Filipino Nurse’s Dilemma

After four years in college, after all the sleepless nights studying unfamiliar territory, after all the pressure absorbed, I finally made it.

I am one of the 29,711 nurses who passed the Nursing Licensure Examinations (NLE) last December 19 to 20, 2010. As I saw my name on the list of those who passed, adrenaline rushed all throughout my body. It is as if I was at the peak of an orgasmic state. There are no exact words to describe that enormous burst of energy. Bliss and flashbacks of misadventures just made the feeling more complicated.

I should be happy, I should be very glad. But something was holding me back. Despite the invigorating feeling, it seems like there’s darkness ahead of me. It was a feeling of uncertainty. It was like I’m running as fast as I could, but only towards the sunset.

After I graduated, I had a lot of time to think. Should I pursue my career as a nurse? What carreer path should I choose? Will I work here or abroad? How hard would it be to land a job? Will I get paid well? Will I be happy? These questions repeated in my mind over and over again. It’s like being in an episode of the Twilight Zone. As the mist of uncertainty slowly cleared away, I found answers.

The working conditions for nurses in our country are turning for the worst. Last January, volunteerism for a fee became a debated issue in the local news. This system has been going on for years. Instead of getting paid, the volunteer nurses are the ones paying. Most of us would agree that volunteerism is part of the Filipino spirit of Bayanihan. However, volunteerism for a fee is merely an exploitation of registered nurses.

Moreover, I learned that the starting salary for a nurse is only about 18,000 pesos (Salary grade 11) a month. But according to Nursing Law of 2002, it should be Salary Grade 15 or at least 24,000 pesos a month. After almost a decade, the nursing law is still not fully implemented. Other privileges and benefits entitled to registered nurses are not given to them.

Because of this, many decide to leave the country. Almost 70% of Flilipino nurses are currently working abroad. The opportunities there are better compared to our own country. Aside from being paid well, nurses abroad also enjoy privileges and the benefits that are entitled to the profession in its entirety. We are one of the main exporters of nurses around the globe. But the irony is that there is great lack of health care providers in both urban and rural communities in the Philippines. Isolated areas in our country receive less attention. Many die without even seeing a doctor or a nurse. Not only the nurses suffer but the people who need health care as well.

When I was still a student on hospital duty, I’ve seen firsthand the state of the poor patients in government hospitals. I’ve encountered patients who cannot afford to buy medicines. Treatments were delayed because of lack of resources, both of the patient and the hospital itself. I’ve also witnessed patients die because of highly preventable and curable diseases. Hospital wards are packed and crowded. The sad state of the sick population is evident primarily from the grim expression on the patient’s faces. The environment itself is non-therapeutic. It is far from the ideals taught in classrooms. Meanwhile, in community settings, the access to health care facilities remains poor. In some isolated communities, it would take hours or even days to reach the nearest rural health unit. But this is only a small piece of the puzzle.

The health budget in 2012 is pegged at 42.693 billion pesos. With a population of 101,833,938 (CIA fact book, July 2011), the estimated health budget for a person in a year is only 419.24 pesos or 1.14 pesos to spend on health per day.

What can you buy with something a bit more than a peso? A low quality cigarette perhaps, to kill the boredom as you wait for your death, hastening it in the process. Meanwhile, debt servicing for 2012 is at 738.6 billion pesos. Budget for national defense increased from 104.7 billion pesos in 2011 to 106.905 billion pesos this year. Behind the statistics is a deeper social meaning. It would seem that the government is not prioritizing the health of its people.

We are not blindfolded, and we have the right to speak. We need to address these problems to the authorities. But what if they are the ones who are blind and deaf to all our complaints? Shall we just sit and light more cigarettes? No, this is where the real battle for our rights begins.

Providing the basic health needs of the poor people in the community is essential in improving the overall health status of the Filipinos. With little or no resources at all, the poorest population are most vulnerable to diseases and illnesses. Of course, I still think of earning money and acquiring wealth. But for now, I’ll use my youth and knowledge to where it is most needed.

I also encourage my fellow nurses and future nurses, as well as other health care providers to devote some of their time to community work. The people need us. We must help them so that they can help themselves. Together, we can enact the change that we are all yearning for. Aside from taking care of people’s health, we must also be progressive and fight for our rights. We can give more meaning from what we have learned in the institutions and universities where we came from.

The issue which concerns nurses today is not just about the search for greener pastures. Despite the inattention that the nurses experience and the worsening health status of the people, we should not be discouraged and continue to do what we are supposed to do. Assessing patient’s vital signs is part of our duty, but more than that, I believe that it is also our responsibility to assess the society’s illnesses. We should also dare to participate and be part of the people’s movement for health and social change.

Alren Aure, R.N.

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