PNA pushes for higher nurses' pay, opposes hiring of unlicensed aids

The Manila Times

PNA pushes for higher nurses' pay, opposes hiring of unlicensed aids  Philippine Nurses Association (PNA) President Elmer Bondoc is pushing for the inclusive implementation of salary grade 15 for all nurses both in the public and private sectors, as well as provincial health workers. He and his group also oppose the hiring of unlicensed healthcare aids amid the shortage saying that it could lead to liabilities and malpractice in the healthcare sector.   Video and interview by Ezrah Raya  Subscribe to The Manila Times Channel - https://tmt.ph/YTSubscribe  Visit our website at https://www.manilatimes.net    Follow us:  Facebook - https://tmt.ph/facebook  Instagram - https://tmt.ph/instagram  Twitter - https://tmt.ph/twitter  DailyMotion - https://tmt.ph/dailymotion    Subscribe to our Digital Edition - https://tmt.ph/digital    Check out our Podcasts:  Spotify - https://tmt.ph/spotify  Apple Podcasts - https://tmt.ph/applepodcasts  Amazon Music - https://tmt.ph/amazonmusic  Deezer: https://tmt.ph/deezer  Tune In: https://tmt.ph/tunein   #TheManilaTimes  #exclusiveinterview  #nurse

Transcript

00:00 I'm Ezra Araya and this is the Manila Times.

00:03 The Philippines, known for exporting nurses and health care workers worldwide, have been

00:09 facing a shortage in nurses within its health care sector.

00:14 Groups say the government failed to address the root cause of the shortage and have resulted

00:18 to a band-aid solution to the problem.

00:21 Recently, President Bumbu Marcos, along with the private sector advisory council, announced

00:26 that around 300 CCAs, or clinical care associates, had been hired in various hospitals nationwide

00:34 to address the shortage.

00:35 CCAs are unlicensed health workers or those yet to pass the nursing board exams.

00:42 The health department partnered with CHED to pave the way for the entry of CCAs into

00:47 the health care system, as well as a nursing review program.

00:51 This year, around 500,000 nurses renewed their licenses with the PRC, more than enough to

00:58 fill the estimated shortage.

01:00 However, insufficiency persists.

01:04 Nursing groups in the country have been urging the government to make a genuine investment

01:09 in the nursing sector.

01:11 Here with us is Philippine Nurses Association PNA President, Dr. Elmer Bondo.

01:19 Welcome to the Manila Times, sir.

01:20 So first off, tell us what is the current state of Filipino nurses in the Philippines?

01:27 Are we better or for worse?

01:28 Over the years we have been receiving, we have been facing a lot of challenges.

01:32 While we are known as the country that produces a significant number of skilled nurses, often

01:37 who are seeking employment outside of the country, we have to also ask the question,

01:42 what would be the reason by which these nurses whom we produce every year, which is said

01:47 to be higher in number of volume, are said to be leaving the country?

01:51 That in itself would actually answer the question, the Filipino nurses in the Philippines is

01:55 not that well because of the fact that Filipino nurses choose not to stay in the Philippines

02:01 because they actually find better opportunities outside of the country, not only for themselves

02:05 but also for their family.

02:06 And for that alone, we cannot actually compel or request a Filipino nurse with such a degree

02:12 to actually not be tempted to the invites of the other countries for them to actually

02:17 settle in because of the better working conditions, better salary, better pace, and better benefits

02:23 also not for themselves alone but also for their family.

02:25 Because when nurses leave the country, there's also a promise of having the opportunity of

02:31 bringing with them the whole family to their workplaces, to the host country where their

02:37 work is said to be situated.

02:39 And there, by that in itself, it's very enticing for the Filipino nurse to actually get into.

02:45 Extending that question and answer, if you may allow me, the state of Philippine nursing

02:49 I have discussed, in return, when the number of healthcare providers, particularly nurses,

02:54 are said to be decreasing in number, the ones who are actually suffering are the sector

02:59 of the community na nangaylangan ng tagapangalaga, which are basically the patients.

