History of Filipino nurses in the United States

Last updated

Since the 1890s, the United States has periodically relied upon Filipino nurses to help meet the needs of the healthcare system. [1] This collaboration has been a significant contributor to the migration of Filipinos to the U.S., as Filipino citizens increasingly had personal connections in America. Since 1960, more than 150,000 nurses have migrated from the Philippines. [2]

Contents

Early history (1898–1930)

After the Spanish–American War (1898), the U.S. acquired control over the Philippines and conferred U.S. national status upon the islands' population. The U.S. Army trained and recruited Filipinos as Volunteer Auxiliary and Contract Nurses to serve in the Philippines, focusing on tropical diseases. [3] The hospitals founded served two U.S. interests: treating their soldiers and exporting Western "civilized" culture to the Philippines. [2] Several nurses were sent to San Francisco and New York City for further training and employment. In 1907, formalized nursing education patterned on the U.S. curriculum was established in the Philippines to train nurses there. A shortage of nurses was increasingly urgent due to the epidemics of tuberculosis, typhoid and other communicable disease and the start of World War I. The Pensionado Act (1903) established and legislated a formalized framework to send Filipino pensionados (government subsidized scholars) to the United States for further education and training. Some stayed in the U.S. for employment. A continuous influx of Filipino nurses worked in New York City, and helped to meet to the demands of healthcare at that time. The Philippine Nurses Association – New York was established in 1928 by the Filipino nurses with the goals of promoting cultural understanding and streamlining professional guidance to other Filipino nurses. The first president was Marta Ubana, who completed her Bachelor of Science in Teachers College, Columbia University. [4]

1940s-1970s

Exchange Visitor Program

In 1948, Congress passed the Smith-Mundt Act, which created the Exchange Visitor Program. [5] The program allowed students and skilled workers to stay in the U.S. for a two-year period to promote cultural exchange. [6] While the program was largely intended to counteract propaganda disseminated by the Soviet Union at the outset of the Cold War, it came at a time when the U.S. had again found itself in the midst of a postwar nursing shortage. Hospitals quickly began sponsoring Filipino women who had been trained in U.S.-style nursing programs abroad. [2] [7] For this reason, despite being open to all countries, the EVP induced a wave of Filipino migration. [7] By the late 1960s, Filipino applicants, the vast majority of whom were nurses, made up 80% of participants in the program. [8]

Immigration and Nationality Act

In 1965, Congress passed the Immigration and Nationality Act, which made it easier for Filipino nurses to petition to stay in the U.S. permanently. In addition, hospitals had caught on to the fact that many of their nurses came from the Philippines and started actively recruiting women to come. [7] The Act had a provision which created a visa for skilled laborers. As a result, nurses could now not only come permanently, but bring their families as well. This brought a wave of immigrants from the Philippines, some of whom may have been taking advantage of the program. In the years immediately after the passage of the INA, board exam passing rates for nurses from the Philippines were very low, leading to the establishment of the Commission on Graduates of Foreign Nursing Schools. [9]

The same year that the INA was passed, Medicare and Medicaid were also created, making healthcare more accessible for millions of Americans who had limited access. Nineteen million Americans enrolled in the programs' first year. [10] The demand for healthcare workers in the U.S. once more outpaced its supply.

Ferdinand Marcos, the president of the Philippines from 1966-1986, saw the emigration of nurses as a potential solution to a domestic economic crisis. The country was struggling with high rates of unemployment. Nurses living abroad decreased the amount of competition within the job market. [11] Wages were also drastically lower in the Philippines than the U.S.; during the 1970s, a nurse in the Philippines would have to work nearly 12 years to make the equivalent of one year's salary for a Filipino nurses in the U.S., creating a very powerful incentive to emigrate. [12] Further, many nurses continued to send money home to family overseas, which Marcos hoped might stimulate the economy. Marcos actively encouraged the emigration of nurses as a means to stabilize the economy. This temporary effort became formalized as a program to encourage the export of nurses. [8] While the program was intended to be a temporary, it became deeply embedded in the nation's economy and did not end until 2022. In 2005, 85% of the Philippine's nurses were employed internationally. [13]

1980s-Present

AIDS Crisis

During the 1980s, HIV/AIDS was discovered, first becoming apparent in the metropolitan centers and then widening to a nationwide crisis. The disease was initially thought to be unique to men who have sex with men, with the earliest reports of AIDS-related Kaposi's Sarcoma being described as a "gay cancer." [14] While this was quickly proven untrue, the idea of HIV/AIDS as a "gay disease" remained prominent. This contributed to the stigma against the disease and people affected by it. This association, combined with the initial lack of understanding as to how the virus was transmitted and the fear that that caused, led to the refusal by many medical professionals to treat people with AIDS. [15] In 1986, the American Medical Association released guidelines allowing physicians who were "emotionally unable" to care for AIDS patients to refer them to another clinician. [16]

