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High-quality nursing

Norman says she worked with several Filipino nurses after she graduated from the University of Virginia School of Nursing in 1969. “I have to say I learned a tremendous amount from them,” she says, describing their attention to detail in patient care as amazing. “They were excellent nurses.”

Although Norman has worked in academia since 1977, her work has taken her to clinical settings throughout that time. That and discussions with nurses who work more often in clinical settings leads her to believe that nurses from the Philippines continue to enjoy a stellar reputation.

“The thing I have understood is the quality that I saw as a nurse is one that has continued,” Norman says. “Filipino nursing schools are very high-quality schools, and the students there graduate with a great deal of nursing experience.”

Norman says that, contrary to what some may believe, Filipino nurses do not work for less than American ones. That’s because, in order to work in the U.S., Filipino nurses must meet the same education and licensure requirements. And it’s illegal to pay someone less, based on ethnicity. “So I think it would be difficult for them to be paid less than what anybody else would be paid,” she says.

Pete-Reuben Calixto, RN, BSN, CNN, a Filipino nurse who works in the kidney, pancreas, and liver transplant unit at the University of California, San Francisco Medical Center, says Filipino nurses are better-prepared in some ways than were Filipino nurses who came to the U.S. when he did in 1979.

He says that they’re much more computer literate and that their English skills are better thanks, at least in part, to the ubiquitous presence of Cable News Network, which broadcasts in 150 countries, including the Philippines.

Different cultures, different views

Calixto says the hardest professional adjustment he had to make involves the different communication styles in the U.S. and the Philippines. In the states, people expect you to look them in the eyes when you speak to them, while in the Philippines, that is considered rude. Calixto felt so uncomfortable with eye-to-eye contact that at first he would move away from people while they were still talking, leading one colleague to wonder whether he was deaf.

Velasquez says that she felt she had to prove herself to American-trained nurses by matching or exceeding their level of expertise. She says because she went out of her way to prove her worth, American nurses always treated her well.

“I think I had to prove myself to be treated well,” she says. She did such a good job of proving herself, Velasquez says, that she was promoted to a management position and later worked as a supervisor at another hospital.

Norman says a recent speaking engagement before a Filipino nurses alumni association exposed her to an impressive number of Filipino nurses who had become professors, managers, executives, and entrepreneurs.

“Many of the people who attended were in the U.S. and were in high-level leadership positions,” she says.

DeCesare, whose company recruits between 150 and 200 foreign nurses on behalf of U.S. hospitals each year, would naturally like to see more Filipino nurses come to the U.S. to work. The problem is that not everyone believes recruiting more foreign nurses is such a great idea, and immigration limits are making it more difficult.

“I think one of the problems we encounter now, as we lobby the House and Senate, is lack of education of the politicians,” she says. “They think this recruitment is designed to take jobs from American nurses.”

That’s not true, says DeCesare. Instead, it’s one method for dealing with the U.S. nursing shortage, which is expected to peak in 2010 despite increased enrollment in U.S. nursing schools.

“This is when I think they really need to look at what can we do if we are not able to produce enough nurses to offset the deficit,” she says.

Norman says the International Council of Nursing, a federation of more than 120 nurses associations, has studied the issue and wants to protect the rights of nurses to work wherever they want. But the council also believes each country should be responsible for educating enough nurses to meet its needs and not rely on luring nurses away from other countries.

“I would hope that we get to where there isn’t as much dependence on
foreign-educated nurses in places like the European countries and the U.S.,” she says.

A drain on Philippines’ nurses

The conventional wisdom, as previously mentioned, in regard to the Philippines is that it produces more nurses than it can use. At least one recent news report questioned that assumption. National Public Radio reported in February that the exportation of 15,000 nurses each year to developed nations like the U.S. poses a serious long-term threat to the Philippines’ health system. The report noted that Filipino physicians, realizing they can make more as nurses in America, are enrolling in nursing school with the intention of immigrating to the U.S. to work.