Tuesday, April 01, 2008

Impractical nursing

This was my column yesterday, March 31.

The Philippine Nurses Association is up in arms over a proposed nursing curriculum, which institutionalizes through a ladderized scheme, a course called practical nursing.

It is easy and tempting to dismiss the assertions of the association as just another one of those overzealous attempts of a professional organization to protect the integrity and the value of its members’ dear profession. Not that the PNA should be taken to task for doing so; it is its mandate to precisely ensure that nursing continues to be a viable and reputable profession.

But is the PNA just buttressing the “exclusivity” of the nursing profession and thereby discriminating against non-graduates of four-year nursing courses as some critics contend? Or is there more to this latest wrinkle to hit the nursing profession than meets the eye?

Ladderization is this relatively new educational scheme that’s being championed by the Technical Education and Skills Development Authority. It’s a scheme that aims to bridge the gap between technical-vocational courses and college degrees by breaking up full degree courses into several short-term technical-vocational courses which students can take up at their convenience.

Students can then finish a full degree course in stages while already being certified and employable after finishing each stage. So far so good, right?

The scheme offers wonderful possibilities for those with natural inclination for engineering or even for those who wish to finish a medical degree but don’t have the resources to do it in one full swing.

A school in Eastern Visayas has been offering a similar scheme for would-be doctors since the eighties. One begins by finishing a course for quack doctors (actually, barangay health workers), then moves on to work at becoming a midwife. The next course would be nursing, then medical technology, and then finally, medicine. A friend who went through the scheme is proud to have five medical degrees to his name.

But because there is a huge global demand for nurses, particularly Filipino nurses, certain sectors—including unscrupulous businessmen who smell a grand opportunity to fleece people of their hard-earned money—are now proposing to apply the ladderized scheme to the nursing profession.

Under the proposed ladderized nursing curriculum, a student can become a “practical nurse” after only 18 months. Then, if he or she chooses, he or she can then proceed to take up a full nursing course later. In the meantime, the appellation “practical nurse” is supposed to be enough for one to become employable.
If we are to believe the claims of certain sectors, being a practical nurse translates into a quick passport to a nursing job abroad.

“Quick,” “employment” and “abroad.” Those are magic words guaranteed to produce hysteria. Those magic words cast a spell equivalent to the one made by the Pied Piper of Hamelin. Naturally, there’s now many people enrolled in practical nursing all of them already salivating at the prospects of being among the very first few to land a job abroad as practical nurse.

The problem is that there are no jobs waiting for practical nurses—both abroad and locally. There is no demand for practical nurses. This is what the PNA and many others have been saying above the din and dynamics of the excitement. Unfortunately, no one seems to be listening—certainly not the Commission on Higher Education and not Tesda who is pushing for this latest wrinkle. Because the whole thing has the imprimatur of Tesda, the whole thing has legitimacy written all over it, in bold uppercase letters. It doesn’t mean of course that the promises being made to entice enrolment in practical nursing programs are realistic. Or attainable.

It’s the “caregiver phenomenon” all over again. That same phenomenon that sent thousands of people into “caregiver schools,” many of them with dubious credentials. I know a number of people including friends and relatives who invested hard-earned money on those caregiver courses that were supposed to be patok—guaranteed to land them jobs abroad. They likewise poured money into the processing of their papers and paid placement fees for jobs that didn’t materialize. Many of them continue to wait, hoping against hope that Canada, the United States, Japan and the United Kingdom would open their gates to Filipino caregivers.

The only ones who profited from the bubble, from the mirage, were the people behind those caregiver schools. They duped people into paying for courses that had very little demand after all.

How can there be a demand for practical nurses when there is an oversupply of professional nurses to begin with?

Let’s do a quick reality check here. Yes, there is a great demand for nurses abroad. The United States, in particular, is projected to need between 500,000 to a million nurses between now and 2020. The problem is that there’s a limit in terms of how many nursing visas can be issued by the United States in a year. My sources say that no new nursing visas have been issued since middle of 2007 as the quota had been reached already.
Add to the equation the fact that we are not the only producers of nurses in the world. India, for example, is giving us stiff competition in this area and there are more Indians out there, lest we forget.

So we do have an oversupply of nurses. These include those who have just passed the nursing board exams (65,000 passed the recent board exams and another 100,000 are expected to take the next one) and those who are awaiting opportunities to get training in local hospitals. Many nurses are volunteering their services to hospitals for free. Many more are even prepared to pay hospitals just to be allowed to train.

In addition, there are a number of graduates of nursing courses who flunk the nursing board examinations. These people finished the full nursing course and are presumably better trained to assist professional nurses.
So who needs practical nurses when there are professional nurses? The PNA is right, practical nursing is a dead-end job. Legitimizing the course only creates victims.

1 comment:

Anonymous said...

Simple. PN jobs is not RN job. Don't equate PN and RN job oppurtunities. Whether you like it or not, PN job will open in the Philippines. It's just a matter of time. Australia, US and Europe started hiring foreign PN. The Philippines is in the position to supply such demand. PNA has no power to stop PN in the Philippines. Whether you like it or not.