The agony of nurses and of a country that lacks them

[Lee]

Please cite the Manila Times--not me--if you disagree with anything in this article.

By Fr. Ranhilio Callangan Aquino                  Manila Times
April 12, 2023 
 

Quote

 

RECENTLY, CHEd Chairman Prospero de Vera 3rd announced what he trumpeted as his solution to the problem of an alarming shortage in the number of nurses who decide to remain in the country and to practice their profession here. From reports, it seems that it is a "solution" he conjured by his lonesome self, because I surmise that his fellow commissioners at CHEd have not lent their concurrence — and, perhaps, may not even be aware of it.

The law that created that regulatory agency is very clear that the CHEd is a collegial body and must act as a collegial body. The chairman is merely its representative, not its embodiment!

The plan is to shorten the nursing course. To what end, it may be asked? It will be recalled that one reason that we transitioned to K to 12 was so that the number of years spent at school would equal the period required of our students' counterparts in the United States, in Europe and in the rest of the world. Now, it seems that Mr. de Vera's solution is to create a "ladderized" program — with exit competencies at the end of each year. "Ladderized" schemes are not new. They have been proposed, tried and have largely failed. Most students who enroll in our colleges will proceed to the full length of the course. Much besides, who will hire the services of a nurse aide, of a nurse assistant? That will return us to the days when those who held the title "Graduate Nurse" had to compete with those who held the full Bachelor of Science in Nursing degree — and of course, suffered by comparison, although it will not be doubted that many in the former group were highly qualified and highly dedicated. But degrees do matter.

A first helpful step will be to listen to the nurses, and to ask why it is that they are eager to pack up and serve in other climes — and the answer will not be too difficult to fathom: they are more handsomely paid elsewhere, and their services and talents receive their corresponding monetary compensation. Obviously, what we pay our nurses is also dependent on the economy of the country, and it will not do to increase the already prohibitive costs of medical and nursing care. Rather than palliative approaches, a more thorough approach must be found. Nurses should not be left to the mercy and the caprice of private hospitals and health facilities which pay them a pittance for their sleepless nights and backbreaking toil. And the pay scale in government hospitals should be attractive enough to keep them in the country, even if only for a few years following their graduation, or to be able to lure them back when they have retired from lucrative employment abroad.

When one thinks of the scandalously fat salary checks of executives in government financial institutions such as the Bangko Sentral and others and the pittance that our nurses receive, any right-minded individual will feel revulsion. It is of course true that you need very high levels of competence to be an architect of the nation's monetary policy, but it is no less true that you need skill, and patience, and a honed degree of scientific knowledge to minister to the sick as nurses are expected to do. Equitable distribution is the issue here — and you do not address that problem by shortening or lengthening curricular years! You deal rather with the more complicated issues of universal health care and related issues.

When we are able to address the issue of equity in regard to the pay scale of nurses, then we shall have the right to legislate compulsory service in the country for some time before they leave for even more lucrative employment abroad. In the law curriculum, legal aid has not only been institutionalized but mandated, and we deal here with students who have spent close to eight years in a university — four years of a pre-law course, and another four years for law proper. It is much the same thing with physicians and their clerkship and internship programs.

And you do not solve the problem of a shortage of nurses by being unduly restrictive in regard to nursing education. State universities and colleges should be encouraged — and aided — to offer nursing throughout the country. Here, as in many other areas of higher education, access is a key issue, but when you have a regulatory agency that approaches its mandate imperiously, then you are not being helpful.

There is no single solution to this convoluted problem — and so it will not do for one bureaucrat alone to announce "his" solution. What should be promising is an inclusive dialogue between all stakeholders, a concerted design of a comprehensive approach, as well as an appeal to all who aspire to be nurses. While nursing schools currently rely on grades exhibited by students from basic education, it might be as helpful to inquire into the disposition and attitude of the applicants to our colleges of nursing, for if nursing is a profession of service, then the notion of serving should not be something abhorrent to one who seeks to be part of the profession!

 

https://www.manilatimes.net/2023/04/12/opinion/columns/the-agony-of-nurses-and-of-a-country-that-lacks-them/1886712

[Old55]

Wow, even for a Filipino newspaper that may be the most convoluted confusing steaming pile of work I've ever read. 

Filipino Nurses are treated very poorly in the local workplace. My sister in law was a nurse in Cebu City until she was able to move to the States. 

[Lee]

You are absolutely right Old55---nurses here are treated like crap. All for 15-20K PhP per month if they can get that.

I don't recall if I read this somewhere or witnessed it first hand but the story was that the nurse was asked by a local if she could back to her room around 1PM.

The patient said that she wanted her hair washed as her family would be there for a visit around 2PM.

[BrettGC]

Interesting if convoluted but the author manages to get his point across.  

They really do need to institute a western style system sort of like the one suggested in the article:

AIN/Orderly (4-6 months study)

Enrolled Nurse (2 years full-time study)

B.Sc in Nursing (3 years full-time with options for honours etc)

If an enrolled nurse starts a B.Sc post-grad, they only get 1 year's credit. I don't know why it's the case, I'm not a medico familiar with all the intricacies.  

