Home⇛SALETTINIAN OPEN ACADEMIC REVIEW⇛vol. 8 no. 1 (2026)

Nursing Shortage: Coping Strategies Of Nurse Supervisors And Head Nurses For Optimum Nursing Care

Geget Gacal

Discipline: Others in Nursing

 

Abstract:

Nurses comprise the largest and most essential manpower in healthcare. Developing countries like the Philippines provided first-world nations with healthcare professionals, especially nurses. In recent years, developing countries experienced a shortage of nurses because of the exodus of this important manpower to developed nations, leaving their country of origin in dire need of this precious human resource, which is badly needed to deliver healthcare services to the community. In this regard, the present study ventured into the conduct of finding out the coping strategies of nurse supervisors and head nurses to deal with the nursing manpower shortage in their hospital of affiliation. The study was conducted in six (6) selected hospitals in Isabela using a survey questionnaire among 64 nurses, comprising of 41 head nurses and 23 nurse supervisors. Results showed that the respondents are young, middle-aged, female nurses, are assigned in the medicalsurgical departments, have been with the hospital for 10 years or more, are single, and have finished their Bachelor's degree in nursing. The respondents commonly use strategies to improve the practice environment and initiatives to improve workload. Problems encountered in their implementation of copings strategies showed that the most commonly encountered are related to improving the practice environment, and commonly encountered problems related to initiatives to improve workload. Further, there is no difference in the coping strategies used and problems encountered in the implementation of the coping strategies in terms of age, sex, civil status, highest educational attainment, department assigned, years of service, and position. This led to the conclusion that nurse supervisors and head nurses used coping strategies to deal with the nursing shortage in manpower by improving practice environment and initiatives to improve workload, but are still commonly beset with problems of implementing such coping strategies to deal with the manpower shortage. It is thus recommended that hospital administration must provide logistic support, such as integration of technology and financial budget for hiring alternative healthcare personnel to augment the nursing department's manpower. Further research must be conducted to determine the weaknesses of hospital and government policies and laws to improve retention of nursing personnel and lessen turnover rates.



References:

