The shift to nursing

Since the start of the year I’ve been speaking at various schools in the country.  I think I have gained a clear idea of the concerns and aspirations of young Filipinos in these uncertain times.  In the exchange that follows every talk, I ask how many in the audience are seriously planning to go abroad after completing their studies.  The raised hands representing prospective immigrants typically outnumbered the ones that would stick it out at home.

I recall that the only time in our nation’s history when migration became a desperate option for many of our people was in the early ‘80s.  The New Society experiment of Marcos had by then been confirmed to be a failure. The credibility of the regime was in tatters. The economy went into a tailspin after the assassination of Ninoy Aquino.  Yet my impression then was that the exodus was basically a middle class phenomenon.  People were moving out mainly because they feared chaos.

Today’s immigrants are different.  They seem more desperate about being able to find a future at home.  It is not political chaos that frightens them so much as stagnation and poverty.  Many have reached a point of indifference.  They think that the country’s leaders are all alike, cut from the same cloth of opportunism and corruption. No one inspires them anymore.  They are voting with their feet, refusing to participate in any political exercise that promises to install a “new” leadership.  They refuse to waste their youth in a society that offers them nothing on which to anchor their hopes.

Many of these young Filipinos are not exactly without job prospects at home.  A number of them may already have jobs, but they do not see their present situation as offering them any opportunity for meaningful personal or professional growth. Their eyes are firmly set on a destination abroad, preferably the United States.  And right now, the only passport available is a nursing degree.

Speaking at the recent graduation ceremonies of the Naga College Foundation, one of the earliest private colleges in Bicol for the training of teachers, I couldn’t help noting that the biggest group, a good one-third of the year’s graduating class, were the nurses. I was told that many of them were “second-coursers,” meaning they were already holders of other degrees, like medicine, accounting, engineering or education.

The shift to nursing has taken the Philippines by a storm.  It is the most dramatic change in the country’s education system since the introduction of computer science courses.  It has spawned far more new schools in the last four years than any other tertiary-level course. It has colonized the academic programs of traditional liberal arts colleges that face extinction if they failed to respond to the demand. Some medical schools are closing down because they cannot get enough students; their faculties and facilities are being swallowed by nursing programs.

The phenomenal demand for nursing personnel abroad, as exemplified by the opening of a special US visa window for qualified nurses, has led to the proliferation of nursing schools unsupported by training facilities.  Existing policies of the Commission on Higher Education (CHEd) require such schools to be accredited with a medical facility that has at least 100 hospital beds.  They also require the engagement of a minimum of five faculty members with nursing degrees.

Where education has become a big industry, the rush to meet the market is sure to sweep aside the formal requirements for offering a popular course.  Compliance is negotiated as school-owners turn to politicians for help in dealing with CHEd officials. The recent resignation of Fr. Rolando de la Rosa as chairman of CHEd is possibly an outcome of his refusal to accede to pressure after he ordered 23 nursing schools to refrain from offering the nursing curriculum until they complied with the minimum requirements.  The weapon the politicians used against him was the power of Congress to cut the Commission’s budget.

The opening for Filipino nurses in the US is of a short-term nature, but the demand for a nursing degree may rise even further in the next five to ten years.  The impetus that drives it is no longer the actual demand for nurses abroad but the overwhelming wish of many Filipinos to leave the country.

Yet it is interesting that, instead of viewing this exodus with alarm, the Philippine government seems to rejoice in it. Every representation we make with governments in the developed countries inevitably revolves around the business of exporting more of our people.  A recent news item reports a public official as positively looking forward to the possibility that in 2005, the number of Filipinos leaving the country to work abroad on a yearly basis will hit the one million mark. Given existing trends, that number may well be a modest estimate.

In general, our people thrive well abroad.  They work hard, are loyal and dependable, and they value their jobs.  The companies and institutions they serve abroad sometimes wonder how any country can cavalierly dispense with the services of such a gifted people.

I am sure there are many deep personal reasons behind the current exodus of our people. But I think of it as societal entropy.  A term from thermodynamics, entropy refers to “the amount of energy unavailable for useful work in a system undergoing change.”  Applied to a society, it is a measure of disorder in the system. In plain language, it simply suggests that the present system in the country is such that it can no longer absorb talent.  That’s one way of looking at our problem.

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