No nurse left behind?

In order to solve the shortage of health workers and to slow them down from flying off to distant lands, a partylist representative has filed a bill that would require all health workers to serve for one year in the Philippines. The problem with this solution is that it does not address the real problems.

It sounds good as a political sound byte, click bait perhaps or for media mileage. The proposed bill may appeal to the misinformed or misguided patriots who love the motherland but don’t do the research, but is as shallow as a dry river bed during the planting season.

For starters, it does not define or categorize what “shortage” these so-called health policy experts are talking about. Are we short of health workers because we don’t train, educate or graduate enough qualified health workers? Has education for health workers become so expensive or unaffordable that students now opt for shorter term courses for immediate employment, thereby creating a “shortage?”

Is the shortage in relation to over population? Has there been an extra-ordinary increase in illnesses or outbreak? Did so many health workers die during the pandemic? Did a large number of health workers suffer PTSD or Post Traumatic Stress Disorder due to the COVID-19 outbreak? Has there been a reduction in the number of active health workers because they opted to do other work or change careers post pandemic or because they are just not being paid enough?

Those are the actual questions and concerns that need to be addressed in order to determine what kind of shortage the mandatory one-year service bill is trying to address.

Is the government providing scholarships or study grants which gives them the right to demand the one year of service? From what I know, the government has very limited funds for scholarships in state colleges and universities and has zero funds for those enrolled in private universities and colleges. It costs approximately P500,000 to send someone through college for nursing at a state university or college and more than double that in a private school.

If we want or need more nurses, then the logical solution is to incentivize enrollment and graduation from nursing, med-tech or medicine. If legislators want real solutions, then they should sit down with CHED and DOH officials to determine the required number of health workers in their constituency or districts, do proper surveys and evaluations of high school graduates wanting to get into medical fields and legislate and fund scholarship programs per district annually.

On the average, people want to study, work and live within their community. Politicians want to protect and maintain their political base. Creating such a system would be a long-term solution for proper distribution of health workers and justifies mandatory service because a district or congress invested in the education and training of health workers.

I have heard of some countries that have an increasingly large population of senior citizens giving full scholarships to students pursuing medicine or health related degrees.

Aside from producing traditional kinds of health workers, the state can develop a curriculum or K-12 track that will teach, train and produce professional nurses’ aides, incorporate pre-nursing and nursing subjects in order to shorten the actual time in college and eventually move them on towards earning a degree in nursing or medical technology. If we have training programs for domestic helpers going abroad, why not for nurses’ aides?

This will provide a mechanism of filtering those with the acumen and character for health and medicine while preparing them for college proper. Such a shorter course could also increase immediate employability.

*      *      *

Even for those who actually were blessed with a government allowance for indigent students, the fact is that these students of nursing, medical technology, medicine, etc., all have to do internships for weeks, months and years, depending on their year level or for residency. They don’t get paid much or at all for staying up during odd hours of the night and they learn so little due to lack of supervision.

Those who are unlucky not to have government allowance have to spend their own money for uniforms, food, dorm and transportation allowance. The internship programs are so bad that in one case I know of personally, the nursing student underwent her “introduction” to internship for about two weeks at the very same time that her university was conducting their exams week.

Given the stress, lack of sleep and night duties, the “indigent” student failed to make the grade average and was stripped of her government allowance. All she could do was cry, pray and hope that she could recover her grade average.  By God’s grace, she got assistance from elsewhere and is now focused on her studies and the goal of finding a job abroad!

Aside from the crappy internship programs and residency programs where health workers and medical students are exploited, I learned from several young doctors and parents about the practice of hospitals that make or require young physicians to “invest” in a unit or office space or do “time-share” with other young doctors. These professionals are educated to be physicians or healers, not tenants or real estate investors.

If congressmen are looking for something to do with their spare time, they should seriously investigate the applied business models of private hospitals, especially those which keep bellyaching that they can’t afford to pay their nurses competitive salaries.

How is it that they can expand or build branches in other cities, invest in new equipment and report increased profits to shareholders but can’t pay their health workers right? Private hospitals have stock holders, they lease or sell time share for offices, they rent out to vendors and parking managements. They are effectively like malls but with a captured market. Take off your blinders, Mr. Congressman.