Ang Nars, Inc. Position Paper on Unemployment and Underemployment
Written by: Leah Primitiva G. Samaco-Paquiz, Founding President

Ang Nars denounces the present condition of many professional Filipino nurses who are unemployed or underemployed.

From 1998 to 2008, the Philippines produced 230,225 registered nurses, creating the problems of unemployment and underemployment. The profession is confronted with serious problems, notably the lack of employment possibilities, positions lower than the applicants’ professional qualifications, inadequate wages and poor working conditions. These are real problems as evidenced by the Philippine Nursing Compensation Survey commissioned by the Philippine Nurses Association (PNA) in the year 2009.

Nurses have become vulnerable victims of unfair labor practices. Society does not afford respect and value to the nursing profession. Our nurses have become apathetic to insults and abuses and have become “willing volunteers” performing regular functions without pay in order to augment their daily survival needs.

All over the country, the major stakeholders are the hospital owners, hospital administrators, medical directors, governors and mayors. They do not open new positions for nurses, or even worse, they do not fill up vacated plantilla positions in order to save on salaries. Others even earn from the training fees for new nurses. All these are part of their revenue generation schemes or cost cutting measures to augment operational budgets. The major stakeholders do not hire regular staff nurses because they will be forced to pay them bigger salaries. This is the the so-called “kalakaran,” or the twisted system that has been implemented over time.

This is where unemployment and underemployment come in because the practice of “on-the-job training” and “enforced volunteerism” are rampant in both private and government institutions.

A. GOVERNMENT HOSPITALS

Ang Nars found out that in one district hospital there were 14 regular nurse positions for a 50-bed capacity hospital. Eight (8) positions were filled which included the chief nurse’s and the supervisor’s positions. but the remaining six positions were not occupied.

The regular staff nurses’ starting salaries were at Grade 11 as provided in the Salary Standardization Law of 2010. The increase in their salaries will be divided into four and will be given within four years’ time starting this year.

The chief nurse and the three supervisors work the morning shift. There are five nurses left who work three shifts: the 7:00 AM – 3:00 PM shift, the 3:00 PM – 11:00 PM shift and the 11:00 PM – 7:00 AM shift. These nurses receive two days off each.

With a 50-patient capacity, there should be at least be a ratio of 1 nurse for every 6 patients in the day shift, meaning there should be 5 nurses for that shift. However, in the Intensive Care Unit (ICU), the ratio should be 1:1; if there are three patients in the ICU, then three more nurses are needed. Nurses are needed in the Operating and Emergency Rooms, as well.

In order to address the staffing problem, in Capiz hospital has devised the Job Order List System. All nurses are asked to apply for open position at the governor’s office. The governor then accepts applicants in the form of job orders. Applicants usually employ the help of backers or the “palakasan system” in order to get a job order.

The salary for one job order amounts to P175.00 and is funded by the province. One nurse should be receiving a salary of P175.00; however ONE job order employs FOUR casual nurses so that each nurse only earns P43.75 a day. The permanent nurses who have job orders work for 12 hours with a salary of only P175.00

There are other forms of underemployment practiced at this hospital. One of these is the practice of keeping the status of nurses as “casual” for a number of years. There are some nurses who have been working for 10 years as casual employees. Others work as nursing aides or accept salaries that are way below the minimum wage. The hospital has even allowed the salary for one plantilla position to be divided between two nurses.

B. PRIVATE HOSPITALS

In private hospitals, a nurse can work as an “on-the-job trainee (OJT) or volunteer” who undergoes a three-month training period without a salary. Instead, the nurse pays a fee in order to work for the hospital. They also do not receive any promise or prospects of permanent employment; either they leave at the end of their stint, or, if they are lucky, they can become one of the following:

a. Relievers – paid P250.00 a day;
b. Probationary Nurses – paid P250.00 a day.
c. Regular Nurses – paid a salary of P290.00 per day. The shortest period before becoming a regular nurse is six months.
d. Casual Nurse – paid P3000.00 a month
e. Contractual Nurse – paid P5000.00 a month. Contractual nurses lose their jobs after five months.

After their short “OJT” or “enforced volunteer”, “enforced trainee” stint, they are given:

a. Certificates of completion as TRAINEES/VOLUNTEERS and
b. Letters of reference

Competent professional nurses who have earned enough skills are in fact eligible by law for employment and should be accorded the corresponding remuneration and benefits on an entry level. THESE NURSES WANT TO WORK AND EARN A LIVING.

STOP UNDEREMPLOYING NURSES! PROVIDE EMPLOYMENT FOR NURSES!
STOP “ON-THE-JOB TRAINING” AND “ENFORCED VOLUNTEERISM’.

