Dissecting Rep. Cynthia Villa's view on the Filipino nurse

By Jeff Vasquez, RN, MN

EVERY nurse from the Philippines is now furious over Rep. Cynthia Villar's statement on the nursing profession. In a one minute question and answer portion, she was asked to react on her role on the failure to close questionable nursing schools which even led to the resignation of some nursing technical expert members on the panel. In her answer, I think the three phrases that pierced through every nurse's heart are: 1) That nurses do not need to finish the BSN programme; 2) That aspiring nurses have only one desire and that is to become a room nurse; and 3) That nurses do not have to be very good.

I laughed at her answer. It's difficult to answer a question under strict time limits and it's even harder to answer it when you lack information to suffice your answer.

I think nurses still need to finish the BSN programme, but we need a better BSN programme. Over the years, I have gained some experience and looking back at how I could have done things better, I thought that in fact, we could have done things better. We teach nursing students everything that they should know yet only a little is remembered. I have an excellent community nursing rotation, if not the best at that time. But I still question up to now the relevance of the CHN bag. Every student carries the CHN bag yet you do not see a community health nurse carry one. You perform wound dressings, visit the sick, yet the patients do not receive follow up from the local health centre.

During the third year, hospital rotations become more common and medical surgical nursing concepts are introduced. Yet, a student becomes confused as what is taught is not being practiced. The clinical instructor struggles to fill in the gap. Looking back, one project at any rotation would have been a review of literature on evidence-based practices. For example, the use of hydrogen peroxide and/or povidone-iodine versus normal saline in cleansing wounds.

Students are inundated with information just to cover all the topics almost to the point of a nervous breakdown yet we know only little will be retained. So what's the point of teaching everything? I guess you really don't have to know everything but rather, a good clinical instructor builds up on those hospital and community rotations to make them meaningful to the student. This entails investing more time and resources on those medical conditions presented by the patients. However, this needs a proper training hospital to obtain very good medical-surgical patient case studies. And please, no more return-demo on enema. It's obsolete. We now use fleet enema so no need for those primitive enema preparation. Every time I tell this story to my colleagues, it never fails to give them a good laugh. We need a curriculum that is truly competency-based in its whole spirit.

Secondly, nurses have many desires, not just to become a room nurse. There is a lot of opportunities for different specialities of nursing but not entirely available in the Philippines. I wonder where that “room nursing” came from? Well, when you were young, you would see a nurse enter your room, give you your meds or take your vitals. So that is a “room nurse.” Sadly, this perception is embedded in a healthcare system that is strongly physician-based. You see your nurse carry the patients' charts while the doctor does the round then nurses carry out the orders. I would like this changed.

I would like to see a nurse who is not just a “room nurse.” I would like to see a nurse who actively assesses a patient who presents to the emergency department and writes down assessment data, provides a nursing diagnosis or impression, orders laboratory tests, and carries out standing orders. I would like to see a nurse on the ward who is actively engaged in the treatment plan. The nurse is asked about the patient's progress, suggestions on treatment, and valued for critical thinking who works hand-in-hand with the doctor. I would like to see specialist nurses on the floor seeing patients with diabetes, stroke, and asthma because in many countries, these patients are successfully managed by nurses. This in turn would also make specialist treatment become accessible to the masses.

I envision a nursing body that genuinely fights for the rights of the Filipino nurses. A body that fights for the improvement of pay and work condition. A body that lobbies for the cessation of volunteer work programme (already attained). A body that initiates advancement of the nursing profession.A body that is truly NURSING and functional.

Lastly, as a nurse in the Philippines, you have to be very good. With everything happening around you, you must be damn good. I couldn't imagine myself to practice back again in the Philippines. It's hard yet you still remain as nurses. There are many nurses back home who are better than me, more experienced than I am, and who have dedicated their lives to become the caring nurses that they are. I salute to all the Philippine nurses. You deserve every Filipino's respect.