Nursing is often described as the backbone of healthcare systems. Yet, for all its importance, nurses around the world continue to face challenges such as unsafe staffing levels, low pay, excessive workloads, and limited opportunities for career advancement. In many countries, one of the most effective ways nurses have addressed these issues is through unions. Far from being antagonistic, nursing unions have served as crucial partners in advancing both workforce welfare and patient care. For the Philippines, where nurses continue to battle low wages, underemployment, and mass migration, the time has come to take nursing unionism seriously.
Global Lessons from Nursing Unions
In Singapore, the Singapore Nurses’ Association (SNA) has been an influential voice in health policy and nursing workforce development. Although not a militant union in the traditional sense, SNA advocates for nurses’ rights, continuous professional development, and recognition of nurses’ contributions. Its ability to partner with government and health agencies ensures that workforce issues are considered in broader health reforms.
In Australia, the Australian Nursing and Midwifery Federation (ANMF) stands as one of the most powerful unions in the country. With over 300,000 members, ANMF has successfully lobbied for better nurse-patient ratios, fair pay, and safe working conditions. The union has demonstrated that protecting nurses is not only about improving livelihoods but also about safeguarding patient safety. Their campaigns for mandated staffing ratios are a global benchmark in how union action directly translates into higher quality care.
In the United Kingdom, the Royal College of Nursing (RCN) has combined professional development with trade unionism. In recent years, the RCN made headlines for organizing nurse strikes to demand fair pay amid a cost-of-living crisis. What made these actions remarkable was the public support they garnered—patients themselves recognized that better pay and conditions for nurses meant safer, higher-quality care.
These examples highlight an important lesson: strong nursing unions not only uplift nurses but also improve patient outcomes and strengthen healthcare systems.
The Philippine Context
In contrast, the Philippines, despite having one of the largest nursing workforces in the world, lacks strong nursing unions. The Professional Regulation Commission (PRC) and the Board of Nursing regulate practice, while organizations such as the Philippine Nurses Association (PNA) play advocacy roles. However, none of these bodies function as unions in the true sense of collective bargaining and labor rights protection.
This gap has left Filipino nurses vulnerable. Entry-level nurses in many public and private hospitals continue to earn salaries well below the living wage. Many endure “volunteer nurse” schemes, where they work without pay just to gain experience. Staffing shortages are rampant, and thousands migrate abroad each year, leaving local hospitals understaffed. Without a strong, organized union, nurses’ voices are often fragmented and drowned out in national policy debates.
Why Nursing Unions Matter for the Philippines
The case for nursing unions in the Philippines is compelling. A union would:
Fight for fair compensation – ensuring that nurses are paid in line with their contributions and aligned with international standards.
Address unsafe staffing levels – by lobbying for legislated nurse-to-patient ratios similar to Australia’s model.
Protect against exploitation – ending exploitative volunteer programs and contractualization practices.
Empower nurses in policymaking – giving them a collective platform to influence national health reforms.
Strengthen retention – by making local jobs more attractive, unions could help curb the massive migration of nurses.
Practical Ways Forward
Building nursing unions in the Philippines will not happen overnight, but there are practical steps that can be taken:
Legislative support: Congress should consider enabling legislation that allows the formation of nursing-specific unions with collective bargaining rights, similar to teachers’ unions.
Partnership with existing associations: Groups like the PNA can collaborate with labor organizations to explore hybrid models combining professional advocacy with labor rights.
Pilot hospital-level unions: Large public hospitals like PGH or regional medical centers could serve as pilots for union organizing, demonstrating how collective bargaining improves conditions without disrupting services.
Public awareness campaigns: Highlighting how nurse welfare directly impacts patient safety can build public support for union initiatives, as seen in the UK.
Capacity building: Training nurse leaders in labor law, negotiation, and collective action will prepare them to represent their peers effectively.
Alliances with global unions: Tapping into networks like the Public Services International (PSI) and learning from counterparts in Singapore, Australia, and the UK will provide valuable guidance.
Conclusion
For too long, Filipino nurses have been lauded as “heroes” while enduring conditions that fall far short of dignity and fairness. The establishment of nursing unions in the Philippines would not only protect nurses but also strengthen the healthcare system itself. As global examples show, when nurses stand together, patients benefit, communities thrive, and health systems grow stronger.
If the Philippines truly wants to honor its nurses—not just in speeches but in practice—then enabling and supporting nursing unions is a step we can no longer afford to delay.
