nursing education situation in the philippines 18141
TRANSCRIPT
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Exporting Health Human ResourceExporting Health Human Resource
No. 1 Exporter of NursesNo. 1 Exporter of Nurses
An estimated 85% of employed Filipino nurses (more thanAn estimated 85% of employed Filipino nurses (more than150,000) are working internationally. (Aiken et al 2004)150,000) are working internationally. (Aiken et al 2004)
70% of all Filipino nursing graduates are working overseas.70% of all Filipino nursing graduates are working overseas.(Bach 2003)(Bach 2003)
No. 2 Exporter of DoctorsNo. 2 Exporter of Doctors
68% of Filipino doctors work overseas, next to India. (Mejia,68% of Filipino doctors work overseas, next to India. (Mejia,WHO 1975)WHO 1975)
(NIH 2004)(NIH 2004)
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Hemorrhage of Human Resources: NursesHemorrhage of Human Resources: Nurses
13,536 nurses left in 2001.13,536 nurses left in 2001.
20002000--2003: approx 50,000 nurses left.2003: approx 50,000 nurses left.
Data casts doubt on the underreporting of the Philippine OverseasData casts doubt on the underreporting of the Philippine Overseas
Employment Agency (POEA) that shows only 91 nurses left for theEmployment Agency (POEA) that shows only 91 nurses left for theUSA in 2000, 304 nurses in 2001, and 320 nurses in 2002. (TanUSA in 2000, 304 nurses in 2001, and 320 nurses in 2002. (Tan etetalal 2004)2004)
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Top 5 Destinations of Filipino NursesTop 5 Destinations of Filipino Nurses
United States of AmericaUnited States of America United KingdomUnited Kingdom Saudi ArabiaSaudi Arabia
IrelandIreland SingaporeSingapore
The number of nurses that left in the last 4 yearsThe number of nurses that left in the last 4 years
(50,000) far exceeds the production of nurses of(50,000) far exceeds the production of nurses ofonly 20,000 in the same period.only 20,000 in the same period.(NIH 2004)(NIH 2004)
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Deteriorating Quality of Nursing EducationDeteriorating Quality of Nursing Education
The number of nursingThe number of nursingschools have increasedschools have increased
1970s: only 401970s: only 40
1990s: 1701990s: 170
June 2003: 251June 2003: 251
April 2004: 370April 2004: 370
June 2005: 441June 2005: 441
June 2006: 470June 2006: 470
By June 2006, almostBy June 2006, almost200% increase in nursing200% increase in nursingschools nationwide sinceschools nationwide since20032003
(NIH 2004)(NIH 2004)
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Deteriorating Quality of Nursing EducationDeteriorating Quality of Nursing Education
Decreasing proportion of nursing graduates who passDecreasing proportion of nursing graduates who passthe national nursing licensure examinationsthe national nursing licensure examinations
1970s and 80s: 80%1970s and 80s: 80%--90%90%
1991: below 61%1991: below 61%
20012001--2003: 44%2003: 44%--48%48%
2004: 55.9%2004: 55.9%
2005: 49.7%2005: 49.7%
2006: 42.42%2006: 42.42%
(NIH 2004, PRC 2005)(NIH 2004, PRC 2005)
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Deteriorating Quality of Nursing EducationDeteriorating Quality of Nursing Education
In 2001In 2001116 nursing schools: passing rate of 50%
In 2002, 150 nursing schools had a passingIn 2002, 150 nursing schools had a passingrate
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Hemorrhage of Human Resources: Other ProfessionalsHemorrhage of Human Resources: Other Professionals
At least 37 Philippine nursing schools offer abbreviatedAt least 37 Philippine nursing schools offer abbreviated22--year courses for doctors to become nurses.year courses for doctors to become nurses.
More than 60% of nursing schools are geared mainly forMore than 60% of nursing schools are geared mainly for
second coursers (nonsecond coursers (non--health professionals who want tohealth professionals who want totake up nursing, e.g. engineers, accountants, teachers,take up nursing, e.g. engineers, accountants, teachers,soldiers).soldiers).
