The Room Nurse saga (1st of two parts)

(Writer’s note: This article has been conceived in response to the contentious remarks of Senatorial candidate Cynthia Villar about the nursing profession)

QUOTING Ms. Cynthia Villar’s remarks: “Actually, hindi kailangan ng mga nurse matapos ng BSN (Bachelor of Science in Nursing) kasi, itong ating mga nurse gusto lang nilang maging room nurse. Or sa Amerika or in other countries e ano lang sila, yung parang mag-aalaga. Hindi naman sila kailangan ganoon ka galing.”

Any professional registered nurse who hears the remarks of Ms. Villar in a cable program will feel a deep sense of dignity loss and belittlement. In fact, such remarks have caused uproar of protests among concerned nursing communities -- academe, practice, research and administration -- including netizens.

The Philippines is a home to at least 700,000 registered nurses (‘de jure’ method of counting) under the Professional Regulations Commission and Board of Nurses, excluding graduate nurses who hold baccalaureate degrees but are yet to be licensed. Knowing the statistics of nurses make them vulnerable to political persuasion and sweet-tongued promises of political candidates.

Having watched the full-length version of Villar’s statements in YouTube has aroused my supposition of the idea that nursing practice is being viewed among non-medically inclined public as something that is least worthy of professionalization, to the point of being reduced to the sub-professional ‘room nurse’.
As the introductory part of a two-part article, I am writing about the scope of professional nursing practice as mandated by Republic Act 9173 or the Philippine Nursing Act of 2002.

It states that: “A person is deemed to be practicing nursing within the meaning of this Act when he or she singly or in collaboration with another, initiates and performs nursing services to individuals, families and communities in any health care setting. It includes, but is not limited to, nursing care during conception, labor, delivery, infancy, childhood, toddler, pre-school, school age, adolescence, adulthood and old age.”

Examining the statement, it presents a general idea of the gravity of the responsibility placed among nurses when rendering nursing quality care to a patient or client with a wounded body, mind and soul.

As such, a rigorous training, a specialized body of knowledge and a host of theories must be tapped on in order to generate the best practices of nursing care that are scientific or evidence-based.

It goes on to state: “As independent practitioners, nurses are primarily responsible for the promotion of health and prevention of illness. As members of the health team, nurses shall collaborate with other health care providers for the curative, preventive and rehabilitative aspects of care, restoration of health, alleviation of suffering, and when recovery is not possible, towards a peaceful death.”

Clearly, nurses have significant and humongous roles to portray in the entirety of the health care system.

Among the lengthy written scope of duties of nurses, I would like to highlight the paragraph on the provision of nursing care through the utilization of the nursing process that states:

“Nursing care includes but is not limited to traditional and innovative approaches, therapeutic use of self, executing health care techniques and procedures, essential primary health care, comfort measures, health teachings and administration of written prescription for treatment, therapies, oral, topical and parenteral medications, internal examination during labor in the absence of antenatal bleeding and delivery...”

Filipino nurses under Republic Act 9173 are required to undergo a licensure examination prior to being legally allowed to practice the profession. Once licensed, nurses have the legal accountability of their actions or interventions to their patients.

As a matter of fact, they are accountable as well to the actions of their subordinates -- caregivers, nursing assistants and midwives -- depending on their organizations’ protocol and this is something that ‘room nurses’ are not entitled to. In fact, the latter have no licensure; only a technical certification.

Professional registered nurses also have a wide-range of career options to practice that necessitates professionalism. They can practice in hospitals, public health facilities and offices; lying in clinics; occupational health as company nurses; school health nurses; administration and management; academe; and research. Again, these are conditions that the so-called ‘room nurse’ can never assume.

I hope that by knowing the magnitude of the scope of practice, professional and ethico-moral responsibilities of nurses to the health care delivery system in general and the sick patients needing quality nursing care in particular, will somehow change how nurses and nursing practice are viewed among people whose perception about the professional registered nurses is nothing more than ‘room nurses’.

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