May 28, 2021 — To celebrate its 73rd foundation anniversary, the UP College of Nursing (UPCN) conducted a webinar entitled “Re-envisioning Philippine Nursing Towards Responsive Health Systems” on April 8, 2021. The webinar aimed to mount more effective responses to stem the tide of the COVID-19 pandemic. 

UPCN Dean Sheila R. Bonito emphasized in her opening remarks the need to revisit Philippine nursing to be more responsive to the evolving demands in the health and development scenario so that nurses can contribute to better health and lives of the Filipino people.

For her part, UP Manila Chancellor Carmencita Padilla cited the great role of nurses. “Nursing, as a key sector and component of the health system, has a societal obligation to think long term to envision a broader and collective approach not only due to COVID-19 but of other future crises,” she stated.

According to the World Health Organization State of The World Nursing Report in 2020, there are 526,331 registered nurse professionals with active licenses in the country, comprising 71.2 percent of the health workforce; outnumbering all other healthcare workers with a density of 49.2 nurses per 10,000 population. This overview of Philippine nursing was presented by UPCN Asst Professor Jenniffer T. Paguio, Head of the College’s Continuing Education and Community Extension Services Program.

However, despite the high nurse density, 2019 estimates show that unhealthy nurse to patient ratios in hospitals and communities lower the international standards for nurse workload. The emergence of the pandemic has significantly increased the workload demands with more acutely ill patients, and salaries still not commensurate to the value of services provided and to the risk they face doing their job. 

She added that a chief nursing officer who shall represent the nursing voice at the highest levels of the DOH has yet to be institutionalized, and advanced practice nursing roles have yet to be determined. 

Dr. Annabelle R. Borromeo, Health Technology Assessment Council Committee Member and Citizens Representative, member of the Technical Working Group for the revision of Philippine Nursing, Dean and Director, Center for Nursing Impact and Patient Outcomes Action Lab, stressed that these prevailing issues stem from the reality that nurses are not valued. Part of the image problem that unfortunately persists to this day is that nursing is framed in the shadow of medicine as evidenced by a textbook the Department of Education recently released which describes the role of nurses as “katulong ng doktor.”

“How do we contribute to uplifting nursing so that we are recognized for our real value and not for being angels or fallen heroes? Let’s face it, the usual cliches are not working anymore like when we say we save lives, are we really presenting data that we do? When we say we’re making a difference, is that really true? The language of decision makers is data and that is where we always stumble.” Dr. Borromeo raised these issues in looking for solutions to the nursing situation in a new and different way. 

Dr. Borromeo proposed the Inquiry-Driven Leadership Techniques which focus on a question-based approach to challenges, enabling leaders to become both creative problem finders and solvers by gaining tools to ask better questions. She also suggested to look into the science of the CHERISH foundational framework which is the seven foundational competencies that are inherent in every nurse patient encounter: C stands for the science and art of Connecting to patients and establishing rapport; H is Holding the patient in respect; E is Evaluating self-efficacy of the patient; R is Responding and anticipating a response; I is Integrating and coordinating care; S is Sustaining the mission; and H is the science of Handing off as patients transition from the hospital to home.

Dr. Borromeo asserted that the nursing curriculum should be designed so that the nurses become strongly committed to primary care specifically in the promotive and  preventive aspects and put the needs of the Philippines first. To accomplish these goals, she proposed to use design thinking as a strategy as it refers to the cognitive strategic and practical processes by which design concepts are developed.

“A requirement for achieving this future is that each nurse contribute until we reach a tipping point. This is in keeping with Dean Sotejo’s (UPCN founder and first dean) vision of professional nursing being vitally useful to society and the service of national significance,” stated Dr. Borromeo.

UPCN Assoc. Professor Luz Barbara Dones in her closing remarks, honored the legacy of another UPCN professor and PRC Board of Nursing chair Dr. Carmencita Abaquin. “To her we owe the 2012 National Nursing Competency Standards which I hope will always be the basis for the nursing education community to shape and re-envision the role of the nurse now and in the future.”

Charmaine Lingdas |  Published in UP Manila Healthscape Special COVID-19 Issue No. 27