(HSA 2005, PNA 2005)(HSA 2005, PNA 2005)
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Hemorrhage of Human Resources: Other ProfessionalsHemorrhage of Human Resources: Other Professionals
Initial HEAD estimates:Initial HEAD estimates:
around 30% of nursing students are secondaround 30% of nursing students are second--courserscoursers
at least 80% of those taking up nursing are planning toat least 80% of those taking up nursing are planning towork abroadwork abroad
between 75%between 75%--90% of faculty members are planning to90% of faculty members are planning towork abroadwork abroad
(HSA 2005, PNA 2005)(HSA 2005, PNA 2005)
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Hemorrhage of Human Resources: Other ProfessionalsHemorrhage of Human Resources: Other Professionals
Biggest review centers:Biggest review centers:
INRESSINRESS P10,000 for 6 weeksP10,000 for 6 weeks
GapuzGapuz P13,400 for 3 weeksP13,400 for 3 weeksPentagonPentagon P14,500 from Sept to DecP14,500 from Sept to Dec
Most nursing colleges also have compulsory inMost nursing colleges also have compulsory in--househousereviews that are paid for by the students (separate fromreviews that are paid for by the students (separate from
tuition and other expenses)tuition and other expenses)
Students/graduates spend around P40,000+ just forStudents/graduates spend around P40,000+ just forreviewreview
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Exploited Health Human ResourcesExploited Health Human Resources
Health workers and professionals areHealth workers and professionals areoverworked and underpaid.overworked and underpaid.
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Exploited Health Human ResourcesExploited Health Human Resources
Doctor to patient ratio (population)Doctor to patient ratio (population)Cuba 1:225Cuba 1:225
USA 1:450USA 1:450
Philippines 1:10,000Philippines 1:10,000--26,00026,000
WHO (Ideal) 1:600WHO (Ideal) 1:600
Nurses to patient ratioNurses to patient ratioPGH 1:15PGH 1:15--26 per shift26 per shift
Davao del Sur 1:44Davao del Sur 1:44--45 per shift45 per shift
Ideal 1:4 per shiftIdeal 1:4 per shiftPhilippines 1:16,000 (population)Philippines 1:16,000 (population)
(AHW 2004, HealthWrights 2004)(AHW 2004, HealthWrights 2004)
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The Unhealthy Philippine Health Care SystemThe Unhealthy Philippine Health Care System
A health care system that cannot maintainA health care system that cannot maintain
its own health human resourceits own health human resourceis not healthy at all.is not healthy at all.
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The Nursing Exam LeakageThe Nursing Exam Leakage
The Nursing Licensure Examination (NLE)The Nursing Licensure Examination (NLE)
Given by the PRC twice a yearGiven by the PRC twice a year
Exam questions are prepared by members of theExam questions are prepared by members of theBoard of NursingBoard of Nursing
Has 5 parts: Test I (Community Nursing), Test IIHas 5 parts: Test I (Community Nursing), Test II(Maternal and Child), Test III (Medical(Maternal and Child), Test III (Medical--SurgicalSurgical
Nursing), Test IV (Fundamentals), Test VNursing), Test IV (Fundamentals), Test V(Psychiatric Nursing)(Psychiatric Nursing)
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The Nursing Exam LeakageThe Nursing Exam Leakage
Basic chronology of the NLE leakBasic chronology of the NLE leak
A few days before the June 2006 NLE,A few days before the June 2006 NLE,
INRESS held an final coaching at one ofINRESS held an final coaching at one ofthe cinemas in SM North EDSAthe cinemas in SM North EDSA
Shortly after the NLE, the leakage wasShortly after the NLE, the leakage wasexposed in Baguio City. PRCexposed in Baguio City. PRC--CARCAR
immediately informed PRC national office.immediately informed PRC national office.
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The Nursing Exam LeakageThe Nursing Exam Leakage
Basic chronology of the NLE leakBasic chronology of the NLE leak
PRC initially said it would investigate beforePRC initially said it would investigate beforereleasing the list of those who passed.releasing the list of those who passed.
Mass resignation of the Technical Committee onMass resignation of the Technical Committee onNursing Education (TCNE) on July 7, citing thatNursing Education (TCNE) on July 7, citing thatCHED has instead (of implementing past memos)CHED has instead (of implementing past memos)buckled down to pressure from poor performingbuckled down to pressure from poor performingschools, politicians and Malacaang,schools, politicians and Malacaang, sacrificingsacrificingquality for mediocrity and businessquality for mediocrity and business
interestinterest..
