Nursing in the Philippines

The history of nursing in the Philippines stems from the caregiving provided by women, priests, and herb doctors during precolonial Philippines. This trend continue during the Spanish colonial era, although women did not have much opportunity to be formally educated in schools because only a limited number of Filipino women received primary education in charitable institutions established by Spaniards. During the Philippine revolution against, Filipino women also became the providers of care for wounded revolutionaries. During the American period in the Philippines, Filipino women were given the chance to become educated as nurses, guided by their American nurse and missionary mentors, until nursing became a full-pledged profession in the Philippines, a professional career not only for modern-day women in the country but also for men in the Philippines (as male nurses).

The advance of nursing in the Philippines as a career is pioneered by a culture of care which was intrinsic in the Filipino people. This was also the case even before Spanish colonization in communities. The evolution of the way the health system was delivered also developed.[1]

History

Early Philippines

Early beliefs of health and illness in the Philippines were in conjunction with beliefs of mysticism and superstitions.[2] The cause of a disease was believed to be due to either another person, whom which was an enemy, or a witch or evil spirits. Filipinos were careful not to upset other people or the evil spirits for the good of their health. These evil spirits could be driven away by persons with power to banish demons. The individuals who were known to rid of demons were either priests or herb doctors. Filipinos who became sick were usually cared for by the female family members or friends in the home.[3]

People thought their health were directly related to many superstitions and legends. Back then, there were no medical professionals but men known to practice magic and the supernatural. These herb men were known as “herbicheros.” Victims that suffered from unidentified illnesses were thought to be cursed by witches and wizards known as “mangkukulam/mangagaway.” Dangerous birthing and “pamao” were thought to come from “nunos”. While in labor, the “mabuting hilot” (good midwife) was usually present. If the birth became too dangerous, bad omens and evil sorcerers were thought to be the cause. Exploding gunpowder from a bamboo cane near the head of the person going through the suffering would usually get rid if the bad omen.[4]

Spanish colonial rule

During Spain's colonial rule (1521-1898) the Philippine education system offered distinct and unequal opportunities for Filipinos based on gender. An example of this sexism, was allowing only limited numbers of females receive primary education in Spanish charitable institutions.[3] Without an education women were unable to gain much knowledge or power. The knowledge of caring for others came from family members and personal experience with the sick. Nursing other individuals was seen as a task not a job or a profession. During the Spanish regime many specialized hospitals were established to care for Spanish king’s soldiers and civilians.[2] To many elite Filipinos the Spanish colonial hospitals were places where those who were not so fortunate to have homes, spent their last days until death.[3]

Philippine Revolution

At the time of the Philippine Revolution many women transformed their homes into quarters to nurse Filipino soldiers and revolutionaries.[2] One of these women was Melchora Aquino, also known as the Mother of the Philippine revolution. In her old age of about 80, Aquino was a supporter of the revolution by providing food and shelter to the revolutionists. In addition she provided care for those who became sick or wounded. However, a few days after the revolution began, Aquino was arrested by the Spaniards for providing care to the rebels. In her strong will to not reveal any information to the Spanish about the location of the rebel leader, Aquino was deported to Guam in the Marianas. After six years of being exiled, the Mother of the Philippine revolution was able to return in 1903, when the Philippines finally gained independence from the Americans. Aquino’s work caring for the ill and the wounded during the revolution has brought comparisons to the British Florence Nightingale. Both these women cared for soldiers during war and paved the way for nursing practice.[5]

American colonial rule

Iloilo Mission Hospital (Union Mission Hospital) which was founded by Protestant Presbyterian Americans in 1901 pioneered nursing education education in the Philippines when it opened the Union Mission Hospital Training School for Nurses. The nursing was later transferred after the post World war II to Central Philippine University.

