Losing our nurses

DEMAND AND SUPPLY - Boo Chanco - The Philippine Star

During the COVID surge some months ago, some hospitals declared being full even if not all the beds in their COVID wards were taken. They just didn’t have enough nurses to take care of more patients.

An article last May in the Journal of Global Health had this headline that captures the sad situation for our nurses: “When the ‘heroes’ ‘don’t feel cared for’: The migration and resignation of Philippine nurses amidst the COVID-19 pandemic.”

The article reports: “One year into the pandemic… Filipino nurses are resigning to work abroad. In the first two to three weeks of October 2021 alone, it was noted that about five to 10 percent of nurses working in private hospitals have resigned.

“In another 2021 news report, a hospital director in a city mentioned that their nursing staff had decreased from 200 to 63 over the past year. Overall, about 40 percent of nurses in private hospitals have resigned since the pandemic began. Thus, hospitals in the Philippines may be understaffed due to the dwindling number of nurses during the pandemic.

“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, while those working in private hospitals may start with as little as P8,000. 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. Some of the nurses even go to work without benefits and hazard pay, despite the heightened health risks and threats during the pandemic.”

The response of our government was to put a cap on the number of nurses who can work abroad. The order was of doubtful constitutionality, but it effectively prevented even those with signed contracts with foreign hospitals from leaving.

Of course, they are needed here during the emergency and some stayed even as the DOH failed to give them whatever meager benefits promised them. Now DOH wants to keep the cap on Filipino nurses going abroad at just 7,000 a year.

“We have a shortage or a gap of around 106,000 para mapunuan natin ‘yung mga facilities nationwide, both for public and private,” DOH officer-in-charge Maria Rosario Vergeire said in a press briefing the other week.

The Philippines also lacks doctors, pharmacists, medical technologists, midwives, physical therapists and dentists, she added. Currently, the DOH has over 2,000 unfilled plantilla positions that includes 624 positions for nurses, 1,332 for midwives, and 63 for dentists. We should retrain our surplus of lawyers and politicians to be healthcare workers so they can start being useful to society.

It was reported in December 2020 that “there are 200,000 jobless nurses because they don’t want to be employed in hospitals where the pay is low.” Many end up working in call centers where the pay is a lot higher than being a nurse in a hospital.

Indeed, many of those who take up nursing do so with the thought of working abroad to earn back the investment on their education, as well as secure the financial future of their families. Their fathers sold carabaos for this. They owe the government nothing, which makes them feel bitter that they are being prevented from realizing their dreams.

We are known internationally as a factory mass producing nurses. A nursing school is a profitable side business of many private hospitals. About 80,000 nurses graduate each year.

Last week, Rico Hizon interviewed in his television newscast the COO of a recruitment company specializing in nurses. The Filipino nurses, the recruiter said, are vital to the US healthcare system. They have 250,000 vacancies to fill.

The demand for Filipino nurses is so high that recruitment agencies are doing more than just interviewing and signing up nurses. They have established partnerships with colleges and hospitals, providing scholarships for nursing faculty to train the next batch of nurses.

They also help the would-be migrants with all the requirements, including making sure they pass our and the US nursing licensure examinations, as well as a test for English proficiency.

They also want the nurses to arrive in the US with their family to a city or town of their choice where they may already have friends or relatives. They are met at the airport and assisted in finding a house, a school for the children, and getting a social security number and a driver’s license.

In other words, our nurses are given the red-carpet treatment they don’t get here. No wonder we lose them and we have to stop them from leaving by some bureaucratic rule.

An article in The Lancet, a medical journal, confirms everything we know about the sad situation for nurses here.

“Almost a fifth of Filipino HCWs are working overseas. In 2019 alone, at least 17,000 Filipino nurses signed overseas contracts.

“The impact of out-migration was more evident during the COVID-19 pandemic, with mass nurse resignations and consequent migration due to unjust compensation, unreceived benefits and hazard pay, and delays in insurance reimbursements.

“Working conditions were straining and debilitating as well, as HCWs were forced to work longer hours, with sub-optimal and inadequate protective equipment. Increasing infection among hospital staff members further exacerbated HCW shortages, pushing the Philippine health system to the brink of collapse.”

The Lancet continues: “Better social, economic and professional opportunities, more robust infrastructure and technologies, and the possibility of family reunificationare some motivations to seek overseas employment.

“The salary differential is particularly glaring. The annual income of a first-year medical resident in the Philippines is averaged at P 720,000, while their counterparts in the US earn P 3,000,000. Mid-level Filipino public hospital nurses earn 57 percent lower than their peers in Vietnam, the second lowest paying country in Southeast Asia.

“Entry-level and private hospital nurses receive even less, averaging P10,000 a month when household expenditure is averaged at P19,886…

“Of the 867,974 registered Filipino HCWs in 2018, only 22 percent remain in service…”

Showing our nurses some love and better pay may keep them here. Otherwise, leaving for abroad is a choice they can’t be denied.



Boo Chanco’s email address is [email protected]. Follow him on Twitter @boochanco.


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