The shortage of willing medical staff led to another influx of migration from the Philippines. In fact, the Filipino population of the United States doubled between 1980 and 1990. [17]

Nursing Relief Act of 1989

In 1989, in recognition of the large wave of Filipino nurses throughout the AIDS crisis, Congress passed the Nursing Relief Act. The Act granted special immigrant status to nurses, which allowed them to apply for green cards, and did not set a limit on the number of visas that could be issued under the program. This allowed many nurses who may have had to leave their families behind to bring them to the U.S. This bill had strong backing from the government of the Philippines, which hoped that nurses might send money back home and stimulate the economy. [17]

COVID-19 Pandemic

The high influx of patients in hospitals and intensive care units during the COVID-19 pandemic was a strain on healthcare systems globally, though it had a particular impact on Filipino nurses in the U.S. Despite making up only 4% of the nation's registered nurses, 25% of deaths among RNs during the pandemic were Filipino. The reasons for this are multiple: Filipino nurses are more likely to work in ICUs and bedside roles than their white counterparts. [18] [2] Further, rates of diabetes and hypertension, which increase one's risk of severe illness from COVID-19, are higher among the Filipino population. [19] There were widespread shortages of PPE during the early pandemic, which elevated the risk to healthcare providers in general, but deaths were disproportionately increased among Filipino nurses due to these risk factors. In California, a state with an especially high proportion of Filipino nurses, Governor Gavin Newsom's mandate to increase the number of patients assigned to each nurse compounded these issues. [20]

Treatment and labor conditions

While nurses are paid far higher in the U.S. than in the Philippines, they have nonetheless been subjected to exploitative practices.

Filipino nurses have, at times, been targeted by aggressive recruiting campaigns that were often deceptive about what benefits they could offer. In the 1980s, the Filipina Nurses Organizing Project (FNOP) partnered with the Philippine Center for Immigrant Rights to pursue legal action against Philippine Overseas Employment Agency, which licensed recruiters who falsely promised nurses green cards and living accommodations. One in the U.S., the recruiters took heavy cuts of nurses' pay, confiscated their passports, and provided inadequate living space, sometimes assigning as many as eight nurses to a single studio apartment. The organizations were successful in having these dishonest recruiters stripped of their certification with the Filipino government. [21]

In the 1980s and 1990s, FNOP was key is lobbying for a number of labor protections for Filipino nurses, including hospital-sponsored H1-B visas, improved living conditions, and equal pay with nonimmigrant workers. [21]

In 2019, 200 Filipino nurses successfully sued a group of New York nursing homes for human trafficking. Nurses were lied to about working conditions, paid less than the amount stated in their contracts, and provided inadquate staff. [2]

See also

Related Research Articles

<span class="mw-page-title-main">Human capital flight</span> Emigration of highly skilled or well-educated individuals

Human capital flight is the emigration or immigration of individuals who have received advanced training at home. The net benefits of human capital flight for the receiving country are sometimes referred to as a "brain gain" whereas the net costs for the sending country are sometimes referred to as a "brain drain". In occupations with a surplus of graduates, immigration of foreign-trained professionals can aggravate the underemployment of domestic graduates, whereas emigration from an area with a surplus of trained people leads to better opportunities for those remaining. But emigration may cause problems for the home country if the trained people are in short supply there.

The American Nurses Association (ANA) is a 501(c)(6) professional organization to advance and protect the profession of nursing. It started in 1896 as the Nurses Associated Alumnae and was renamed the American Nurses Association in 1911. It is based in Silver Spring, Maryland and Jennifer Mensik Kennedy is the current president.

<span class="mw-page-title-main">Overseas Filipinos</span> Filipino diaspora

An Overseas Filipino also known as Balikbayan is a person of full or partial Filipino origin who trace their ancestry back to the Philippines but are living and working outside of the country. They get jobs in countries and they move to live in countries that they get jobs in. This term generally applies to both people of Filipino ancestry and citizens abroad. As of 2019, there were over 12 million Filipinos overseas.

<span class="mw-page-title-main">SUNY Downstate Medical Center</span> Hospital in New York City, United States

SUNY Downstate Health Sciences University is a public medical school and hospital in Brooklyn, New York. It is the southernmost member of the State University of New York (SUNY) system and the only academic medical center for health education, research, and patient care serving Brooklyn's 2.5 million residents. It is the only state-run hospital in New York City. As of Fall 2018, it had a total student body of 1,846 and approximately 8,000 faculty and staff.