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The Nursing Exam LeakageThe Nursing Exam Leakage
Basic chronology of the NLE leakBasic chronology of the NLE leak
But even without an investigation, theBut even without an investigation, thePRC released the list of those who passedPRC released the list of those who passedand stated there was no leak involved.and stated there was no leak involved.
PNA President George Cordero alsoPNA President George Cordero alsolobbied the PNA chapter in Baguio to keeplobbied the PNA chapter in Baguio to keepthe matter under wraps as it mightthe matter under wraps as it might
jeopardize the countrys request to bejeopardize the countrys request to bemade an NCLEX center.made an NCLEX center.
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The Nursing Exam LeakageThe Nursing Exam Leakage
Basic chronology of the NLE leakBasic chronology of the NLE leak
Nursing groups were formed to pressure the PRC.Nursing groups were formed to pressure the PRC.The USTThe UST--led group called for a nullification of theled group called for a nullification of the
entire NLE and a reentire NLE and a re--take.take.
The nursing community became embroiled andThe nursing community became embroiled anddivided on the redivided on the re--take debate.take debate.
The PRC allowed the oathThe PRC allowed the oath--taking of those whotaking of those whopassed even after promising the ADPCN that itpassed even after promising the ADPCN that itwill defer such action.will defer such action.
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The Nursing Exam LeakageThe Nursing Exam Leakage
Basic chronology of the NLE leakBasic chronology of the NLE leak
The USTThe UST--led group filed a TRO against the PRCled group filed a TRO against the PRCfor the oathfor the oath--taking. The processing of paperstaking. The processing of papers
also stopped.also stopped.The Senate and the HOR Committees on HealthThe Senate and the HOR Committees on Healthbegan conducting their respective investigations,began conducting their respective investigations,but the govt agencies involved did not attend thebut the govt agencies involved did not attend thehearings.hearings.
Witness testimonies already point to theWitness testimonies already point to theinvolvement of key leaders/members of the PNAinvolvement of key leaders/members of the PNAand BON.and BON.
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The Nursing Exam LeakageThe Nursing Exam Leakage
Major groups implicatedMajor groups implicated
Dr. George Cordero: owner of INRESS andDr. George Cordero: owner of INRESS andPhilippine Colleges of Health Sciences (PCHS);Philippine Colleges of Health Sciences (PCHS);President of the Philippine Nurses AssociationPresident of the Philippine Nurses Association
(PNA)(PNA)BON members Anesia B. Dionisio and Virginia D.BON members Anesia B. Dionisio and Virginia D.MadejaMadeja
Gapuz and Pentagon Review centersGapuz and Pentagon Review centers
PRC Chair Leonor TriponPRC Chair Leonor Tripon--RoseroRosero
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The Nursing Exam LeakageThe Nursing Exam Leakage
Major government agencies involvedMajor government agencies involved
Professional Regulation Commission (PRC)Professional Regulation Commission (PRC)
Board of Nursing (BON)Board of Nursing (BON)
Commission on Higher Education (CHED)Commission on Higher Education (CHED)
Dante Ang (Commission on Overseas Filipino andDante Ang (Commission on Overseas Filipino andPresidential Task Force on the National LicensurePresidential Task Force on the National LicensureExam/EO 550)Exam/EO 550)
National Bureau of InvestigationNational Bureau of Investigation
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The Nursing Exam LeakageThe Nursing Exam Leakage
Major groups of stakeholdersMajor groups of stakeholders
Association of Deans of Philippine Colleges ofAssociation of Deans of Philippine Colleges ofNursing (President Carmelita Divinagracia, DeanNursing (President Carmelita Divinagracia, DeanUERM CN)UERM CN)
PNA and PNAPNA and PNA--CARCAR
Concerned Nurses (UST, FEU)Concerned Nurses (UST, FEU)
ANSWER (broad interANSWER (broad inter--school alliance)school alliance)
BSN (Bukluran ng mga Samahang Nurses)BSN (Bukluran ng mga Samahang Nurses)
Health Alliance for Democracy (HEAD)Health Alliance for Democracy (HEAD)
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The Nursing Exam LeakageThe Nursing Exam Leakage
Positions regarding the issuePositions regarding the issue
PRC: No LeakagePRC: No Leakage No ReNo Re--taketake Voluntary reVoluntary re--take for freetake for free Bonus 2%Bonus 2%
Dante Ang/Arroyo admin: Compulsory ReDante Ang/Arroyo admin: Compulsory Re--taketake Compulsory reCompulsory re--take of Tests III and Vtake of Tests III and V
PNA: RePNA: Re--take alltake all No reNo re--taketake
UST, UE, UP: Compulsory reUST, UE, UP: Compulsory re--take of Tests III, Vtake of Tests III, VCHED: Wala kaming kinalaman dyan!CHED: Wala kaming kinalaman dyan!