03:03 So if our numbers are to be decreasing by the thousands, we're also robbing the opportunity

03:09 for every Filipino people to receive the best amount of care to be given by the Filipino

03:14 nurse.

03:15 Because the reason by which other countries are very fond and expect that Filipino nurses

03:21 will be actually moving into their countries is because of the ability of a Filipino nurse

03:27 to actually take good care of patients very well.

03:30 And we are actually robbing the Filipino people of that skill and services that our Filipino

03:35 nurses can actually offer because of the problems that are said to be not resolved from then

03:40 to present.

03:41 That's what you've said, sir.

03:42 We have no shortages of nurses.

03:45 In fact, it's just that more nurses are going out of the country.

03:49 And it seems that the Philippines is not the only ones needing nurses.

03:52 There are other countries as well in the Western Hemisphere who could pay better and could

03:58 offer them better.

04:00 So sir, can you give us an update?

04:03 Since I know that there's a current shortage in the nurses, and I know the very few nurses

04:09 na natitira or that are left in the Philippine hospitals are in dire working conditions,

04:17 as I've heard.

04:18 So tell us, sir, has the working conditions improved?

04:22 And how about the monthly salaries of both private and public nurses?

04:27 Let us qualify first the concept of salaries.

04:32 There is what we call a great disparity of the salaries received by the nurses working

04:37 in private and those who are working in public or government hospitals.

04:42 More so, Ezra, we have to also qualify the fact that there is also a great disparity

04:46 of salary that is said to be given to nurses working in two types of government facilities.

04:52 One is retained and the other one is said to be operated by the local government unit

04:57 or that of the provincial government.

04:59 So that's one.

05:00 The disparity between the salary grade of a nurse working in government facilities and

05:05 that of a private hospital is too wide.

05:09 To date, there are still nurses who are receiving as low as P8,000.

05:15 That's roughly P16,000 a month.

05:17 That's basically not sufficient to actually support oneself, not yet the family, but oneself

05:23 in terms of his or her daily living allowances.

05:27 So that's the disparity between government and that of the private institutions.

05:31 Which one is higher?

05:33 Is that the salary of the public or the private nurse?

05:37 The salary of the government, of course.

05:39 Government.

05:40 However, if we're going to look at the government, those that are said to be due age retained

05:47 and those that are said to be operated and actually the funds are dependent on the provincial

05:51 government and the local government units, the due age retained is higher.

05:56 Because in our Republic Act 9173 or the Philippine Nursing Act of 2002, what is inscribed in there

06:02 is supposed to be every Filipino nurse supposed to be receiving a salary grade of P15,000

06:08 is roughly P35,000.

06:10 However, when we actually lobbied for this years back, only in 2019 that we actually

06:16 won the battle, but we were only able to successfully have the SG15 be implemented among nurses

06:22 working in due age retained hospitals.

06:25 That being said, if we're going to compare those that are said to be working in private

06:29 hospitals, LGU and provincially operated hospitals are not receiving SG15 and therefore, that's

06:36 the disparity that I'm actually telling you a while back.

06:40 If we're going to look at the time from 2002 to 2024, SG15 is said to be not enough

06:46 anymore.

06:47 If we're going to check the inflation rate year after year, 35,000 for a family, for

06:54 a nurse with a family is also insufficient.

06:57 That is why what we are asking government is actually to help us to have what we call

07:01 an inclusive implementation of the salary grade.

07:05 Good thing about this interview is the fact that I have received yesterday the response

07:12 of the Malacanang Palace through the Department of Health about our position papers that we

07:19 sent the office of the president last year by September.

07:22 Yesterday we have received the discussion of the Department of Health and said that

07:27 they cannot actually ask the LGU to actually regulate that of the hospitals operated by

07:35 the LGU and the provincial government because they are said to be dependent on how much

07:39 money they actually produce every year in their budgetary requirements.

07:44 However, if we're going to argue that particular note, health is said to be something very

07:50 essential because if the Filipino people, particularly that of the citizens, are said

07:55 to be very sick without any carers, the citizens will actually die and the society will actually

07:59 not flourish.

