Why are nurses mostly Filipinos?

 

By: Adelaimar C. Arias-Jose

Registered and licensed attorney in the Philippines

I’m an avid reader and published author. I am a public speaker and mentor. I am a mother and wife.

If you go to the Middle East, there are a lot of Filipino nurses working there. The same goes for countries such as the UK, Canada and the US. Yes, there are a lot of Filipino nurses working outside the Philippines.

Why? There are two general reasons: there is a shortage of nurses in Western countries and a high demand for nurses; in the Philippines, there is an oversupply of nurses who study nursing specifically because they want to work in Western countries.

As for the Philippines being a poor country:

1. Nurses in the Philippines do not earn very much and yet they spend a fortune on education to become nurses. They work abroad to get a good return on their investment.
2. Filipinos are very family-oriented. We care for the elderly members of our families in intergenerational homes and family structures. It is this caring and nurturing trait in Filipino nurses that make them attractive to foreign recruiters.
3. Since the 1970s, the Philippine government has encouraged the migration of Filipino skilled, semi-skilled and unskilled laborers, as well as professionals. The dollars they earn help maintain the Philippine economy. Nursing is one job that allow nurses to travel and work abroad, and maybe migrate and become naturalized citizens of Western countries.
4. In the Philippines, professionals are highly esteemed. Doctors, nurses, dentists, lawyers, accountants, engineers - - all types of work that require a four-year college education, passing a board examination, and obtaining a license has much social prestige. Filipinos are quite determined to study hard to become licensed professionals and by being a professional, to gain societal prestige and the social mobility that accompanies it.
5. Most students in the Philippines who cannot afford medical or dental school will take nursing or physical therapy or other allied medical professional training. Some use a nursing degree to work and earn money so that they can go on and finance their medical education.
6. I have heard of Filipinos who obtained medical degrees in the Philippines but cannot make enough money so they go abroad and qualify as nurses first. They seem to find qualifying as nurses easier than qualifying as doctors. They save the money they earn as nurses to finance their training to be doctors.

As for the shortage of nurses in Western countries:

1. There is a greater need for nurses in developed countries that are now experiencing a “graying” of their population. In Western countries, people aged 60 and above are slowly outnumbering younger people. The elderly require nursing care and the number of nurses produced by Western countries cannot satisfy the increasing demand for nurses and nursing services. Thus, a lot of hospitals must recruit nurses from Asia. The Philippines, on the other hand, has an over-supply of nurses.
2. A nursing education in Western countries is quite expensive. American university students often accumulate a lot of student debts. Thus, studying to be a nurse will drive them deeper into debt and poverty. Being a nurse is often just not worth the financial risk.
3. Nursing is probably not a very attractive career for people in advanced economies. People in countries like the Kingdom of Saudi Arabia, Canada, the UK and the US do not wish to work at jobs that are physically demanding such as nursing. Besides, nursing requires people to work with the sick or the injured and this often causes them depression or anxiety, burnout or compassion fatigue. Some of them find the sight of blood unnerving. Working as a nurse exposes them to these emotional, psychological and mental hazards at work.
4. Nursing is highly competitive. A nursing student must do internships, they must pass licensure examinations and get periodic training and retraining in the use of technology and processes that have been recently developed. A lot of younger Westerners are turned off by all the studying that nurses have to do just to get their license. On the other hand, Filipinos are trained from childhood to respect the value of education. Filipinos are raised with the idea that education is the ticket out of poverty. Most parents are willing to work hard and spend their money to have their children become nurses because they fully expect their children to land nursing jobs abroad.
5. Western countries are litigious societies. Medical malpractice cases are inevitable and so medical and healthcare professionals need to spend on malpractice insurance. This is another reason why there are few young people who opt for nursing careers in Western countries. It is too financially risky to practice as a nurse when you can be sued for malpractice and lose your license and your source of livelihood.
6. In order to rise in the nursing profession, there is a requirement for specialization. This means more studying, more training, and more expenses for further nursing education. To be promoted to an administrative nursing position, nurses must study and train, and get different licenses. They must undertake studies and write papers if they want to get promoted. This makes nursing an unpopular career choice for Westerners who want to rise in their profession without costing them too much time and too much effort.
7. There is also a growing incidence of bullying experienced by nurses in Western countries. Some nurses become a target of hostility or violence perpetrated by patients or patients’ relatives. Thus, people in Western countries are not keen on working as nurses. Whereas, Filipinos, because of their long history of colonization and because they live in an archipelago that endures devastating typhoons, well, Filipinos have developed resilience and emotional self-regulation necessary to thrive in less than friendly working conditions.
8. These factors (numbers 2–7) cause a shortage of nurses and severe understaffing in hospitals in Western countries. This understaffing often mean longer shifts and more overtime work for nurses already employed. These conditions put nurses at risk of mental illness, injury, and burnout or compassion fatigue. Thus, nursing is not a popular career choice for Western teenagers. It is considered by some a very risky type of job as nurses are exposed to all manner of stresses. On the other hand, Filipino nurses are willing to face these risks in exchange for salaries that are higher than what they would earn working in the Philippines.
9. Filipino nurses do not have as much difficulty with English as it is one of the official languages in the Philippines as well as the medium of instruction in schools. Naturally, when there are nursing staff shortages in English-speaking countries, they will hire Filipino nurses who are already speakers of English because it will not cost as much to train them in using English as a second language.

These are some reasons why you see a lot of Filipino nurses working in the US, Canada, the UK and the Middle East. Once, there was a news report of Filipino nursing staff getting caught in armed conflict in Libya. The Philippine president threatened to recall all the Filipino nursing and other medical and healthcare professionals working in Libya if the government of Libya cannot ensure their safety. The medical and healthcare system of Libya will fail if all the Filipino staff will repatriate.

Yes, there are a lot of Filipino nurses working abroad. Even countries such as Japan and Germany have begun recruiting Filipino nurses because of the graying of their population, because of the understaffing and because Filipino nurses are willing to work abroad.

UPDATE:

In light of the Covid-19 pandemic, nurses have become frontliners in this struggle. Filipino nurses are fighting. They are caring for their patients to the best of their ability and with what materials and resources are available.

There are two sides to this: the side of the patients in rich countries where Filipino nurses work and the side of the Filipino nation they had left behind.

Filipino nurses are working abroad caring for patients in their adoptive countries where they often suffer discrimination. Yet, they serve. They are unable to care for patients in their own country. They are unable to see or be with their families at home and they are certainly away from their families back in the Philippines.

The Philippine medical community is overwhelmed. Numerous nurses and doctors have died in the fight. It is ironic that the nation known for exporting nurses abroad is now in dire need of them.

If you are hospitalized and cared for a Filipino nurse or doctor, please bear in mind that they are caring for you instead of caring for their own family and countrymen. They may likely get sick or die while caring for sick people thousands of miles away from their homes and family. If they die, they will very likely not see their families. They will not even return home in a pine box for their families to give them a proper burial. They may come home in an urn.

Please be kind to Filipino nurses in your community. Tell them the truth about your travel history and exposure, symptoms and underlying conditions when you see them. Your life and their May depend on your honesty.

Do not hoard essential supplies such as alcohol, gloves, personal protective equipment, N95 masks.

Most importantly, do not add to the number of the sick they have to care for. Stay at home if you can. Maintain social distance. Help them fight. Help them survive the fight. Help them see their families again.