Why a Doctor Choose to Be A Nurse?

Since 1994, 100,000 Filipino nurses have left the Philippines to work abroad. A good proportion of that figure are doctors who decided to become nurses.

Here is one more young doctor shifting into the field of nursing. She expresses her sentiments and reasons for choosing a new career. It is worth appreciating how someone begins with idealism, and later on, transforms to a new person with a totally different outlook in life.

I do not blame her for her decision. Maybe if majority of the doctors here become nurses, and leave for greener pastures abroad, some good leader(s) of this country will notice there's a big problem in the health system, and do something about it. I just pray that when that happens, it is not too late yet.

Excerpts from the article:

"If this nation thinks that paying $200 to a doctor here is equivalent to $5,000 to a nurse abroad and should be enough compensation for our toil and brains, I am not going to play a martyr. We doctors are just like every decent, hard-working citizen of this country who has an instinct of self-preservation. We are trying to stay afloat even as the nation seems to be sinking. Government officials can continue to bicker until one day they have to go to a hospital --- only to find it empty. We boast about the brawn we send overseas, but if we lose our brain as well, what is going to happen to this country?

"Since I am young and broke, this could all be useless bellyaching. But couldn’t it also be the valid complaints of a thinking citizen of this country? Although some of our colleagues remain hopeful about our country’s future, I don’t think I can stay longer, waiting for a miracle. I am turning 30 in a few months, with only one ton of medical textbooks and a stethoscope for assets. And I still owe my parents half a million pesos in medical school tuition. A doctor cannot save lives if his own is in peril."

Some Facts what is happening:

1. In the last 10 years, the Philippines exported close to 90,000 nurses overseas.

2. In the last four years, 3,500 doctors left the country to take on nursing posts abroad.

3. The number 1 course choice here is now Nursing. I have friend lawyers, engineers, and yes, doctors who are all shifting to nursing to work abroad.

4. The Philippines is now exporting more nurses than it is producing, resulting in substandard patient care and a real crisis in hospitals.

5. Migrant health workers are still predominantly female, meaning more families are losing their traditional caregivers --- the wives, mothers, and sisters. According to a 2004 Asian Development Bank report, 65 percent of Filipino workers overseas are already women.

6. Because of equal opportunity in employment (something non-existent here) abroad, age is not a hindrance to working, and more senior doctors and nurses opt for retirement to study nursing and work abroad. This leaves an unwanted vacancy in health personnel in hospitals especially in the provinces.

7. About 10 percent of the Philippines' 2,500 hospitals have closed down in the past 3 years mainly because of the loss of doctors and nurses to jobs overseas.

8. Next to India, the Philippines is already the second largest source of doctors in hospitals abroad. The country also supplies 25 percent of all overseas nurses worldwide.

9. The preferred country of destination is the United States because of the possibility of acquiring U.S. citizenship and all its privileges. But 57 percent of Filipino nurses abroad are in Saudi Arabia and only 14 percent are in the United States, while 12 percent are in the United Kingdom.

10. PGH, the country’s premier government hospital, is also seeing an exodus, with up to a quarter of its 2,000-nurse workforce leaving in the last few years. While it used to accept only the top graduates of the country’s nursing schools, it can no longer afford to stick to such standards. Now, as long as a nurse makes the minimum passing grade, an apparently desperate PGH will take the applicant.

11. About 5,500 doctors are now enrolled in 45 nursing schools in courses that were tailor-made for them. Two thousand doctors have already taken up the Nursing Board Exams, topping the test in 2003 and 2004. In 2004, the topnotcher in the medical board exam announced his plans to work overseas as a nurse.

12. It is no longer hip and cool to become a doctor here. Of the 39 medical schools in the country, three have ceased operating because of steeply declining enrollment. The Iloilo Doctors College of Medicine, for instance, reported a 74-percent decrease in enrollees.

Reasons for this mass migration of our health workers include the prevailing political instability, widespread corruption, and all-too-important financial aspect.

A nurse working in the UK for 6 months can earn as much as P500,000 (half a million pesos). A nurse in the US can get a signing bonus anywhere from US$2,000 to US$10,000.

Here, nurses in the provinces get about P2,000 monthly (US$35.90). In government hospitals, nurses get P9,000 monthly (US$161.55), and in private hospitals, it could go down to P4,000 (US$71.80). Under Republic Act 9173, an entry-level nurse should get about P13,300 a month (US$238.74). The key word "should" is most likely a joke. This law is not properly enforced.

Bottomline is that the aging population in western countries will increase in the next 5 to 10 years, and demand for nurses and doctors from developing countries like the Philippines will continue to rise.

US NURSING WAGES
A new study links the nursing shortage in the US with salary figures lagging behind inflation rates. The study covers the period between 1996 and 2000, when there was a notable shortage in US nursing staff coinciding with a salary range below the inflation rate. When salaries were increased, there was a significant 9.2 percent increase in the nursing staff. I wonder if this increase came from the US, or from international manpower sources like the Philippines.

The lowest median wage for US nurses quoted in the study, came from the Memphis area, where the wage was $19.50 per hour. In today's exchange rates, this around P1,000 per hour. A nursing shift is about 8 hours, so that's about P8,000 per shift. Not bad, if you ask me. P8,000 is a month's salary here. And I'm doing my math at a time when the Philippine peso is stronger. Imagine the rates years ago.

The highest median wage is in Oakland, CA where the pay is $39 per hour or nearly P2,000 using today's rates. That's a cool P16,000 per nursing shift. Whoa! I hear there are even signing bonuses and relocation fees provided today with each new nurse hired.

No wonder even doctors here want to be nurses abroad.