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Nursing in the Philippines is provided by professionally trained nurses, who also provide a quarter of the world's overseas nurses. Every year, some 20,000 nurses work in other countries. [1] Nurses in the Philippines are licensed by the Professional Regulatory Commission. The advance of nursing in the Philippines as a career was pioneered by a culture of care that is intrinsic in the Filipino people. This began before Spanish colonization. [2]
Only a limited number of Filipino women received primary education in charitable institutions established by Spaniards, this trend continued during the Spanish colonial era. During the Philippine revolution, Filipino women also became the providers of care for wounded revolutionaries. During the American period in the Philippines, Filipino women were given the chance to become educated as nurses, guided by their American nurse and missionary mentors, until nursing became a full-pledged profession in the Philippines, a professional career not only for modern-day women in the country but also for men in the Philippines (as male nurses).
Early beliefs of health and illness in the Philippines were in conjunction with beliefs of mysticism and superstitions. [3] The cause of a disease was believed to be either another person, who was an enemy, or a witch, or evil spirits. Filipinos were careful not to upset other people or the evil spirits for the good of their health. These evil spirits could be driven away by people with the power to banish demons: priests or herb doctors. Filipinos who became sick were usually cared for by their female family members or friends in the home. [4]
People thought health was directly related to many superstitions and legends. Back then, there were no medical professionals but men known to practice magic and the supernatural. These herb men were known as “herbicheros.” Victims who suffered from unidentified illnesses were thought to be cursed by witches and wizards known as “mangkukulam/mangagaway.” Dangerous birthing and “pamao” were thought to come from “nunos”. While in labor, the “mabuting hilot” (good midwife) was usually present. If the birth became too dangerous, bad omens and evil sorcerers were thought to be the cause. Exploding gunpowder from a bamboo cane near the head of the person going through the suffering would usually get rid of the bad omen. [5]
During Spain's colonial rule (1521–1898) the Philippine education system offered distinct and unequal opportunities for Filipinos based on gender. An example of this sexism was allowing only limited numbers of women to receive primary education in Spanish charitable institutions. [4] Without an education women were unable to gain much knowledge or power. The knowledge of caring for others came from family members and personal experience with the sick. Nursing other individuals was seen as a task, not a job or a profession. During the Spanish regime many specialized hospitals were established to care for the Spanish king's soldiers and civilians. [3] To many elite Filipinos, the Spanish colonial hospitals were places where those who were not so fortunate to have homes, spent their last days until death. [4]
At the time of the Philippine Revolution many women transformed their homes into quarters to nurse Filipino soldiers and revolutionaries. [3] One of these women was Melchora Aquino, also known as the "mother of the Philippine Revolution". In her old age of about 80, Aquino was a supporter of the revolution by providing food and shelter to the revolutionists. She provided care for those who became sick or wounded. However, a few days after the revolution began, she was arrested by the Spaniards for providing care to the rebels. Because she did not reveal any information to the Spanish about the location of the rebel leader, Aquino was deported to Guam in the Marianas. After six years of exile, she was able to return in 1903, when the Philippines finally gained independence from the Americans. Aquino's work caring for the ill and the wounded during the revolution has brought comparisons to the British Florence Nightingale. Both these women cared for soldiers during war and paved the way for nursing practice. [6]
Although the Philippines had gained independence from Spain, the United States began to instill their power upon the islands, and a conflict broke out between the Filipinos and the Americans. This was the start of the Philippine–American War. The presence of Americans played a vital role in influencing the development of nursing into a profession. Nurses and missionaries from the United States came to act as nurse mentors for the Filipina women. Nursing education, like teaching and missionary work in the Philippines, provided white American women with a sense of purpose in the colony. [4] This influence then continued with the building of many hospitals where American nurses took charge and Filipino women began to learn under careful eyes.
An example of this was the development of the Iloilo Mission Hospital. [7] In 1901, through the efforts of Dr. and Mrs. Joseph A. Hall, missionaries of the Presbyterian Foreign Mission Board from the United States, a temporary bamboo clinic was erected at Calle Amparo (now Ledesma Street), Iloilo City, to serve as a venue for the treatment of health care to the very poor. This was made possible because Joseph Hall was a doctor and his wife was a nurse. Like other professions, nursing in the Philippines evolved only from the apprenticeship system.