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The Nursing Exam LeakageThe Nursing Exam Leakage
HEAD analysisHEAD analysis
Leakage is only a symptom of a longLeakage is only a symptom of a long--standing deterioration of the nursingstanding deterioration of the nursing
educationeducation
Like other exams given by the PRC, theLike other exams given by the PRC, theNLE has been fraught with leakages thatNLE has been fraught with leakages that
have exemplified the collusion betweenhave exemplified the collusion betweengovt officials and big businessgovt officials and big business
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The Nursing Exam LeakageThe Nursing Exam Leakage
HEAD analysisHEAD analysis
The commercialization of nursingThe commercialization of nursingeducation has worsened the quality ofeducation has worsened the quality ofnursing educationnursing education
This commercialization is rooted in theThis commercialization is rooted in theLabor Export Policy of the Arroyo regimeLabor Export Policy of the Arroyo regime
Rather than seek solutions, the ArroyoRather than seek solutions, the Arroyogovt seeks to centralize everything (e.g.govt seeks to centralize everything (e.g.regulate review centers under govtregulate review centers under govtcontrol) to increase its revenuescontrol) to increase its revenues
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Health Under the Arroyo RegimeHealth Under the Arroyo Regime
Filipino nurses have become aFilipino nurses have become acommodity: subject to TRADE andcommodity: subject to TRADE and
PROFITSPROFITS
The national government hasThe national government has
ABANDONED its responsibility toABANDONED its responsibility toensure the HEALTH of their PEOPLEensure the HEALTH of their PEOPLE
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WHATWEWANT
HEAD proposals: IMMEDIATEHEAD proposals: IMMEDIATE
Conduct a speedy, thorough, impartial, andConduct a speedy, thorough, impartial, and
independent investigation of the leakageindependent investigation of the leakage
Identify and prosecute the guiltyIdentify and prosecute the guilty
Completely revamp the PRC, BON, and CHEDCompletely revamp the PRC, BON, and CHED
Allow those who have passed to seek jobsAllow those who have passed to seek jobswithout discriminationwithout discrimination
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WHATWEWANT
HEAD proposals: LONGHEAD proposals: LONG--TERMTERM
Review and uphold the recommendations set byReview and uphold the recommendations set bythe TCNE. Set the standards for nursing schoolsthe TCNE. Set the standards for nursing schools
to operate and ensure complianceto operate and ensure compliance Ensure the quality of education through aEnsure the quality of education through a
thorough review of the curricula and quality ofthorough review of the curricula and quality ofnursing facultynursing faculty
Ensure the integrity of the conduct ofEnsure the integrity of the conduct ofexaminations and other tests pertinent to theexaminations and other tests pertinent to thecompetence of Filipino nursescompetence of Filipino nurses
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WHATWEWANT
HEAD calls:HEAD calls:
Unite and Uphold the Integrity of the NursingUnite and Uphold the Integrity of the NursingProfession!Profession!
Conduct a Speedy, Thorough, and IndependentConduct a Speedy, Thorough, and IndependentInvestigation! Identify and Prosecute the Guilty!Investigation! Identify and Prosecute the Guilty!
Stop the Commercialization of NursingStop the Commercialization of Nursing
Education!Education!
Stop the Arroyo Administrations Labor ExportStop the Arroyo Administrations Labor ExportPolicy!Policy!
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HEAL.
STRUGGLE.
LIBERATE.
Health Alliance for
Democracy (HEAD)