This document discusses several key issues and challenges facing nursing as a profession. It outlines 4 main issues: 1) Lack of health workers and nurses in poor rural areas due to personal orientations, working conditions, and lack of plantilla positions. 2) Low wages and poor working conditions due to lack of full implementation of relevant laws and benefits being given only partially. 3) Heavy workload due to understaffing resulting in overtime or 16-hour shifts with lack of equipment and supplies. 4) Unfair labor practices such as demands for experience and oversupply of nurses leading to volunteerism. Options proposed include fully implementing relevant laws, increasing health budget allocation, and positioning nurses as leaders in primary healthcare.

1. Issues and Challenges
in Nursing
Prof Ed B Rillon 2012

2. Objectives
1. Analyze the priority issues in
nursing today.
2. Discuss possible options for
said issues confronting the
profession.

3. What is Nursing
S Nursing is a therapeutic
interpersonal process, a
scientific discipline. Its thru its
caring aspect that the dazzling
array of technologies is
countered (Watson 2007).

4. Watson’s ‘Caritas’ Caring
Science
1. Humanistic- altruistic values- practice of loving
kindness and equality with self and others;
2. Enabling faith and hope-being present
authentically
3. Sensitivity to self-others- on going spiritual
development;
4. Developing authentic trusting caring relations
5. Allowing expression of positive -negative feelings,
listening to Another’s story

5. Watson’s Caritas---
6.Creative problem solving process;
7.Relational teaching-learning /inner
subjective meaning’
8. Creating healing environments
9. Assistance with basic needs-sacred
acts; and
10 Openness to existential-spiritual
unknowns- allowing for MYSTERY
AND MIRACLES.

6. Watson’s Proposal
S Nurses must reclaim Nursing Arts
which have scientific basis.
Modalities are:
S Intentional touch (TLC therapeutic
healing)
S Visualization or imagery
S Music therapy
S Massage
S Pet therapy and
S Other biological interventions

7. Donna Cardillo -A Daybreak
for Beginning Nurses
Nursing care comes in many forms.
Sometimes it is the ability
to make someone feel physically
comfortable by various means,
Other times it is the ability to improve
the body’s ability to achieve
or maintain health. But often
It is an uncanny yet well honed knack
to see beyond the obvious and address
in some way, the deeper needs
of the human soul.

8. Caring is
the most abstract of
all concepts in nursing.

9. ISSUES

10. 1. Lack of health workers to
include nurses in poor
remote rural areas.
Analysis
Root Causes:
 A. Personal- orientation of nurses too focused in
hospitals not public health.
Desire of parents for children to go abroad and
nurse herself.
48% in hospitals
28% in academic institutions
17% public health

11. S B. a working environment that
allows exploitation of
nurses,oppression and violation
of fundamental rights. E.g. The
rape of “Florence”
S C. no plantilla positions for
nurses at BHU.

12. 2. Low wages and poor
working conditions
SRoot causes:
a. RA 9173 (Nursing Act of
2002) and RA 7305 (Magna Carta
of Public Health Workers not fully
implemented.
Min. for PHN = SG 15
(P25,000/mo)
Reality= SG 11 after 10 yrs.
Private sector= P6-8,000mo
w/in range of min. wage.

13. S Magna Carta benefits given in
piece meal partially not entirely.
Hazard pay, SA, overtime pay,
night shift differential, holiday
pay,laundry allowance. (Diminished
under “cost saving” measures to
augment hospital operations.
LGUs= funds not available.

14. 3. Heavy Workload
SNCMH- Nurse patient ratio=
1:200
Others 1:30
SUnderstaff= overtime or 16 hrs
straight
S Over and above these= lack of
equipment and basic medical
supplies. If there are,patients pay
under users scheme.
SConflict in patient service interest
vis a vie income generation policy.

15. Workload
S Public Health Setting
S 1:40,00 (standard= 1:15,000
popuation)
S (tev hard to reach areas)

16. 4. Unfair labor practice-
Volunteerism
SRoot causes:
SA. unfair demand for hospital
experience for hiring.
SB. Too many nurses- 200,000
available nurse manpower

17. 5. Health a vital social
service but not a state
priority
S2011 Health Budget
Php 33 billion= 2.5% of total
national budget.
Less than one peso a day
allocation per Filipino.
Ibon Primer Series(2008)

18. OPTIONS

19. P’noy Nurses Agenda ( in support
for universal access to health for
the Filipino )
S P- Positioning nurses as frontline
leaders in Primary Health Care
S N- Nursing Law and MAGNA CARTA
S full implementation
S O- Operationalization of
government programs and projects
for nurses
S Y- Yearning for Phil complimentary
laws and policy on Health Budget
allocation of 5% from GDP.

20. Additional Root Causes
Fast growing population= 2.2 %
70% poor (61 M)
Option = obvious

21. POVERTY
( Poverty Trap)
S The environment of the nurse is
also creating poverty in the
profession.

22. Conclusion
S The core value of nursing is
CARING.
S The NURSE as a patient advocate
has to share the responsibility for
the creation and promotion of an
environment necessary for good
health esp. to the underserved and
poor communities.

23. STHANK YOU