There are so many aspects of our trip to the Philippines that I love, it is impossible to pick a favorite. Each focus area of our trip is rich with unique opportunities for sharing and learning. Sharing what we know about nursing; our routines, skill-sets, education, expectations for practice, passions. Our sharing combined with what we learn at the Mary Johnston School of Nursing, clearly illustrates a global approach to nursing practice. Global nursing practice that draws on the uniqueness of culture, economics, politics, nursing knowledge, resources, and passion that leads to quality outcomes for the many individuals and families that receive nursing care around the world.
Meeting with Mr. Lester Naval, Director of Nursing at Mary Johnston Hospital, I learned about the most significant challenges he faces as he works each day to ensure that patients receive the care they need and nurses can work in an environment that supports their practice. A nursing shortage is very real in the Philippines. Many go to nursing school here, but many also leave to work overseas or leave nursing to work at other jobs. For example, we rode with a Grab (Uber) driver one day who worked as an RN in an Emergency Department for 7 years. He had to leave and find a way to make more money to support his growing family with a second child on the way. Driving for Grab provided a larger paycheck than a job as an RN with a BSN degree.
So, Mr. Naval searches for ways to retain his nurses on staff. He has started a new program of using nursing assistants who help the nurses during their shifts to accomplish all of the patient care that is required. He is advocating to raise nursing salaries. The hospital is a private hospital with a mission focus, reaching a very impoverished community. Combining this reality with the already very low nursing wages makes this a very challenging uphill battle.
Another challenge he faces is resources. Gloves, soap, hand sanitizer, catheters, IV supplies; syringes; these are all things that nurses use daily in large quantities and supplies are not free. How do you keep enough gloves on hand? It’s pretty tough! Equipment that we often consider disposable is cleaned, autoclaved and reused as this is the only way to keep stock in supply. Assessment equipment, such as BP cuffs, stethoscopes are in short supply throughout different areas of the hospital.
Exposure to this reality is a moment of awakening for U.S. nursing students. Knowledge of the seemingly endless supply of gloves, syringes, needles, catheters, soap, BP cuffs, and stethoscopes, in our hospitals and nursing schools at home has new meaning and value. How do we respond to this new awareness? Reflecting on this question is a task of each student on this trip. My own personal awareness and reflection has led me to answer with education. Educating those who live and work in a more privileged environment to be aware and contribute to a global nursing practice. Educating those who live and work in a less privileged environment to use resources efficiently and incorporate our nursing science effectively with available resources to provide quality patient care.