08:00 That's one of the arguments that we're always telling government that if and when that the

08:05 CILG cannot actually compel because of the ruling that local government actually have

08:11 their own means of generating their own income, there must actually be what we call a policy

08:17 coming from national government to actually compel the local government to always find

08:22 means to actually jack up the amount of budget they actually provide for healthcare.

08:27 To date, the problem in terms of the working conditions of the nurses working in government

08:32 hospitals is the fact that they don't have a plan, they are still higher than the nurses

08:37 working in government hospitals who are said to be working on a contractual basis or that

08:42 of a suborder position in which salary is not given on time, on the dot, normally a

08:48 month, two months, or three months delay.

08:50 So to go back to your question, does the working condition of the Philippine nurses change?

08:54 It actually did not because it is the same problem we actually have faced before, even

08:59 before, months prior to the pandemic, during the pandemic, and actually right after the

09:04 pandemic.

09:05 What is really quite saddening is the fact that during the pandemic, we were given so

09:09 much of a promise, promises to actually support the causes of the nurses of the Philippines.

09:14 Kaya lang, to date, when we look back, we were then tagged as the heroes of the pandemic,

09:21 given promises to actually be at the front lines all the time because during that time,

09:25 we were very essential as part of the society.

09:27 Pero ngayon, ni Phil has told us that we are again being sidestepped because of the realities

09:32 that what we desire for our colleagues who are working at the hospital, government is

09:39 seemingly not providing adequate solutions for the problems that are said to be besetting

09:44 nursing from then to present.

09:46 What we hear from last year to present are solutions that in our organization, the PNA,

09:52 we call band-aid solutions.

09:53 Going there, sir, I know now that you've mentioned it.

09:56 Recently, there's been around hundreds were hired as CCAs or clinical care associates.

10:04 These are clinical care associates.

10:07 They're unlicensed as far as we're concerned, and they are yet to pass the board exam, meaning

10:14 they eventually will.

10:15 Do you agree with the hiring of these unlicensed healthcare workers?

10:22 You have a term that you call them.

10:24 Yeah, we call them clinical care associates.

10:26 Yes.

10:27 That's a term coined by the government, particularly that of the joint administrative order between

10:35 SED and that of DOH that was signed last year.

10:39 The first signing was in July, but there was ceremonial signing that was held last November

10:42 2023 also.

10:43 Actually, Lamu Ezra, if you're going to look back at the history of such a particular proposal,

10:50 it all started with a proclamation by DOH sometime in June last year that DOH is going

10:55 to issue a temporary license to those who did not pass the board exams, particularly

11:00 those who got 74.

11:02 We did not expect that that was a prelude actually to the clinical associates because

11:06 at that time, when we actually were able to block that proposal because as current in

11:13 our Republic Act for nursing in the Philippines, we cannot provide temporary licenses to those

11:20 who are said to be on their boards because the only way for us to be given licenses is

11:23 you're supposed to be a practitioner plus license of that.

11:28 In our in our in our in our area, the only provision about the provision of the temporary

11:31 licenses is from is on the perspective that we're going to bring in a talent outside of

11:36 the country in the Philippines to actually work for us because of a certain need, for

11:40 example, during the pandemic or a particular outbreak.

11:43 Now we were able to intercept that and we were very happy about it, but there were rumors

11:46 during that time that the clinical care associates would actually be on their way.

11:51 But it was actually hidden from us.

11:55 The signing, the writing of the guidelines and the joint administrative order, it was

12:02 not actually participated in by PNA.

12:04 And that basically is quite sudden for us on our part as a welfare organization because

12:09 we were supposed to be part of that particular drafting of that particular set of guidance

12:13 because if and when we were actually part of it, we would outrightly say a strong negation

12:17 on that particular proposal because clinical associates, as per the claim by PISAC last

12:24 I think that was two months ago that the Philippine government is able to champion the problem

12:29 of Philippine HRAs because of the 200 hired CCAs that were deployed both in private and

12:34 government hospitals.

12:35 We beg to disagree because CCAs can never replace or be a complimentary worker without

12:43 a registered nurse because we know for a fact that being licensed is your gateway towards

12:49 the world of a professional.

