Nigeria's 2024 National Policy on Health Workforce Migration confronts a fundamental challenge: rebuilding trust between healthcare workers and government. Using Mayer, Davis, and Schoorman's organizational trust framework, this analysis explores how trust shapes healthcare workers' migration decisions. Drawing from comparative African experiences and implementation evidence, this paper argues that without addressing core issues of trust through demonstrated policy implementation, sustained commitment to workforce welfare, and competitive compensation, even well-designed retention policies will struggle to retain Nigeria's health workers.