Next to realistic and more decent salaries, there are two other concerns that Filipino nurses badly want addressed to help improve their plight as healthcare practitioners: exploitation and a more significant role in the healthcare delivery system.

It is appalling to hear of nurses claiming to be on their feet up to 12 hours a day or more only to receive a measly salary of 6,000 pesos (USD 125.00) per month. And while there are nurses who receive 18,000 pesos per month (USD 376.00) it is still far short of the mandated 24,000 pesos (USD 501.00) under the 2002 Nursing Act.

The Comprehensive Nursing Law, vetoed earlier this year by former President Benigno Aquino III, would have addressed the issue of low wages. At the same time, it would have banned the practice of volunteerism, false trainings and other unfair labour practices like excluding new nurses from mandatory state benefits.

Prominent champion of nurses, Alliance of Young Nurse Leaders and Advocates (AYNLA) International Inc., said nursing professionals took a massive blow with the rejection of the proposed measure.

AYNLA Chairperson Reigner Jireh Antiquerra told MIMS the veto “obstructed the hope of nurses to contribute more to the healthcare sector.”

The alliance - created in 2009 - is a member of the National Youth Commission and the World Health Organization Global Health Workforce Alliance, and has played important roles in reinforcing the rights of nurses in certain issues.

Most notable among AYNLA’s work was its partnership with the Department of Health at the height of nurses’ exploitation and unemployment when nurses had to pay hospitals to get work and experience, and worse, serve without compensation.

As member of the DOH Ad Hoc Committee, AYNLA was in charge of collating and filling up the necessary documents required by the agency from nurses allegedly exploited by hospitals.

Their efforts resulted in the adoption of Senate Resolution No. 806 banning paid nurse training programmes.

Not all accounted for

The latest statistics from the Philippine Nurses Association puts the number of unemployed nurses at 200,000 while there are 300,000 de-skilled professionals, or those holding non-nursing jobs.

Meanwhile, there are 40,000 nurses working in hospitals and other healthcare settings, most of whom are clamoring for a raise in pay.

Despite these figure, it is still difficult to peg the actual number of nurses in the country.

A study led by researchers of Lyceum of the Philippines, Batangas City, published in the Asian Journal of Health, indicates there are about 2.6 million registered nurses in the Philippines. The numbers suggest there could be more nurses unaccounted for.

The Professional Regulation Commission (PRC), in the latest Nurse Licensure Exam, said some 6,000 nurses joined the roster out of 14,000 who took the exam, and while the number is less than half of the examinees, it is still a significant addition to existing nurses.

Shifting tasks

In its position paper, a copy of which was furnished to MIMS, AYNLA argued that giving nurses more roles will greatly benefit the local healthcare delivery system. Under the so-called Independent Nursing Practice (INP), certain procedures exclusively performed by doctors will be taken over by nurses.

The task-shift, according to the alliance, will reduce the cost of health services. With nurses able to perform once-exclusive services provided by physicians should enhance competition and effectively lower costs.

At the same time, with nurses taking over these roles, unnecessary and costly hospital readmissions would be reduced. In effect, nurses will help make services more affordable and convenient, while employing a more patient-centred approach to healthcare delivery.

A similar practice is already being done in the United States. The Massachusetts General Hospital employs ARNs or Attending Registered Nurses, where a patient is assigned to an attending nurse for the duration of the hospital stay and even after discharge. ARNs, according to a hospital personnel, have greatly improved the quality of care and patient satisfaction.

Not impossible

Addressing the problem of unemployed nurses is not impossible, according to Carl E. Balita, himself a nurse who runs a known nursing review institute, and is staunch advocate for the profession.

First, he said all 61,000 schools nationwide, as well as the 42,000 barangays (villages) as well as companies with over 50 employees must employ nurses.

Second, if all 1,921 private hospitals and 721 public hospitals nationwide, with their combined bed capacity of over 94,000 also employed nurses accordingly to the proper nurse-patient ratio of 1:10, there will likely be no unemployed nurses.

Compared to other professionals like engineers, there has been no change in nurses’ salaries even with the expansion of their market potential, in the last decade.

A World Bank report showed that health expenditure increased from 3.21 percent in 2000 to 4.71 percent four years later, yet the largest number of health professionals - nurses - hardly felt any change, particularly in the area of compensation.

AYNLA has vowed to take the cudgels for the sector by pushing for the rationalization of salaries and providing more positions and opportunities for nurses.

An end to exploitation

Other than salary adjustments, the group has its focus on addressing exploitation of nurses, specifically ‘false volunteerism,’ tagged as today’s most discreet and insidious form of nurse abuse.

Under this system, nurses are forced to take jobs outside their profession, or take on an underpaying nursing job.

The organisation has been pressing for a strong regulation and monitoring mechanism that would put an end to the practice. Without it, nurses’ situation will only become worse and drive away more nurses from the profession, and could probably result in the collapse of the healthcare system.

They are again hoping that the new Congress will work to pass the Comprehensive Nursing Law, refiled by Senator Antonio Trillanes IV, and eventually signed into law by the President.

Finding their voice

AYNLA is well aware that nurses, already overworked and struggling to do their best in delivering healthcare in spite less than ideal working conditions, still have very little voice to fight for what they deserve.

It is also discouraging that only a limited number of interest groups are actively looking into their plight and listening to their sentiments.

Communication is obviously a concern that needs to be addressed to enable this group of professionals to be properly heard and their concerns resolved.

AYNLA hopes to encourage dialogue between nurses, nursing groups and organizations, along with other related stakeholders to arrive at suggestions which would improve the welfare of the Filipino nurses. MIMS

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