In need of nursing

By Marifi Jara

QUELIMANE, Mozambique–The bubble has burst, not so recently nor too suddenly, for nursing as one of the surest ways to go abroad, earn considerable foreign money, and help make life better for the family.

Estimates are about 100,000 nurses in the Philippines are currently unemployed with 40,000 more expected to be added this year.

Considering how costly it is to get through nursing school, that makes for a lot of sleeping investment for families who have sacrificed much for the dream.

The government, through the Department of Health and the Department of Social Welfare and Development with local government units (LGUs), is hoping to ease the situation through its Registered Nurses for Health Enhancement and Local Service (RH Heals) program. It’s similar to the Labor Department’s NARS (Nurses assigned in Rural Service) program, but RH Heals offers a bit more compensation through counterpart funding from the LGUs. The target is twofold: provide jobs to some of those thousands of unemployed nurses and improve health care in the underserved rural communities. It’s a wonderful project, reminiscent of the Doctor to the Barrios program initiated in 1993 by then Health Secretary Juan Flavier, himself once a doctor who served the barrios.

RH Heals should prove to be a more attractive project in the sense that the nurses will get a fixed salary and are not being asked to do it all “for the love” (read: pure, from-the-heart volunteerism). It also aims to eventually absorb these nurses into the health care institutions, though most of them would probably rather seek greener pastures later.

Dagupan is adopting a similar scheme with its Barangay Assigned Nurses (BAN) program, wherein registered nurses will be employed and assigned at the barangays to make health services more accessible to the public.

RH Heals targets to employ 10,000 nurses; Dagupan’s BAN program will take in at least 31 with one for each barangay (some could have as many as three). All good, but the sad part is that still leaves many thousands more of jobless nurses.

That means thousands more could easily fall victim to the adulterated volunteerism (definitely not the “for the love” kind) that is going on in some hospitals wherein, get this: nurses are not just not paid to work but they actually have to pay the hospital to allow them to work there as “volunteers” and gain some desperately needed experience and certificate of employment. It’s being called “volunteerism-for-a-fee”.  A disgrace to the very essence of volunteerism!

This brazen scheme is actually not entirely new.

The Philippine nursing sector has long recognized the negative impact in the country of the “massive runaway nurse migration”, as what a 2005 study commissioned by the International Labor Organization called it.

According to that study, titled “Migration of health workers: Country case study Philippines”, the nursing sector in 2001 already drafted a strategic plan to address the situation and one of which was: “…(6) the delegation of authority to health-related organizations, including the Philippine Hospital Association, Philhealth and nursing bodies such as the Board of Nursing and the Philippine Nurses’ Association (PNA), to exercise police power to prevent domestic work-related exploitation; indeed, there are local hospitals that do not offer salaries to nurses in exchange for volunteerism and residency requirements;…”

Now a decade later, the situation is worse because we have practically become a factory of nurses with a limited market for the product. It hasn’t helped any that there was that board exam leakage scandal a few years ago and then there’s the global economic slowdown, which has driven down recruitment.

The nursing industry needs a cure — not a quick-fix but something that will be good for the long term. Perhaps it could start with more LGUs taking the cue from RH HEALS and BAN and institutionalizing the program. The private sector, particularly the pharmaceutical companies, big private hospitals, and big firms that have a stake in rural areas, could also make it part of their CSR programs (corporate social responsibility). It’s time for a re-think on nursing, volunteerism, and healing.

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