Why Registered Nurses from the Philippines Stay?

Why Registered Nurses From The Philippines Stay?
Vilma Reyes-Jackaron, BSN, RN
Author Affiliation: MSN student, Blessing –Rieman College of Nursing, Quincy, IL
Correspondence: Vilma R. Jackaron, 611 Cherry Street, Quincy, IL 62301([email protected]).


The threat of nursing shortage in the United States can be alleviated by foreign educated Filipino registered nurses. Myriad of reasons, topped by financial gains, family cohesiveness and professional enrichment are the primary driving force that entice them to work and stay in the United States. Recognizing their unique background in facilitating their assimilation in the American health care system can ensure an effective and productive member of the nursing workforce.

Why Registered Nurses from the Philippines Stay?
Leaving one’s family in search for a better future and lucrative opportunities is a difficult decision to make. For foreign educated registered nurses from the Philippines, this decision is the beginning of a promising life for their families and their personal and professional growth. Although the journey is different for everyone, in terms of money and effort, most nursing graduates from the Philippines do their best to achieve the American dream.
However, not all registered nurses from the Philippines achieve the American dream, resulting in hardship for those individuals who must return to the Philippines and creating a turnover of registered nurses for their American employers. To reduce the turnover of Philippine-educated nurses thereby maintaining the number of registered nurses in the United States, employers must implement strategies that induce theses registered nurses to stay. For these strategies to be effective, they must be based on an understanding of why registered nurses from the Philippines stay with their American employers.

Literature Review
In the past, the sociopolitical turmoil that was inflicted by Martial Law in the early 1970’s, was the main reason why Filipino registered nurses left the country and decided to work and stay in the United States. Families tend to endure the hardship of separation in the hope that such selfless sacrifice would mean reunification later (1, 2). Years passed and success stories among Filipino registered nurses in the United States spread like wild fire. The Philippine government was quick to act in response to the need for more registered nurses from the Philippines. The country’s nursing curriculum was patterned as closely as possible to that of the United States, abolishing the 3 year diploma program and implemented the Baccalaureate Nursing program(3). With such support from the government, the Philippines became the top producer of registered nurses in the region outside of the United States(4).Creating a surplus that made it impossible for these nurses to find nursing jobs in the country that will give them a decent pay to live and support their families(5). The sense of self respect and professional growth became more of battle cry for Filipino registered nurses who just recently exposed an abusive practice in the Philippine healthcare system. In an article entitled, “Glut of Filipino Nurses leads to Exploitation”, new Filipino registered nurses were asked to pay PH 3,000.00 TO PH 5,000 to be admitted as volunteer RN to gain the required hospital experience vital for them to start applying for nursing jobs to other countries(6). Such personal and professional degradation highly contribute to Filipino registered nurses’ desire to work and stay in the United States. The advanced technology in equipments and modalities in the United States lured most Filipino registered nurses to dream to be part of prestigious hospitals in the US (1) An article in John Hopkins magazine, entitled,”Migration, Brain Drain, and Going Forward,” Filipino nurses hired by John Hopkins University hospital shared their self-fulfilling achievements and professional growth they acquired that no nurse in the Philippines can achieve for next decade to come (7).

The Path to Success to the Great American Dream
As the road to success may not be always smooth and easy, it has been the same in the case of some Filipino registered nurses. The literature revealed very few Filipino registered nurses would desire to go and leave their employers if not because of their immigration status (5).For Filipino registered nurses who came to the United States with H1B visas, they leave the US after they finished their contract to work .Very much different if one can successfully avail of the EB3 visa which will provide the Filipino registered nurse and her immediate family members a legal permanent residence visa. In the case of four foreign educated registered nurses from the Philippines that worked in a rural Midwestern hospital for not less than 3 years, including the author of this article, reasons to stay ranged from the present employer providing the much coveted legal permanent residence visa for the nurses and their immediate families and the simple yet decent life this small town can offer. The family oriented way of life, topped with the hospital’s Magnet status and continuous desire to excel in providing the best healthcare in the region are enticing enough for these nurses to stay. A study conducted by McNeese-Smith (2001) well supported the idea of how foreign educated nurses from the Philippines value their employers’ goodwill from employment sponsorship by providing immigrant visas, decent pay and working condition and advances in professional growth. Interestingly enough, her research further elaborated how foreign graduate nurses from the Philippines can be vulnerable to factors that affect their commitment to their employers. The tendency to waiver loyalty to employers range from perceived lack of appreciation, lack of support, politics, and lack of commitment from employers themselves, contrasting factors that most foreign graduate nurses from the Philippines value and considered a major reason to work and stay with their US employers(8).

