Migration Philippines HealthcareImpact of Migration to the Profession of Nursing in the Philippines
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The Philippines Nurses are trained for domestic and international purposes of delivering care to clients. But because of the international shortage of nurses, most of the graduates from the Philippines turn to international employment and leave their homeland for better wages and bigger opportunities. This leads to the Philippines depletion of well-trained nurses and placing its healthcare in a vulnerable situation.
There are advantages and disadvantages in migration of nurses from a developing country such as the Philippines. Sending its nurses to developed countries like the United States, Saudi Arabia and Canada can lead to economic development for the Philippines but may also lead to poor healthcare delivered to the local people.
The depletion of professional caregivers in the Philippines result in poor healthcare offered to the local people and poor education of future nurses coming from the Philippines. Although the remittance coming from the nurses working abroad helps in development of the Philippines economy, there is no reassurance that this can actually help in the countries healthcare.
To improve the situation regarding nurses’ shortage for the country, the Philippines needs find balance between importance given towards the economic growth of the country and the kind of healthcare delivered for the local people.
Impact of Migration on the Profession of Nursing in the Philippines
Part 1: Theory
Nursing shortage is an international crisis that both developing and developed countries encounter throughout the decades. Countries around the world continue to seek ways to fill the gaps that the healthcare is missing in terms of human resources. Few of the strategies that different countries use to fill the gaps in nursing are expanding nursing schools and international recruitment.
The depletion of healthcare providers is a serious issue that a lot of nations encounter internationally but among the most affected are the developing countries such as the Philippines (Perrin, Hagopian, Sales & Huang, 2007). Fortunately for well-developed countries, such as the United States, Canada and Saudi Arabia, they can offer money incentives, free housing or immigrant visas to Registered Nurses from developing countries and therefore attract the Registered Nurses to come to them for work on a contract for a number of years or as an immigrant and live there in a permanent basis (Lorenzo, Galvez-Tan, Icamina & Javier, 2007).
Known as the largest exporter of nurses worldwide, Philippines Produce about 20,000 nurses annually. Considered as a third-world country is in great need for better healthcare especially in terms of human resources but due to lack in public health funding from the government, the country ends up loosing their skilled and experienced healthcare providers to the well-developed countries such as the United States and Saudi Arabia.
As the need for registered nurses grew internationally, the country matches this need by producing and exporting more and more Registered Nurses through school expansion and creating more agencies to work on sending nurses abroad (Brush&Sochalski, 2007). There are about 460 Nursing Colleges that offer the Bachelor of Science in Nursing (BSN) Program found in the country (Lorenzo, Galvez-Tan, Icamina & Javier, 2007). The expansion of nursing schools is a way of coping with the vast increase in the need for well-trained nurses.
Migration of nurses graduating from the Philippines to the United States had been in progress for more than 50 years. The shortages of nurses in the United States are covered with a majority of foreign nurses coming from the Philippines. As Asia’s main exporter of nurses to foreign countries, The Philippines is experiencing a ‘Brain Drain’, the immigration of professionals to other countries, depleting the home country of their own professional population (Ordonez&Gandeza, 2004).
Although there are a vast number of nursing students graduating from the Philippines, the speed in which Registered Nurses leave the country is much faster than the speed that the country can replace them. This cycle puts the Philippines in a vulnerable situation in terms of integrity and quality of the country’s healthcare services delivered to its local people (Lorenzo, Galvez-Tan, Icamina& Javier, 2007).
In other aspects of looking at International nurse recruitment, it is considered ‘stealing’ or ‘poaching’ of already scarce human resources of poverty driven countries, but the fact that the Philippines encourage migration of its nurses to other countries and promoting nurses as a leading “Export Product” offered internationally (Xu& Zhang, 2005), migration of nurses away from the homeland cannot be considered ‘poaching’ or ‘stealing’.
Together with the US market demand in nurses and the explicit policy of exporting nurses as a product, the Philippines nurse production increases overtime. Although the country is working harder to supply the international need for nurses, the lost of professional health workers puts the country in a position in which it is left with lesser qualified and lesser experienced personnel to be in charge of public health in the local populace and may bring major problems to the countries healthcare.
