Camarines Sur Rep. LRay Villafuerte has called on the Department of Health (DOH) to track down almost 130,000 licensed nurses who are believed jobless, underemployed or doing non-nursing jobs and then try hiring enough of them to fill the current gap, in lieu of the proposal by Secretary Teodoro Herbosa to employ board exam flunkers, which, said the congressman, could end up being “a cure worse than the disease.”
Villafuerte said that, for starters, “the DOH should also find out who among the almost 30,000 graduates who passed either of the two most recent PNE (Philippine Nurse Licensure Examination (NLE) tests are not yet working—and then “make its best effort to try convincing the still-jobless among these passers to fill up the DOH-estimated 4,500 nursing vacancies in government hospitals nationwide.”
“While we laud newly confirmed DOH secretary Health Secretary Ted (Herbosa) for thinking out of the box in finding swift ways to reverse the worsening nursing shortage, I fear that the conditional hiring of unlicensed nurses or graduates who had flunked the professional board exams as a way to instantly fill up the increasing number of vacancies could, in the end, chip away at our vaunted healthcare system.”
The president of the National Unity Party (NUP) said, “The immediate hiring of still-jobless NLE passers and or already licensed nurses but who are unemployed, underemployed or doing non-nursing jobs is a much better option than Secretary Ted (Herbosa)’s plan on the conditional hiring of unlicensed nurses or nursing board exam flunkers, which might possibly end up being a cure worse than the disease.”
He cautioned Herbosa against hiring nursing graduates who flunked the NLE, as this could “likely open the door to the wholesale hiring of second-rate medical frontliners that could undercut our healthcare system in the long haul.”
“While we laud newly confirmed DOH secretary Health Secretary Ted (Herbosa) for thinking out of the box in finding swift ways to reverse the worsening nursing shortage, I fear that the conditional hiring of unlicensed nurses or graduates who had flunked the professional board exams as a way to instantly fill up the increasing number of vacancies could, in the end, chip away at our vaunted healthcare system,” Villafuerte said.
He said, “The huge demand for our doctors and nurses overseas, which is the main reason behind the worsening nursing shortage, underscores our country’s excellent healthcare system. So what will happen to our healthcare system that is highly esteemed across the globe if the DOH ends up filling the nursing vacancies with board exam flunkers who obviously are ill-prepared to become frontliners in our hospitals?”
Villafuerte issued this statement in response to Herbosa’s recent plan to immediately fill up 4,500 vacancies in over 70 DOH-run hospitals nationwide by granting temporary licenses to board-eligible nursing graduates and those who failed the NLE, and then assign them to these government medical facilities.
Herbosa said the hiring of either board flunkers or those have not yet taken the NLE as nursing assistants in hospitals could be the immediate solution as the country could run out of nurses in three to five years if we do nothing to stop these healthcare providers from leaving for higher-paying jobs overseas.
Villafuerte pointed out that the government-accredited national association Filipino Nurses United (FNU), citing DOH data, said recently there were about 124,000 registered nurses who, as of December 2021, were unemployed, underemployed or doing non-nursing work.
The FNU further said that 29,293 nursing graduates combined had passed the last two NLEs—18,529 in the November 2022 test and 10,764 in the May 2023 board exam.
“Nobody knows who among these 124,000 registered nurses as of end-2021 or the almost 30,000 new nursing board passers are still out of work or doing non-nursing jobs at this time,” Villafuerte said. “The DOH would do well to track them down and try convincing a sufficient number of the still unemployed among them to work in government hospitals, as a way to start reversing the worsening nursing shortage in the country.”
He said that looking for the registered nurses and new board passers who are either without jobs yet or doing non-nursing work could be the priority of the National Nursing Advisory Council (NNAC), which Herbosa plans to set up to focus on addressing the concerns of Filipino nurses.
Herbosa announced last June his planned issuance of an administrative order (AO) to establish his proposed (NNAC).
Under Herbosa’s conditional hiring plan, the DOH will temporarily recruit nursing graduates who scored 70%-74% in the board exams—or below the passing svore of 75%—on condition that they retake and pass the professional test within four years after they are hired, and then require them to continue working for government hospitals for four years after they pass the exam, before they are allowed to leave for abroad should they want to do so.
These temporary licensed nurses will then have to render up to four years of return service to a government hospital after they pass their board exam before they are allowed to leave for foreign jobs.
