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Nursing Shortage in the Philippines: The Real Score






I was listening to the radio the other night. The radio anchor was interviewing this young nurse who has just learned that she placed 4th in the recently concluded Nurse Licensure Examination. Apparently, this young nurse is set to leave for the United States of America on an immigrant visa.

The radio anchor felt that it was rather unfortunate that a young and brilliant nurse would rather choose to use her knowledge and skills in a foreign land giving care to foreigners while a great majority of her countrymen are deprived of even the most basic of health services.

This sentiment is not isolated. In fact, several articles have been written on the exodus of our professional health workers. Some were well-placed and had valid points while others were plain ignorant and unfair. I once read an article, where nurses were labeled as "mukhang pera" because they leave the country to literally wipe a foreigner's ass while leaving their aging parents who have no one to look after them so they can earn green bucks.

I think the practice of blaming migrating nurses for the shortage or lack of decent and competent care in Philippine hospitals is utterly unfair and ignorant.

Point #1
True, hospitals close shop because they have no nurses and doctors left to man their wards. However, this cannot be fully attributed to the mass exodus of nurses to 1st world countries. Every year, thousands enrol to nursing schools, thousands more graduate from these schools, and a great number of this, pass the licensure examinations and become nurses. There is a constant supply of nurses. The shortage is in the job vacancies. Some hospitals simply refuse to hire more people as a way to cut operational costs. This is a fact.

Point #2
Nurses in government hospitals are underpaid yet overworked. In some cases, the nurse to patient ratio is as bad as 1:50. That's one underpaid and overworked nurse tasked to care for fifty patients with varying needs. As if this is not enough, they are constantly at great risk of losing their hard-earned license and means of livelihood should they commit grave oversights.

Point #3
Nurses undergo a 4-year rigorous academic and clinical training before they even get to sit for a licensure examination and this entails huge financial costs. While other courses get allowances from corporations when they undergo On-the-Job practicums, it is the opposite for student nurses. Student nurses pay training institutions varying amounts of affiliation fee for every day of duty. Add to that the cost of the supplies that will be used for every day of duty. The point that I'm trying to get at is that obtaining a nursing education involves tremendous financial costs that is unheard of in other professions/fields (I should know, nursing is my 2nd degree) and yet, a professional nurse's average pay is comparable or near to minimum wage. Nurses also have mouths to feed and bodies to keep warm (Read: families).

Point #4
In the early years of nurse migration, critics claim that the continuous migration of nurses to 1st world countries would result to a problem they call, "Brain Drain." This is the phenomenon where the best skilled and trained nurses leave and the less than stellar ones (Read: incompetent) remain to care for the filipino. In recent years, a rather exaggerated term has been created to describe the phenomenon. They now call it, "Brain Hemorrhage." While there may be some ounce of truth to the claim, I see it as self-defeating. It's "damn if you do, damn if you don't" If nurses migrate, they contribute to the health care decay that is the "Brain Drain" However, if they choose to be "patriotic" and remain in the service of the filipino, they are generally described as "incompetent" if we are to follow the logic of the "Brain Drain" phenomenon.

Point #5
Filipino nurses working abroad earn more than your average Overseas Filipino Worker. Thus, by simple math, it can be safely assumed that they are able to make more dollar remittance to their families in the Philippines. This means stronger peso for the the economy, lesser cost for social services for the government, families left behind get access to quality education, healthcare, and a generally better life. It is a well established fact that OFWs are the lifeblood of our country's economy. This is why OFWs are called "modern day heroes." Then why discriminate against the nurse OFW?

Nurses are human beings too like any other Tom, Dick, or Harry. They have dreams, aspirations, wants, and needs. If they choose to leave the country to find a greener pasture elsewhere, it should not be taken against them as it is just human nature to satisfy one's need. Each one of us has a right to pursue our goals and dreams. Engineers work in the middle east so they can earn their keep and realize their dreams; Seamen go on long and arduous voyages so thay can give their families a glimpse of the goodlife. Why can't nurses do the same?


Discuss this Article at the Message Board.

24 comments:

Anonymous said...

Tang ina, lyle! kaw nagsulat ani. oh my gulay, im so FROUD OP YOU!!! hehehe just kidding. Congats lyle, sa wakas ATTY na gyud ka este RN diay hehehe.
-CFL-

Anonymous said...

grabe! who arth thou that knowest such diction.the language is so sticky and rich with ideas.bravo!!!fellisimo.tama jud lagi ko, ikaw na jud diay lyle...wala koy masulti ba kundi...firti fud!!! chillet

glen ventanilla said...

helo!!!ako pala c glen.2nd yir biostudnt s UP..gumagawa kasi ako ng paper sa english namin at ang napili kong topic e doctors becoming nurses..hayun..just want to tankyu for d opnions..tanx!those helped a lot. for me, id rather stay and care for the Filipinos..they need our medical help more than any other people in the globe..mas lalo na ang mga tao sa rural areas..i hop ganon din an iba coz noting satisfies more than helpng the people who needs it the most. TAnx agen.