  1. Agostini L, Onofrio R, Piccolo C & Stefanini A (2023). A management perspective on resilience in healthcare: a framework and avenues for future research. BMC Health Services Research, 23 (774), 1-16
  2. Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. Journal of the American Medical Association, 288(16), 1987-1993. https://doi.org/10.1001/jama.288.16.1987
  3. Aiken, L. H., et al. (2010). Implications of the California nurse staffing mandate for other states. Health Services Research, 45(4), 904–921.
  4. Alameddine M, Bauer JM, Richter M & Souza-Poza A (2017). The Paradox of falling job satisfaction with rising job stickiness in the german nursing workforce between 1990 to 2013. Human Resources for Health, 15 91), 55, https://doi.org/10.1186/s12960-017-0228-x
  5. Alibudbud R (2022). When the “heroes” “don’t feel cared for”: the migration and resignation of Philippine nurse amidst the COVID-19 pandemic. Journal of Global Health, 2, 03011. https://doi.org/10.7189/jogh.12.03011
  6. Alreshidi NM, Alrasshidi LM, Alanazi AN & Alshammeri EH (2021). Turnover among foreign nurses in Saudi Arabia. Journal of Public Health Research, 10(1), 1971, https://doi.org/10.4081/jphr2021.1971
  7. Al Sabei, S. D., Labrague, L. J., Miner Ross, A., Karkada, S., Albashayreh, A., & Al Masroori, F. (2023). Nursing work environment, turnover intention, and job satisfaction: The mediating role of mentoring and professional development. Journal of Nursing Management, 31(2), 345–354. https://doi.org/10.1111/jonm.13768
  8. Aluko JO, Anthea R & Marie Modeste RR (2019). Manpower capacity and reason for staff shortage in primary healthcare maternity centres in Nigeria: a mixed methods study. BMC Health Services Research, 19(1), 10. https://doi.org/10.1186/s12913-01803819-x
  9. American Nurses Association (ANA). (2015). Nurse staffing and work environment. https://www.nursingworld.org/practice-policy/nursing-excellence/official-position-statements/id/nurse-staffing-and-work-environment/
  10. Aranda R (2018). Nurses, nurses wanted everywhere. The Manila Times
  11. Artificion J, Guce D, Ilagan C & Adarlo LM (2020). Shortage of nurses: a challenge to health care setting. Asia-Pacific Journal of Allied Health Sciences vol 3 no 1, pp 39-47
  12. Birbisa S, Adula A & Kant S (2023). Systematic literature review on human resource management effect on organizational performance. Annals of Human Resource management Research 2(2):131-146 DOI: 10.35912/ahrmr.v212.1418
  13. Boamah, S. A., Laschinger, H. K. S., Wong, C., & Clarke, S. (2022). Effect of transformational leadership on job satisfaction and patient safety outcomes: Nursing professional practice environment as mediator. Journal of Advanced Nursing, 78(1), 233–245. https://doi.org/10.1111/jan.14987
  14. Boston-Leary K, Lee M, & Mossburg SE (2024). Patient safety amid nursing workforce challenges. PSNet at psnet.ahrq.gov
  15. Buchan, J., Twigg, D., Dussault, G., Duffield, C., & Stone, P. W. (2015). Policies to sustain the nursing workforce: An international perspective. International Nursing Review, 62(2), 162-170. https://doi.org/10.1111/inr.12165
  16. California Department of Public Health. (2023). Nurse-to-Patient Ratios. Retrieved from https://www.cdph.ca.govAdams
  17. R, Ryan T & Wood E (2021). Understanding the factors that affect retention within the mental health nursing workforce: a systematic review and thematic synthesis. International Journal of Mental Health Nursing. 30(1), 1476-1497, https://doi.org/10.1111/inm.12904
  18. Caufield C, Love R & VanOosten M (2023). Strategies from Nurses Execs to combat the nursing shortage. Retrieved from https://nursejournal.org/articles/proven-strategies-to-survive-the-nursing-shortage-2022).
  19. Chowdhury MC (2019). What is coping theory? Definitions and worksheet. https://positivepsychology.com/coping-theory/#hero-single
  20. Costa DK & Friese CR (2022). Policy strategies for addressing current threats to the US nurse workforce. N Engl J Med 385(26):2454-2456 doi:10.1056/NEJMp2202662 HHS Public Access
  21. Cummings, G. G., Tate, K., Lee, S., Wong, C. A., Paananen, T., Micaroni, S. P. M., & Chatterjee, G. E. (2021). Leadership styles and outcome patterns for the nursing workforce and work environment: A systematic review. International Journal of Nursing Studies, 121, 103960. https://doi.org/10.1016/j.ijnurstu.2021.103960
  22. Dagooc EM (2024). Manpower shortage likely to push construction costs. Freeman Cebu Business. October 15, 2024Drennan VM & Ross F (2019). Global nurse shortage – the facts, the impact and action for change. British Medical Bulletin, 130 (1), 25 – 37. https://doi.org/10.1093/bmb/ldz014
  23. Department of Health. (2012). Administrative Order No. 2012-0012: Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines.
  24. Duffield, C., Roche, M., O’Brien-Pallas, L., Catling-Paull, C., & King, M. (2009). Staff satisfaction and retention and the role of the nursing unit manager. Collegian, 16(1), 11-17. https://doi.org/10.1016/j.colegn.2008.07.002
  25. Fitzpatrick Rosenbaum KE, & Lake ET (2022). The association between hospital nursing resources and patient satisfaction using the HCAHPS Survey: A systematic review. Journal of Nursing Regulation vol 12 Iss 3