12:51 And without the license, you cannot practice similar to that of a professional.

12:54 Therefore your work really is a step down care provider to that of a nurse.

12:59 But the problem that we actually have with clinical care associates would be they are

13:02 not actually like RNs but they are graduates of the program.

13:07 And if they are graduates of the program, we cannot actually like prevent them, number

13:12 one, from being abused by the management of the hospital to actually allow them to do

13:17 certain things that are said to be outside their competency, their competence.

13:22 But the question there would be what are the things that they can do without a proof that

13:27 they are competent enough to do so because they don't have a license.

13:30 Number two, we cannot also prevent these clinical care associates to actually like do things

13:34 that they were trained for short of a license that when actually, when they actually like

13:40 commit an error for that matter, they will not be the ones liable because they don't

13:44 have any license.

13:45 The ones supervising them will be liable for their negligent acts if ever there will be.

13:50 And these are the RNs.

13:51 That's where we are coming in.

13:53 Given the fact that RNs are supervising the CCAs, RNs work is said to be also split.

14:00 Instead of them paying attention to the people committed under their care, you will actually

14:04 be like looking into the work done by the CCAs.

14:07 And mind you also, Ezra, there were also claims that the guidelines, the 23001 between said

14:14 and that of the OAS said that there are only what we call certain tasks that a CCA can

14:19 actually do.

14:20 If we're going to look at the matrices that were provided for, that are provided in rather

14:26 the JAW or the administrative, you will see there are certain activities that are said

14:30 to be done by the clinical care associates that are supposed to be done only by a licensed

14:33 nurse, licensors for that matter.

14:35 And to top it all, one word, assessment.

14:38 Assessment is supposed to be not delegated because assessment is basically a nursing

14:44 responsibility that can actually be done by a nurse for that matter.

14:48 Secondly, we are not in favor of that particular concept of hiring unlicensed nurses or what

14:54 we call clinical care associates because the JAW in itself is not very clear about the

15:01 protection that it provides the clinical care associates.

15:05 Suppose there actually be what we call negligent acts.

15:09 The burden of the burden is said to be connected to the one supervising them.

15:13 And the one supervising them is not only the staff nurse, but also, but more importantly

15:17 spelled out in the JAW is the chief nurses.

15:20 So for that particular line and for that particular clause, the RNs are still the ones responsible

15:27 in overseeing the activities of the clinical care associates.

15:31 Case in point, last week, a day before the signing of the MOU between PNA and that of

15:37 the Manila Times, came a news that was actually written to actually give out a warning to

15:43 the public about signing of no claims, especially during in a hospital problem.

15:48 There was a news that came out that there was a nursing aid who actually like made use

15:53 of a glove to actually like be filled with warm water and placed around the genital area

15:58 of a pediatric patient that actually bursted, that caused the first and second degree burns

16:04 on the part of the patient.

16:07 So she's a nursing aid.

16:09 And nursing aid works under the supervision of the nurse and clinical care associates

16:14 actually are similar to that of a nursing aid.

16:16 When you talk about AIDS or AIDS, they're supposed to be like licensed professionals,

16:20 not step down care providers.

16:21 And that is where we are coming in.

16:23 That's why we are very persistent in making the government know of the situation of Philippine

16:29 nursing so that we can actually like win the battle for our colleagues to actually like

16:33 get what they actually deserve, because it is high time for them to actually receive

16:37 what must be given to them.

16:39 Very well said, sir.

16:40 And the registered nurses are actually still supervising the CCAs or the clinical care

16:47 associates, which are also nursing aid.

16:54 And certain accidents may be committed if these nursing aids are released into the health

17:01 care system.

17:03 And they have nothing to lose because they don't have licenses that could be canceled.

17:07 Sir, for my final question, let's talk about long term solutions.

17:12 So what should the government do to entice more Filipino nurses to work here at home?

17:18 Actually our battle card would be, it's always the government should provide a reason for

17:23 Filipino nurses to stay.

17:25 And what must be done as of current would be, number one, is to actually like provide

17:29 the nurses what must be given to us.