Source: http://www.angnars.com/index.php?option=com_content&view=article&id=378:ang-nars-position-paper-on-unemployment-and-underemployment-may-262010

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Ang Nars, Inc. Position Paper on the Practice of “On-The-Job Training” or “Enforced Volunteerism”
Written by: Leah Primitiva G. Samaco-Paquiz, Founding President

Ang Nars believes that nurses in public and private institutions are entitled to a decent working environment as they continue to render health services to their clients.

Competent professional nurses who have earned enough skills are in fact eligible by law for employment and should be accorded the corresponding remuneration and benefits on an entry level. THESE NURSES WANT TO WORK AND EARN A LIVING. However, the lack of employment opportunities often drives these nurses to settle for far less than they deserve.

Today, voluminous applications from new nurses for “on-the-job training (OJT)” or “volunteer programs” flood hospitals all over the country. To “volunteer” means to give of one’s time to render work willingly without pay or remuneration. However, volunteerism and training are two different things. The nurses who apply for these so-called OJT positions do not receive compensation for their services. To add insult to injury, these nurses often have to pay a training fee for the “privilege” of working for these hospitals.

These nurses do not even hold any hope of being able to oppose the arrangement. Often, they simply submit to this injustice and shell out a “training fee” for the dubious privilege of being included in the shortlist of applicants who are hoping to get the first shot at a vacated plantilla position. They are given the same assignments and responsibilities as regular staff nurses for three months, but are let go of when they have served their purpose. Nurses who complete these “training programs” are given completion certificates indicating the number of hours rendered and are henceforth presumed to be good enough to meet the “experience requirement” for employment overseas. This vicious cycle repeats with new batches of nurses every three months. The major stakeholders can afford to kick the old nurses out because they never run out of applicants.

The training programs these hospitals conduct are supposed to be orientation programs on the policies and procedures for new nurses of these institutions. They should be provided free of charge by the employing local government unit, private or government health facility. These training programs should not pose as remedial programs designed to augment what these institutions perceive as a lack in these nurses’ education

Also, since these nurses are only casual employees, hospitals are not legally responsible for these OJT nurses’ actions. If these nurses were to commit mistakes on the job, who will take care of them should they be sued in court?

The issue of this “forced volunteerism” serves to remind the stakeholders of the need to rationalize the nursing profession and for the need to find ways to absorb the thousand of nurses who lack jobs in a country where nursing services, especially at the community level or at the primary level, are sorely lacking.

Ang Nars challenges its fellow nurses in positions of responsibility as well as the major stakeholders to look closely into the problems and concerns of our nurses. Ang Nars believes that these major stakeholders are a critical force that can create plantilla positions for our nurses within the government, private institutions and the community level.

Ang Nars calls on these stakeholders to help institutionalize the following changes towards our noble nursing profession: implement Sec. 32 of RA 9173, or the Nursing Law of 2002; fully implement the Magna Carta of Public Health Workers; send “Nurses To The Barrios” and “Nurses To Barangays”; encourage our nurses to “hang their shingles”; open Ang Nars Primary Health Care Clinics so our nurses can collect professional fees; provide training programs for nurses from tertiary hospitals which will be accredited by the PRC-Board of Nursing Continuing Professional Education Council; provide orientation programs for newly employed nurses with no training fees; provide proper salaries for regular staff nurses; provide humane and safe working conditions similar to those enjoyed by regular staff nurses working for these health facilities; and to create built-in system policies within the Department of Health (DOH) for nurses.

STOP EXPLOITING NURSES! START TREATING NURSES AND WITH DIGNITY!
STOP “ON-THE-JOB TRAINING” AND “ENFORCED VOLUNTEERISM”!
PROVIDE EMPLOYMENT FOR NURSES!

Source: http://www.angnars.com/index.php?option=com_content&view=article&id=381:ang-nars-position-paper-on-the-practice-of-on-the-job-training-or-enforced-volunteerism-june-7-2010

Know more about Ang Nars, Inc.

PRC-BON Board Resolution No. 20 Series of 2009
Amendment to Board Resolution No. 17 Series of 2009 Dated July 31, 2009 on Prescribing a Dress Code for Examinees in the Nurses Licensure Examination

Key Points:

1. Examinees who are not in the prescribed dress code WILL NOT BE ALLOWED TO TAKE THE EXAMINATION.
2. Your school uniform is the appropriate attire for the licensure examination.