This system laid the foundation upon which the Union Mission Hospital Training School for Nurses (now Central Philippine University College of Nursing) was built in 1906. Between the time that this school was built and the time that the Philippines gained their independence from US colonial rule in 1946, the nursing profession continued to grow with the development of more nursing schools and more Filipina women seeking to become nurses. [3] While taking advantage of these learning opportunities Filipinos began to learn more about the United States and the opportunities that the country could hold for them, such as extending their education and increased pay. This began the migration of nurses to the US. As individuals began travelling to and from the US, the stories they brought home began to spark the interest of others to follow. [8]
After World War II, when Manuel Roxas assumed the presidency of the Republic of the Philippines on July 4, 1946, it officially marked the end of the colonialism between the US and the Philippines. Like much of the rest of the world, the Philippine islands were in ruins and Roxas was determined to rebuild his country. He made it clear to his constituents that the new government was still going to rely heavily on US financial support in order to rehabilitate its national economy. Roxas’ first attempts to balance the Philippines' budget included collecting unpaid taxes, reducing expenses and promoting foreign trade, which would include the exportation of Filipino nurses. Already trained by Americans, Filipino nurses were the perfect candidates to assist the US and other countries experiencing post-World War II shortages. At the time in the Philippines there were also rumors of a nursing shortage; however, this was questionable, due to the expanding health programs, inefficient use of nurses' time and skills, and loss of qualified nurses to other countries. By the mid-1960s, Filipino nurses were entering the US by the thousands. [9] The benefit to the travelling nurses was that they were able to make nearly 20 times as much as they had earned back home. Part of this money would be sent back to their families as remittance, which would boost the Philippine economy. A negative effect of the high exportation rate was that the nurses were adding to their own country's nursing shortage problem. The Philippines also faced losing one of its greatest sources of social capital: educated workers. The negative effects were also seen in the US, as American salaries decreased because Philippine nurses who newly arrive would work the same job at a lower wage.
Many US states passed reforms in licensure for nurses. Decreased training mandates were created, as well as stricter adequacies for getting into a nursing institution. For instance, one prerequisite was at least one year of high school education. The idea of having students work in a more active role prior to seeing patients was a new idea that was beginning to pay off. [10]
In the Philippines, it was also the early 1900s when the first school for nursing was established. The program of study was still shattered and unclear. Only a few students were enrolled informally in this kind of education. A legislation or law was needed at the time, contributing to the establishment of the "First True Nursing Law" in 1919. [11] The Filipino Nurses Association was founded on September 2, 1922, which was later renamed to Filipino Nurses Association in 1966. [12]
The Philippines is the leader in exporting nurses to meet the demands of the United States and other developed nations. It has been argued, however, that the Philippines' persistent production of nurses for the global market is a state strategy to develop an export industry for economic development. Things such as immigration services and nursing licensing authorities encourage the production of nurses for export. [9]
Of all registered health practitioners, nurses are among the largest group, even though there are very few nursing positions or jobs available to them. Only 15-25% of jobs in the Philippines are provided for the nursing population. The remainder of the work force go on to seek out other professional career opportunities outside the country. Per year, the national government has approximately 18,000 nursing positions with an eventual turnover of 1,000 careers. The increase of Filipino nurses overseas has attracted the curiosity of other countries to better understand nursing in the Philippines and what makes Filipino nurses accommodating. [13]
The first two years of general education is grounded on liberal arts that strengthen the values and character of the person as a caregiver. The language of instruction in all local institutions is English. This prepares the student for licensure both locally and internationally. This also gives the nurses access to ever-growing literature in the health sciences. The community skills, competence and confidence in the use of English certainly contribute to healthcare in any setting. The curriculum also strengthens the students' capabilities to participate in research in nursing and other health sciences, provides flexibility in the openness to the use of new teaching approaches, and encourages active involvement in extension work that reaches out to the other sectors. [14] All registered nurses in the Philippines are required to have a bachelor's degree in nursing. [15]
The first pursuit to constitute the nursing practice was made by the Director of Health in 1913, but was not officially enacted upon by the Filipino legislature. In 1915, Act No. 2493 was made known; this amended Gov Ph Act 310 so nursing could be practiced. This law allowed "for the registration of graduate nurses under the Bureau of Health" (Philippines). Pre-qualifications were not mandatory in order to become an RN since nurses simply signed up. Each candidate, however, needed to be at least 20 years of age at the time of sign up, and be of adequate health and upstanding character. [16] A law that allowed the practice of nursing was reformed in April 1919. Act 2808, also known as "the First True Nursing Law", established the Board of Examiners for Nurses. The first board exam for nurses was given in 1920.
