Friday, January 25, 2013

[Vital Signs Column] No New Grads

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Vital Signs Column
By: Alvin Cloyd Dakis, RN
February 01-15 Issue

I was recently interviewed in one of the major News TV channels about the US’s policy on not hiring newly graduated and foreign-educated nurses onto their shores. This policy drew different reactions from Filipino nurses who are particularly one of the many foreign-educated nurses who migrate and work in the US.

Personally, I support this initiative of the US government. Let me share you my thoughts on the matter.

First, Filipino nurses are known to be highly technical and skilled in giving nursing care matched with unparalleled compassion and tenderness – one of the main characteristics why Filipino nurses are preferred over other foreign-educated nurses to serve US patients. It is but necessary to produce nurses who are highly competent for the global market.

Second, because Filipino nurses would have to serve the Philippines and the Filipinos prior to any service they would be rendering anywhere in the world. I believe that Filipino nurses should care for Filipinos foremost.

But are Filipino nurses undertrained?

Perhaps I would be very certain of my response if the training for Filipino nurses were like that in the 70s. But the increasing demand to fill the huge health human resource gaps especially in nursing all over the world made this certainty vague for me. In less than 3 decades the Philippine Nursing profession ‘ballooned’ its graduates and ‘mushroomed’ its nursing schools.  Among the current 192 nursing schools, only a few closed their schools because of the low turn-out of enrollees, but none were closed because of their low performance in the Nursing Board Exams - none to date.

So while we are producing an average of 80,000 nurses a year, can we confidently say that these 80,000 have indeed acquired basic competence necessary for their employment abroad? I don’t think so. How about local employment? Perhaps.

While the Philippine Board of Nursing claims that each Filipino nurse, upon graduation would possess the basic competencies required of them to practice the profession, I would still, time and again, would encounter a young nurse seeking further clinical experience (take note, basic experience like bedside care, similar to the one they learn in school) either as a volunteer or as a trainee of some sort.

Would a program such as RNHEALS be sufficient to address the gap in the so-called ‘enhancement’ of such supposedly acquired competencies of these nurse graduates? To some yes, to some no. However I believe that when RNHEALS would truly serve its purpose, it is implemented properly and there are transparent reporting and monitoring mechanisms – it will become a good tool to enhance such competencies and would help new nurses in establishing their confidence doing those nursing skills.

So if the US is very strict in their policies for entrance of foreign-educated nurses, are there any other countries where Filipino nurses can work?

While the US and UK and some countries in the west are quite stricter, the Middle East still is an open space for Filipino nurses and are still in demand. Other countries like Australia, New Zealand and Japan continue recruiting Filipino nurses to their workforce. This 2015, talks about the Mutual Recognition Agreement (MRA) where ASEAN countries would open their doors for nurses coming from within South East Asia and consider ‘reciprocity’ so nurses (and perhaps other health professionals) can work within the region.

Many nurses also said that if salaries and benefits are more competitive in the Philippines, they might not leave the country.

This hold true to many nurses I know. The salary of nurses in the country is so meager; it could not sustain a family of four. A government nurse’s salary falls around 11-15,000 (Salary Grade 11 from what is originally approved in the Philippine Nursing Law) and nurses in the private hospitals would earn much lower – around 6-8,000 only. A more morbid report from some nurses in the province would earn 4-5,000 practicing in private institutions.

The Salary Standardization Law repealed the Salary Grading provided by the Philippine Nursing Law when it was signed by then President Arroyo even before this provision can be implemented properly. Many nurses do not know this and have questioned repeatedly why nurses do not receive monetary remuneration commensurate SG15. Also, the Philippine Nursing Law disregarded the nurses working in the private sectors when it failed to even recommend a basic salary rate for them, making it sound like it was a law meant to protect the interest of nurses working in the public sector and the government.

Nonetheless, there are efforts done by certain legislators who are backed by some nurse advocates on sponsoring legislation that would revert nurses’ salary grade from SG11 to SG15 (kind of ridiculous actually). Also, nurses’ benefits in the country is so poor (well, to many public health professional too, to say the least) to the point that a further drop per Peso would mean the world to them. Many of the benefits provided by the Magna Carta of Public Health Workers too are often disregarded, neglected and blatantly violated.

Apart from monetary remunerations and other tangible benefits nurses should receive, more importantly is the morale they receive from the government and the general public. Many a times, nurses in the country are not treated right, seen as second-class health professionals and are not appreciated much.

Well, we do not demand to be treated godly, just decently and with respect – a respect we similarly give to a dignified profession providing health care. Appreciation and recognition should come with nurses’ meaningful participation in the different areas such as consultation and actively engaging in policy recommendation, implementation and evaluation. But these things happen when nurses, my colleagues, start to think that no one else could help the profession but the nurses themselves.

It’s that time of the year again when we hear campaign jingles, see scattering posters and conspicuously see advertisements of those who would seek positions in the government. Nurses should use this opportunity to obligate public servants and leaders seeking public offices to pay attention to the needs of the profession and also to solicit support from them should they win. Nurses should also actively campaign for identified champions of the profession.

For comments, please email me at

1 comment:

  1. this is very well said. if the salary is higher nurses would not go abroad to work.
    nurses staffing in hospital is very low compared to what is ideal maybe that is the very reason why many nurses are unemployed and underemployed.
    but i think nurses should open to pdn as it is very in demand now and the pay is higher than being a staff nurse.
    i hope the salary increase will be approved soon. but hopefully the hospitals wouldnt cut low the nurse employment just to compensate.