Although the Philippines had gained independence from Spain, the United States began to instill their power upon the islands and this broke out in conflict between the Filipinos and the Americans. It was the start of the Philippine–American War. The presence of Americans played a vital role in influencing the development of nursing into a profession. Nurses and missionaries from the United States came to act as nurse mentors for the Filipina women. Nursing education, like teaching and missionary work in the Philippines provided white American women with a sense of purpose in the colony.[3] This influence then continued with the building of many hospitals where American nurses took charge and Filipino women began to learn under careful eyes.

An example of this was the development of the Iloilo Mission Hospital.[6] In 1901, through the efforts of Dr. and Mrs. Andrew J. Hall, missionaries of the Presbyterian Foreign Mission Board from the United States, a temporary bamboo clinic was erected at Calle Amparo (now Ledesma Street), Iloilo City; to serve as a venue for the treatment of health care to the very poor. This was made possible because Andrew Hall was a doctor and his wife was a nurse. Like other professions, nursing in the Philippines evolved only from the apprenticeship system.

The Central Philippine University College of Nursing and Allied Health Sciences (the former Union Mission Hospital Training School for Nurses), the first and oldest Nursing school in the Philippines.

This system laid the foundation upon which the Union Mission Hospital Training School for Nurses (now Central Philippine University College of Nursing and Allied Health Sciences) was built in 1906. Between the time that this school was built and the time that the Philippines gained their independence from US colonial rule in 1946, the nursing profession continued to grow with the development of more nursing schools and the growth of Filipina women seeking the title of a nurse.[2] While taking advantage of these learning opportunities Filipinos began to learn more about the United States and the opportunities that the country could hold for them, such as extending their education and increased pay. This began the migration of nurses to the United States. As individuals began travelling to and from United States, the stories they brought home began to spark the interest of others to follow.[7]

Post-colonial Philippines

After World War II, when Manuel Roxas assumed the presidency of the Republic of the Philippines on July 4, 1946, it officially marked the end of the colonialism between the United States and the Philippines. Like much of the rest of the world, the Philippine islands were in ruins and Roxas was determined to rebuild his country. He made it clear to his constituents that the new government was still going to rely heavily on US financial support in order to rehabilitate its national economy. Roxas’ first attempts to balance the Philippines budget included collecting unpaid taxes, reducing expenses and promoting foreign trade. Forms of foreign trade would include the exportation of Filipino nurses. Already trained by Americans, Filipino nurses were the perfect candidates to assist the United States and other countries experiencing post World War II shortages. At the time in the Philippines there was also rumor of nursing shortage however it was questioned to be true do to the expanding health programs, inefficient use of nurses’ time and skills and loss of qualified nurses to other countries. By the mid 1960s, Filipino nurses were entering the United States by the thousands.[8] The benefit to the travelling nurses was that they were able to make nearly 20 times as much as they were earning back home. Part of this money would be sent back to their families as remittance and this remittance would in turn assist in boosting the Philippine economy. The negative effects of the high exportation rate, was that the nurses were adding to their own country’s nursing shortage problem. As well the Philippines faced losing one of its greatest sources of social capital, which are educated workers. The negative effects are also seen in the United States as American salaries decrease because Philippine nurses that newly arrive would work the same job at a lower wage.

Early 1900s

Many states in the United States passed reforms in licensure for nurses. Decreased training mandates were created as well as stricter adequacies for getting into a nursing institution. For instance, one prerequisite was at least one year of high school education. The idea of having students work in a more active role prior to seeing patients was a new idea that was beginning to pay off.[9]

In the Philippines, it was also the early 1900s when the first school for nursing was established. The program of study was still shattered and unclear. Only few students are enrolled informally to this kind of education. A legislation or law was needed at the time, contributing to the establishment of the First True Nursing Law in 1919.[10]

Today

The Philippines is the leader in exporting nurses to meet the demands of the United States and other developed nations. It has been argued however, that The Philippines' persistent production of nurses for the global market is a state strategy to develop an export industry for economic development. Things such as immigration services and nursing licensing authorities encourage the production of nurses for export.[8]

