Wanted: Presidential adviser to save PH nursing
The Philippine nursing sector stands at a critical juncture, facing a perfect storm of challenges that demand urgent and strategic government interventions. Out of 951,105 registered nurses, according to latest government data, only 509,297 are actively practicing in the Philippines. Better pay abroad has led to their mass exodus.
With a health-care system focused on hospital care, a shrinking hospital workforce, low wages, and systemic issues that deter licensed nurses from working in health-care settings, the next three years of the Marcos administration present the greatest opportunity to address these longstanding issues through informed and decisive leadership.
One key solution is to have a presidential adviser for nursing affairs, a crucial position that can help in crafting nursing policies that value our well-educated and expert workforce. The adviser can serve as the bridge to link the executive and legislative branches, ensuring that health-care-related policies receive the necessary attention and prioritization. Policies that advocate nurse retention, workforce development, and compensation reforms need coordination with Congress, the Senate, the Department of Health, the Department of Labor and Employment, the Commission on Higher Education, and the Professional Regulation Commission.
In many developed nations, a chief nursing officer (CNO) plays a vital role in shaping nursing policies, a model that the Philippines has yet to adopt formally. A presidential adviser could pave the way for the institutionalization of a permanent CNO, aligning the country’s health-care leadership, particularly with our excellent nursing practitioners, with global best practices.
One of the immediate tasks of the presidential adviser for nursing affairs would be to address the alarming rate of nurse migration. While migration itself is not the issue, the lack of policies to ensure a sustainable supply of nurses within the country is a critical concern. The adviser must champion competitive salary adjustments, improved working conditions, and professional development programs that encourage nurses to stay and serve in local health-care institutions such as hospitals and rural health units.
Moreover, the widespread phenomenon of nurses shifting careers to business process outsourcing jobs cannot be ignored. Many Filipino nurses choose to work in medical transcription, telehealth services, and pharmaceutical companies rather than endure the poor working conditions in local hospitals. These jobs offer better pay, fixed hours, and less physical strain compared to health-care institutions, particularly hospital work. The presidential adviser must find ways to influence the restructuring of salary scales, enforce fair labor practices, and introduce incentives such as scholarships to enhance and advance practice, and foster career pathways that make nursing a practical and rewarding career choice.
Another crucial aspect is addressing understaffing and excessive workloads in public hospitals. Reports show that nurses in some government hospitals are assigned up to 30 patients per shift, far beyond safe staffing ratios. This compromises patient safety and leads to burnout. The presidential adviser for nursing affairs must spearhead legislative and policy reforms to align our staffing ratios with global standards. This includes securing budget allocations for hiring more nurses and ensuring their proper deployment in urban and rural areas.
The adviser should also push for sustained investment in health-care infrastructure as many public institutions and hospitals lack basic medical equipment, sufficient ward spaces, and modernized facilities, further discouraging nurses from staying in government service.
The adviser must work towards harmonizing Philippine nursing education and practice within international standards to ease greater global mobility and recognition for Filipino nurses. This means engaging with international regulatory bodies, global health organizations, and foreign employers to ensure ethical recruitment practices while protecting Filipino nurses’ rights and welfare abroad.
Most importantly, this adviser should lead national conversations on nursing as a critical pillar of the country’s health-care system to elevate the profession’s status, secure better compensation, and ensure that the voices of nurses are heard in national decision-making.
With strategic leadership, policy reforms, and sustained investments, the country can reverse the declining retention of nurses, improve working conditions, and ensure a stable and well-supported nursing workforce.
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Jerome Babate, RN, MBA, PhD, LCLP is based in Sydney, Australia, and heads the Filipino Nursing Diaspora (FiND) Network, an international organization of Filipino nurses. Professor Rozzano Locsin, RN, PhD, FAAN is a FiND Network adviser. Both are passionate advocates for the welfare and empowerment of Filipino nurses across the globe.