Today, nurses must acquire their degrees through a combination of competency-based and community-oriented courses. The Philippine curriculum has several advantages compared with those of other Asia Pacific Economic Cooperation (APEC) institutions. This kind of education offers much more than a solely skill-based curriculum can (Rogado 229). The four-year requirement to earn a bachelor's degree in nursing meets the minimum entry requirement for professional nursing practice. [17]
The Professional Regulation Commission (PRC) oversees the licensing of registered nurses as authorized by the Philippine Nursing Act of 2002.
The Professional Regulatory Nursing Board implements and enforces the Nursing Act. The board is composed of a chairperson and six additional members, all of whom are nurses with at least a master's degree and ten years of nursing experience. The board inspects nursing schools, conducts licensure examinations, issues and monitors certificates of licensure, promulgates a code of ethics, participates in recognizing nursing specialty organizations, and prescribes guidelines and regulations governing the profession under the Nursing Act.
In 2009, the Commission on Higher Education of the Philippines released a report showing the top 20 nursing schools in the country, based on the average passing rates on nursing board examinations. The top 20 nursing schools in the Philippines with 1000 or more examinees are the following:
For schools with 100 to 999 exam takers, the following are the top 20 nursing schools in the Philippines
Only three schools had a 100% passing rate (with 10 or more examinees) from November 2009 to July 2011: University of the Philippines Manila, Philippine Christian University, and Negros Oriental State University. [20]
A registered nurse (RN) is a nurse who has graduated or successfully passed a nursing program from a recognized nursing school and met the requirements outlined by a country, state, province or similar government-authorized licensing body to obtain a nursing license. An RN's scope of practice is determined by legislation, and is regulated by a professional body or council.
The Convention of Philippine Baptist Churches (CPBC) is a Baptist Christian denomination in the Philippines. It is affiliated with the Baptist World Alliance and is headquartered in Jaro, Iloilo City. CPBC was founded in 1900 as the oldest and first organized union of Baptist churches in the Philippines. This occurred after the country opened to Protestant American missions in 1898, following Spain's transfer of the Philippine islands to the United States.
Iloilo City, officially the City of Iloilo, is a 1st class highly urbanized city in the Western Visayas region of the Philippines, located on the southeastern coast of the island of Panay. It is the capital city of the province of Iloilo, where it is geographically situated and grouped under the Philippine Statistics Authority, but remains politically independent in terms of government and administration. In addition, it is the center of the Iloilo–Guimaras Metropolitan Area, as well as the regional center and primate city of the Western Visayas region. According to the 2020 census, Iloilo City has a population of 457,626 people. For the metropolitan area, the total population is 1,007,945 people.
The University of the Philippines Manila is a public, coeducational, research university located in Ermita, Manila, Philippines. It is known for being the country's center of excellence in the health sciences, including health professional education, training, and research. It is the oldest of eight constituent universities of the University of the Philippines System, and predates the founding of UP by three years. It was originally established on December 1, 1905, as the Philippine Medical School and later renamed as the UP College of Medicine and Surgery on June 10, 1907. In 1983 it was renamed as University of the Philippines Manila.
Central Philippine University is a private research university located in Jaro, Iloilo City, Philippines. Established in 1905 through the benevolent grant of the American industrialist and philanthropist John D. Rockefeller as the Jaro Industrial School and Bible School under the supervision of the American Baptist Foreign Mission Society, it is the first Baptist and second-American founded university in the Philippines and Asia.
West Visayas State University is a public normal research university located in La Paz, Iloilo City, Western Visayas region of the Philippines. It was established in 1924 as Iloilo Normal School under the tutelage of the Thomasites, but dates back its founding in 1902 as a part of Philippine normal school system with Iloilo National High School established by the American colonial government. It later became West Visayas State College in 1965 and acquired its university status becoming West Visayas State University in 1986.