Profit of Migration:
The Philippines benefit in terms of remittance from overseas Filipino workers in well-developed countries and therefore help in their economic development. Ranging from U.S.$290.85 million in 1978 to U.S. $ 10.7 billion in 2005 (Lorenzo, Galvez-Tan, Icamina & Javier, 2007), the Philippines is benefiting largely in terms of economic development from the money sent by Filipino healthcare providers from foreign countries.
An indication that although being depleted of Nurses and other healthcare providers, the country is also intensely benefiting from the remittance of the people that work abroad. Philippines “international specialty” nurse migrants are hailed as heroes whose remittance contributed to nations building success (Brush&Schalski, 2007).
Agencies and hospitals from developed countries use catchy slogans such as “Your Cap is Your Passport” to attract Registered Nurses from developing countries to work for them. It is a privilege for Filipino nurses to be able to migrate to foreign countries and find better opportunities that they cannot achieve by staying in their home countries (O’Brien, 2001). Becoming a registered nurse is a privilege and an easy access out of a country that is poverty stricken.
The Philippines is depleted of its own healthcare workers and even in terms of medical facilities and supplies, it is lacking proper attention. Compared to the facilities in the developed countries, hospital conditions were miserable because of lack of funding and ignorance in terms of healthcare (Christman, 2000). This lack in sufficient facilities can be one of the factors that push Registered Nurses to want to exit the country (Lorenzo, Galvez-Tan, Icamina &Javier, 2007).
Another good reason why Registered Nurses are pushed out of the country is the salary received compared to the salary offered by developed countries. In the Philippines, a nurse can earn an average of U.S.$170 monthly (U.S.$ 2,040 per annum).
If compared to the salary that developed countries offer which is U.S. $ 3000 to $4000 (U.S. $36,000 to $48,000 per annum), the incomparable amount that most nurses see as a reason to leave the country. What they can earn in a year outside their homeland is comparable to twenty years of work in their homeland (Brush&Sochalski, 2007).
Remittance from nurses working abroad increases economic stability of the country but the cost of Nation’s Public health is still at risk (Brush& Sichalski, 2007).
Standards of Education:
While continuing to reach international needs for healthcare workers, the Philippines tries to increase number of schools that would train nurses but unfortunately although Nursing schools in the Philippines continue to expand, the increase in numbers of nursing students passing the Philippines National nurse licensure examination is declining. Compared to year 1970’s and 1980’s, a national pass of 85% decreased to 45-54% by year 2001-2004.
Large numbers of schools don’t usually mean high performance rates (Brush & Sochalski, 2007). The under investment of healthcare systems can lead to a growing healthcare disparity in the country and lead to poor quality of care given to clients. The poor quality of nurse graduates is due to the inadequate curriculum offered in the Philippines.
There are too many students in schools that training them individually in clinical settings are limited. Poor facilities and equipment, as well as shortage in qualified clinical instructors add to the Problem of educating too many nursing students (Perrin, Hagopian, sales& Huang, 2007)
Culture differences in terms of getting education can lead to some issues identified in the nursing program of the Philippines. Issues such as the way Filipino nurses are trained to do what the doctors say, it is an initial shock for them to see that nurses are encouraged to question doctors and be accountable.
Although Nurses in the Philippines finish a Bachelors degree of science in Nursing program, and structured after the United States’ nursing Program, Biases in the work place for nurses working abroad are a big issue due to the kind of education that they get in their homeland.
The assumption that Filipino nurse’s education is inferior or that English skills are poorer leads to disrespect in the workforce consisting of Filipino nurse working abroad (Kinderman, 2006).
“Research shows that education in the Philippines promotes conceptual pathways that develop strong critical thinking abilities”. (Kinderman, 2006) The statement contrast with how the nurses are perceived in other countries by their co-workers.