Anonymous said...

kung saan kayo masaya..go lang kayo.ang importante hwag nyo sayangin ang pinag aralan nyo,isipin ntin ang mga pghihirap d lng s pagaaral kundi ang ating mga magulang at mga tao sumuporta sayo.

Nurse Jenny said...

Try to visit this site How to start a nursing agency its a nursing guide.. And its a solution to the nursing shortage crisis.

sheila dela pena said...

i was so impressed with what is being posted..i have considered everything as a fact..long live the heroes of today....mabuhay Filipino nurses

Anonymous said...

wow!thank you po sa mga points na binigay niyo,,nabasa ko pa siya..very impressing po talaga yung mga sinabi niyo...nursing studen di po kasi ako kaya i appreciate whatever you have written here,,i'm really proud to be nursing student...

Tupac said...
This comment has been removed by the author.
Anonymous said...

Nurse's Shortage in this country? C'mon! ilan ba ang naggraduate every year na nurses and ilan sa mga ito ang nakakapasa.. if im not mistaken last june 2007 more or less 30,000 nurses have passed the NLE. I agree with the author, wala sa supply ang problema, but sa demand. we have overspilling number of nurses pero iilan lang bang hospitals ang nghihire ng new staffs all over the country?

in my own observation, majority of hospitals are now taking advantage on nursing students attending duty at their institution. mas napapagaan na nga ang trabaho ng mga employee staffs, ung mga istudyante pa ang nagbabayad ng napaka mahal na RLE fee! and because may nakakatulong na silang mga estudyante bakit pa sila maghihirire ng bagong staffs diba?
i believe this is one of the reason kaya kokonti nalang na hospital ang nagoofer ng job hiring these days.

kawawa naman ang karamihan ng magulang na pinipilit ang kanilang mga anak para lang magnursing sa paghahangad na maiahon sila sa kahirapan. d nila alam kung gaano na kahirap ngaun ang sitwasyon ng mga nurses sa pilipinas.

whiteknight said...

Well said. I do hope our government right now read your comments lyle. This is my sentiments too. It's just easy for them to say that all nurses should stay here in the Phils. for a number of years before they should be allowed to go out. This is UNFAIR and unconstitutional. Is our government the one paying for our huge tution fees, miscellaneous, psychia and all the others fees that burdens us throughout the years of studying? (I am refering here of private schooled nurses) Why is it that they put so much emphasis on this doctors & nurses exodusing when they have not yet addressed the root cause of this scenario many years ago? Can they not understand that these nurses have also their own needs to meet just like any other professionals do? What do they think of us, missionaries? The government should not imposed drastic actions without considering it's consequences. The exocus of nurses will continue not because of the trend but it's the reality among us ALL filipinos, isn't it? In India (which is our #1 competitor), I have heard that their government helps their graduate nurses easily go out by giving them financial assistance since it still entails a lot of expenses before a nurse can go abroad. So why not our government here do the same? To government agencies such as DOLE,etc. we are not selfish, we just want our life as comfortable as yours. I hope you sincerily understand our situation. Do not make us a sacrificial lamb. Do not blame us. It's our system that force health professionals to seek greener pasture outside. Hope it's clear to you. We will count on you.

Anonymous said...

lyle ang galing mo,

tama ka, ang nurses dito sa pinas ay inaabuso na parang wlang pinag-aralan. ang liit ng sweldo 3,000 a month, may volunteer program pa na wlang sweldo for 6 months, mga gamit sa hospital tulad ng mask at sabon para handwashing tayo pa bibili. may mga tao pa na nagsasabi mga nurses daw ay mukhang pera. tang ina paano namin mabibigyan ng magandang buhay ang ating pamilya kun 3000 a month lang ating kikitain. paano kung tayo na ang magkasakit. may gobyerno ba na magbibigay ng gamot? wla! so mga nurses magaral kayo ng mabuti para sa NCLEX. at kung gusto nyong magkaroon ng review materials. meron akong libre. para sa mga nurses na magtake ng NCLEX o CGFNS. email nyo lang ako sa rugraf23@yahoo.com meron akong mga materials na tulad ng pearsonvue, feuer ma audio lecture etc. bigyan ko kayo lahat. basta magaral lang kayo ng mabuti. idol ko kasi ang nagsulat ng article nato. go go go lyle. sorry sa mga nasabi kong medyo bastos. pero gusto ko lang ipahayag ang aking sarili. salamat lyle for posting this article.

ccc said...

