nurses oathtaking

This Is Why Nurses Are Leaving The Country

If you are a qualified nurse working in the Philippines, the phrase ‘overworked and underpaid’ has probably crossed your mind many times.

The second thought that must have crossed your mind will be seeking better job opportunities abroad.

According to the Philippine Overseas Employment Agency (POEA) almost 19,000 nurses leave the country every year.

While this may be seen as a sign of competitive edge of Filipinos in the global landscape, it is, on the other hand, a sign that the country isn’t providing enough to these professionals for them to practice their expertise in the country.

The real unsung heroes

In reality, it can be said that the Philippines yearly produces a sufficient number of physicians and nurses. According to the Medical Information Research Information Center Global (MRICG), the country has an annual production of about 38,000 nurses and 4,500 physicians. Further, it has been reported that there are currently 130,000 physicians and 500,000 registered nurses in our country.

However, despite these numbers, a ratio of doctors and nurses to the total population is still very far from the ideal, because there are just not enough job opportunities even in government hospitals. This is the main reason why most health professionals practice abroad or even consider changing careers.

While there isn’t any shortage of registered nurses in the country, the reality on the ground reveals the true picture of the challenges faced by Filipino workers in the nursing profession today.

Complaining of excessive workload may sound like a typical work challenge, but the issues aren’t that simple for nurses. Here’s why.

Overworked and underpaid

The biggest challenge that nurses face in our country’s health care set up is the high nurse to patient ratio, especially in rural and public hospitals. Top this off with an extremely low salary with minimal benefits that drive qualified candidates away.

Despite all the hard work that our nurses do, their salary barely makes up for it. Considering that they save lives, it’s quite glaring how poorly compensated most of them are in our country.  According to the Department of Labor and Employment (DOLE), in the local labor market, an entry-level registered nurse receives a salary of ₱8,000 – ₱13,500 per month.  Registered nurses hired at hospitals commonly receive an average salary of ₱9,757 per month. 

In the government, the average salary per month is around ₱13,500 while in the private sector, the rate average is around ₱10,000 per month.

Compared to other public servants in the country like teachers and police officers who are now enjoying a fairly good compensation, nurses are still getting exploited or compensated poorly at best.

This leaves hospitals and nurses currently working in these centers short-handed, thus creating the chaotic set up for nurses now where it’s common for them to work longer hours without getting paid extra and take care of more patients that they could handle.

Besides the fact that most nurses are not adequately compensated, they are also often exploited by hospitals in return for earning a nursing experience (volunteer).

While working an extra 1 to 3 hours in an office set-up on an extremely busy day can be normal, it’s basically a normal scenario for nurses every day.

Nurses don’t exactly clock off immediately when their 8-hour shift is up. On a typical day, they work beyond their working hours endorsing all their patients to the next shift without getting paid for their one or two hour overtime service. On some days, nurses have been known to work 16 hours straight due to the unexpected absence of a colleague.

Increase risks of untoward incidents due to staff shortages

It’s a fact that most public hospitals in the Philippines struggle to provide sufficient care to all their patients. Not just because of the lacking facilities but also because of staff shortage. While there is an abundance of Registered Nurses in the Philippines, not all hospitals make use of this.

The lack of human resources basically affects the delivery of quality healthcare to patients. According to the Philippines Department of Health, the ideal nurse to patient ratio is 1:12, but this is hardly true in many hospitals, even in private ones.

In Jose Reyes Memorial Medical Center, the nurse to patient ratio in the male surgical ward is 2:59. The ratio is 2:64 in the women surgical ward, as well as the stroke unit. Meanwhile in National Kidney Transplant and Institute (NKTI), in a regular ward where there are 25 to 35 patients, there are only two nurses on duty.

In reality, an ideal care scenario isn’t exactly applicable in most cases, not because of the lack of equipment and facilities, but due to the lack of nurses. The ideal nurse to patient ratio alone can’t even be met by most hospitals (except for the prestigious ones).

The Philippine set-up for nurses couldn’t get any worse, especially now as doctor and nurse shaming become more common. Many nurses fail not because our nurses back home are incompetent, but because the environment that our healthcare system has laid out isn’t exactly ideal for patient care.  

Is it any wonder that many resorts to looking abroad to improve their employment prospects?

Filipino nurses are in great demand abroad

According to Yale Global Online, a sizable percentage of the adult workforce in the Philippines pursues overseas employment opportunities, creating a revenue stream that supplements the national economy.

A lagging job market at home and the need for workers in certain industries and nations abroad contribute to the export of labor. Employers around the world compete for the educated workers fluent in English.

About 20 percent of registered nurses in California are from the Philippines, and demand for Filipino nurses may rise as the United Kingdom pursues Brexit and anticipates replacing 12 percent of its non-British medical staff at the National Health Service.

For 2016, elsewhere in Asia was the leading destination for more than 80 percent of Filipino workers. The Philippines, lacking reliable access to family-planning programs, has a high fertility rate, and the population climbed from 26 million in 1960 to 105 million today. Family-planning policies could help stabilize a hyper-competitive domestic job market and contribute to economic growth.

Compared to other public servants in the country like teachers and police officers who are now enjoying a fairly good compensation, nurses are still getting exploited or compensated poorly at best.

Naturally, it’s a no-brainer for registered nurses in our country to venture overseas for a shot at a better life (and work environment). The pay scale for nurses overseas are literally ten times more than here in the Philippines:

CountryAverage monthly salaryPeso equivalent
Canada$4,097 (CAD)₱168,000
New Zealand $3,900 (NZD)₱139,000

Recent developments

In October 2019, the Supreme Court has ruled that government nurses are entitled by law to a minimum monthly salary of up to ₱30,531 which is equivalent to Salary Grade 15.  However, whether or not it’s indeed a victory still remains up in the air. 

In an interview with Health Secretary Francisco Duque III, he admitted that the salary adjustment was not factored in when the Department of Health (DOH) submitted its proposed budget for 2020. In the same breathe, however, Duque assured that the DOH will include the wage adjustments in the 2021 budget.

With the pandemic taking a toll on our healthcare system, it’s a challenging landscape to enlist nurses in this battle now. It has shed some light to the government and the general public about the grave importance of healthcare workers like nurses. Perhaps, this wake up call will serve as a bargaining chip for nurses to achieve better working condition? Only time can tell  

Despite all this, many of them still chose to stay and serve the country. For the average person, it may seem like normal occupational hazards, but in reality, the overall working condition for nurses in our country is a far cry from how it should be. The excessive nurse to patient ratio alone isn’t even their fault, to begin with, and they are part of a large statistic of the plight of healthcare workers in the country.

While the overall climate of the healthcare system in the country greatly affects the patients, let us not forget that nurses are also suffering from it, too. 

The president of the Philippine Nurses Association had shed some light on the plight of its members in a previous media interview. The group had been lobbying for better wages and working conditions for nurses since the time of the administration of the late President Corazon Aquino and had highlighted the long road ahead to better wages for nurses.

“The salary increase of our nurses is still a dream.”

Perhaps, nurses are leaving not just because of the promising opportunities overseas, but also because of how underappreciated their profession is in the Philippines?

[Source 1, 2, 3, 4, 5]

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