Nursing is one of the most respected and important jobs throughout the world. Nurses take care of patients, provide psychological support, help doctors, and assist in the recovery process after illness or injury. In the Philippines, nursing is also one of the most popular courses amongst the college students. Every year, thousands of young Filipinos take up this course as a career option, not only because they wish to help others but also due to the chances of getting employment abroad. However, this dream is both advantageous and problematic. Many Filipino nurses are successfully working abroad, but their presence is sorely missed in the country’s hospitals and health care centers. This Opinion piece will delve into the reality of being a nurse in the Philippines and abroad, the main reasons so many nurses depart the country, and the ramifications on the healthcare system.
The Advancement of Filipino Nursing Professionals
The Philippines is one of the leading sources of nurses for the rest of the world. There are around 37,000 nursing students that graduate every year according to higher education authorities in the Philippines(CHED). The majority of them intend to seek employment internationally. More than 28,000 nursing graduates from the Philippines took the United States licensure exam NCLEX for the first time in 2024 and more than fifty percent of them were able to pass it on their first attempt. Most of the other countries such as USA, UK, Canada and Australia consistently employ nurses from the Philippines in order to fill gaps within their healthcare systems. This has resulted in an upwards of 300,000 Filipino nurses that are currently working overseas. For instance, the National Health Service(NHS) in United Kingdom has employed around fifty thousand Filipino nurses which is nearly a quarter of all foreign trained nurses working in the NHS.
Reasons for Nurses Exiting the Philippines
The most noticeable reason why trained nurses in the Philippines search employment outside the country is due to lack of wages. For instance, nurses in private hospitals in the Philippines earn as little as PHP 8,000, which is less than USD $150. Even government hospitals pay nurses PHP 33,575 which is approximately USD $600. This is not enough to sustain a living in most urban cities. On the other hand, nurses in the U.S. can earn up to $80,000 while nurses in Canada and the U.K are also increasingly being paid more, in addition to receiving better benefits. Moreover, the working conditions in the Philippines are highly challenging. An ideal situation would have a ratio of one nurse to every twelve patients but in some hospitals, one nurse may simply be given the task of looking after fifty or sixty patients. Because of lack of proper medical equipment, along with absence of timely payments for danger allowances, increases in stress on the nurse’s job becomes inevitable. In addition to that, many nurses exit the country because they believe the lack of sustaining career paths available in the Philippines. Unlike U.S and Australia where nurses can work their way up to advanced roles like Nurse Practitioner which come with more responsibilities and higher pay.
The Impact on the Philippines
Nurses gain a lot of experience when working abroad, but it has serious consequences for the Philippines. As a result of Filipino nurses working abroad, the country is now facing a challenging shortage of nurses. According to the Department of Health, there is a deficit of at least 127,000 nurses, a figure that could potentially reach 250,000 by 2030. Some of the hospitals and even rural clinics have been forced to close certain departments due to understaffing. It is this poor and remote community which is the worst affected as these people may not have access to even the basic facilities of healthcare. Nurses are also under intense pressure as the number of patients increases, and fewer nurses are available for shifting. Because the number of patients cannot be reduced, they have to spend more time waiting. This impacts the standard of healthcare provided as its quality is drastically reduced. The shortage also increases the workload for the remaining nurses. This overworking leads to a high chance of burnout and, unfortunately, more resignations, creating a cycle that is hard to stop.
Advantages of Working Abroad
Given the hardships back home, there are also benefits for Filipino nurses working overseas. A number of them support their family’s economic activities by sending them money. In fact, Filipino overseas workers (OFWs) including nurses reportedly sent home USD 36 billion in remittances in 2023. Such capital inflows enable the purchase of housing, education and even daily necessities. By the some of these nurses returning to the Philippines later on, they tend to possess advanced skills, enhanced clinical experience and substantial financial resources which contribute to refined local healthcare systems. Furthermore, the prospects of employment overseas have encouraged the pursuit of nursing education and training which may add to the supply of health professionals even if many of them eventually migrate.