Tama ka Lyle. Maraming hospitals ang padadaanin ka muna sa training bago ka i-hire. Okay lang yun para di mangapa sa trabaho, ang masakit nga lang eh ikaw pa ang pagbabayarin. Aalilain ka na, wala ng sweldo, ikaw pa ang magbabayad. Pano gaganahan ang mga nurses natin sa Pinas kung ganito kababa ang turing sa atin. Mamatamisin pa naming magpunas ng pwet ng foreigners kesa i-exploit ng kapwa namin Filipino. Para sa gobyerno natin, kung guston nyo manatili nurses sa pinas, tratuhin nyo kami ng tama. mga kano at ibang lahi ay willing magbayad at pinapahalagahan serbisyo namin pero sa pinas inaabuso at nilalamangan pa ang mga kawawang nurses. Mabuhay tayong mga nurses!!! Thanks Lyle

Ramzenger said...

Excuse me, nurse ako s states pero hindi ako nag pupunas ng pwet ng foreigner dito, trabaho ng CNA yan. At saka may dignity ang nurse dito and part ng job mo is to work with doctors and not to work under them, pwede kang mag discuss sa doctor kung s tingin mo n hindi tama ang reseta niya. Sa states pwede kang taas nou ng nurse k. ni rerespeto may utak s sarili. Sa pinas PI talaga, bigyan k n ng napa raming work, sahod mo katiting ng mga kurakot ng corrupt government officials, pero wl ka pang pupuntahan na ayuda kung kailangan mo. Bulok ang sistema s pinas, at s mga taong nag sasabi n mukhang kaming pera?hmm, kasi may kokote kami, ayaw naming pumila pr bumiling bigas pr lang maka raos, bulok ang utak ninyo dahil hindi ninyo n aintindihan n ang buhay is all about choices, ambulok kayo sa pilipinas hangang mamatay kayo wl kaming paki-alam dahil bulok kayo.kami nga tong naghahanap ng paraan pr makaraos sa kahirapan tapos mukha kaming pera?bulok kayo alam ninyo bakit, dahil ayaw namin n ulila kami ng mga bulok ninyong sistema-bulok! Sa mga nurses n nag lilingkod pr s taong bayan-mabuhay kayo pero reminder lang, wlang tutulong sa inyo pag kailangan ninyo ng tulong, sa pinas mag nanakaw k ng sardinas bugbog sarado k, mag nakaw k ng billiones at sikat ka-bulok!!!

gaylordfocker615 said...

Man, everything you said on there just hit the spot!

Anonymous said...

Nice article,very well said. Nursing shortage daw..sa Pilipinas pa? sa dami ng mga graduates ntin shortage me pa?mdami tyo nurses d2 kht nga mga 2nd courser pumapasa din sa board exam e hindi rin mabigyan ng chance magwork dito.masisisi mo ba ang mga nurses kung aalis cla ng pinas dhil sa bulok nila systema...khit pa mgapunas ng pwet...dollar naman ang byad e dito satin inaalila ka na nga ikaw pa mgababayad ng training mo makapagpractice ka lang...hay sobra na! ayaw lang nila mag hire dahil maraming student nurses na sinasamantala nila na makakatulong nila sa ward. I myself,board passer,and i am having a trauma searching a job here in manila...

JaN said...

It’s been almost six months since I decided to quit my CS job and focus on getting my act together as a nursing professional. So for the last 160 days or so, I was at home bumming around trying to finish some PSP game or I was bouncing from one hospital to another trying to get the latest "word" if hospital A (to Z) was hiring. Now if they weren’t, the follow up questions were did they need volunteers, were they conducting trainings, do they have on the job trainings and other substantial queries I could think of just to make my visit worthwhile. Yeah I could have just called to get the information that I needed but that didn’t get me anywhere the first quarter of the year when I tried to let my fingers do the walking. You get the idea that it was a tedious and grueling process and the summer heat didn’t help either. I wouldn’t have minded all that if I had something to show for it after, but I didn’t. Some of these hospitals had train-to-hire schemes for a fee not lower than P8,000 (yes, we’ll pay them to work our butts off) but even these programs were always full. I've probably submitted 7 packets containing my credentials and I've yet to receive an email or a phone call saying "not in a million years" or something to that effect.
I’ve learned quite a few things these past few months and the lesson that resonated so loudly is that in this time of over abundance of nurses, its not what you know but who you know that matters in order to simply start your career. It’s hard not to paint everyone with the same brush when you can see it happening right in front of you. Nepotism and favoritism is definitely part of our culture and I don’t think that’s going to change anytime soon. My only request to people who’re able to callously get their sons, daughters or other relatives into a training program or even a position in a hospital simply because they work there or know someone who can pull some strings is to think of the people that were cut from the program or circumvented from getting a job because your son/daughter/relative TOOK it from them.
I’m currently waiting outside a huge closed door as I write this. When it opens in order to commence the process of screening train-to-hire applicants, I will find myself either taking my first step officially into my profession or once again have a slamming door in my face.