17:32 We need to actually have a great decision coming from the government that SC15 be implemented

17:42 across.

17:43 Regardless, whether the hospital has the ability or not the ability today, for it is said to

17:49 be written in the law, it must be implemented.

17:51 On the side of the government, if there is a need to actually like implement SC15, it

17:58 is not supposed to be a reason that budget is not enough, this and that.

18:03 Because a law is written, it's the mandate of the government to look for funds for that

18:09 particular law to be properly implemented.

18:12 Number two, government also should rethink that LGUs and provincial governments be also

18:18 given a compelling order coming from the national government that they must be prioritizing

18:24 the implementation of SC15, but to date, it is not being done.

18:29 Number three, if private hospitals really have these difficulties of providing what

18:34 must be given to the nurses in terms of salary grade, they must actually do better in terms

18:40 of their cutting down of expenses to be shifted towards salaries of their manpower so that

18:46 they can actually maintain their operations.

18:49 Apart from that, governments also rethink of doing some things to recalibrate the benefit

18:56 packages that are received by the nurses in the Philippines.

19:00 If we cannot actually mimic or mirror the benefit packages that other countries are

19:07 providing nurses when they leave the country here in the Philippines, we cannot actually

19:12 give them enough reasons for them to stay.

19:16 Of course, we studied for four years and we spent so much in terms of our education towards

19:21 licensure and all.

19:22 Then, when we graduate, we will receive a salary that will not reach a semester's tuition

19:28 fee.

19:29 So, no Filipino nurse can actually stay in the country.

19:34 There are what we call government initiatives, for example, bilateral agreements that were

19:38 done imposing a deployment ban, but at the end of the day, you cannot prevent the nurses

19:44 from leaving the country, not unless government would actually provide a decent working environment

19:49 for them, humane salary that is said to be similar to that of what nurses can be receiving

19:55 outside of the country.

19:56 Kung ganun na mangyari, that can actually become the solution for us to actually enjoy

20:02 the services given forth by the Filipino nurses that's being enjoyed by the rest of the world

20:06 because the care given by a Filipino nurse is said to be world-class naman talaga.

20:11 But the thing is, a while back, we are being robbed of that opportunity of experiencing

20:16 the care of a fellow Filipino because no one cares for them.

20:22 The concept would be we need to provide, we need to care for the carers of the country.

20:27 In one paper I wrote, there will be no progressive society without care providers because in

20:34 the absence of care providers, the society will be ill and society will not progress.

20:38 That might probably be one of the strongest battle cry of the government is kung walang

20:44 mga nurses, hindi magkaprogress ang bansa natin because sick individuals will always

20:49 be sick because of the absence of the bridge from the heart of the healthcare profession

20:56 which basically is said to be nursing.

20:58 Long-term solutions, legislations.

21:00 We are really hopeful that government will actually heed our call in making sure that

21:05 what we are lobbying for the law to be more caring for nurses, salary grade is said to

21:13 be well implemented, even higher because of the inflation rate, number two, a good working

21:18 environment for nurses, the end of contractualization and advancing other career pathways for nurses,

21:24 particularly advanced practice nursing is a gateway for us to be able to match what

21:27 is being offered by the world to the Filipino nurses that is very attractive.

21:32 If we have all of those in our country, at least we're going to give every Filipino

21:36 nurse the right to decide and inform the decision that staying is equally as beneficial compared

21:43 to leaving.

21:44 And those who are said to be leaving the country are the ones who actually decided upon themselves

21:47 that they actually are leaving the country, not for the reason of financial advancement,

21:52 but more importantly, other reasons that are said to be not related only to finances because

21:56 they could actually get that also from our country.

21:59 Very well said, Sir Anne Moreno.

22:01 Thank you so much.

22:02 Philippine Nurses Association President and Registered Nurse Elmer Bondoc.

22:07 And like what you said, we need to care more for our health care workers.

22:11 Thank you, Sir.

22:12 Thank you very much.

22:13 Thank you.

22:14 Thank you.

22:22 (beep)

22:24 [BLANK_AUDIO]

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