By Alvin Cloyd Dakis, RN

Alvin Dakis is the founder and president of the Alliance of Young Nurse Leaders & Advocates International Inc. (AYNLA), a national organization of nurse advocates. He is also a blogger & youth leader. Email him through: alvin.dakis (at) aynla.org.

Contributions from all sectors, especially the youth, are welcome on Mulat Pinoy. Popdev stories cover many issues; while reproductive health is a frequent topic of discussion, articles may also discuss population in relation to the environment, employment, education, food supply, gender, religion, housing, health, and others. Send an email to popdev (at) mulatpinoy (dot) ph.

Read Part One here. This is Part Two.

The government’s aid

The Arroyo government came up with a stopgap project called NARS: Nurses Assigned in Rural Service. The program would deploy around 10,000 nurses in underserved local areas in the country for six months. Each deployed nurse would get an allowance of around PhP8,000, and another additional budget from the local government where he or she is deployed.

The NARS project seemed effective initially, though critics argued that this kind of project is not sustainable enough to answer the growing crisis in nursing employment. Before the project concluded in 2010, a nurse-participant of the NARS project was raped in Maguindanao, which got more media attention and a call to protect the nurses being deployed in rural areas.

The Aquino government has taken shape in 2011, and along with it comes a new hope for reforms and social change. The new government faces the same growing crisis in nursing unemployment, which was unresolved by the Arroyo administration. The Aquino administration seems to have copied the project and installed RN HEALS: Registered Nurses for Health Enhancement & Local Service. It is very similar to the NARS program, except it extends the nurses’ service from 6 months to 1 year, having to rotate half a year in community health and the other half in a public hospital. After completion, the nurses would gain a certificate of participation, and then go back to being unemployed.

There is another project the government is designing through the Department of Labor and Employment, which they claim is “more sustainable.” Using entrepreneurship as the key ingredient, nurses will be taught how to manage their own businesses through microfinancing and a cooperative system. However this project needs to have more refining prior to its implementation, and has been put on hold.

Push for reforms

With the current government having little to no prepared sustainable program to save 287,000 unemployed registered and professional nurses in the country, the country is now experiencing a demoralization of the nursing profession. Most of its unemployed nurses now seek jobs not found in their curriculum, or are totally outside the nursing practice.

In most of my talks, I refer to something called ‘Professional Poverty’: our country is very rich in health human resources (e.g., nurses) that are unemployed or underemployed, and the state fails to see the vast impact of this fact on public health. We still need a lot of nurses in our health system, yet the government finds it hard to employ a single nurse. How are reforms for healthcare helping this issue?

The Department of Health has been pushing for its Rationalization Plan for more than five years. The Rationalization Plan aims to further upgrade/specialize services in hospitals and increase the number of hired staff based on new standards set by the department. For example, a public hospital’s ward might need 20 nurses but only employ half; the Rationalization Plan will mandate the hospital to add 10 more nurses to comply with the new standards. This plan seems benevolent and outstanding, but it will entail billions of pesos of investment from the government’s treasury. That alone has been a big concern and has been a bottleneck of the Department of Budget and Management. Until now.

Senator Edgardo Angara has also pushed for a bill that will develop community health delivery and increase placement of health professionals in rural areas. This bill, the Community Health Delivery and Health Team Placement Act, aims to “elevate the availability of primary health care in the Philippines and the competence of Philippine health care practitioners.” According to the bill, nurses will lead operations in 4th-6th class municipalities and allow them to conduct ‘telemedicine’ remotely with physicians, who will also conduct periodic visits in the locality.

This act is breakthrough legislation for public health and acknowledges nurses as heads of operations in public/community health for the first time. This bill needs to be supported and be passed into law. With this, we can see an increase in the number of nurses in community/public health.

To be concluded in Part Three.