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A Library Paper on the Effects of Excessive Production of Nurses

The Philippines, according to recent news, has currently a high unemployment and underemployment rate of Filipino nurses.One of the reasons behind this is the overproduction of nurses by Philippine Nursing Schools Overproduction nurses in the country still persists from approximately 350 schools (personal communication, Philippine Nurses Association, 2005).It was reported (Klein, 2003) that the country produces more than 9,000 nurses annually, 5,000-7,000 of whom become licensed.

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Da Prat, 2005) Another cause is the decreasing demand for Filipino nurses in the United States and other countries. About four years ago, Nursing became an in demand profession abroad for Filipinos after various countries allowed immigrants to work and to have other immigration opportunities. It was then that an overwhelming number of students became enthralled by this high salary and decided to get a degree in Nursing. Eventually, entrepreneurs took advantage of this increased demand to establish nursing schools due to the growing number of students who want to earn a degree in nursing.

Apparently, not all the nursing schools offer quality-nursing education. This, too, affected the chances of the students to be employed. Moreover, the passing rate of the PRC nursing board examinations has significantly declined for the last ten years, despite the increasing numbers of nursing graduates. (Hernandez, 2008) The proponents of the research have identified two categories that influence the overproduction of nurses, the intrinsic and extrinsic.

The intrinsic factors include the interests of the students, and migration, whereas the peer pressure, and parental influence fall under extrinsic. The first intrinsic factor that influences the overproduction of nurses is the student’s interest. Personal interest is a feeling or emotion of a person that causes attention to focus on an object or an event or a process. (Encarta Dictionaries 2008) In this study, it denotes on the students’ way of selecting a particular degree when they will be in college that involves their primary attention and concentration.

The college choice process has been defined as a funnel that progressively narrows the pool of students who consider attending higher education and finally resolves where they will attend (Litton, 1982; Hossler & Gallagher, 1987). Bateman and Spruill (1996) assert that the college choice process is ongoing, continuing throughout a student’s undergraduate career and beyond. Understanding why and where students initially choose to attend college is not only important in and of it, but may also be critical in understanding students’ continuing decisions about college attendance. Bateman and Spruill, 1996) Student’s aspirations of becoming a nurse have rooted from the following factors. First, they believe that nursing offers many job opportunities. Some of the career options that are available to nurses include home health care, volunteer opportunities, legal work, doctor’s office work, pediatric nursing, acute care nursing, surgical nursing, etc. , and they can even have additional training to become Nurse Practitioners, Nurse Midwives, and Nurse Anesthetists. Blanche, 2010) Second, it could offer them high salary and lots of benefits. According to Dr. Jaime-Galvez Tan of the University of the Philippines, wanting to earn and have a better life are the common reasons why registered nurses want to move to America, where the salary is $4,000 dollars a month compared to $180 to $220 per month in the Philippines. (Petrun, 2007) Lastly, Nursing is the field of interest and ambition of some students. Doctors may be the head of the operation in some cases but the nurses are the heart and soul.

According to Professor Adelani Ogunrinade, the National University of Lesotho Vice-Chancellor, Nursing is a noble profession that requires dedication, compassion, love and care to patients. Another intrinsic element is migration. The developed countries have experienced chronic nursing shortages due to different factors, which include aging baby boomers and the lack of interest of its citizens to take up nursing. As a result, they recruit nurses from developing countries. Globalization and the General Agreement on Trade and Services (GATS) further promote this phenomenon to the developed nation’s advantage.

To entice professionals to their countries, they offer benefits that include higher salaries, better working conditions and more career opportunities. The low wages, poor working conditions, and poor economic and political situations further drive Filipinos away from their country. These have led to mass migration of nurses, which is a phenomenon unique to the Philippines. Furthermore, the reasons for the migration of the professionals are a combination of “push” and “pull” factors. Push factors relate to exporting countries like the Philippines, while pull factors are to importing countries.