<span class="mw-page-title-main">Nurse practitioner</span> Mid-level medical provider

A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, prescribe medications and formulate treatment plans. NP training covers basic disease prevention, coordination of care, and health promotion.

Travel nursing is a nursing assignment concept that developed in response to the nursing shortage in the United States in the 1970s. This business supplies nurses who travel to work in temporary nursing positions, mostly in hospitals. While travel nursing historically refers specifically to the nursing profession, it can also be used as a blanket term to refer to nursing and allied health professionals, physicians, advanced practice nurses, physician assistants, dentists and other support staff including certified nursing assistants.

The Ann Arbor Hospital murders were the murders of 10 patients by unauthorized administration in their IV of the curare drug Pavulon in an Ann Arbor, Michigan, VA hospital in 1975. After a vast FBI investigation into the deaths, the nurses Filipina Narciso and Leonora Perez were charged with murder but convicted only for the charges of poisoning and conspiracy. Public opinion was against prosecution of the nurses on the basis that they could have had only the most trivial of possible motives for conspiring to commit such extremely serious crimes, and the case was dropped after a retrial had been ordered.

<span class="mw-page-title-main">Nursing shortage</span> Overview of global nursing shortages

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.

Filipino Austrians are Austrians of full or partial Filipino descent and are part of the so-called Overseas Filipinos. When excluding Afghan, Iraqi and Syrian refugees, Filipinos make up the fourth largest group of Asians within Austria, behind Iranian, Chinese and Indian people and form the largest Southeast-Asian community in the country. The majority of them live in Vienna, the capital of Austria.

<span class="mw-page-title-main">Nursing</span> Health care profession

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.

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. 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.

In South Africa, private and public health systems exist in parallel. The public system serves the vast majority of the population. Authority and service delivery are divided between the national Department of Health, provincial health departments, and municipal health departments.

<span class="mw-page-title-main">Iloilo Mission Hospital</span> Private hospital in Iloilo City, Philippines

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".

<span class="mw-page-title-main">History of Filipino Americans</span> Overview of the history of Filipino Americans

The history of Filipino Americans begins in the 16th century when Filipinos first arrived in what is now the United States. The first Filipinos came to what is now the United States due to the Philippines being part of New Spain. Until the 19th century, the Philippines continued to be geographically isolated from the rest of New Spain in the Americas but maintained regular communication across the Pacific Ocean via the Manila galleon. Filipino seamen in the Americas settled in Louisiana, and Alta California, beginning in the 18th century. By the 19th century, Filipinos were living in the United States, fighting in the Battle of New Orleans and the American Civil War, with the first Filipino becoming a naturalized citizen of the United States before its end. In the final years of the 19th century, the United States went to war with Spain, ultimately annexing the Philippine Islands from Spain. Due to this, the history of the Philippines merged with that of the United States, beginning with the three-year-long Philippine–American War (1899–1902), which resulted in the defeat of the First Philippine Republic, and the attempted Americanization of the Philippines.

<span class="mw-page-title-main">Demographics of Filipino Americans</span> Overview of the demographics of Filipino Americans

The demographics of Filipino Americans describe a heterogeneous group of people in the United States who trace their ancestry to the Philippines. As of the 2020 Census, there were 4.4 million Filipino Americans, including Multiracial Americans who were part Filipino living in the US. Filipino Americans constitute the third-largest population of Asian Americans, and the largest population of Overseas Filipinos.

<span class="mw-page-title-main">History of nursing in the United States</span> Professionalization of nursing since the Civil War

The history of nursing in the United States focuses on the professionalization of Nursing in the United States since the Civil War.

<span class="mw-page-title-main">Central Philippine University – College of Nursing</span> Nursing school at Central Philippine University


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.

The Pensionado Act is Act Number 854 of the Philippine Commission, which passed on 26 August 1903. Passed by the United States Congress, it established a scholarship program for Filipinos to attend school in the United States. The program has roots in pacification efforts following the Philippine–American War. It hoped to prepare the Philippines for self-governance and present a positive image of Filipinos to the rest of the United States. Students of this scholarship program were known as pensionados.

<span class="mw-page-title-main">Impact of the COVID-19 pandemic on hospitals</span> Consequences of COVID-19 pandemic for hospitals

The COVID-19 pandemic has impacted hospitals around the world. Many hospitals have scaled back or postponed non-emergency care. This has medical consequences for the people served by the hospitals, and it has financial consequences for the hospitals. Health and social systems across the globe are struggling to cope. The situation is especially challenging in humanitarian, fragile and low-income country contexts, where health and social systems are already weak. Health facilities in many places are closing or limiting services. Services to provide sexual and reproductive health care risk being sidelined, which will lead to higher maternal mortality and morbidity. The pandemic also resulted in the imposition of COVID-19 vaccine mandates in places such as California and New York for all public workers, including hospital staff.

