Quality Nursing Education: A Remedy for the Brain Drain

As scarcity of nurses happens in developed countries such as the United States, the Philippines tries to help settle the gaps in these countries by providing them with the professionals that they need. From 1992-2004, almost 90,000 of the proficient nurses in the Philippines can be seen in different parts of the globe (POEA, 2004). The Philippines was said to be the pioneer and the leading producer of nurses for the developed countries as it comprises 25% of the nurse migrants in the developed countries (Estella, 2005). As a matter of fact, it has been stated that around 83% of the nurses working in the United States are Filipinos (Philippine Star, 2007).

With the promise of the greener pastures settled in front of their eyes, Filipinos suddenly had this grown interest for the Nursing profession. If before, the motivation of the Filipinos in taking up Nursing was to offer care for the vulnerable population, right now, the dream of financial prosperity weighs greater than this intent. Nursing suddenly became a sort of a manpower business where the quality control department has been deleted somewhere.

Production of RNs: Surplus with underlying Scarcity

Presently, the estimated job positions for nurses in the government, private and educational institutions, are around 27, 160 (Department of Health, 2000). The number of nurses produced yearly is more than enough to neutralize the number of nurses who leave the country to work overseas. The Philippine nursing workforce has a surplus of nurses for the domestic market.

While the Philippines hold a handful of nurses in quantity, the quality of the nurses in the domestic work force is the one suffering. As the pursuit of greater financial and career prospects abroad becomes appealing to the eyes of the Filipinos, the phenomenon of brain drain starts to attack the profession and the health care system. Brain drain or the Human Capital Flight is the large scale emigration of a large group of highly skilled and knowledgeable individuals, such as the nurses (Buchan, 2008).

An evident cause of the creation of nurses with poor quality is the poor education that has produced them. From 50 nursing schools, a mushrooming 350 schools started to boom during the start of the second millennium. Most of these new schools were not even accredited to have passed the CHED standards (Estella, 2005). As a result, a decline in the passing rate from 54% in 2004, down to 39% in 2009 becomes noticeable (Professional Regulation Commission, 2011).

The nursing practice seems to be affected with this phenomenon as well. Since those who were qualified for migration are often the highly skilled and experienced nurses, the hospitals in the Philippines are being deprived of these kinds of nurses. A poor health care environment suffers from the hiring of poor quality and inexperienced nurses. Increased incidence of cross infections, more patient injuries are being reported and adverse surgery outcomes are some of the social effects of migration ( Buchan, 2003).

The Nurse Migration Magnet

Migration has been the “survival tactic” of the Philippines, in putting up its financial resources. With the billions of dollars in remittances saving the economy from collapse, the government does not have the temerity to reverse the practice of manpower export. It is almost impossible for the government to put a halt on the outsourcing of nurses (Evangelista, 2008). The government may even contribute to the individual motives of the nurses to leave the country and support the magnet of nurse migration.

While it may be impractical for the country to stop migration, something can still be done with the dilemma of brain drain in the profession. In order to properly enmesh solutions to the problem of Human Capital Flight, it will be helpful to scrutinize the system of motivation of the nurses in leaving their jobs in the country. Dissecting the individual characteristics, job characteristics and work situation characteristics gives a picture of why so many nurses are in the magnet of migration (Mintzberg, 1989).

1. Individual characteristics
The prevalent pulling force that urges Filipino to work overseas is the chance for them to earn a decent work pay. An average nurse is being paid from a range of P6,000-P8,000 in a private hospital to P8,000-P10,000 in a government hospital (DOLE, 2003). This makes the nurses one of the lowest paid professionals in our country (World Salaries Organization, 2005). Aside from this low amount, salary inequities also lead to the dissatisfaction of the nurses with their jobs.