The main “push” factor that motivates workers to go abroad is low salaries and poor employment conditions in the source countries, whereas the higher salaries offered, the immigrants status incentive and more career development opportunities are the ones considered as “pull” factors. To a particular extent, there is a mirror image of push and pull factors which pertain to the relative payment of pay, career opportunities, working conditions and working environment of the source and destination countries (Buchan et al, 2003).

However, there are also some extrinsic factors that may contribute to the overproduction of nurses. First of which is peer pressure. Peer pressure is defined as the influence of a social group, which is considered as a person’s equal in such as respect, age, education and social class. (Encarta Dictionaries 2008) In this study, it refers to the persons or significant others that can manipulate the decision-making of the nursing students. Moreover, parent’s influence is also categorized under extrinsic factors. It is defined as the parent’s chance or ability to choose for their children (Encarta Dictionaries 2008).

In this study, it refers to the capacity of the parents that can control the respondent’s decision to what degree to take in college. One consistent finding in research suggests that adolescents’ own aspirations are influenced by their parents’ aspirations or expectations for them. When adolescents perceive their parents to have high educational expectations for them, adolescents are likely to have higher aspirations for themselves. A 1998 Sylvan Learning Center report indicates that parents’ and children’s views about career aspirations are more compatible than incompatible.

Parents are influential figures with whom, whether intentionally or unintentionally, children become aware of and get exposed to occupations or career opportunities and implied expectations. (Taylor et al, 2004) Other studies have separately examined the influences of each parent on the career choices of their sons or daughters and have found that mothers tend to have more influence on the career decisions/aspirations of their children than fathers. For instance, Mickelson and Velasco (1998) cited their interviews conducted with 70 young adults in 1986.

They found that mothers were the most influential and that daughters’ occupational aspirations were often similar to their mothers’ chosen professions (Mickelson and Velasco, 1998). In similar studies, students were asked items such as, “What do you want to do with your life? ” and to indicate if they agree or disagree with statements such as “My mother (father) encouraged me to make my own decisions. ” The students’ responses were similar to those of their parents. These studies also found that students wanted to discuss career planning primarily with their mothers.

Overall, research supports the influence of parental expectations and aspirations on the career decisions and aspirations of their children. These expectations lay a foundation for parents’ behaviors and interactions with their children, which then indirectly or directly influence choices they make in the future (Taylor et al, 2004). Different problems have surfaced due to overproduction of nurses. The unemployment and underemployment of nurses in the Philippines are not only caused by the diminishing demands of foreign countries, but also caused by the overproduction of nurses by different nursing schools.

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. Our economy is unable to absorb the large number of new entrants into the labor market each year. It is particularly difficult for young workers to find employment, and even more difficult for them to find well-paid, secure and safe jobs.

Data from the PRC showed around 400,000 licensed nurses are not gainfully employed and an estimated 80,000 new nurses join their ranks each year. Furthermore, due to unavailability of hospital jobs, nurses, whether waiting for immigrant visa or not; whether newly registered or not, find other sources of income or jobs unrelated to nursing. The Philippine Overseas Employment Administration, in a report, showed only 10,000 nurses are able to work in foreign countries while others become underemployed or are working in jobs not related to their profession.

In the year 2008, there were high rates of unemployment and underemployment in the Philippines due to overproduction and the declining demand for nurses in the United States. Nursing became an in-demand profession among Filipinos because of work opportunities and immigration overseas. With that, nursing schools in the Philippines increased in number. However, not all provide quality education for the students. The passing rate of PRC nursing licensure examination was decreased for the last 10 years. As a result, the Philippine Nurses Association (PNA) reiterated the need of focusing in the quality of education instead of commercializing it.

