[OPINION] The state of Filipino nurses, before and during the coronavirus

Johanna Zehender
'Hindi po kami under sa mga doktor.... We work with doctors, not for them.'

I am a Filipino nurse. Now I’m sure you’re wondering why I have a foreign-sounding surname. Those who don’t know me usually mistake me as being married to a foreigner, but the truth is, I’m actually half-German and half-Filipino, and I was born and raised in Davao City. 

Last year, nurses all over the country called for a pay hike – a petition that was junked because it had no legal basis and violated the “hierarchy of courts.” I, like so many of my fellow nurses, was disappointed and saddened by the turn of events. Despite a more favorable Supreme Court ruling this year, the same petition was not approved. 

Nursing – a noble profession that began with Florence Nightingale, which involves the use of scientific knowledge and skills coupled with compassion and empathy to provide care and relief to the sick and dying – takes a lot of hard work. To even be one in the Philippines takes double the hard work. We are degree holders and professionals like teachers, AND we also serve the public.

We not only use our hands at work but we use our brains as well. ‘Di po kami “under” sa mga doktor, as we have the knowledge and the skills to act independently and competently within the scope of our practice. We work with doctors, not for them – please note that “with” and “for” are two different prepositions. We actually work for our patients. According to Donna Wilk Cardillo, we are the “heart of healthcare” since we were trained to view the patient as a whole and not as a disease, and then use therapeutic communications skills to address their needs. Everything we do in hospitals or in our respective communities is for their benefit.

Sadly, the current healthcare system just doesn’t seem to work for us.

It was not too long ago when a government official sparked outrage among Filipino nurses the world over during her senatorial campaign, when she said it wasn’t necessary for a nurse to be skillful and that nurses are “room nurses only.” As I’ve observed though, it’s true that not all people are aware of what nurses really do.

In local soap operas, especially when the lead character or a relative of the lead character is hospitalized, more often than not nurses are just passive players in the background and are only called to action when the patient is suddenly in a critical condition. The show I remember best is ABS-CBN’s My Dear Heart, which featured doctors and their interactions with nurses. I recall one scene where the evil Doctor Francis, played by Eric Quizon, simply switched Heart’s IV vials, so the nurses ended up giving the wrong medications.

What happened to observing the Rights of Medication Administration? Diyos ko, in real life, hindi kami ganoon ka-bobo! It’s no wonder most people view us as incompetent and even see us as “mga katulong lang sa ospital.” (Judy Ann Santos’ TV drama Habang May Buhay and Angel Locsin’s film Everything About Her were exceptions, though.) Yes, we are primarily caregivers for the sick and injured who are unable to manage their illness on their own, but we do so much more than that.

So what’s it like to be a nurse?

For years, it’s been a known and sad fact that nurses in the Philippines are underpaid and overworked. Quite often, especially in the government hospital ward setting, we care for as many as 60 patients in a shift (sometimes more than that!) while doing nursing assessments, making proper documentation, carrying out doctors’ orders, taking in admissions, facilitating patient discharges, providing health education, and performing procedures like inserting IV lines, administering ordered medications and blood transfusions, and performing basic life support measures on morbid patients – all done while being exposed to tuberculosis, pneumonia, Hepatitis B and even HIV! (READ: ‘When I wake I cry’: The hell doctors, nurses face on France’s virus front line)

On “toxic” shifts, we end up skipping meals, working overtime, and losing sleep later on. While we do get to have off days, they’re only good for catching up on sleep, grocery shopping, paying bills, and washing our uniforms. Our current pay grade just isn’t enough to compensate for the stress and dangers we encounter at work, as well as the struggle we go through to provide for our families.

And then we have the added stress of dealing with the demands of patients and watchers alike. We definitely understand that some patients make requests as to the care they want versus the care they actually need, based on their anxiety, fear, and frustrations related to their hospital stay. Please know that as much as we would like to cater to all of your requests during a shift, we nurses have a thing called prioritization of tasks.

If you see one of us doing medication rounds, please spare your request for a change of bedsheets for later. If you see us doing CPR and assisting a doctor doing endotracheal intubation on a dying patient, please understand that a non-flowing IV line and a busted aircon are minor problems. If you’re MGH with a bill and you see us suctioning an intubated patient with decreasing O2 saturation, please wait to be discharged after the patient has been stabilized. If we cannot answer to your minor requests or needs right away, please don’t say we’re busy bitches and shame us on social media right. Because, more often than not, we either have stat surgeries, blood transfusions, and patient crashes (sometimes they come all at once!) to act upon.

We nurses are simply humans working to save other humans. While we help patients heal, we get tired, hungry, and miss out on time with our loved ones, and we still get bashed and are underappreciated. Because of our low pay, most of us end up choosing to work abroad in countries where there are nurse shortages. Some even quit and take on non-nursing jobs – what a pity after all those years working on those BSN and PRC cards, which could’ve been used to help more people!

A government that fails to care for its health care professionals will eventually end up jeopardizing the very people it aims to serve. With the rising number of highly skilled nurses and other allied health workers leaving for greener pastures, what do you expect will happen to the quality of health care in the Philippines, especially in the rural areas? (READ: Germany to fly in Filipino nurses to care for their coronavirus patients – report)

Military personnel and policemen are now enjoying higher pay. Teachers are now next in line. How about us nurses? We may not be on the battlefield but our bodies are endangered at work, since, as I’ve said earlier, we are exposed to infectious diseases. We may not have the same opportunity to shape the minds of students in the classroom setting, but we are on the front lines of health care, promoting health, assessing, making important and lifesaving referrals, implementing care plans, and basically making sure things are under control during our shift.

Let all of this be more than enough for those in power and the general public to actually rethink nursing and understand that we deserve to receive what should have been due to us all these years. This battlecry means so much more now, with the growing threat of COVID-19– Rappler.com