MANILA, Philippines - An estimated 187,000 Filipino nurses are unemployed. The Professional Regulation Commission (PRC) says these nurses are competing for some 70,000 nursing positions in private and public hospitals. But as if that were not enough, the Philippine Nurses Association (PNA) admits the problem of unemployment in the nursing profession may just have gotten bigger.

"Another 92,000 nursing students took the board exams last Saturday. By statistics, 50% or less would pass, so you could expect [at least] 35,000 to be added to the swelling number of unemployed," says PNA President Dr. Tita Barcelo.

Training for a fee

Speaking on ANC's "The Rundown" on Thursday night, Barcelo says, given the sheer volume of new registered nurses and a shortage of skilled nurses, the health industry is faced with the persistent problem of where to place them.

She adds the situation has encouraged the prevalence of unskilled workers having to pay their way for 3 to 6 months of hospital training to get work certification.

"Ideally, they should be employed for in-service training, but because there are no vacancies for the skilled nurses, then these nurses get to work in these hospitals as volunteers. There's no vacancy for the beginners, but there are vacancies for the skilled nurses. But to get to be a skilled nurse, you have to go through training in the practice of profession."

Barcelo says new nurses often agree to do volunteer work because they take a chance at becoming part of the hospital labor pool. In case there's a vacancy, she says, hospitals often choose from those who've already volunteered.

Barcelo admits the situation is worse off today, unresolved despite efforts they made three years ago to hold a dialogue with hospital owners.

"It was not as bad as it is now. In the past, they volunteer without pay, but now, they pay, which is ridiculous, a perversion of the word volunteerism," Barcelo laments.

She says nursing graduates pay anywhere from an average of P4,000 to P5,000 for 3 months of training to as high as P10,000 for 6 months. But if hospitals don't pay these volunteers, the least they could do is not charge them for training.

Curbing the practice

Today, Barcelo says, there are on-going measures meant to discourage hospitals from taking in volunteers without pay.

"There's a new executive order, in effect, discouraging hospitals to get volunteer nurses," Barcelo notes. "Hospitals should not just call them volunteers; rather, they should be given certification of work which can be utilized by nurses."

Barcelo says they are also exploring the possibility of pursuing a legislative solution, citing discussions with Senator Edgardo Angara, an author of the 2002 Nursing Law. He adds the law has a provision for a salary grade of P15,000 which has never been implemented.

'Paradoxical surplus'

Dr. Gene Nisperos, vice chairman of the Health Alliance for Democracy (HEAD) calls the surplus "paradoxical."

"These hospitals actually do need the nurses except they don't want to spend the money and provide them tenured positions," Nisperos says.

"We're not talking about private hospitals, we're talking about government hospitals where you have wards full of patients and nurses who extend their work because there are too many patients for them. In a sense, you have all these nurses who have no experience and yet they're not being hired by government. The hospitals should be hiring them but aren't and are instead making them pay."

Nisperos says the government should find a way to hire these nurses, provide them options within the health system, and make nursing a viable career in the country, as well as make labor migration a matter of choice, not a necessity.

"The position taken by the previous government is that nurses are our primary export commodities. If that continues, the current paradoxical surplus of nurses will just worsen," Nisperos says.

Call for real solutions

Amid such challenges facing the nursing profession, Nisperos hopes the Aquino government will find real and lasting solutions.

"We're looking very closely at how the new president will follow through with his campaign platform. Certain issues need to be addressed, particularly how much importance health will have in this administration. We see that in his appointment of the new health secretary, his vision of public health, the need to improve health infrastructure, health human resource," Nisperos says.

"Health has always been a deodorizer. Giving out PhilHealth cards, that should stop. If this government is intent on making a big change, health should be at the forefront of change, and it should be comprehensive, not piece meal, not stop-gap like in the past administration."

He now calls on the new government to stand firm on its promises and truly make health a priority goal.