“Chronic” aptly describes the shortage of nurses in the Philippines. In terms of health care, “chronic” describes a condition of illness that has persisted for a long time, which may already be difficult or impossible to treat.

Citizens grapple with the myriad consequences of a dearth of nurses: difficulty in getting admission in hospitals, even for emergency cases; struggles in scheduling surgeries and other operating room procedures that require specialized nurses; and competition for privately hired caregivers who take over many aspects of focused patient care during hospital admission that were previously assigned to hospital nurses.

Jane’s family rushed her to a private hospital in Mandaue City after their 69-year-old mother required emergency medical care. Jane was finally brought to her private room at nine in the evening of the next day, spending P20,000 of the P25,000 initial deposit from procedures performed in the emergency room, where she waited for nearly 24 hours with other persons queued for admission.

A relative accompanying Jane to her room saw that several rooms on their floor were unoccupied. Confronted by this irate relative, a staff member said that lack of nurses limited the admission of patients.

In Cebu City, a surgeon scheduled surgery for Joe, suffering from pancreatic cancer, two weeks later than his preferred date. The surgeon explained that the septuagenarian could not be scheduled for mid-morning surgery because the private hospital’s operating rooms (O.R.’s) were booked solidly for day and afternoon procedures, with slots open only for surgeries to be performed until the late hours of the evening.

Difficulties in scheduling were not due to a spike in patients but the lack of skilled and experienced nurses to assist in the O.R., explained the surgeon. Joe’s family grappled with the dilemma of delaying the surgery needed by their father or considering another surgeon in another hospital.

In 2021, local and international media reported the threatened mass exodus of nurses and other frontline health workers who were in umbrage after the special risk allowances failed to reach them, with unions alleging that the promised benefits and compensation were paid out by the government to private hospitals, which delayed or never released the money to workers.

Yet, what ails the health care system in the Philippines is not mass exodus but the protracted, unchecked hemorrhaging of registered nurses, who choose overseas work due to industry-standard salary and other benefits.

Wary of the long shifts, low salary, lack of employer’s concern for their welfare, and nursing duties’ toll on the worker’s physical and mental health, nursing graduates gravitate to other industries that offer better pay, safer work conditions, and better life-work balance.

Blaming the human factor for the ills of the Philippine health care industry is myopic as the government has dragged its foot in intervening for the welfare and protecting health care workers from exploitation by private and public hospital owners and administrators.

At the height of the pandemic, hospitals were never short on patients. Now, as the country re-opens, private hospitals are expanding with new infrastructure for specialized institutes, laboratories, and clinics. Citizens are returning to hospitals to seek elective surgeries, laboratory tests, and other procedures for health maintenance, monitoring, and employment.

However, hospital nursing staff continues to be understaffed, underpaid, undertrained (with older, more experienced nurses vacating positions to younger, less experienced counterparts that serve as mentors for the rest of the nursing staff), and physically and mentally exhausted from working 12-hour or longer shifts, postponing meals and toilet use to conserve the use of personal protective equipment, and facing onerous work conditions such as no work, no pay.

The chronic maladies affecting nurses impact on us all.