The world will be short of 5.6 million nurses by 2030, based on the WHO’s State of World Nursing Report in 2020. The Filipino nurses are the best for the Filipinos and the choice of the world, as envisioned in the Philippine Nursing Roadmap. The Filipino nurses are the best for the Filipinos but they are leaving to respond to the irresistible offers of foreign countries. The WHO recommends that countries need to invest in massive acceleration of nursing education, create at least 6 million new nursing jobs by 2030 and strengthen nurse leadership.
The recent DOH report expressed that the Philippines is short of 92,000 physicians and 44,000 nurses. We also lack 19,000 medical technologists, around 14,000 pharmacists, and around 17,000 radiologic technicians and radiologic technologists. The Private Hospital Association of the Philippines has consistently expressed alarm for the exodus of nurses.
For the past 20 years, the Professional Regulation Commission has registered 606,428 nurses and 55,783 physicians. Prior to the pandemic, an average of 30,000 nurses are registered a year for the past 20 years, and there is no reason for the country to have scarcity of nurses, if only we give our nurses reasons to stay.
With the increased health-care demand, the full implementation of the Universal Health Care Law, and the availability of the local resources due to the Mandanas-Garcia Ruling, the welfare of health professionals should be and may be addressed properly, before it is too late.
The problems
Nurses are not regarded well in the Philippines. The Salary Grade 15, which was provided by RA 9173 in 2002, took almost two decades to benefit the nurses in government. The nurses in private institutions remain within the bracket of the minimum wage, even at present.
The positive practice environment is not provided, not only to nurses, but to many health professionals as well. The absence of these is the reason why, while nurses may want to be home to serve Filipinos, they are pushed away to grab the opportunities overseas.
Even before the pandemic, the nurses were deployed as “casual, job orders” under the Nurse Deployment Program, which gave the “carrot” of higher salary but lacks plantilla positions for job security and career progression. Their services are under contractualization scheme, which does not provide for security of tenure.
The Build, Build, Build program built health facilities and infrastructures but did not supply the human resource through permanent job positions to manifest the seriousness of the government, national and local, in prioritizing health specially amid the pandemic.
There was the imposition of the deployment ban after the cap of 6,500 deployments in 2021. The ban is increased to 7,000 deployments in 2022, a big threat still to the lack of nurses in various hospitals, especially the private hospitals.
All these reveal that the problem is not really a shortage of nurses. On the contrary, we have a surplus of competent nurses. What we lack is societal compassion and the initiative to pay attention to health-care workers’ needs and provide immediate sustainable solutions.
The proposed solutions
Investments in education, in all health science courses, are long-term solutions in forms of scholarships and subsidy for public and private institutions offering these health courses. Scholarships in graduate studies are needed to supply the scarce qualified instructors and educators in various areas of health sciences.
Immediately, the government needs to create and fill up plantilla positions for various nursing positions cognizant of the nurse-patient ratio, which is scientifically based on the acuity of care. The Nurse Deployment Program should be shifted to a more sustainable investment in health human resource that provides for security of tenure and positive practice environment.
There may be a need to have a National Chief Nurse position in the Department of Health to ensure a more orchestrated strategic directions and tactical execution of nursing agenda for the universal health care.
The PhilHealth needs to remain true to its mandate as a national health insurance that enables and empowers the private healthcare institutions. Government may need to subsidize the private hospitals, specific in their human resource development, to cushion the increasing cost of health care.
In the short-term, there are solutions to increase the supply of health-care professionals, specific to nursing, which may also provide for models in other health-care disciplines:
- Strengthening of the Expanded Tertiary Education Equivalency and Accreditation in nursing.
- Provision of the scholarships and subsidies for the drop-outs in nursing schools due to financial reasons.
- Institutionalization of the Nurses Licensure Examination Competency Enrichment Programs by the Centers of Excellence and Centers of Development among nursing colleges and universities, as an extension service to nursing graduates.
- Creation of a Bridging Program for those RNs who have left the practice of nursing and shifted to BPO, airline services, business, etc.
- Engagement of the repatriated overseas Filipinos who were health- care workers across various levels of nursing career paths. This may be an attractive proposition towards brain-gain.
Almost two years must have been long enough a time for the government to realize that the heroism they attribute to health frontliners needs measurable rewards, not as a palliative band-aid solution but as a sustainable and equitable investment on health human resource, which is the most important resource of the health care system.
By the way, there is a looming commoditization of nursing education, again, as the moratorium in the opening of nursing school is lifted.
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