Mary Goretti Boland, MSN, RN, FAAN is a Pediatric Nurse and Doctor of Public Health, and a Fellow of the American Academy of Nursing. She is nationally known for her work developing innovative healthcare programs for underserved children with HIV/AIDS and other chronic diseases. In 1978, Boland staffed an innovative mobile health screening van for the Ironbound Community Health Project in Newark, New Jersey. She became director of the AIDS program at Children's Hospital of New Jersey and served as the coordinator for the Children's AIDS program (CHAP) at United Hospitals Medical Center in Newark. She served on the AIDS Advisory Committee in New Jersey and the National AIDS Advisory Committee. The United States Department of Health and Human Services gave her an award for her work in pediatric AIDS/HIV treatment.

References

  1. ↑ "Filipino and Filipino American Nurses in the United States | School of Nursing" . Retrieved 2024-03-07.
  2. 1 2 3 4 5 "How Filipino Nurses Have Propped Up America's Medical System". TIME. 2021-05-30. Retrieved 2024-03-07.
  3. ↑ "Filipino Nurses in the U.S."
  4. ↑ "US nursing shortage may again spur recruitment from PH". 2 November 2017.
  5. ↑ "Background of Exchange Vistor Program in the Philippines - Exchange Visitors Program of the Philippines". www.evpcommittee.ph. Retrieved 2024-03-07.
  6. ↑ "Chapter 1 - Purpose and Background | USCIS". www.uscis.gov. 2023-06-08. Retrieved 2024-03-07.
  7. 1 2 3 "Why are there so many Filipino nurses in the U.S.?". Berkeley. 2022. Retrieved 2024-03-07.
  8. 1 2 Masselink, Leah E.; Shoou-Yih, Daniel Lee (March 21, 2012). "Government officials' representation of nurses and migration in the Philippines". Health Policy and Planning. 28 (1): 90–99. doi:10.1093/heapol/czs028. PMID   22437505 . Retrieved 2024-03-08.
  9. ↑ "Filipino Nurses Working in the U.S." www.conexusmedstaff.com. Retrieved 2024-03-08.
  10. ↑ "A brief history of Medicare in America". medicareresources.org. 2022-12-01. Retrieved 2024-03-08.
  11. ↑ O'Neil, Kevin (2004-01-01). "Labor Export as Government Policy: The Case of the Philippines".
  12. ↑ Choy |, Catherine Ceniza (2019-09-30). "Why Are There So Many Filipino Nurses in California? | Essay". Zócalo Public Square. Retrieved 2024-06-29.
  13. ↑ Masselink, Leah E.; Shoou-Yih, Daniel Lee (2010-07-01). "Nurses, Inc.: Expansion and commercialization of nursing education in the Philippines". Social Science & Medicine. 71 (1): 166–172. doi:10.1016/j.socscimed.2009.11.043. PMID   20399550.
  14. ↑ Wright, Joe (8 May 2006). "Remembering the Early Days of 'Gay Cancer'". NPR. Retrieved 7 June 2024.
  15. ↑ "Immigrant Nurses".
  16. ↑ Freedman, B. (1988). "Health professions, codes, and the right to refuse HIV-infectious patients". The Hastings Center Report. 18 (2): S20-5. doi:10.2307/3562422. JSTOR   3562422. PMID   11650067.
  17. 1 2 Women & the American Story (2021). "Immigrant Nurses". New York Historical Society. Retrieved 13 June 2024.
  18. ↑ Nazareno, Jennifer; Yoshioka, Emily; Adia, Alexander C; Restar, Arjee; Operario, Don; Choy, Catherine Ceniza (July 2021). "From imperialism to inpatient care: Work differences of Filipino and White registered nurses in the United States and implications for COVID‐19 through an intersectional lens". Gender, Work & Organization. 28 (4): 1426–1446. doi:10.1111/gwao.12657. ISSN   0968-6673. PMC   8251240 . PMID   34230784.
  19. ↑ "Filipino American nurses, reflecting on disproportionate Covid toll, look ahead". NBC News. 2021-06-04. Retrieved 2024-06-29.
  20. ↑ Stefanian • •, Claudette (2020-12-22). "Hospital Staff Overwhelmed as Southern California ICU Capacity at 0%". NBC 7 San Diego. Retrieved 2024-06-29.
  21. 1 2 "Filipinos on the Frontlines: Our Bodies Are Not Disposable". Plan A Mag. 2020-05-04. Retrieved 2024-06-29.

Further reading

This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.