Part 2: Reflection From Another Perspective
As a nursing student in the Nursing Education Program of Saskatchewan (NEPS) it is a privilege to be able to attain my nursing bachelors degree in Canada specifically in Saskatchewan. Although I’ am from a foreign country, my appreciation for the nursing program in Canada is truly genuine because of my experiences in healthcare back in my homeland as patient at a young age.
Upon researching this specific topic on nurse migration from my own country, I feel that my understanding in the importance of nursing not only in Saskatchewan but also worldwide is better understood. I always thought that nursing back home was just another profession that people choose to become because they want to exit the Philippines, but now I see that there are other reasons why nurses back in my homeland (Philippines) are pushed to migrate to other countries.
I was not aware of the negative effects of loosing nurses in a poor country. I always thought that people never really knew the importance of health in third-world countries such as the Philippines. When I was a little kid in my homeland, nurses were just a figure that I see in pictures because there was no such person that tended to my health needs. Most of the illnesses that people encounter are usually dealt at home because of lack in money or just basically no one can perform nurses’ role in our town except the people in our household.
I now understand that there are more problems associated to the shortage of nurses in worldwide. Not only do nurses affect health issues in the Philippines but as well as the economy of the country. Not only is it political but also personal reasons why nurse from the homeland want to migrate to other countries.
It brings me sorrow to find that not a lot of changes had occurred in terms of nursing shortage back home. Indeed the government of the Philippines had worked hard to produce more nurses for domestic use but most of them end up in foreign countries, leaving behind hospitals empty of its nurses and poor health management. Not only do nurses in the Philippines significant in our own country but to other countries as well. This shows how nurses are not just locally important but internationally acclaimed and needed in many aspects of the world.
Brush, B., & Sochalsk, L. 2007). International Nurse Migration: Lessons From the Philippines. Policy Politics & Nursing Practice: 8 (1); 37-46. Retrieved July 8, 2007, from Health Source: Nursing/Academic Conditions database.Cite:http://search.ebscohost.com/login.aspx?direct=true&db=hch&AN=25431604&site=ehost-live
Perrin, M., Hagopian, A., Sales, A., & Huang, B. (2007). Nurse Migration and Its Implication for Philippines Hospitals. International Nursing Review: 54(3) ; 219-226. Retrieved October 4, 2007, from Biomedical Reference Collection: Comprehensive database. Cite: http://search.ebscohost.com/login.aspx?direct=true&db=byh&AN=26087274&site=ehost-live
Xu, Y. & Zhang, J. (2005). One Size Doesn’t Fit All: Ethics of International Nurse Recruitment from the Conceptual Framework of Stakeholder Interest. Nursing Ethics: 12(96); 571-81. Retrieved October 4, 2007, from CINAHL plus with Full Text database. Cite: http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2009153594&site=ehost-live
Kinderman, K.T. (2006). Retention Strategies for Newly Hired Filipino Nurses. The Journal of Nursing Administration: 36, (4); 170-2. Retrieved October 4, 2007, from MEDLINE database.
Ordonez, R.V., & Gandeza, N. (2004). Integrating Traditional Beliefs and Modern Medicine: Filipino Nurses Health Beliefs, Behaviours, and Practices. Home Health care Management & Practice: 17 (1); 22-7. Retrieved October 6, 2007, from CINAHL plus with FULL TEXT database.
Christman, M.(2000). A PERSONAL ACCOUNT OF A MEDICAL MISSION. Journal of the American Academy of Nurse Practitioner: 12(8); 309. Retrieved October 4, 2007, from Biomedical Reference Collection: Comprehensive database. Cite:http://search.ebscohost.com/login.aspx?direct=true&db=byh&AN=9220477&site=ehost-live
Lorenzo, F.M., Galvez-Tan, J., Icamina, K. & Javier, L. (2007). Nurse Migration from a Source Country Perspective: Philippine Country Case Study. Health Services Research: 42(3); 1406- 18. Retrieved October 4, 2007, from CINAHL plus with Full Text database.
O’ Brien, G. (2001). Reaching Overseas, nursing West: 18 (6); 51. Retrieved October 6, 2007, from Health nursing Fulltext Elite database.