Post Grad courses in medical specialities, as well as medical admin, data analysis, statistics, research etc - yes nurses do go into those fields.  

Given the PI education system those timings would be up to 12 months longer.  I'm basing the stated timings on current course lengths in Australia where most bachelors degrees are 3 years, there's no "fluff subjects" to "expand your.. whatever"  as there are in other countries.  It may be different in other western countries. 

I sort of grind my teeth when I see how little nurses are paid in many countries, they're some of the lowest paid university graduates world-wide.  There are exceptions, I have a really good mate I was in AFG with, she was a RAAF medic and she started her B.Sc whilst still serving, finished just after discharge, then studied post-grad specialities whilst earning.  She moved to Canada where she's a PICC line nurse on insane money; even more so than in Australia where she was on very good money.  So much so that she takes 4 months off a year to go and work for Doctors Without Borders and they hold her job for her.  Compare that to PI nurses...

Pay competitive money, it's basic business.  As for stopping graduates going overseas for employment... Are you kidding me?  

[Dave Hounddriver]

9 hours ago, Lee said:

Please cite the Manila Times--not me

Just a point of order here, if anything in your post is quoted and replied to then it is attributed to you.  There is no way to change that.  It is the forum system.  So when it happens, and it will, keep it in mind that it is not personal.  Thank you.

Now as to countries that lack nurses, it would be easier to name one that doesn't.  I cannot think of one.  Can anybody here think of a country that is not lacking nurses?

[Major Tom]

4 hours ago, BrettGC said:Pay competitive money, it's basic business.  As for stopping graduates going overseas for employment... Are you kidding me?  

The most compassionate nurse that I had during a long term hospital stay was a Filipina. The Philippines loss is my gain, not just for me, but for so many other people in countries that have nurses from the Philippines.

[Lee]

Dave, there is normally a pretty good work around to avoid erroneously quoting a poster and not the article that the poster contributed.

In the case that I am citing one might start with "The article in the WSJ stated......"

Underneath that copy and paste the part of the post that is to be quoted. Then use the quote function on the toolbar to highlight it.

Underneath this then list your comments about the post.

On other forums I have seen huge "dogfights" start where a poster of an article was attacked for something that they never said.

[Old55]

58 minutes ago, Lee said:

Dave, there is normally a pretty good work around to avoid erroneously quoting a poster and not the article that the poster contributed.

In the case that I am citing one might start with "The article in the WSJ stated......"

Underneath that copy and paste the part of the post that is to be quoted. Then use the quote function on the toolbar to highlight it.

Underneath this then list your comments about the post.

On other forums I have seen huge "dogfights" start where a poster of an article was attacked for something that they never said.

In most cases members here play nice but are free to speak their minds.

When members post unnecessarily dramatic or controversial content on a regular basis they will be warned or removed. The forum rules state one can reply reasonably to the content as they wish but not personally attack the poster.

[BrettGC]

4 hours ago, Major Tom said:

The most compassionate nurse that I had during a long term hospital stay was a Filipina. The Philippines loss is my gain, not just for me, but for so many other people in countries that have nurses from the Philippines.

Same.

[KC813]

7 hours ago, Dave Hounddriver said:

Now as to countries that lack nurses, it would be easier to name one that doesn't.  I cannot think of one.  Can anybody here think of a country that is not lacking nurses?

Strangely enough Dave, yes:  the Philippines does not lack nurses.  They just do not want to work in the Philippines medical system.  This was raised repeatedly during covid, that around only 50% of RNs in the country were actually employed in healthcare, with a large bulk of available nurses preferring to work outside of the industry or not work at all.  This was also raised again in a Senate hearing last month discussing the shortage of healthcare workers.

The most accurate statement in the quoted opinion piece: “there is no single solution to this convoluted problem”.  Most countries have some problems delivering medical care – most often attributed to financial limitations. 

What makes the Ph public healthcare problem different is how it was created by uniquely Filipino laws and societal traits.

--A government that created a culture and entire bureaucracy that encourages workers to go abroad and send back money; at times labeling OFWs as ‘heros’ and even implying a patriotic motivation.

--With overseas job opportunities, nursing schools in the Ph proliferated since the 70’s, turning the country into a “nurse mill”.  This glut of nurses has been a historic factor in keeping in-country wages low.

--Labor laws that encourage contractualization over direct hiring.

--The economic/educational ‘caste system in the Philippines.  One of the most common observations I hear from PH nurses overseas (mainly US & UK) is that they are treated so much better then they were in the Philippines. Like Old55 implied, simply, their bosses treat them nicely. 

--The benefit to many persons in politics or with strong political influence and own private hospitals to keep the system as-is as they profit by drawing paying patients away from the government facilities.

--Around 900 ‘medical missions’ arrive in the Philippines each year to provide medical/surgical/dental services in underserved areas.  Although their goal may be charitable, these missions (and hundreds of containers full of supplies) take the pressure off the government to adequately fund healthcare.

We all know there are some excellent medical facilities in the Philippines for those who can afford the cost.  And the nurses are here, but until they are treated better many will go abroad or just stay away from healthcare!