four hospitals. A significant number of respondents as shown by 58.4% disagreed that they were satisfied with the amount of annual increment on their respective salaries and these affected their job performance. Majority 53.2% of respondents were strongly of the opinion that employees are not promoted on basis of merit and competence and these adversely affected nursing professionals' job performance in level four hospitals. Further, majority of study respondents as shown by 53.2% agreed that employee recognition enhances job performance among nursing professionals working in Meru County government level four hospitals. Additionally, majority of study respondents as shown by 56.2% observed that those in the nursing profession didn't receive adequate feedback on their job performance from their respective supervisors which affected their overall performance. The study concluded that annual salary increment for nursing professionals significantly affected their job performance and fraud free promotion opportunities provide big motivation for nursing professionals. Based on the research findings, the study recommends the County government with the help of national government to put in place measures that would ensure that the nursing professional salary structure is harmonized with those of the private sector. The study also recommends that since the study variables accounted for 79.4% of the variations in job performance of nurses working in level four hospitals, further research should be done to establish the other factors that contributed to the unexplained (20.6%)