Brief Profile of Healthcare

Of all registered health practitioners, nurses are among the largest group even though there are very few nursing positions or jobs available to them. Only 15-25% of jobs in the Philippines are provided for the nursing population and with that, the remainder of the work force go on to seek out other professional career opportunities outside of the country. Per year, the national government has approximately 18,000 nursing positions with an eventual turnover of 1,000 careers. The increase of Filipino nurses overseas has attracted the curiosity of other countries to better understand nursing in the Philippines and what makes Filipino nurses accommodating.[11]

Education

The first two years of general education is grounded on liberal arts that strengthen the values and character of the person as a caregiver. The language of instruction that is taught in all local institutions is English. This prepares the student for licensure both locally and internationally. This also gives the nurses access to ever growing literature in health sciences. The community skills, competency and confidence in the use of English certainly contributes to healthcare in any setting. The curriculum also strengthens the capabilities of the students to participate in research in nursing and other health sciences, provides flexibility in the openness to the use of new teaching approaches, and encourages active involvement in extension work that reaches out to the other sectors.[12] All registered nurses in the Philippines are required to have a Bachelor's degree in Nursing.[13]

The very first pursuit to constitute the nursing practice was made by the Director of Health in 1913, but was not officially enacted upon by Filipino Legislature. In 1915, Act No. 2493 was made known, this amended Gov Ph Act 310 so nursing could be practiced. This law allowed “for the registration of graduate nurses under the Bureau of Health” (Philippines). Pre-qualifications were not mandatory in order to become an RN since nurses simply signed up. Each candidate however, needed to be at least 20 years of age at the time of sign up, and be of adequate health and upstanding character[14] A law that allowed the practice of nursing was reformed in April 1919. Act 2808, also known as “the First True Nursing Law” established the Board of Examiners for Nurses and soon, the very first board exam for nurses was given in 1920.

Today, nurses must acquire their degree through a “combination of competency-based and community-oriented courses." The Philippine curriculum has several advantages compared with those of other Asia Pacific Economic Cooperation (APEC) Institutions. This kind of education offers much more than a solely skill-based curriculum can (Rogado 229). The four year requirement to earn a bachelor's degree in nursing meets the minimum entry requirement for professional nursing practice.[15]

The first two years of general education is grounded on liberal arts that strengthen the values and character of the person as a caregiver. The language of instruction that is taught in all local institutions is English. This prepares the student for licensure both locally and internationally. This also gives the nurses access to ever growing literature in health sciences. The community skills, competency and confidence in the use of English certainly contribute to healthcare in any setting. The curriculum also strengthens the capabilities of the students to participate in research in nursing and other health sciences, provides flexibility in the openness to the use of new teaching approaches, and encourages active involvement in extension work that reaches out to the other sectors.[16]

Legal regulation

The Professional Regulation Commission (PRC) oversees the licensing of registered nurses as authorized by the Philippine Nursing Act of 2002.

A Professional Regulatory Nursing Board implements and enforces the Nursing Act. The board is composed of a chairperson and six additional members, all of whom are nurses with at least a master's degree and ten years of nursing experience. The board inspects nursing schools, conducts licensure examinations, issues and monitors certificates of licensure, promulgates a code of ethics, participates in recognizing nursing specialty organizations, and prescribes guidelines and regulations governing the profession under the Nursing Act.

In 2009, the Commission on Higher Education of the Philippines released a report showing the Top 20 nursing schools in country based on average passing rates in nursing board examinations. The top 20 Nursing Schools in the Philippines with 1000 or more examinees are the following: Silliman University clinched the top post having an average of 96.57 percent followed by the Saint Louis University, 95.42; Trinity University of Asia with 95.06; University of Sto. Tomas, 95.06; Cebu Doctors' University, 91.89; Saint Paul University, 89.79; Central Philippine University, 86.72; De La Salle University-Health Sciences campus, 85.26; Saint Mary’s University, 84.10; San Pedro College, 83. 10; Manila Doctors College, 82.56; Centro Escolar University-Manila, 81.50; Angeles University Foundation, 76.37; Mariano Marcos University, 75.55; University of San Agustin, 73.25; University of Cebu, 70.99; Metropolitan Hospital College of Nursing, 70.54; Ateneo de Davao University, 70.20; San Juan De Dios Education Foundation, 69. 91; and University of St. La Salle, 67.55.[17]

