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Rhea Patulay saw the shortage of Filipino nurses up close, sitting by her husband Rico’s hospital bed as he recovered from a minibus accident.
“No one is seeing patients,” he said recently in an interview in Tagalog through a translator. “Doctors usually take care of you for surgery, surgery and when doing rounds, which take a long time to show up.”
Patulay said one of the nurses working overnight at a hospital near Manila looked like she was still a student. “He said to me ‘Mom, I’m assigned here.'”
Filipinos typically train more nurses than they need, knowing they will work internationally and send money back home to support their families.
However, since the COVID-19 pandemic, government health officials say that about 40 percent of all Filipino nurses have left the country or retired.
The Philippines has a shortage of 350,000 nurses
“We want to stop the bleeding as soon as possible,” said Dr. Maria Rosario Vergeire, an officer at the Department of Health, in a recent interview, added that the Philippines lacks more than 350,000 nurses. .
“Why are high-income countries actively recruiting?” she said. “The countries that get the nurses should also be in exchange so that there is something for our country.”
Government officials, hospital administrators and nurse advocates in the Philippines are trying to find ways to create their own health care system, even as recruiting delegations – including from Canada – arrive.
Delegates from Manitoba and New Brunswick have just returned from recruiting trips in February.
The Manitoba government said it is offering letters of intent to nearly 190 registered nurses, 50 licensed practical nurse equivalents and 110 health care aides.
The New Brunswick delegation interviewed more than 500 candidates and made 241 job offers, a spokesperson for the province’s Department of Health said. As of March 1, 164 offers have been received.
A delegation from Saskatchewan was in the Philippines in December and has made more than 170 job offers for RNs, continuous care assistants and medical laboratory assistants.
And that’s just a Canadian province. Countries around the world are competing to attract nurses from the Philippines.
Several provinces are looking to the Philippines to recruit nurses to help with staff shortages. That’s a problem for some in the country, which is experiencing a critical nursing shortage.
Western countries ‘increasingly aggressive’
“This is now a problem,” Melvin Miranda, president of the Philippine Nurses Association, said through a translator in a recent interview in Manila.
In the past, says Miranda, nurses looked for international opportunities, but since the pandemic, countries like Canada have called, “becoming more aggressive in recruitment.”
Experienced nurses are attracted by “great offers and compensation,” he said, noting that salaries are at least double those in Canada.
While Miranda said she doesn’t want to hold nurses back from opportunities abroad, she also worries about the country’s health care system.
“We feel it in the community, especially in remote areas that cannot be reached. The data shows: Why is there a high mortality rate in high-risk pregnancies in remote provinces and areas? Because services through adequate labor cannot be reached,” he said .
“So I think this is alarming. If this continues, it will continue to increase the number of cases and we cannot stop it.”
Not to mention the strain and increased workload on nurses left behind, caring for more patients than is considered safe, Miranda said.
“For example, nurses are assigned to manage patients in critical condition. They can manage [a ratio of] 1:5 or 1:7 to ensure quality management and monitoring. But if until the number of patients increases beyond the standard ratio, the nurses will not be able to manage, to be honest,” he said.
“[If] our nurses will be at high risk of error, potentially compromising the quality care that patients deserve.”
Torn between opportunities, duties for the country
One solution is for Western countries like Canada to help pay for nursing training places or provide scholarships for students who will become nurses, said Dr. Rene De Grano, president of the Philippine Association of Private Hospitals Inc.
Most countries are recruiting experienced nurses, which leaves a big hole in the Philippine system.
“For example, you are a dialysis specialist for a kidney center, a heart in a heart center, an ICU,” he said. “They have very good training, so centers abroad prefer, [but] those nurses are not enough now, there are only a few. If he gets it, it’s a big deal.”
Filipino nurses say there are jobs in their country and greater pay and opportunities available abroad.
“We are dedicated to our country. We are willing to stay, but we have some requests that our country cannot give us,” said Lawrence Vergara through a translator, during a break in the hospital ward.
Vergara is a nurse who worked in Dubai before returning to the Philippines during the pandemic. They want to move the whole family to Canada, Australia or New Zealand – partly because of the difference in salary, but also to give their children new opportunities.
“This is my ambition. No matter how difficult it is, I will take risks, for my family and career benefits as well.”
Amir Pagadilan has been dreaming of moving to Canada since 2016, learning English and making an application. She is a chemo-dialysis nurse who is forced to work two jobs to support her family.
Court was one of hundreds of screened applicants who received an interview with the Manitoba delegation. He was overcome with emotion after learning he got a job offer with conditions.
“My mom always said, ‘In God’s time,'” he said, pausing to wipe his eyes.
“I’m sorry, I’m sorry. I’m just happy because I feel like it’s a gift from God. I’ve tried many times since 2016, but it’s hard to get a specific position. It’s very patient.”
Ethical, economic, safety issues
Manitoba labor and immigration minister Jon Reyes said the province needs to fill nearly 2,000 nursing vacancies.
Reyes, originally from the Philippines, said the delegation’s goal is to recruit 350 Filipino nurses through the fast track in the next two years.
“We want to make sure that this batch comes to have a smooth transition so that they can be gainfully employed immediately, and that will benefit Manitobans,” he said at the reception in Manila.
But there is growing concern in less developed countries that rich countries like Canada are exploiting fragile health care systems.
“It’s the higher-income, wealthier countries that are going on these global shopping trips to address shortages, that they can’t recruit enough,” said Howard Catton, CEO of the International Council of Nurses in Geneva, in an interview. this week.
“They take it from the shelves that are already very, very bare and at least they can lose a nurse,” he said. “You have to be sure you’re not going to do any harm by recruiting from that country.”
Catton, who held a meeting in Bangkok this week with organizations from nine countries representing nearly 10 million nurses, said they were all concerned about international recruitment and shortages.
This includes countries like the Philippines and India, which typically export health care workers to countries around the world.
About 10 percent of nurses in Canada and 15 percent of nurses in the U.K. are internationally trained, a result of “the decision not to educate your own nurses enough,” Catton said.
“This may have worked in the past, where you could recruit overseas as a fairly quick solution to fill the gap in the short term. But I think for all the ethical and economic reasons … and the security of providing a health workforce on your own, it’s not a strategy you can rely on in the future.
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