Where have all the nurses gone?

I could write about the country’s female tycoons who have grown their fathers’ businesses to dizzying heights, including Tessie Sy-Coson, Helen Yuchengco-Dee, Robina Gokongwei and Josephine Gotianun-Yap; or I could write about the Dumaliang sisters who staunchly defend that piece of paradise known as Masungi Georeserve; or I could write about our Filipina athletes waving the flag around the globe.

March 8, after all, is International Women’s Day and the rest of the month is always a good time to celebrate the countless achievements of the Filipina.

But I also want to put the spotlight on the Filipina nurses, especially the mothers who are forced by circumstance to leave our home country to work abroad, leaving their families behind.

It’s a reality that we continue to face today.

The problem, unfortunately, affects all our nurses, women and men, and the issue goes beyond higher wages. This is something our government and health industry must address.

Beyond wages

Areo Comonal, a Filipino registered nurse who also became a registered nurse in Illinois way back in 1997, says in an interview that the problem goes beyond wages.

“Essentially, we are behind by 25 years in technology in health care,” Comonal said in a virtual interview I had with him last year. We are still in touch and the situation remains the reality in our nursing profession.

The bigger problem, he said, is that nurses feel like second class citizens in their own country.

In the Philippines, doctors treat nurses just as assistants and not as part of a medical team.

In contrast, in the US, Comonal said nurses like him feel psychologically safe.

“Doctors engage with the nurses. We work as a team. Doctors consult with us and listen to us regarding patients’ care,” he said.

This is sometimes not the case in the Philippines. Some nurses feel that if they speak their mind, doctors may lash out at them.

In the US, he said, you make your own destiny. If you want to undergo training, you can apply and the hospitals will even reward you if you train.

Whereas in the Philippines, there are so many fees before you can even earn your first paycheck.

On-the-job training also comes at a cost, Comonal laments.

Thus, he said, if the Philippines wants to stop the exodus of health care workers, it must change a system that favors those in the upper part of the health care system. Nurses and orderlies must feel valued.

Global shortage

The pandemic put the spotlight on the global shortage of nurses of about 5.9 million, according to a May 2022 article published in the Journal of Global Health, authored by Rowalt Alibutud.

“Asia is among the regions with the lowest density of nurses in the world, despite having countries that largely supply nurses in other regions. The Philippines alone supplied about 240,000 nurses to Organization for Economic Cooperation and Development (OECD) countries with an outflow of 15,000 to 20,000 nurses per year.

“This made the Philippines the largest supplier of nurses to OECD countries. The high nurse-to-patient ratio and low wages were among the common reasons for Filipino nurses to work in other countries. While it gave rise to a global diaspora of Filipino nurses, it also resulted in a low number and unequal distribution of nurses in the Philippines. This migration and resignation of Filipino nurses from the Philippine health care system may have accelerated during the pandemic,” the article said.

In the first two to three weeks of October 2021 alone, it was noted that about five percent to 10 percent of nurses working in private hospitals have resigned.

Among the commonly cited reasons for the resignation is low wages.

“An entry-level nurse working in a public hospital starts with a monthly salary of about P33,575 (about $670), while those working in private hospitals may start with as little as P8,000 (about $160). These wages may not be enough to cover the cost of living in the Philippines. For example, the estimated cost of living in Metro Manila, the largest Philippine metropolitan area, is P50,798 (about $1,080). Some of the nurses even go to work without benefits and hazard pay, despite the heightened health risks and threats during the pandemic,” according to the paper.

In contrast, in the US, a registered nurse can get a monthly pay of $11,500.

Last month, the Private Sector Advisory Council (PSAC), led by Sabin M. Aboitiz, president and CEO of Aboitiz Group, said it is doing its part in addressing the shortage of nurses in the country through various collaborative public-private programs in the health care, overseas welfare and education sectors.

Initiatives include the Clinical Care Associates Program for underboard nursing graduates, Enhanced Master’s Nursing Program and the bilateral labor agreements with other countries in the training and deployment of Filipino nurses, said PSAC Health Sector lead Paolo Borromeo, president and CEO of Ayala Healthcare Holdings.

The CCA is designed to create a pool of licensed nurses and to address the shortage of nurses in the country. Borromeo said CCA recruitment will continue for the 2024 and 2025 nursing board examinations.

This is a good step.

Moving forward, and beyond training, the government and the private sector must also work to create an environment where our nurses feel valued here in their very own home, whether they are male or female, whether it’s Nurses Day or Women’s Day or just an ordinary day.

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Email: [email protected]. Follow her on Twitter @eyesgonzales. Column archives at EyesWideOpen on FB.