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Nurse Understaffing Problem in USA

Nurse understaffing is a common problem for many developed countries including the USA. The increasing number of older patients, low salaries, and insufficient prestige of the profession contribute to the shortage of nursing professionals. In its turn, inadequate nurse staffing and work-related stress lead to nursing professionals’ burnout, fatigue, and, as a result, high turnover rate (Khamisa, Oldenburg, Peltzer, & Ilic, 2015).

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Hayward, Bungay, Wolff, and MacDonald (2016) note that approximately half of new nursing practitioners quit within three years after starting their practice. Although the data concerning leaving the profession are not available, such statistics make it clear that it is critical to develop interventions aimed at helping nurses cope with stress, burnout, and fatigue. This paper includes a critique of the article by Eslami Akbar, Elahi, Mohammadi, and Fallahi Khoshknab (2015) that dwells upon nurses’ accounts concerning their methods to address job-related stress.

Background of Study

The impact of job-related stress has been explored in many spheres including healthcare. It has been acknowledged that nurses have to face stressful situations regularly, which leads to their fatigue and burnout (Eslami Akbar et al., 2015). The strategies nurses use to cope with stress have also received certain attention in academia. However, Eslami Akbar et al. (2015) state that quantitative studies have been conducted in the majority of cases, which leads to the lack of stakeholders’ insights, so the researchers aim at addressing this gap. The authors argue that the lack of qualitative information leads to an incomplete understanding of the efficiency of some coping strategies.

Eslami Akbar et al. (2015) note that negative patient outcomes and organizational issues linked to nurses job-related stress are associated with 300-400 million dollars every year. It is also emphasized that the emotional and physical burden of patients and their close ones, as well as nursing professionals, cannot be estimated. The purpose of the study under analysis is the exploration of nurses’ experiences related to their use of various strategies that help them handle stress. Although the research questions are not provided explicitly, it is possible to infer that the major research question was as follows.

What are the coping strategies nurses utilize to address job-related stress? This question and the purpose of the study are linked to the problem mentioned above. The methods employed by experienced nursing practitioners can become the basis for the development of an effective intervention for nurses.

Method of Study

The research design of the study is appropriate as it enables authors to gain insights into some of the most common nursing professionals’ coping strategies and their relevance to nurses. Unstructured interviews were conducted with 18 participants (11 females and 7 males) recruited by purposeful sampling (Eslami Akbar et al., 2015). Importantly, one of the inclusion criteria was the educational level of the nursing practitioners, so the participants had a bachelor’s or master’s degree.

The participants were encouraged to share their feelings, emotions, and attitudes towards the methods they use to tackle stress. Quantitative methods would only identify some trends without estimating the meanings behind the use of certain coping techniques. Eslami Akbar et al. (2015) do not identify any perspective from which their research was developed.

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Although there is not a specific section devoted to the analysis of the existing literature on the matter, the authors provide quite an extensive review of the studies on the related topics. They refer to quantitative and qualitative, as well as meta-analysis, studies, which help develop a deep understanding of the existing trends and gaps. Although Eslami Akbar et al. (2015) cite relevant data, the sources are often rather outdated as they are published in the 2000s or even 1990s. The lack of recent studies can be regarded as one of the weaknesses of the study in question. The authors do not evaluate the studies they refer to, but they mention some of their strengths. It is noteworthy that no vulnerable populations or topics were involved.

Results of Study

The major finding of the study as reported by Eslami Akbar et al. (2015) is the identification of the most common coping strategies that include self-control, condition situational control, spiritual coping, condition preventive monitoring, seeking help, and avoidance. It is also noted that control-based strategies prove to be the most effective techniques associated with the most favorable outcomes for nurses. Spirituality and time management are also characterized by considerable efficiency. Eslami Akbar et al. (2015) adds that the strategies nursing professionals utilize often depend on their personalities as reported by the participants. This finding is supported by the evidence provided in the studies published earlier.

The primary implication for nursing practice involves insights into different coping strategies nurses use to address stress. The study can be instrumental in developing effective training interventions that can equip nursing professionals with the necessary knowledge and skills. Nurses can use the most appropriate methods in different settings. The findings are consistent with the existing knowledge base and provide some qualitative information. The data can also be used to develop some policies that could improve the working environment for nurses. The information concerning coping strategies could also be incorporated into the curriculum in medical school, which could potentially decrease nurse turnover and understaffing.

Ethical Considerations

Eslami Akbar et al. (2015) addressed all the major ethical considerations. They receive the necessary permission from the corresponding entities. They also obtained written consent from the participants who had all the details concerning the study. The confidentiality of the data was ensured through a set of standard procedures. Unstructured interviews were conducted individually, which contributed to the confidentiality and anonymity of the participants and the information they shared.


In conclusion, the article by Eslami Akbar et al. (2015) provides insights into strategies nurses employ to handle stress, as well as their reasons behind the choice of the coping technique. The major relevance of the study is its qualitative nature as the majority of studies concerning stress-coping methods are quantitative. Eslami Akbar et al. (2015) claim that control and spirituality can be seen as the most effective components of methods utilized in nursing practice.

Time management, self-control, and control over situations tend to help nursing professionals cope with stress and, as a result, reduce their burnout and fatigue. The study under consideration can help develop effective interventions that will equip nurses with valuable knowledge and skills. Furthermore, the information can be used to improve the existing nursing programs that would help graduates obtain the skills that will be relevant in their career life. Finally, the data can be instrumental in introducing certain changes to policies and regulations on different levels. These can be state laws and recommendations as well as particular facilities’ policies and guidelines.


Eslami Akbar, R., Elahi, N., Mohammadi, E., & Fallahi Khoshknab, M. (2015). What strategies do the nurses apply to cope with job stress?: A qualitative study. Global Journal of Health Science, 8(6), 55.

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Hayward, D., Bungay, V., Wolff, A. C., & MacDonald, V. (2016). A qualitative study of experienced nurses’ voluntary turnover: Learning from their perspectives. Journal of Clinical Nursing, 25(9-10), 1336-1345.

Khamisa, N., Oldenburg, B., Peltzer, K., & Ilic, D. (2015). Work-related stress, burnout, job satisfaction and general health of nurses. International Journal of Environmental Research and Public Health, 12(1), 652-666.

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