When extreme work becomes the norm: an exploration of coping strategies of public sector nurses

Drawing on extreme work and transactional stress literature streams; this paper investigates the mechanisms used by public sector nurses to cope with their extreme work conditions in the fragile state context of Egypt. Our findings, which are based on 24 qualitative interviews, show that, to cope with their extreme job duties, nurses engage in the following four strategies–reassertion of professionalism, submission and fatalism, cronyism, and temporalism. Moreover, we found that the low availability of social, physical, and psychological resources and the perceived inadequate provision of entitlements also played a role in this context. Finally, our study is among the first to link the fragile state environment with extreme work conditions in healthcare sector while simultaneously highlighting the related coping mechanisms.