Nurses’ exodus

It’s one of the noble professions – one of the handful that young girls aspired for in my time.

As in the other noble profession of teaching, unfortunately, there is much discontent in the nursing community in the Philippines.

The causes of discontent are similar: long hours, hard work, low pay. As narrated by Maristela Abenojar, president of the Filipino Nurses United, nurses in some private hospitals are getting as low as P5,000 to P7,000 a month. Work in some hospitals, she says, can be 12 to 16 hours of straight duty in a day.

Yes, that’s below the minimum wage, but they can even count themselves lucky. Some new nurses have to pay the hospital for the privilege of working and getting residency credentials.

For thousands of nurses, there’s another problem: contractualization.

Abenojar says that in both the government and private sectors, there’s “endo” for nurses, with “contract of service” renewed every six months.

Her group is seeking higher pay for all the 600,000 registered nurses in the country, in both government and private hospitals, through the implementation of Republic Act (RA) 9173 or the Philippine Nursing Act.

RA 9173 was passed way back in 2002. Section 32 of the law mandated an entry level Salary Grade 15 for government nurses, or P31,545 up to P33,279 at current rates. But Gloria Macapagal Arroyo, during her presidency, issued Executive Order 811 in 2009, reducing this to SG 11 or P22,055 at current rates.

The Supreme Court ruled that a mere EO could not amend or repeal a law.

Today, Abenojar says, there are regular government nurses getting about P18,000 a month. She says in many of the country’s 1,009 private hospitals, the average monthly pay is even lower, at P8,000 to P10,000.

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Last Oct. 8, the Supreme Court (SC), acting on a petition filed in 2015 by Ang Nars party list, ruled that Section 32 of RA 9173 should be implemented – but only subject to the availability of funds, to be determined by Congress.

As the SC ruling was handed down after the House of Representatives had already approved the 2020 national expenditure program submitted by Malacañang, the pay hike may no longer be factored into next year’s General Appropriations Act.

This is according to Health Secretary Francisco Duque, who said a more realistic schedule for the pay hike would be 2021. And he can speak only for the salaries of government nurses, even if he agrees with the stand of Abenojar’s group that the salary increase should be for both the public and private sectors.

Duque also pointed out that other workers in government notably teachers are also demanding pay raises.

Understandably, those were not statements Abenojar wanted to hear. “We want it now, we don’t want it next year,” Abenojar told “The Chiefs” on Cignal TV’s One News channel recently after hearing Duque’s pronouncement.

“We are saving lives… and we are contributing a lot to the development of our country,” Abenojar said as she called for salaries commensurate to the value of their work.

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Like public school teachers, nurses are complaining that priority in the salary hike, with the entry level pay pegged at around P30,000, was given to soldiers and personnel of the Department of the Interior and Local Government – cops, firemen and jail guards.

Compare this with the P18,000 for nurses, Abenojar says, and the exodus of nurses for overseas jobs will continue.

In previous years, the lack of nurses, doctors and other health professionals led to the shutdown of about 100 private health centers.

“Not all nurses want to get out of the country and leave their families here,” Abenojar said as she noted that the living wage for a family of five has been pegged at P32,000 a month.

If nurses can get “just salaries” in their own land, they won’t leave, she said.

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The Philippine Overseas Employment Administration reports that every year, an average of 19,000 nurses leave the country to work abroad.

Abenojar said others abandon nursing for higher paying jobs such as in call centers.

In previous years, nursing schools mushroomed amid a spike in global demand. Even Filipino doctors studied nursing to work in high-paying job markets such as the US, Britain and Dubai.

People from other developing countries also saw the demand and competed for the jobs. Our nurses, however, had an edge in their English proficiency as well as the natural Pinoy tender loving care.

The global demand eventually slackened, and an ensuing glut forced several schools to shut down their nursing programs. At one point, there were reports that the Philippines had a glut of over 300,000 nurses. A health official told me at the time that the local jobs were there, but the nurses didn’t want the low wages.

Today, says Abenojar, new job markets are opening overseas, so enrolment in nursing is again picking up.

But the nurses are most needed in the Philippines, where many hospitals are understaffed. While the nurses are available, however, a number of them would rather take non-nursing jobs with better pay.

Duque admits that Philippine hospitals cannot compete with the average salaries of P150,000 to P200,000 a month being offered to nurses abroad.

Compounded by “contract of service” or endo schemes, going overseas or working in a call center can become more tempting for a nurse.

“This starvation salary is not only killing us, it is also killing our families,” Abenojar said.