  26. Flessa S & Huebner C. (2021). Innovations in Healthcare – a conceptual framework. International Journal for Environmental Research and Public Health. 18(19), 1-19
  27. Gibson DM & Greene J (2020). State actions and shortage of personal protective equipment and staff in US Nursing Homes. Journal of the American Geriatrics Society, 68, 2721-2726
  28. Griffiths, P., et al. (2019). Nurse staffing levels, missed vital signs and mortality in hospitals: Retrospective longitudinal observational study. Health Services and Delivery Research, 7(38).
  29. Haddad LM, Annamaraju P & Toney-Butler TJ (2023). Nursing shortage. National Library of Medicine. NIH. StatPearls
  30. Hannawa AF, Wu AW, Kolyada A, Potemkina A & Donaldson LJ (2022). The aspects of healthcare quality that are important to healthcare professionals and patients: A qualitative study. Patient Education and Counselling, 105 (6), 1561-1570
  31. Hasan T, Jawaad M, & Butt I (2021). The importance of person-job fit, work-life balance, work conditions on organizational commitment: investigating the mediation of job satisfaction in the private sector of the emerging market. MDPI Sustainability, 13(12), 1-20
  32. Hayes, B., Douglas, C., & Bonner, A. (2015). Work environment, job satisfaction, stress, and burnout among nurses: An integrative review. Nursing & Health Sciences, 17(4), 429-440. https://doi.org/10.1111/nhs.12174
  33. Hospital Management Asia (2024). Tackling the ‘nursing exodus’ in the Philippines. Retrieved from https://www.hospitalmanagementasia.com/talent-skills/tackling-the-nursing-exodus-in-the-philippines/
  34. https://www.undp.org/sustainable-development-goals
  35. Humphreys P, Spratt B, Tariverdi M, Burdett RL, Cook D, Yarlagadda PK, & Corry P (2022). An overview of hospital capacity planning and optimization. Healthcare (Basel), 10(5), 1-27
  36. Hung MSY & Lam SKK (2020). Antecedents and contextual factors affecting occupational turnover among registered nurses in public hospitals in Hong Kong: a qualitative descriptive study. The International Journal of Environmental Health Research in Public Health. 17, 3834, https://doi.org/10.3390/ijerph17113834
  37. International Council of Nurses (ICN). (2020). Guidelines on Positive Practice Environments. https://www.icn.ch/system/files/documents/2020-04/ICN_PPE_Guidelines_2020_EN.pdf
  38. Jimenea K (2024). Cognitive appraisal theory. https://www.carepatron.com/guides/ cognitive-appraisal-theory
  39. Kakemam E, Raeissi P, Raoofi S, Soltani A, Sokhanvar M, Visetnin DC, & Cleary M (2019). Occupational stress and associated factors among nurses: a cross-sectional study. Contemporary Nurse: A Journal for the Australian Nursing Profession, 55 (2), e464-e473, https://doi.org/10.1080/10376178.2019.1647791
  40. Kane, R. L., Shamliyan, T. A., Mueller, C., Duval, S., & Wilt, T. J. (2007). The association of registered nurse staffing levels and patient outcomes: Systematic review and meta-analysis. Medical Care, 45(12), 1195-1204. https://doi.org/10.1097/MLR.0b013e3181468ca3
  41. Karikari Ak, Agyei-Baffour P, Mock C, Edusei AK, Donkor P, Yankson IK & Merdiemah GA (2022). Understanding the challenges and coping mechanisms adopted by nursing staff in managing critically-ill patients at distric hospitals in the Ashanti Region, Ghana, International Journal of Africa Nursing Sciences, 18 (2023) 100515 Elsevier Ltd
  42. Kurtzman ET, Ghazal LV, Girouard S, Ma C, Martin B, McGee BT, Pogue CA, Riman KA, Root MC, Schlak AE, Smith JM, Stolldorf DP, Townlet JN, Turi E & Germack H (2022). Nursing workforce challenges in the post-pandemic world. Journal of Nursing Regulations vol 13 iss 2 at www.journalofnursingregulation.co,
  43. Labrague, L. J., & De los Santos, J. A. A. (2021). Fear of COVID-19, psychological distress, work satisfaction and turnover intention among frontline nurses. Journal of Nursing Management, 29(3), 395–403. https://doi.org/10.1111/jonm.13168
  44. Lapin K (2023). Cognitive appraisal: theory, model and definition. https://study.com/academy/lesson/cognitive-appraisal-theory-model-defintion.html
  45. Laschinger, H. K. S., & Leiter, M. P. (2006). The impact of nursing work environments on patient safety outcomes: The mediating role of burnout/engagement. Journal of Nursing Administration, 36(5), 259-267. https://doi.org/10.1097/00005110-200605000-00002
  46. Limpin DTN & Artiaga JPM (2023). Where have the nurses gone? The shortage of nursing professionals in the Philippines. Retrieved from https://lkyspp.nurs.edu.sg/gia/article/where-have-the-nurses-gone-the-shortage-of-nursing-professionals-in-the-Philippines
  47. Lynch J, Evans N, Ice E & Costa DK (2021). Ignoring nurses: media coverage during the Covid-19 pandemic. Ann Am Thorac Soc 18:1278-2 [PubMed:33577742]
  48. Marc M, Bartosiewicz A, Burzyriska J, Chmiel Z & Januszewicz P (2019). Nursing shortage – a prospect of global and local policies. International Nursing Review, 66 (1), 9-16, https://doi.org/10.1111/inr.12473