For 100 to 999 takers the following are the top 20 Nursing Schools in the Philippines: University of the Philippines Manila topped the list with 99.41 percent; followed by Xavier University with 97.82; West Visayas State University, 96.75; St. Paul University-Iloilo, 96.16; University of the East Ramon Magsaysay Memorial Medical Center, 95.80; Cebu Normal University, 94.64; Pamantasan ng Lungsod ng Maynila, 93.14; St. Paul University-Dumaguete, 92.29; Mindanao State University, 92.15; Palawan State University, 92.05; Philippine Christian University, 91.35; Velez College, 90.92; Colegio de Sta. Lourdes of Leyte Foundation, 88. 55; Chinese General Hospital College of Nursing and Liberal Arts, 87.60; St. Paul University-Manila, 85.31; Easter College, 85.26; Southville International School and Colleges, 84.77; St. Paul University-Quezon City, 83.87; Adamson University, 83.57; and Lyceum of the Philippines University with 82.20.[18]

Only three schools had 100% passing rate (with 10 or more examinees) from November 2009 to July 2011: University of the Philippines Manila, Philippine Christian University, and Negros Oriental State University.[19]

See also

References

  1. ↑ Rogado, Isabelita C. "Nursing in the Philippines". Nihon Shuchu Chiryo Igakukai Zasshi 13.3: 229.
  2. 1 2 3 4 Nursing Portal Philippines . Retrieved 2012-06-07.
  3. 1 2 3 4 Choy, Catherine Ceniza. (2003)..Empire of Care . Google e-book preview. Retrieved 2012-06-07.
  4. ↑ "History of Nursing in the Philippines". Nurselabs.
  5. ↑ Renato Perdon .200 Year Birth Anniversary of Melchora Aquino: Mother of Philippine revolution”.
  6. ↑ Pedregosa, Elmer (2001). History of Iloilo Mission Hospital
  7. ↑ Choy, Catherine Ceniza. (2010). Nurses Across Borders: Foregrounding International Migration in Nursing History
  8. 1 2 Brush, Barbara. ( 2010). The Potent Lever of Toil: Nursing Development and Exportation in the Post colonial Philippines
  9. ↑ Reyes, Eric Estuar (2005). "Placing Work, Home, and Empire in Filipino America: A Review Essay". Journal of Asian American Studies 8.1: 23. Check date values in: |access-date= (help);
  10. ↑ "Republic Acts". Republic of the Philippines.
  11. ↑ "NURSING and MIDWIFERY DATA BANK The Philippines" (PDF). Philippine Nursing and Midwifery Data Bank. World Health Organization.
  12. ↑ "BS in Nursing in the Philippines". FindUniversity.ph.
  13. ↑ "Nurse Immigration Information".
  14. ↑ Giron-Tupas, Anastacia (1980). "History of Nursing in the Philippines". Manila: University Book Supply.
  15. ↑ Rogado, Ma. Isabelita C. "Nursing in the Philippines". Nihon Shuchu Chiryo Igakukai Zasshi.
  16. ↑ "BS in Nursing in the Philippines".
  17. ↑ Angelo G. Garcia. "152 nursing schools told: Improve or else…". Manila Bulletin. Retrieved 2009-12-18.
  18. ↑ Hannibal C. Talete. "CHED warns 152 nursing schools for low performance". Balita.ph. Retrieved 2010-04-27.
  19. ↑ http://topnursingschoolsph.blogspot.com/2012/01/performance-of-schools.html
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