Female:
clinical uniform
white shoes
white stockings
without nameplate, school insignia or logo or pin

Pregnant Female:
white clinical scrub suit

Male:
clinical insignia
white shoes
white socks
without nameplate, school insignia or logo or pin

PRC-BON Board Resolution No. 20 Series of 2009

New Intra-Partal, Immediate Care of the Newborn and Intra-Operative Forms:

PRC-BON Memorandum Order No. 1 Series of 2009 ANNEX

PRC-BON Board Resolution No. 220 Code of Ethics for Registered Nurses

PRC-BON Code of Ethics for Registered Nurses

PRC Oath Form or Panunumpa ng Propesyonal

PRC Oath Form or Panunumpa Ng Propesyonal

This article is written by RUSTY L. FRANCISCO, EdD, RNC, CEN, CCRN, CNAA and appeared first in the Philippine Daily Inquirer last May 13, 2009. I have asked for his permission if I can post it here and I am glad that he allowed me to do so. This is a good read for nurses and I hope you get inspired by his words. -Rona RN (admin)

Allow me to share my views on the present nursing curriculum and its impact on our nurses’ education and global competitiveness.

The present four-year nursing program includes three summers. If a summer is equivalent to a semester, then the present nursing program is actually five-and-a-half years long. Therefore, the proposal of the Commission on Higher Education (CHEd) to add one more year to what is at present a four-year course—that is a five-year course without summers—is better for two reasons: (1) nursing students can enjoy a much-needed respite during summer, and (2) their parents will be given time to save money for the following semester.

However, we should not worry so much about the length of the program or the tuition fees to be paid. Let’s rather focus on the proper implementation of the curriculum per se. The present curriculum is a well-researched program that was carefully developed by our country’s dedicated deans and noted nursing academicians in consultation with different nursing sectors and specialty groups. In fact, our nursing curriculum’s conceptual framework has been hailed as a blueprint for excellence and has been adopted by many Asian and western countries. And it has been presented at numerous international conventions and accepted by our nursing colleagues globally. Given its content, the curriculum can be said to be in parallel with the global standards of nursing care and practices.

As one of the many Filipino nurses given the chance to teach nursing subjects in the United States for more than 15 years, this is my observation: even though the US nursing program has two entry levels, the predominant one is the Associate Degree in Nursing (ADN), a two-year nursing program with barely 600 actual nursing hours in the clinical areas; and it yields amazingly and consistently a very high passing performance in the nursing licensure (NCLEX-CAT) examination.

As to the Filipino nurses’ global competitiveness, to this day they remain the number one choice of other countries trying to make up for their acute nursing shortage. Our nurses may be noted for being inherently caring, respectable and compassionate, but more employers (nursing homes and hospitals), especially in the United States, are now so concerned that the nurses they hire are truly trained in the western nursing practices and standards, or “globally competent.”

Nursing competence (not the BSN degree or passing or topping the mandatory examinations) is very crucial in the effort to prevent and totally eliminate nursing malpractice/negligence. It’s a known fact that the United States is one of the most litigious countries in the whole world and yet it is a favorite destination of our nurses for long-term work tenure.

Hats off and kudos to all our nurses in the academic arena!

—RUSTY L. FRANCISCO, EdD, RNC, CEN, CCRN, CNAA,
chief operating officer, International Division,
NC-CLEX- Global Training Center,
docrusty@ncclex.com

Why do we need to adopt the Integrated Management of Childhood Illness (IMCI) approach in the Philippines? A presentation by Marco Antonio C. Sto. Tomas, Board of Nursing

Integrated Management of Childhood Illness (IMCI)

Download the PowerPoint presentation of Integrated Management of Childhood Illness.

Board of Nursing (BON)
Mental Health and Psychiatric Nursing
Course Syllabus

I. Description
Principles, concepts and theories underlying psychiatric nursing care to individuals, families and communities in a variety of settings.

II. Terminal Competencies
1.    Utilizes knowledge from the psychological, biological sciences, theories of personality and human behavior in the care of psychiatric clients.
2.     Utilizes the nursing process in giving holistic nursing care to all kinds of clients.
3.     Applies appropriate communication techniques with clients, families and other members of the health team in various settings.
4.     Demonstrates leadership and management skills to ensure safe and quality care.
5.     Works collaboratively with other members of the health team.
6.     Applies the ethico-legal principles in psychiatric nursing.
7.     Participates in research undertakings and utilizes findings to improve psychiatric nursing care.
8.     Assumes responsibility for personal and professional growth.

III. Content Outline
1.     Personality development and principles of mental health
A.     Mental health as a concept
B.     Principles of Psychiatric Nursing
C.     Nursing process in Psychiatric Nursing
D.     Research as a tool in improving psychiatric nursing care.