Table 1. 1 shows the results of Philippine Nursing Board Exam from year 1997 up to year 2008. According to the data, the number of passers is considered also as the number of registered nurses in the Philippines for the last 12 years. With this number of registered nurses in the country, unemployment and underemployment are progressing up to the present. Table 1. 1 Aside from the given data, Department of Labor and Employment (DOLE) and Board of Nursing (BON) made a review of the statistics from the year 1952 to 2008 the country has licensed 480,992 Filipino nurses out of 523,272 who actually passed the nursing licensure examination.

Reflected in National Statistics Office and Labor Force Survey, the total number of Filipino nurses employed between October 2001 and 2007 were 58,000, which represented only 3. 86% of the total 1. 5 million employed professional workers. Based on the data, it can be concluded that there were more unemployed and/or underemployed nurses during the year 2001 to 2007. Furthermore, there were also unemployment and underemployment as a result of the retrogression of the United Sates visa and the change of policy in the United Kingdom in the year 2006.

Governor Leah Primitiva Samaco-Paquiz, the PNA National Capital Region Zone II National President, explained in an interview that “in the US alone, the quota for visas has been filled up resulting in delayed processing of visas with current efforts focused on 2006 accepted applicants, while the domestic market is now oversaturated with nursing pools in major hospitals as high as 1500 and with employment waiting times ranging from six to 12 months. ” Nursing pools refers to those who were considered by the hospital employers but waiting to be officially employed.

She also stated that the current nursing employment market is a buyer’s market that allows current employers to be highly selective and where the quality of a vast number of job seekers is very closely scrutinized. In the recent report of the Professional Regulation Commission (PRC) last July 2010, they updated that there were 187,000 unemployed nurses in the country today. According to them, nurses cannot find jobs because there are no vacancies in the hospitals. Lack of experiences also prevents them in seeking for jobs especially when they planned to go abroad.

As a result, Filipino nurses ended up as underemployed, and even grab jobs with low salary. For the PRC, this is a waste of manpower if the government still allows nurses to be working abroad as caregivers and nursing assistants. Many students still want to earn a degree in nursing despite the fact that there is an evident high unemployment and underemployment rate in the country. Even nursing schools are increasing in number, without taking appropriate measures to ensure the right quality of education for the students. The following factors, therefore, are necessary in order to alleviate the overproduction of nurses.

The government plays a big role in alleviating the number of nurses produced every year, thus helping our economy to improve and progress. It has a vital part in providing available jobs for future professionals. And when it comes to overproduction of nurses, the Philippine government is necessary to control the existing problem. The government should know and investigate on each of the nursing schools in the Philippines if they are to produce competent nursing professionals, made visible by passing the NLE (Nursing Licensure Examinations).

If the school is not capable of doing so, it would be better if they advise it to close. As of now, it was reported that the Commission on Higher Education (CHED) would be closing 177 nursing schools in the country. (Nieva, 2008). It would also be better if the government would impose additional subjects in the nursing curriculum and increase practicum hours for nursing students. The government agency made this move to ensure the quality of Filipino nurses making them more competitive to the global arena. And most importantly, the government should allot more funds for health services, to accommodate nurses (Alave, 2008).

Not only should the growing unemployment rate be addressed but also the salary rate as well. Nurses are professionals but they cannot work unless they volunteer or pay a hospital a huge sum of money just to be trained. Then if they even get absorbed, the pay is just pesos away from the minimum limit. Moreover, nurses are not just professionals, they save lives. They should be treated with respect and be properly compensated like every other profession here in the Philippines. Furthermore, the family also affects the decision of students in making choices in life. Lorentzen, 2008) One of the decisions they make is centered on their future career in life. Since family members are the people most often encountered by the students, then it is a big factor to consider. Family, specifically the parents should support and know what their children want to be in the future, and where they extremely do well in order to have a more secured future. Filipinos, nowadays think that taking up Nursing is an easy and fast access to a better life. And so, parents are forcing their children to take up nursing, finding themselves in the end underemployed, and perhaps, unemployed.

