Saturday, February 02, 2013

[Vital Signs Column] Losing the Power of the Numbers

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Vital Signs Column
By: Alvin Cloyd Dakis, RN
February 16-28 Issue

The December Nursing Licensure Examination results were out! 16, 908 new nurses join the Philippine health workforce out of the 49, 066 takers. A staggering 16,908 more to those almost 300,000 unemployed and underemployed nurses struggling in the country.

This is one of the most alarming national passing percentages in the Philippine nursing profession. In this recent board exam we only have around 35% passing rate. Is this something we should be proud of?

Numbers Game
The Philippines on an average produces more than 100,000 nurse graduates a year – way over what the country can absorb and need and even the largest number of health professionals produced over all other health professionals combined.

Let’s look at the total number of nurses we produced in the last few five years (2008-2012):

                                                Passers                 Takers
December 2012                  16,908                   49,066
June 2012                             44,731                   60,895
December 2011                   22,760                   67,095
July 2011                              37,513                   78,135
December 2010                   29,711                   84,287
July 2010                              37,679                   91,008
November 2009                  37,527                   94,426
June 2009                            32,617                   77,901
November 2008                  39,455                   88,649
June 2008                            27,765                   64,459

                                       Total Passers              Total Takers
2012                                       61,639                   109,961
2011                                       60,273                   145,230
2010                                       67,390                   175,295
2009                                       70,144                   172,327
2008                                       67,220                   153,108

Looking at the figures, the Philippines produced an average 150,000 nurse graduates in the last five years but only produced an average 65,000 nursing board exam passers. And in the past five years the country already had 755,921 nurse graduate takers of the Board Exam and produced 326,666 professional nurses. Knowing where these nurses are would be extremely difficult.

Can the national passing percentage affect how the general public and the international market see the Philippines’ nursing education, training and production? Certainly. A low national passing percentage would somehow reflect how nursing education (which includes the nursing curriculum, training, facilities and faculties) is operating in the country. And when you look closely to the participating nursing schools, some of them produce 0% passing.

Moratorium and Mushrooms
Since 2004 there have been reports that CHED issued a moratorium to low performing schools – this would mean schools producing below 30% national passing rate. Nine years after, it would seem that CHED and the Board of Nursing only managed to shut down around 80 schools of nursing, and this is not even fully implemented yet since in the December 2012 Board Exams there were still 490 participating schools of nursing.

Why is CHED taking it too long for them to implement their moratorium? I remember vividly during one House Committee hearing on higher & technical education, Committee Chair Rep. Sonny Angara asked the CHED representative to hasten the implementation of the moratorium. Well I guess from 2004, it is only now that CHED has taken this matter closely.

But one would wonder how come CHED allowed 490 nursing schools to operate in the country like that. Contrasting with 35 medical schools, 129 midwifery schools, 35 pharmacy colleges and 95 physical & occupational therapist colleges – 294 in total, nursing schools are evidently outnumbering the others. Clearly nursing schools were established with only one thing in mind – producing thousands of nurses only for work overseas.

In almost a decade, how are CHED and the Technical Committee on Nursing Education monitoring these schools? Well I think the answer is right before our eyes.

One of the factors I think that affects our national passing percentage is due to the fact that graduates of the nursing course can take the nursing board examination unlimitedly. This change occurred during the amendment of the Philippine Nursing Law in 2002 where the law became silent on how frequent one can re-take once he or she fails the exam. Prior to this amendment, the nursing profession, just like any other health profession would give three chances for the taker to pass the exams and should they fail again, would require the taker to take a refresher course.

Apart from the unlimited kind of re-taking the nursing board exam, one thing that is critically lost is that they stopped putting a cap on the admission of students. An admission exam should be re-implemented for those who would really desire to take up nursing.

Spoiling the numbers
While the country produce such number of nurses and graduates, it did not help in addressing many of the country’s health problems especially that one in providing sufficient health human workforce to serve the Filipinos.

Many hospitals cannot employ additional nurses because they are financially constrained. Many rural health units are having hard time addressing the health concerns of their localities because of the lack in human resource. Clearly there is something wrong with how the Philippines handle its health human capital.

Government program like the RNHEALS will never solve the problem in health human resource because even though we strongly reiterate that RNHEALS is a competency-enhancement training program that includes deployment, many of its local implementers see it the other way – that RNHEALS nurses are additional workforce, adjunct and assistants to the current staff nurses. In one of my previous columns, I made mention that RNHEALS is a benevolent program gone wrong because of three things: wrong expectations both from the implementers and the recipients of the program, wrong orientation and understanding of the program, and wrong implementation of the program due to the other two mentioned earlier.

The estimated number of active Filipino nurses in the country is about 700,000; more than 300,000 were produced for the past five years and those 300,000 are the ones hit with the unemployment and underemployment crisis now. Most Filipino nurses do not see the power in this number – that this number when used properly can change policies, create good laws and push the State to provide better opportunities for nurses and to protect the nurses’ welfare.

But it takes each nurse to start believing in that power and to start standing for their rights. Nurses doesn’t necessarily need an organized representation in Congress to push for the nurses’ welfare agenda, although of course this would be very much welcomed, nurses need to imbibe this within themselves. That in everything they do, they represent the profession, and that together they can make a difference. 


  1. I remember din when Rep. Angara told CHED to hasten hasten the implementation of the moratorium. I feel that they should do this immediately coz tayo rin magsusuffer sa huli.

    1. Let's see that Sonny Angara makes it to the Senate then. :)

    2. I really believe that Sonny Angara is the one of the few who can really make a difference in this country. I hope he wins.

  2. I really hope that Rep. Edgardo Sonny Angara wins this elections. We really need someone we can depend on. So far, siya lang ang nakikipag laban sa mga trabaho ng nurses at teachers. Alam ko meron din siyang isang pending law that will grant teachers with a P33,000+ minimum wage salary. Imagine what he can do with us nurses?