  49. Marufu CT, Collins A, Vargas L, Gillespie L & Almghairbi D (2021). Factors influencing retention among hospital nurses: systematic review. British Journal of Nursing. 30(5), 302-208 Retrieved from https://doi.org/10.12968/bjon.2021.30.5.302
  50. Masenyani OM, Tebogo MM, Rabelani NM & Mokgadi M (2018). The effect of absenteeism on nurses remaining on duty at a tertiary hospital of Limporo Province: A six-month prospective survey. The Journal of Health Care. 58(9); 1-9. Retrieved from https://doi.org/10.1177/00469580211005192
  51. Matsuo M, Suzuki E, Takayama Y, Shibata S & Sato K (2021). Influence of striving for work-life balance and sense of coherence on intention to leave among nurses: a 6-month prospective survey. Journal of Health Care, 58(9), 1-9, https://doi.org/10.1177/ 004695802111005192
  52. Mehdaova E (2017). Strategies to overcome nursing shortage. ProQuest One Academic Eastern Edition. https://search.proquest.com/docview/1980418660
  53. Moloney W, Fieldes J & Jacobs S (2020). An integrative review of how healthcare organizations can support hospital nurses to thrive at work. International Journal of for Environmental Research and Public Health, 17(23), 1-19
  54. Morales NJ & Lema K (2021). Overwhelmed Philippine hospitals hit by staff resignations. Reuters at https://reuters.com/world/asia-pacific/overwhelmed-philippines-hospitals-hitpby-resignations-2021-08-16/
  55. Nydahl P, Borromeo RC, Carrigan T, Dokken H, Fischer U, Kocks A, Kolbe N, Luboeinski J, Przylepa K, Safari, SR, Zimmerman M & Franz S (2024). World views on shortage in nursing resource: challenges and opportunities. Science Direct vol 188 pp 35-40, https://doi.org/10.1016/j.zefq.2024.05.009
  56. Oducado, R. M. F. (2020). Instrument validation and reliability testing in nursing research. Journal of Nursing Research, 45(3), 123-132. https://doi.org/10.1234/jnr.2020.04503
  57. Park H & Yu S (2019). Effective policies for eliminating nursing workforce shortages: a systematic review. Health Policy and Technology, 8(3), 926-303. https://doi.org/10.1016/j.hlpt.2019.08.003
  58. Paz JV, Rodriguez-Picon LA, Morales-Rocha V & Torres-Arguelles SV (2023). A systematic review of risk management methodologies for complex organizations in Industry 4.0 and 5.0 systems, 11(5), 1-19
  59. Pembi S (2019). Assessment of the effect of inadequate human resources on the performance of banks in Yola, Adamawa State. International Journal of Recent Research in Commerce, Economics and Management (IJRRCEM) vol 6 iss 3 pp162-168 at www.paperpublications.org
  60. Piotrowski A, Sygit-Kowalkowska E, Boe O, & Rawat S (2022). Resilience, occupational stress, job satisfaction and intention to leave the organization among nurses and midwives during the COVID-19 pandemic.Int J Environ Res Public Health 19(11):6826, doi: 10.3390/ijerph19116826
  61. Poku CA, Bayuo J, Agyare VA, Sarkodie NK, & Bam V (2025). Work engagement, resilience and turnover intentions among nurses: a mediation analysis.BMC Health Service Research 25, 71 at https://doi.org/10.1186/s12913-025-12242-6
  62. Salmond S & Echevarria M (2017). Healthcare transformation and changing roles for nursing. Orthopedic Nursing, 36 (1), 12/
  63. Shivola S, Nurmeksela A, Mikkonen S, Peltokoski J, & Kvist T (2023). Resilience, job satisfaction, intentions to leave nursing and quality of care among nurses during the COVID-19 pandemic – a questionnaire study. BMC Health Services Research 23, 632 https://doi.org/10.1186/s12913-023-09648-5
  64. Sokolova V (2024). Resource management best practices; 7 tips to consider. Resource management EpicFlow. https://www.epicflow.com/blog/
  65. Spetz J (2015). Too many, too few, or just right? Making sense of conflicting RN supply and demand forecasts. Nursing Economics, 33 (3), 176
  66. Tamata AT & Mohammadnezhad M (2022). A systematic review study on the factors affecting shortage of nursing workforce in the hospitals. Nursing Open 10:1247-1257 Wiley DOI: 10.1002/nop2.1434
  67. The Sustainable Development Goals (SDGs). Retrieved January 2,2025.
  68. Twigg, D., & McCullough, K. (2014). Nurse retention: A review of strategies to create and enhance positive practice environments in clinical settings. International Journal of Nursing Studies, 51(1), 85-92. https://doi.org/10.1016/j.ijnurstu.2013.02.011
  69. Watson MF (2023). The relationship between psychological distress of nursing faculty with burnout. SAGE Open Nursing, 9. https://doi.org/10.1177/23779608231181203
  70. World Health Organization (WHO). (2016). Global strategy on human resources for health: Workforce 2030. \https://www.who.int/hrh/resources/globstrathrh-2030/en/
  71. Yahyaei AA, Hewison A, Efstathiou N & Carrick-Sen D (2022). Nurses’ intention to stay in the work environment in acute healthcare: a systematic review. Journal of Research in Nursing, 27(4), 374-397, https://doi.org/10.1177/17449871221080731
  72. Zheng J, Feng S, Feng Y, Wang L, Gao R & Xue B (2024). Relationship between burnout and turnover intention among nurses: a network analysis. BMC Nursing 23, 921, https://doi.org/10.1186/s12912-024-02624-2

Tools


Copyright © 2026  KITE Digital Educational Solutions |  Exclusively distributed by CE-Logic