2.     Crisis and Crisis Intervention
A.    Crisis intervention
B.     Common crises situations

3.  Anxiety Response and Anxiety Disorders
A.    Etiological theories of anxiety
B.     Levels of anxiety
C.     Ego defense mechanisms
D.     Anxiety related disorders

4.  Anxiety Disorders in Childhood and Adolescence
A.    Childhood
B.     Adolescence

5.  Psychophysiologic disorders
A.     Theories of psychophysiologic disorders
B.     Predisposing factors
C.     Common organ systems affected by psychological factors
D.      Nursing care and psychopharmacology

6.  Personality disorders
A.     Psychodynamics of personality disorders
B.     Predisposing factors
C.     Types of personality disorders
D.     Nursing care and psychopharmacology

7.   Emotional responses and mood disorders
A.     Psychodynamics of mood disorders
B.     Predisposing factors
C.     Alterations in mood
D.     Treatment modalities, psychopharmacology and nursing care

8.  Thought disorders (Schizophrenia and psychotic disorders)
A.     Theories of etiology of schizophrenia
B.     Types of schizophrenia
C.     Primary and secondary symptoms of schizophrenia
D.     Treatment modalities, psychopharmacology and nursing care

9.  Substance abuse and related disorders
A.     Alcoholism
B.     Drug abuse and dependence
C.     Treatment modalities, psychopharmacology and nursing care

10. Organic Mental Syndrome and Disorders
A.     Etiology
B.     Fundamental principles in the care of cognitively impaired person
C.     Organic mental syndrome
D.     Organic mental disorders
E.     Treatment modalities, psychopharmacology and nursing care

Download the Word Document of Mental Health and Psychiatric Nursing Course Syllabus.

• Course Syllabus for Foundations of Nursing Practice Including Professional Adjustment
• Course Syllabus for Maternal and Child Health Nursing
• Course Syllabus for Community Health Nursing and Communicable Disease Nursing
• Course Syllabus for Nursing Care of Adolescents, Adults and Aged

Board of Nursing (BON)
Nursing Care of Adolescents, Adults and Aged
Course Syllabus

I. Description
Nursing care of clients with alterations in health patterns throughout the life cycle utilizing the nursing process. This course also includes disaster nursing and care of clients in acute biological crises.

II. Terminal Competencies
1. Applies the nursing process to health care situations.
2. Relates the pathological changes brought about by stresses, illness, etc. to patient care.
3. Institutes health teaching strategies to help create a therapeutic environment for clients, families and communities.
4. Utilizes the different techniques of enabling the clients, families and communities to cope with illness or death.
5. Strives to continue reaffirming the dignity and worth of man through the provision of supportive comfort measures to patients, families and communities at all times and even when death is inevitable.
6. Communicates effectively with clients and members of the health team.
7. Analyzes socio-economic, cultural, political and other factors in relation to the occurrences of illness or disease conditions.
8. Integrates the socio-political, technological and economic systems and their influence on the Philippine health care delivery.
9. Conducts research and uses research studies to improve patient care.
10. Assumes responsibility for personal and professional growth.

III. Content Outline
1. Concepts of Stress and Illness
A. Health-illness continuum
B. Epidemiology of illness
C. Stress models
D. Response to stress

2. Nursing Interventions in Illness
A. Holistic approach in different stages of development stages
1. Biophysical
2. Psychosocial
B. Pharmacological therapeutics
C. Patients in surgery
D. Patients in pain
E. The dying process

3. Care of Patients with Specific Disturbances in
A. Oxygenation
B. Fluids and electrolytes . Metabolism
D. Inflammatory and immunologic responses
E. Perception and coordination . Cellular aberrations

4. Care of Patients with Peripheral Vascular Disorders
A. Structure, function and assessment
B. Arterial disorders
C. Venous and lymphatic disorders
D. Diagnostic procedures

5. Care of Patients with Urinary Disorders
A. Structures, function and assessment
B. Renal disorders
C. Diagnostic procedures

6. Care of Patients with Integumentary Disorders
A. Structure, function and assessment
B. Protection of the skin, hair and nail
C. Restoring skin structure and function

7. Care of Patients with Hematologic Disorders
A. Basic concepts of hematology assessment
B. Blood transfusion
C. Erythrocytes disorders
D. Diagnostic procedures

8. Care of Patients with Neurologic Disorders
A. Structure, function and assessment
B. Head and spinal injury
C. Diagnostic procedures

9. Care of Patients Experiencing Disorders of the Liver, Biliary Tract and Pancreas
A. Structure, functions and assessment
B. Evaluation and management
C. Diagnostic procedures

10. Nurses Role in
A. Infection control
B. I.V. therapy
C. Emergency and disaster situations
D. Life threatening conditions

Download the Word Document for Nursing Care of Adolescents, Adults and Aged Course Syllabus.

• Course Syllabus for Foundations of Nursing Practice Including Professional Adjustment
• Course Syllabus for Maternal and Child Health Nursing
• Course Syllabus for Community Health Nursing and Communicable Disease Nursing
• Course Syllabus for Mental Health and Psychiatric Nursing