Filipino nurses have been abused for too long. It’s time to stop. It’s time for the global community to know the about the harsh realities and the unjust system in the Philippine healthcare-settings. What kind of abuse do I mean?
1. False volunteerism
Most hospitals in the Philippines require their nurse applicants (licensed nurse) to volunteer for 2-6 months or for some, 1-2 years depending on their hospital policy. Nonetheless, the job responsibilities of these volunteers are the same with staff nurses who are regular employees. Worse, some hospitals require their applicants to pay to volunteer just to gain experience.
The Philippine Department of Health had already issued a memorandum 5 years ago mandating to terminate all “Nurse Volunteer Programs”, “Volunteer Training Programs for Nurses” and all similar or related programs, in all DOH-retained hospitals in the Philippines. A bill was also released last Oct. 30, 2014, which prohibits the exploitation of volunteer registered nurses in public and private hospital clinics and health facilities.
But why Filipino nurses continue to volunteer and why do hospitals continue to impose such policies? Since volunteerism was prohibited, hospitals disguise their programs as training and they call their applicants “nurse trainees” instead of volunteers. Through this, they can effectively collect training fees from the so-called “nurse trainees” and save expenses in terms of their human resources. Some hospitals promise a job position for these hopeful trainees. Without undergoing such “training programs”, a nurse applicant cannot land a position in the hospital.
With such rules, the cycle of abuse continues. The exploitation becomes a culture. Most of the Filipino nurses accept the fact that they need to undergo exploitation just to gain working experience. “Volunteering is temporary”, most nurses claim. “After 2 years, our goal is to work abroad”. Hence, turn-over is very rapid in almost all hospitals.
2. Job order, contractual, or forever reliever
In order for the hospital to save expenses without compromising their human resources, instead of hiring nurses to a permanent position, they let them work as contractual or reliever. This means, nurses who are under job order or signed as contractual do not have benefits the same as the regular employees. Relievers are under an agreement of “no work no pay”, and no benefits. Since there are limited job vacancies for staff nurse in the Philippines, most nurses would opt to work as relievers or job orders rather than staying jobless. Besides, 2 years of work experience is every nurse’s goal.
3. Very poor compensation
Relievers and contractual nurses in private hospitals are paid usually a minimum wage of $5-6 per day. Regular employees usually receive an average of $130-$270 per MONTH. For nurses employed in government institutions, their usual salary range from $400-$550 per MONTH. For job order under the government, their usual pay is $400, without the benefits of a regular employee.
4. Poor working conditions
Most hospitals, especially in government institutions, lack provisions of a safe working environment and proper protective equipment. Moreover, it is not only the health-care workers who suffer from such condition but most especially the patients. Because of overcrowding in hospital wards, patients are forced to share beds and even share one oxygen tank. Poor ventilation, poor lighting, unhygienic lavatories, and poor healthcare services, in general, are what most public institutions offer.
5. Always overtime but no overtime pay
Despite many unemployed nurses in the Philippines, staff nurses in the hospitals are forced to be on duty longer than the legally-mandated eight hours. Some nurses have to work 12-16 hours. The main reason you ask? Hospitals lack nurses, an irony in the Philippines. Nurse supervisors ask their subordinates to work overtime but some are not compensated with overtime pay. Instead, those extra hours rendered are just paid as basic pay. Unfair, right?
Some hospitals have another way to deal with over time. They practice offsetting instead of paying an employee overtime. But according to Labor Code Article 87, it is illegal. Undertime should not be offset by overtime. Undertime work on any particular day shall not be offset by overtime work on any other day.
An article by Philippine Labor Laws explains that “offsetting undertime against overtime is improper because the employee would be deprived of the additional compensation for the overtime work he has rendered. Note that under time is covered only by the regular hourly rate whereas overtime is subject to additional overtime rate. If the two are to be offset, the employee loses overtime pay to which he is entitled”.
6. Unreasonable nurse-to-patient ratio
The nurse-to-patient ratio in government hospitals ranges from 40-60 patients per nurse. In critical care areas, nurses have to handle 2-4 patients, some even more. In private institutions, one nurse usually handles 8-12 patients.
7. No medical insurance
Not all hospitals have medical insurance for their health-workers. It is quite obvious that working in the hospital is a health hazard, but none of it matter to the hospital employers.
8. Politicking especially in government hospitals
Some hospital heads hire their nurses based on the endorsement of public officials. Some qualified nurses are left unemployed because they prioritize applicants with backings from the mayor or from the governor. Is this practice can be justified ethically? You would probably say no. Ostensibly, this has been the norm in the hospital settings for generations.
9. Training is very costly
Training in the Philippines became an avenue for business. Some training can even cost a month’s pay of a nurse.
10. Nurse floaters
According to Medical Dictionary, a float nurse is someone who is available for assignment to duty on an ad hoc basis, usually to assist in times of unusually heavy workloads or to assume the duties of absent nursing personnel. A float nurse is recruited from a group of nurses called a float pool. Also called the contingent nurse. Nurse floaters have been a practice across the globe by almost all hospitals. But here in the Philippines, there are no clear policies about the rights of the nurses that will protect them in any inappropriate assignments.
This article may not be able to cover all the maltreatment to nurses. Perhaps, it is just a glimpse of truth. But why is the cycle of abuse continues? Is there anything we could do to stop all these? Are the abuses product of ignorance or a culture of tolerance?
There have been legislations to protect the rights of the nurses in the Philippines. However, there are loopholes which the hospitals can use to get away with their malpractices. Hopefully, in the years to come, lawmakers will be able to push a law that could truly promote the rights of the healthcare professionals and improve the health of the Filipino people. For now, the best option for the Filipino nurses is just to go abroad.
- “float nurse”. Medical Dictionary. Retrieved from http://medical-dictionary.thefreedictionary.com/float+nurse
- Philippine Labor Laws. (2010). Overtime Pay. http://www.laborlaw.usc-law.org/2010/02/23/overtime-pay/
- Senate Office of the Secretary (2014, Oct. 14). An act prohibiting the exploitation of volunteer registered nurses in public and private hospitals, clinics, and health facilities and providing penalties for violation thereof. Retrieved from ihttps://www.senate.gov.ph/lisdata/2008717198!.pdf