Another need that migration satisfies among nurses is the pursuit for personal and professional development. Majority aspires to have an international training in a developed country as the training enhances their expertise in their chosen field of specialization

2. Job characteristics
The poor promotion programs and working conditions are other factors that push some nurses out of the country. Nurses tend to be frustrated with the lack of recognition for their efforts. Moreover, a nurse-patient ratio of 3:50, a below the minimum salary, and unpaid hours of overtime, puts down the morale of these professionals.

3. Work situation characteristics
The political condition in one’s work environment is another source of disappointment for nurses. Nurses find it unfair to see how obvious nepotism happens in institutions, starting from the hiring of nurses to the promotion. In addition, the crab mentality that persists among co-workers also leads one to pursue plans of leaving the country.

Empowerment of Philippine Nursing Profession

In order to ease the phenomenon of brain drain in the country, a remedy must be placed on the quality of the profession. The best crops are harvested from the roots and this is basically the role of the health professions education. No matter what the initial intents of a student are in taking up nursing, still, the educational institution takes control of the molding and shaping of the goals and motivation of the nurses they produce.

The Commission on Higher Education must push the strict regulation of the substandard nursing schools in the country. Educational institutions that do not work for the production of highly skilled nurses must not be allowed to operate. The mushrooming of nursing schools must not be anymore tolerated (Estella, 2005).

The curriculum of Nursing must also be revisited to see if the core competencies of nurse are achieved by the nursing graduates. Most nursing graduates may have developed the skills but their competence is still not adept to the working environment in the Philippine hospitals.

Community Health Nursing must also be given more units in the Nursing curriculum as this is basically the health care system that the rural areas of the country possess. Opening the eyes of the nurses to community nursing can help imbibe patriotism in nurses and lead them to choose to serve the country’s rural areas. Nurse educators must inculcate to their students the value and essence of being a nurse for their own country. They must motivate the students with the right goals for the profession. Students must be able to think that nursing is a professional devotion and not a mere money making job.

The nursing profession could have prevented the reliance with the highly skilled and qualified migrants; if in the first place, the right objectives were settled. Eventually, those who have the most sincere objectives for the nursing profession are the ones who stay and remain in the field, while the others move otherwise.

Photo credit: nursing-now.blogspot.com

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  • Raymond James Canute

    “As a matter of fact, it has been stated that around 83% of the nurses working in the United States are Filipinos (Philippine Star, 2007).”

    Do you mean that in the United States, only 17% of nurses are Americans? I don’t think so. Maybe 83% of the internationally-educated nurses in the United States are Filipinos.

  • tony acuna

    whatever the figure,it only leads to one issue,massive brain drain of professionals

    • Raymond James Canute

      @ tony acuna: i have never denied the fact re: massive brain drain of nurses. but the thing is, since it is an article the facts ought to be accurate. Also, it won’t do justice to the source (Philippine Star) where it was quoted.

  • air11ria

    Thank you for that comment. I wasn’t able to screen the statement, yes, the article was referring to 83% of the internationally-educated nurses.

  • Air Brillante

    Yes, you’re right and we have to do something about it before we completely lose the competence of our profession.

  • Roy

    Totally disagree with this statement, “As a matter of fact, it has been stated that around 83% of the nurses working in the United States are Filipinos (Philippine Star, 2007).” These are the real facts about nurses in the United States. Of the three million (more or less) nurses in the U.S., 86% are White non-Hispanic, 2% Hispanic, 5% Black non-Hispanic, 0.5% American Indian and 3.5% Asian/Pacific Islander and I’m sure majority of these Asian nurses are Filipinos. Based on this, nursing profession in the US still considered as white female dominated profession and male nurses comprised only about 6% to 7% percent of the total nurses. As of to date, a lot of Americans are taking nursing course seriously and this will be the solution of those health care issues in this country. I wish luck to those Filipino nurses that still hope to come to the US.

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  • Elrond

    There is no more need for Pinoy nurses in the USA. Thousands upon thousands of American nurses are already in the pipeline to fill the shortage. No more dreams of migration to America ever for Pinoy RNs.

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