Tributes to nurses’ heroism have been romanticized and lost their value when nurses are too exhausted to even appreciate them and when nurses have become like beggars for the benefits they never asked for (though they most deserve) but were promised them in recognition of their heroic roles.
Yes, there is no doubt that nurses are heroes. But this article will not overstate what is obvious—it takes a hero to be in that suffocating PPE to care for patients who are harboring the deadly virus and to hold their hands when cure is not possible towards their peaceful death, not alone but with a nurse. Their self-sacrifice extends to their beloved families who are next in line in the chain of transmission.
The microscopic villain may knock these heroes down and get them infected but they rise up anew donning their PPEs like armors and fighting back to save lives on a daily basis until we all live happily ever after. We had classic episodes of these series traced back during the Crimean War in the mid-eighteen hundredth when the founder of modern nursing etched her name in history as Florence Nightingale. And this Covid-19 is just a sequel in a series of real-life pandemic horror and thriller known to history. And in all of these, there are nurses in the main cast. But just like a Netflix series that we thought has ended, after humanity puts an end to this pandemic, the next episodes may be anticipated with new twists and plots for us to watch the heroism come back to life.
It is intrinsic of nurses to care. The care is in the core of the cure they are able to contribute as professionals who are vital co-equal members of the health-care team. But the education and training of nurses extend beyond their professional privilege. There is a solemn vocation in its historical, philosophical and theoretical foundations that integrate compassion with professional competencies worthy of every remuneration, salary, wage, and benefits.
Heroism is how the public regards and romanticizes nursing amid the pandemic, and such distracts us from what nurses really need from us—the support for the provision of their most basic and safety needs.
Not expendable dying heroes in crisis
During the celebration of its 99th year, the Philippine Nurses Association released a manifesto for and on behalf of the nurses who, while caring for patients, are now losing patience. It launched #Silentnomore campaign to voice out nurses situation, which is described as grappling to survive. PNA reports that the nurses are underpaid with politics getting in the way of nurses’ demands for better compensation. It cried out amid the allegations of corruption and ineffectiveness in the implementation to policies aimed at social amelioration. The manifesto cited that nurses are at crisis point, emotionally and mentally, for being torn between the pursuit of what they love to do for others professionally and the need to survive personally.
The manifesto calls on the support of the government and the public that nurses serve—an expression of care for those who care. The PNA enumerated the following as what is due to the nurses:
1) A decent living wage and one that afford a way for nurses to lead their lives without having to work abroad;
2) Benefits that the law guarantees to be given in a timely and equitable manner;
3) Uniform and timely implementation of the Bayanihan to Heal and Recover as One Laws; and
4) Special Risk Allowance (SRA) and Hazard Pay to be given timely and fairly to all nurses, even if not directly exposed to the virus.
These demands are not extra-ordinary. They are just the execution and implementation of what is already mandated (and promised) by various laws. The nurses cannot be blamed for their impatience as the RA 9173 in 2002 is, up to this day, yet to be fully implemented to benefit at least the government nurses and receive the mandated Salary Grade 15 equivalent to around P33,000. The SRA has not been released efficiently to make nurses feel their importance, of course in the similar way that the entire health-care personnel feel neglected and ignored in a whole health-care system seemingly in distress.
The best for the Filipino and the choice of the world
This statement is not only a motherhood statement. It is a vision of the Philippine Nursing Profession Roadmap 2030. The Filipino nurses are the best for the Filipinos—if they will have the logical reason to stay. The Filipino nurses are undoubtedly the choice of the world. The pandemic has accelerated the partial attainment of the 2030 vision as even the developed countries now are offering their best opportunities for the nurses to take the road to the greener pasture.
The Private Hospitals Association of the Philippines Inc. (PHAPI) has admitted publicly that some of the hospital units have to be closed due to lack of nurses. The private hospitals can hardly match what the government hospitals are law-bound to offer in salaries and benefits. How much more can they approximate the converted peso-value of job offers overseas?
The private hospitals in the Philippines are trying to compete and provide nurses with the best incentives like graduate studies, vacation packages, rice subsidies, family hospitalization coverage, among others. But the financial gains being offered by hospitals abroad are simply irresistible. Some private hospitals, cognizant of the inevitable overseas employment of their nurses, have even partnered with foreign hospitals for the future deployment of their current nursing work force. It has become an attraction for nurses to be employed within a limited period prior to their dream foreign deployment through these hospitals.
Competing with hospital job offers now are vaccination centers, with local government and sponsors, capable of offering a relatively high daily salary or allowance to nurses as vaccinators. Without exhausting hospital routines, many nurses are now in these vaccination centers. The Colleges of Nursing are also in need of qualified clinical instructors now who shall be working mostly in the comforts of their homes in a flexible learning set-up. Also, the rich families can afford private duty nurses for their home-based relatives. The BPOs are also out there with some attractive offers for nurses.
But the demand for nurses is not unique in the Philippines. In 2020, the WHO released the pre-pandemic State of World Nursing to reveal that the world needs 6 million nurses to achieve global health targets. And the recommendation is for the investment in massive acceleration of nursing education. But even as we invest in education, the situation of nurses in the Philippines is not encouraging. While the enrolment for nursing is having an upward trend, the eyes of students (and sponsoring parents and relatives) are not looking at local employment but the global demands, which offer brighter future.
Yes, Filipino nurses, as envisioned, will continue to be the choice of the world and they are the best for the Filipinos. But if our government and the Philippine society will fail to give nurses the positive practice environment they rightfully deserve, the health human resource will be weak with nursing being its biggest sector. Thankfully, there remain many nurses who choose to stay and serve the Filipinos. But until when? Only time can tell.
By the way, if the government can construct a memorial monument for the fallen health workers at the Libingan ng Bayani, they may want to take care of the living frontliners first. As a nursing leader asserts: We don’t need dead heroes!
Nurses cannot feed their families purely with heroic tributes. The Filipino nurses are dying, literally and figuratively. Let us care for them so they can care for us, Filipinos.
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