Each Family should wake up to the reality that being a nurse is not just a profession; it’s more of a vocation, and compassion in rendering service is a necessity since nurses are handling lives. The Philippines is known to produce more nursing graduates, and have more nursing schools, compared to any other country in the world. From 17 schools during the period 1907 to 1950 that produced 7,286 registered nurses, the country in 1999, had 186 nursing schools (Opiniano, 2002) with the combined capability to produce over 20,000 RNs a year, according to the UP Manila Journal (January-March 2000 issue; Corcega et al).

According to this research, a huge difference in number of nursing schools is seen thus producing huge number of nurses per year. As previously mentioned, when Nursing became an in demand profession, people in the business community also saw an opportunity to establish nursing schools due to the increasing number of students who want to earn a degree in nursing. However, not all of these nursing schools provide the quality education needed in nursing. As a result, Nursing graduates from these schools get a lower probability to be employed.

While there are many nursing graduates, the success rate of the PRC nursing board exams has significantly decreased for the last 10 years (48% passing rate). In view of this, the Philippine Nurses Association (PNA) reiterated the need to focus on quality nursing education instead of commercializing the profession. In relation to the CHED’s order of closing incompetent schools, the remaining school should also implement policies that are stricter in order to screen deserving student nurses, particularly in their training of becoming the future nurses.

Nursing schools should set standards for the students to meet for them to be proficient nurses. Career decision making is a dynamic and ongoing process where your knowledge of self, your values, interests, temperament, financial needs, physical work requirements or limitations, etc. , the effects of past experiences, new information, and changes in your life situation and environment all intertwine. Each career decision is limited by what you are capable of now or in the future, by your ability to identify alternatives, and by what you are willing to do.

Taking up nursing, and deciding to make it as a future career is a great risk because nurses don’t handle any material things, they are handling lives. Some of the reasons why students choose nursing are: forced by parents, a misconception of sure ticket to United States, and lastly, to follow the trend. Choosing one’s future career is no joke. So, right decision-making should be taken into consideration for a more secured future. People should know one’s strengths and weaknesses to serve as throttlehold for the next chapters in life.

The Philippines continually produce more nurses than what the country needs, even more than the country can support. With all the current news regarding the decline in nursing demand and the continued increase of the number of unemployed and underemployed nursing graduates, if this condition is not properly controlled, this rate of unemployment/underemployment would, also, continue to persist. Not only does this count as a waste of time and money but the future of these students and the indirect effect to the country’s economy, isn’t beneficial at all.

It would also be considered as a waste of time for students and parents alike who were poorly compensated for their efforts to create a better future for their children. Now the big question is: What will become of these students who are currently affected by the decreased demand for nurses? Along with the currently unemployed, they would probably find themselves competing for high-pay jobs with other numerous unemployed nurses. Tough times are in store for future students after graduation, putting even more strain on the employment sector as it tries diligently to find employment for students.

Unless the government pays more attention to this concern and investigate and strictly implement the standards on each of the Nursing schools in the Philippines, only incompetent nurses would be produced, adding up to the growing number of unemployed nurses and graduates who are currently confronted with country’s grim unemployment and underemployment status.

References Bateman, J. M. , & Spruill, D. A. (1996). Student decision making: Insights from the college choice process. College Student Journal, 30, 182-186. Blanche, Julie. (2010, March 9). 10 reasons a nursing degree is a good bet in education today. Retrieved on September 4, 2010 from http://www. nurses-forum. com/blog/246/10-reasons-a-nursing-degree-is-a-good-bet-in-education-today/ Chrisholm, M. , French B. et al. (2010). Safety concerns of hospital-based new-to-practice registered nurses and their preceptors. The Journal of Continuing Education in Nursing, 41 (4), 163-171. Daly, M. , Byers, E. , & Taylor, W. (2004). Early years management in practice: A Handbook for early years managers. (pp. 69-70). Oxford: Heinemann Educational Publishers. Danna, D. , Jones, J. , Schaubhut, R. (2010). From practice to

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