Foreign educated registered nurses from the Philippines are not far different from their US educated counterparts in terms of reasons why they decide to work and stay with their employers (Vestal and Kautz, 2009).Registered nurses from the Philippines are always enthusiastic about coming to the US and venture on a promising personal and professional life away from their own countries. They value the support their employers and managers provide and words of appreciation they get for a job well done. However, Filipino nurses have the same concerns as their US educated counterparts in terms of dissatisfying factors like, floating and patient workload, but less disturbing among Filipino nurses owing to their work background from the Philippines where floating and patient workload can be comparably worst(9).It is highly suggested by Chan, McBey, Basset, O’Donnell and Winter (2004) that hospital administrators must find ways to implement human resource strategies that will attract new nurses while retaining high performing nursing personnel currently employed by the organization. In addition, Kooker and Kamikawa (2010) found out that engaging staff, and having high expectations, coupled with high support from the upper management level can improve retention strategies. Providing data to unit level staff to measure improvements with emphasis to renewed accountability and maintaining focus on quality patient care. These are all very visible and viable strategies being implemented in a Midwestern rural hospital where the author along with 3 other foreign educated registered nurses from the Philippines .These nurses were employed by the hospital for almost 7 years now. The decision to stay with our present employer strongly suggest that upper level management had done a good job of addressing the personal and professional needs of their foreign educated registered nurses from the Philippines. The continuing effort of the hospital administrators and managers to empower the nursing staff had earned the hospital its magnet status. The work is not yet done and all efforts are geared towards making it the employer of choice in the region. While most in the literature agree that improving healthcare work environment is one key strategy to impact nursing shortage and turn over (Vacharakiat, 2008, Kooker and Molina, 2010, Chan, McBey, Basset, O’Donnell and Winter,2004),for most foreign educated registered nurses from the Philippines, the simple joy of successfully acquiring a job, the honest appreciation of those whom they directly provide care and sense of unity among their peers are all equally important in deciding to work and stay loyal to their US employers(8).


1. Allgood J. Filipino Nurses in Baylor University Medical Center: A Personal Recollection. Proc (Bayl Univ Med Cent) 2001; 14(4):406-409.
2. Salary of Nurses in the USA Blog posted by ceblogger http:// www.blogcebuworld.com. Updated September 6, 2008.Accessed May 5, 2011.
3. Steefel L. Hands from Abroad Shape Up Nursing Shortage. http:// www.news.nurse.com .Updated April 6, 2001.Accessed May 5, 2011.
4. Katigbak J. Filipino Nurses Still Rule the Roost in the US. Star Washington Bureau. http://www.philstar.com/Article.aspx?articleid=403402.Updated September 28, 2008.Accessed May 6, 2011.
5. Lorenzo FE, Galvez-Tan J, Icamana K, Javier L. Nurse Migration from a Source Country Perspective: Philippine Country Case Study. Health Serv Res. 2007 June; 42(3 Pt 2):1406-1408.
6. Jumilla L. Glut of Filipino Nurses Leads to Exploitation. ABS – CBN News. http://www.abs-cbn news.com. Updated January 1, 2011.Accessed May 12, 2011.
7. Walker J. The Global Nursing Shortage: Migration, Brain Drain and Going Forward. John Hopkins Magazine. http:// www.magazine.nursing.jhu.edu/2010/08/. Accessed May 13, 2011.
8. McNeese D. A Nursing Shortage: Building Organizational Commitment among Nurses. Journal of Healthcare Management May 2001.http:// www.entrepreneur.com/tradejournals/article/75373174.html. Accessed May 16, 2011.
9. Vestal V, Kautz D. International Perspective: Responding to Similarities and Differences between Filipinos and American Nurses. Journal of Nursing Administration. January 2009; 39(1):8-10.
10. Chan CCA, McBey K, Basset M, O’Donnell M, Winter R. Nursing Crisis: Retention Strategies for Hospital Administrators. Research and Practice in Human Resource Management.2004; 112(2):31-56.
11. Kooker B, Kamikawa C. Successful Strategies to Improve RN Retention and Patient Outcomes in a Large Medical Center in Hawaii. Journal of Clinical Nursing. 2011; 20(1, 2):34-39.

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  • jian rontas

    hi. im jian, and im a first year student taking up nursing here in the philippines, bicol specifically. i just would like to ask if i would still get a job after i graduated my college despite the fact that there are overload of nurses in the philippines. i am thinking if i would shift to another course or not.. can you help me???please.. by the way, one of my dream is to reach an american country and work there,but this dream seems to be impossible. :(((

  • roikydu

    Hospitals in the USA don’t hire nurses with only an experience in the Philippines. They want nurses with at least 1 year of experience in the USA. They have training programs for new graduates and nurses in the Philippines are among that category no matter what year you have graduated and you have to wait for almost a year to get in.

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