Friday, November 28, 2008

The herd mentality

This was my column last Monday, November 24.

I have written about the nursing profession and the challenges it faces a number of times in the past. My interest in the issues is both personal and professional. Many members of my family are nurses—an older sister, two aunts and a number of cousins are nurses. My son is in nursing school—he chose the course on his own and I’m hoping that he will eventually proceed to medicine, which should be the normal career path rather than the other way around (i.e., fully-trained and certified doctors going back to nursing school to get employment abroad as nurses). A great number of nephews, nieces, relatives, and children of friends and former classmates are in nursing schools all over the country.

My professional interest in the issues emanates from my being a human resource management professional and academic who is gravely concerned about the mismatch problem in this country between what the academe produces and what industry needs. It’s a problem that’s becoming more and more pronounced each year.

Obviously, we are producing more nurses than can be absorbed by the system—both local and global. Worse, we are having problems with academic standards and technical training. And yet, we continue to fall victim to the classic herd mentality syndrome.

Some experts say that more than half of our college students are in nursing schools. Producing nurses has become the new cottage industry in this country and many educational institutions are cashing in on the trend. Why, even computer schools have transformed themselves into nursing schools. The problem is that many of these schools do not have the facilities or the academic personnel to produce qualified nurses.

Most of the qualified senior nurses are already working abroad. The ones that are left behind are either retired nurses who have been forced to give up retirement to become clinical instructors, the truly devoted and nationalistic who have stayed behind out of a strong sense of altruism, or the truly incompetent— those who have not been able to meet global standards.

Over the weekend, a total of 88,750 nursing graduates are set to take the licensure examinations for nurses. According to the Professional Regulation Commission, the projected number of examinees sets a new record in Philippine history: The most number of examinees for a professional licensing examination ever.

Given the fact that our nursing schools continue to overflow with students, I am willing to wager that it’s a temporary record. It will be broken next year. The number of examinees for the nursing board exams will continue to increase algebraically in the next few years.

The PRC schedules two rounds of licensing exams for nurses, one in the middle and another towards the end of the year. In the exams conducted June of this year, 64,459 took the exams. Only 43.07 percent (27,765) passed. The nursing board exam is not traditionally one of the professional licensing exams with very high mortality. Until recently, the passing rate has always been more than half of the total examinees—the passing rate for the year 2001 was 54 percent. But given the abysmal quality of academic training for nurses in this country, I predict that the percentage of passers will continue to go down.

Obviously, the Commission on Higher Education has a huge problem in its hands. Unfortunately, many of the private academic institutions in this country are owned by powerful political families and are therefore difficult to rein in.

The problems have now become even more complicated. We are also facing the challenge of arbitrary and exploitative practices of the top hospitals and nursing schools.

In an effort to ensure that they produce only extremely competitive graduates, a number of our more established nursing schools have become more arbitrary and discriminatory in their academic policies. Because there is a huge demand out there and many of these schools have wait lists that extend from here to eternity—they simply take on as many freshmen as they could and leave the more rigid screening for later. I was amazed to find out, for example, that many of our nursing schools have more than 60 sections of freshmen nursing students.

What they do is then impose stricter and more stringent academic requirements in junior and senior year— and very often arbitrarily!

As an academic who is also renowned for being a “terror professor,” I have an ambivalent attitude towards setting high academic cutoffs. However, I do think there is something wrong with a setup where institutions make money by giving students fall hopes and then dashing them to pieces when it becomes convenient for them to do so. What is happening is that many of our nursing schools simply make money out of freshmen and sophomore nursing students and then do the real screening during junior and senior years.

And then there is the problem with hospitals who exploit fresh nursing graduates by taking them in as “volunteers.” Given the surplus of nursing graduates, many hospitals scrimp on manpower costs by simply taking in fresh graduates who are more than willing to “train” without pay just to acquire the necessary clinical experience in a hospital setting. Worse, there are now hospitals that even charge nursing graduates a handsome fee before they can be allowed to undergo training in their hospitals. Some charge examinations fee, processing fees, and other creative ways to make money out of our hapless nurses.

It’s time we try to put some sense into this whole nursing herd phenomenon.

My good friend Grace Abella Zata, who is running unopposed for the post of 2009 president of the People Management Association of the Philippines, the national professional organization of human resource management professionals, has made this one of her pet advocacies in the last three years or so. She’s been in the lecture circuit and has been in far too many meetings with representatives from government, industry and academic trying to get everyone to send this message across clear and loud: There are a number of viable careers in this country and in the world other than nursing.

There is a dearth of qualified accountants, engineers, even information technology graduates. Most companies in this country have a long list of openings for these posts. From a strategic perspective, government should really be encouraging more students to go into science and technology courses if we intend to become more competitive as a nation. Our agricultural colleges are almost empty and have now transformed themselves into colleges for arts and sciences.

2 comments:

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