What Solutions Exist?
The Philippines needs to focus on improving the appeal of the nursing profession locally in order to fill the nurse shortage gap. Salary increases are one option. Some Congress proposals suggest increasing the starting salary of government nurses from PHP 33,575 to between PHP 56,000 and PHP 70,000 per month. This would make contesting staying in the country more attractive. The government can also improve working conditions by hiring more nurses to ease the workloads, modernizing equipment, and ensuring all benefits like hazard pay and health insurance are provided timely. Enhanced opportunities for professional advancement, like advanced training or designated roles such as Nurse Practitioners offered to expatriate nurses, could help retain nurses within the country. It is equally necessary to carefully manage international recruitment by coupling the sponsorship of local training and funding to rural hospitals with aid.
A Global Issue
Recognizing the ongoing global need for nurses is critical, especially with the missing 6 million nurses on the global scale as reported by The World Health Organization. As the population ages and the demand for healthcare increases, the wealthier countries will continue to turn to vulnerable nations like the Philippines for assistance. That means the Philippines has to find a way to train enough nurses to satisfy both domestic and international demand. Some specialized people suggest that with the appropriate policies, the country can turn into a global nurse training center where nurses will be trained to be proficient in every aspect of nursing, making the system beneficial for all.
Globally, Filipino nurses are known for their compassion and skill owing to their dedication to service. As helpers in the hospitals of Manila or as practitioners in the clinics of London, they take pride in their profession. Unfortunately, the increasing emigration of nurses from the Philippines is seriously jeopardizing the country’s healthcare resources. Nurses are forced to leave the country due to the lack of reasonable payment, adequate working conditions, and opportunities. Urgent action is needed to retain more nurses in the Philippines to improve health outcomes for Filipinos, and this can only be done by the government. It entails increasing wages, improving the quality of hospitals, and providing nurses with the esteem and aid that is long overdue. At the same time, there is nothing wrong with supporting those who wish to work abroad and appreciating their service to the country. After all, one’s place of work does not determine their nursing identity; rather, the degree of caring does. And caring, especially on the part of Filipino nurses, is something unconditional, no matter where they are.
References
Commission on Higher Education (CHED). (2023). CHED releases nursing program enrollment and graduation data. https://ched.gov.ph/ched-releases-nursing-program-enrollment-and-graduation-data
Department of Health Philippines. (2024). Philippine health workforce profile and shortages. https://doh.gov.ph/nursing-shortage-2024
Gadon, J. (2023, December 15). One NHS nurse in four was recruited from abroad, latest figures show. The Times. https://www.thetimes.co.uk/article/nhs-nurses-abroad-foreign-hospital-staff-j26jsvphq
International Council of Nurses. (2022). Global nursing shortage report. https://www.icn.ch/news/global-nursing-shortage-report-2022
Philippine Overseas Employment Administration. (2024). Statistics on Filipino nurses deployed abroad. https://poea.gov.ph/statistics-nurses-2024
Philippine Statistics Authority. (2024). Overseas Filipino workers remittances data. https://psa.gov.ph/content/overseas-filipino-workers-remittances-2024
Republic of the Philippines Congress. (2024). House Bill 5276: Salary standardization for nurses. https://www.congress.gov.ph/house-bills/hb5276
Republic of the Philippines Congress. (2024). Senate Bill 2694: Nurse salary and benefits. https://www.congress.gov.ph/senate-bills/sb2694
U.S. National Council of State Boards of Nursing. (2024). NCLEX first-time test takers and pass rates. https://www.ncsbn.org/nclex-pass-rates-2024.htm
World Health Organization. (2023). State of the world’s nursing 2023: Investing in education, jobs, and leadership. https://www.who.int/publications/i/item/state-of-the-world-s-nursing-2023