cristina said...

Hi. I am awed by your article. It is all true as I am in the same standpoint on the issue. I believe that God gives opportunities to people as a means to help others. Kagaya ko I am working here in the UK as a nurse but I don't want to think of it as a because I am mukhang pera. This is my practical choice. And considering that there are so many people in our country now who are desperate for jobs, why should I be in the same predicament while there is an opportunity for me to work somewhere else. If I had my way I would get as many people from our country as I can and have them work here with me. Hindi natin pwedeng sisihin ang ibang taong gustong guminhawa. Dapat lang diba? Dapat nga nating tulungan para makamit ito. Maraming nurses sa atin ang gustong makalabas ng bansa dahil sa hirap ng buhay at sa kawalan ng magandang trabaho sa atin. At siguro na rin dahil sa di magandang pamamaraan ng ating pamahalaan. Patriotism is not as rigid as what others may think. You can serve your country in different ways and you don't have to be in your country to do that. For those who work abroad they can do this by constantly sending money to loved ones, making the peso stronger as you said. By investing in our local business ventures, makakatulong din ito. My point is, working abroad can be a means to an honourable end. Especially if you have the intention to help other people in ways that you won't be able to do if you stayed in your country. Let us stop crab mentality and start moving forward. Magsipag tayong lahat and help our country to prosper. It does not matter where we are it's the effort we put in towards our goal of helping our fellow Filipinos make better of themselves.

Aaron said...

actually there's a demand in the Philippines. It's obvious. a 2:150 nurse-patient ratio or even worse. That's demand. But there are no JOBS. There's allocation, but no budget for the healthcare sector. So why blame nurses for leaving their homeland to serve others'.

normster said...

I couldn't agree with the author more. Don't let other people tell you otherwise! We all want to be a nurse for different reasons-if you choose to say here in the country to be a community health nurse there is nothing wrong with that! what really irks me are those people shoving their opinions and ideas right down our throats and romanticize the thought of us being the next florence nightingale of the philippines!Kudos to you sister!

jennilyn said...
This comment has been removed by the author.
tnhs1997 said...

nice article. i wish mabasa to ng mga bulok na pulitiko..

xxx said...

to ramzenger:
cno bang kalaban mo? ang taong bayan o ang gobyerno? parang ang laki naman ng galit mo sa bansang PINAS! sana ipinanganak ka na lng na KANO! BULOK KA RIN!

Maria Theresa said...

THIS IS TRUE...ANG DAMI MGA NURSES NA INAABUSO AT ANG DAMI RIN BAGONG NURSES NGAUN NA WLA MAPASUKAN MAGANDANG HOSPITAL..my kapitbahay ako na 2006 pa sya nkapasa sa board exam and now he's still a TRAINEE at PGH...do u knw wat trainee means?trainee na parang isang student. ung klngan mu p magbayad pra lng mkpag trabaho k dun at pwde mu gmiting experience wen u plan 2 go abroad...i remember wen sec duque said na government hospital don't do that "TRAINEE" policy...oh common...bgyan nyo mgandang trabaho at sweldo ang mga nurses and no reasons pra umalis pa mga nurses d2 sa pinas...hndi yong kmi pang mga nurses ang magbabayad sa hospital pra lang makapag trabaho kami...

Joseph said...

I think What's on the mind of that young person is that she doesn't want herself to be deprived from the opportunities to grow. let's face it how can a brilliant mind grow in this wretched country? And please don't blame it on her or the other Nurses its not their fault I'm sure going out of the country and working with foreign culture is also hard for her, the problem is the opportunities to grow here. I was surprised that in order for a nurse to get a Job here in the Philippines they need to pay a placement fee. Another thing is when a nurse is hired here in the they are on a six month probationary period and they only get an allowance for the services that they give.

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