Jaro is a district in Iloilo City, Philippines, located on Panay Island in the Western Visayas region. It is the largest district in terms of both area and population, with 130,700 people according to the 2020 census. Jaro merged with Iloilo City in the 1940s during the American administration in the Philippines. It is also the largest among the seven districts of Iloilo City. La Paz district and the present municipalities of Leganes and Pavia were historically part of Jaro before becoming independent.
Nursing in the United States is a professional health care occupation. It is the largest such occupation, employing millions of certified professionals. As of 2023, 3,175,390 registered nurses were employed, paid a median income of $86,070.
A nursing shortage occurs when the demand for nursing professionals, such as Registered Nurses (RNs), exceeds the supply locally—within a healthcare facility—nationally or globally. It can be measured, for instance, when the nurse-to-patient ratio, the nurse-to-population ratio, the number of job openings necessitates a higher number of nurses than currently available, or the current number of nurses is above a certain age where retirement becomes an option and plays a factor in staffing making the workforce in a higher need of nurses. The nursing shortage is global according to 2022 World Health Organization fact sheet.
Trinity University of Asia, also known as TUA or simply Trinity, is a non-sectarian private university located in Quezon City, Philippines. It was named after Trinity College (Connecticut) whose president then was the founder's father. Formally established in 1963 as an elementary, high school and collegiate educational institution by the Protestant Episcopalians, it dates back its earliest establishment in 1907 when the Trinity University of Asia - St. Luke's College of Nursing, its oldest organic academic unit, was established under the St. Luke's Hospital, the present day St. Luke's Medical Center. It later acquired its university status on July 18, 2006.
The University of the Philippines Manila College of Medicine (CM) is the medical school of the University of the Philippines Manila, the oldest constituent university of the University of the Philippines System. Its establishment in 1905 antedates the foundation of the UP System and makes it one of the oldest medical schools in the country. The Philippine General Hospital, the national university hospital, serves as its teaching hospital.
Nursing is a health care profession that "integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence". Nurses practice in many specialties with varying levels of certification and responsibility. Nurses comprise the largest component of most healthcare environments. Shortages of qualified nurses are found in many countries.
Health professional requisites refer to the regulations used by countries to control the quality of health workers practicing in their jurisdictions and to control the size of the health labour market. They include licensure, certification and proof of minimum training for regulated health professions.
Saint Paul University Iloilo, also referred to by its acronym SPUI or SPU Iloilo, St. Paul, St. Paul's, is a private Catholic basic and higher education institution run by the Philippine Province of the Congregation of the Sisters of Saint Paul of Chartres in Iloilo City, Iloilo, Philippines. It is one of the six campuses comprising the Saint Paul University System. It was founded in 1946 by the Sisters of Saint Paul of Chartres from France with the help of American Catholics. It presently offers academic programs in basic education, tertiary and post-graduate studies in the fields of information technology, teacher education, business, accountancy, liberal studies, nursing, and physical therapy.
The Iloilo Mission Hospital, referred to as CPU–IMH, IMH, or Mission, is a private tertiary, academic, teaching hospital in Jaro, Iloilo City, Philippines, managed and operated as the university hospital of Central Philippine University. It was established in 1901 by American missionary doctor Joseph Andrew Hall as "the first Protestant and American-founded hospital in the country".
The Central Philippine University College of Medicine, also referred to as CPU COM, CPU College of Medicine, CPU ColMed or CPU Medicine, is the medical school of Central Philippine University, a private university in Iloilo City, Philippines. Established in 2002 and opened in 2003 with its first dean, Dr. Glenn A. M. Catedral, it is one of the youngest colleges and academic units of the university.
The history of physical therapy in the Philippines relates how physical therapy started in the Philippines and how it evolved as a profession through three significant phases in the history of the Philippines: from the American era leading to the Japanese occupation of the islands during World War II, and up to the modern-day time period of the independent Philippine Republics. It was introduced in the Philippines ahead of rehabilitation medicine.
The history of nursing in the United States focuses on the professionalization of Nursing in the United States since the Civil War.
The Central Philippine University College of Nursing, also known as CPU CON or CPU College of Nursing, is a department within Central Philippine University, a private university in Iloilo City, Philippines. It was established in 1906 as the Union Mission Hospital Training School for Nurses as the first nursing school in the Philippines.
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