OJT for Nurses -- An exploitation?

ON JANUARY 11, 2011, the Senate Committee on Health and Demography, chaired by Sen. Pia S. Cayetano, together with the committees on finance, labor, employment and human resources development tackled on Philippine Senate Resolution No.166, which seeks to look into reports of registered nurses and nursing graduates who work as "on-the job trainees" (OJTs) but were the required to pay for their training, work experience and certification, instead of being hired as regular hospital staff.

I can relate to this issue very well because before I became an immigration attorney, I worked as a registered nurse in the Philippines as well as here in New York. I saw and experienced for myself what it feels like to be a nurse - long shifts, heavy workload, less pay. And as an immigration attorney, I also see in my nurse-clients the sacrifices they have to endure just to pursue the American dream.

I know for a fact that this "pay for training" scheme is rampant and widely practiced whether it be in government or private hospitals. And who benefits here? It works both ways. The nurse obtains the certificate of training while the hospital receives the fee and of course, the added manpower at little cost.

As this training supposedly ends at a short and specific period usually after four to five months, the hospital is always guaranteed that there will be nurses lining up for the next batch. And the whole cycle starts again.

I would suggest that the Committee should look into the credentials of a hospital and its training staff. Is the hospital accredited as a training institution? Who accredits it? Does the staff possess the qualifications to train these nurses? Does the hospital have enough equipment and resources? Are there training protocols and manuals that are adhered to during the training?

How do these nurses get screened? Are these nurses supervised while they are performing direct nursing care? Is their presence in one work shift counted in the regular staff nurse-patient ratio? What is the scope of their patient care?

Do they perform independent nursing care to patients or they just wait on what their training staff tells them to do? What is the liability of the hospital and these trainee-nurses in case there is harm or injury brought to a patient? What is the quality of training nurses get? How do we evaluate how good and effective the training was? And which government agency is tasked to regulate this? Or are our own government hospitals equally guilty as well?

It cannot be denied that this practice is open to some suspicions. Aside from making money on the front end by requiring nurses to pay a training fee, is this also a way by hospitals to obtain cheap labor under the guise of training? If so, is this not a form of exploitation? Of course it is! Our nurses are already burdened and exploited enough since the first day of nursing school with the prohibitive cost of education and the lack of employment opportunities after graduation. Yet, these nurses are still willing to work and pay as trainees even with out any remuneration just to make sure they obtain that single piece of training certificate. It is only in nursing that you pay for your own training. This does not happen in other professions!

And we come to ponder the state of our healthcare system. How bad is it that our hospitals do not have the financial resources to hire more nurses under regular hiring practices such that they resort to this questionable hiring scheme? How disappointing it is that our nurses do not have enough employment opportunities such that they choose to pay their way in order to gain some semblance of hospital experience? In the greater scope, how does this practice affect the delivery of care to our patients? What does the government need to do in order to improve our healthcare? And what can we do as ordinary citizens?

Healthcare poses a lot of complex questions and even more complex answers. One thing is simple though. Our nurses are a precious resource in that system. They are an integral part in the health and well-being of this nation and its people.

It is now time for us to change the way we treat our nurses and give them the respect, dignity and honor worthy of the profession they are called for.

I fully support and highly thank the Senate for initiating this inquiry. It is my hope that positive changes will come out as a result of this investigation.

*****

This column is not a substitute for professional legal advice obtained from a US licensed immigration attorney. The information contained herein does not constitute a warranty or guarantee or legal advice regarding a reader's specific immigration case. No attorney-client relationship is and shall be established with any reader.

For any questions, comments and observations, please contact Atty. Marco Tomakin at mtomakin@gmail.com or at 0917-964-3365; 0909-270-1058; (032) 236-7494; (032) 254-9697.