According to a Professional Regulation Commission (PRC) report, although the average passing rate for the NLE this 2023 and in 2022 was a higher 74.84%, the average during the previous six years was a lower 60%, which means that about 60,000 of the 130,000 examinees in those years failed to pass the exam.
Villafuerte said this conditional hiring plan will “lower the bar for the nursing profession as it will, in effect, pull down the passing rate from 75% to only 70%.”
“Licensed nurses are supposed to abide by a certain set of standards for competence in their profession. We will be throwing such professional standards out the window if we cavalierly allow to treat patients even those who, in flunking the board exams, are apparently ill-prepared to competently and safely care for the sick,” he said.
Under the Philippine Professional Nursing Practice Standards (PPNPS) of the PRC Board of Nursing, all nurses are “expected to perform competently,” said Villafuerte.
Those in the nursing practice are required under the PPNPS to have the “knowledge, skills and attitudes necessary to provide competent, efficient and safe nursing care, and maintain the integrity of the nursing profession” he said.
Moreover, he said, certain nursing students will no longer feel compelled to excel in their academics, which will undercut their preparation for, and competence in, this field of medical work, if they know that they eventually only need to get a grade of 70%, instead of the higher passing grade of 75%, in the board exams to be able to work in government hospitals at least.
Citing the view by FNU president Maristela Abenojar in a radio interview last month, Villafuerte said that the concern of this national association of nurses is that the board exam is supposed to measure the skills and knowledge of nursing graduates, hence those who fail to get a grade of 75% or higher filters out those who are not ready yet to practice the profession.
As pointed out by Abenojar, he said, the DOH’s planned grant of temporary licenses will also undermine the system of accountability as licensed nurses risk losing their licenses once they are found guilty of negligence or endangering the lives of their patients.
Villafuerte added that as noted by Abenojar, for non-licensed practitioners found endangering the patients under their care once they are hired as temporary assistants, “who will account for their possible acts of negligence?”
“As an analogy, will you be comfortable riding a vehicle driven by somebody with no driver’s license or who had flunked the driving test of the LTO (Land Transportation Commission)?” he stressed.
Moreover, he said, the temporary hiring of unlicensed medical workers will not fill the gap in nurses, “because even if non-licensed nurses or exam flunkers are hired, there will be more and more licensed nurses who will join the mass exodus from the Philippines, for so long as these two factors remain: the big demand for them and the much higher pay abroad.”
To help reverse the exodus of nurses, Villafuerte has sought the congressional passage of House Bill (HB) No. 1094 that is meant to encourage these healthcare workers (HCWs) to stay in the Philippines through reforms in nursing education.
HB 1094 seeks reforms in nursing education, including the introduction of basic and postgraduate programs that would train and encourage nurses to work in communities and seek leadership or management positions in their profession in local hospitals instead of leaving for overseas jobs.
“The huge demand for our doctors and nurses overseas, which is the main reason behind the worsening nursing shortage, underscores our country’s excellent healthcare system. So what will happen to our healthcare system that is highly esteemed across the globe if the DOH ends up filling the nursing vacancies with board exam flunkers who obviously are ill-prepared to become frontliners in our hospitals?”
This proposed “New Philippine Nursing Act”—he introduced this bill with fellow CamSur Reps. Miguel Luis Villafuerte and Tsuyoshi Anthony Horibata plus the Bicol Saro partylist—provides for a graduate program for nursing education that shall be a post baccalaureate nursing course, which builds on the experiences, and skills of a nurse towards mastery, expertise, and leadership in practice, research and education.
Villafuerte had urged Herbosa, following his recent confirmation by the Commission on Appointments (CA), to give top priority to working on the release of still-unpaid Covid-19 emergency allowances long due HCWs and non-HCWs.
The majority leader of the CA, Villafuerte was principal author in the House of Republic Act (RA) 11469 or the “Bayanihan to Heal as One Act” (Bayanihan 1) and RA 11494 or the “Bayanihan to Recover as One Act” (Bayanihan 2) that enabled the then-Duterte administration to respond to the Covid-19 global crisis and provide financial aid to low-income families, displaced workers and other sectors badly hit by the pandemic along with emergency allowances and other benefits to HCWs.
He was also one of the authors of RA 11712, which allowed the release of the Covid-19 benefits to HCWs and non-HCWs even after the expiration of the Bayanihan 1 and Bayanihan 2 laws.
