200 hospitals shut down on nurses’ lack

Brain drain or the loss of skilled intellectual and technical employees has plagued government and private hospitals in the last two years, causing the permanent closure of 200 institutions across the country and the partial shut down of another 800.

The partial closures meant that one to two hospital wards had stopped operating in the absence of doctors and nurses, who left for better geographic, economic or professional environments.

Former Health Secretary Jaime Galvez Tan, who served under the administration of former President Fidel Ramos, said in an interview that hospitals were forced to cease operations as doctors and nurses were no longer interested to work for them.

Hospitals affected by the migration of health workers, particularly nurses and doctors, are in the remote countryside where health care is badly needed, according to Tan.

Among the hospitals that closed were the Almagro Community Hospital in Western Samar, the Tapul Municipal Hospital, Tangkil Municipal Hospital, Pangutaran District Hospital, Siasi District Hospital and Panamao District Hospital in Sulu, and the Sergio Osmena District Hospital in Zamboanga del Norte.
“In Sulu, majority of the municipalities have only one doctor. The municipalities of Pata, Talipao, Lugus and Pandami have no doctors at all,” Tan said.

Partially closed were the Calbayog District Hospital, Gandara District Hospital, Basey District Hospital and Tarangnan District Hospital in Western Samar, the Malipayon District Hospital, San Jose District Hospital and San Andres District Hospital in Romblon, and the Jolo Provincial Hospital.

So far no hospital, private or government-run, has shut down in Metro Manila and the well-off provinces of Davao and Cebu because of the brain drain, Tan said. Health workers prefer to work for well-known hospitals that are popular among patients.

“Andito kasi ang pera at resources. Kaya nga may overflow ng health workers at pasyente sa mga ospital na ito (Here is where the money and the resources are. That is why there is an overflowing of health workers and patients in these hospitals),” Tan said.

But when one goes to Samar and other poor provinces, like Kalinga Apayao, Mindoro, Sulu and Agusan, and in the Autonomous Region in Muslim Mindanao and the Caraga Administrative Region, one can find areas with no hospitals, he said.

The latest statistics available from the health department and the National Statistics Office showed the majority of doctors and nurses are concentrated in the National Capital Region and in Region 4-A or the Southern Tagalog. As of 2007, there were 125,899 doctors and 5,426 nurses in the capital and 75,213 nurses and 3,876 doctors in Region 4-A.

In the ARMM there were 4,058 nurses and 2,726 doctors, and in Caraga were 8,854 nurses and 232 doctors. These were the regions with the least numbers of health workers.

Tan said all the hospitals that closed were licensed. “There is no such thing as fly-by-night hospitals, because before a hospital can operate it must have authority from the DOH, and accreditation from the Philippine Health Insurance.”

25 Things You May Not Know About What Nurses Know

Throughout the years, nurses have been associated with everything from cute little white dresses and matching hats, the mistaken impression that they have few skills beyond a friendly smile and the willingness to give bed baths, the distributors of medicine to make you feel better, or simply as doctors’ helpers. Of course I’m generalizing as much as the people who think these things are. When I worked as an RN, the “what do you know, you’re just a nurse” patients had definitely become few and far between. So what do nurses actually know? Some of it may surprise you.
1. Science – lots of it: Yes, being a nurse requires a science degree which of course entails a lot of science courses and science knowledge. A nurse’s head is jam packed with the finer points of biochemistry, nutrition, math, microbiology, pathophysiology and more.
2. Accountability: If a doctor writes an order – for medication or otherwise – and it’s incorrect or misinterpreted, and the nurse carries out that order, the nurse is held partially accountable for the error. This is one of many reasons nurses dole out the bucks for medical malpractice insurance.
3. Time Management: Nurses are masters when it comes to managing all the medical, procedural, pharmaceutical, personal and often emotional needs of upwards of 8 patients. Remember this, next time you’re in the hospital and it takes your nurse that extra minute to answer your call light.
4. How to lead a team: Just like Phil Jackson can pull together the Lakers and make sure everyone does their job and plays well together, a nurse is responsible for making sure their patients are getting everything they need from their care team (doctor, nutritionist, social worker, physical therapist, etc.).
5. Advocacy: When nobody else is there to speak for the patient – whether for long term care needs after leaving the hospital, home health services or further rehabilitation – the nurse is trained to step in and be their voice.
6. Thick Skin: When part of the nurse’s job is to wake doctors up from a sound sleep in the middle of the night (often after they’ve been awake for several days) – tact and a thick skin become vital. These qualities also apply to daily encounters with patients, their families and other hospital departments.
7. Stand Up Comedy: Laughter truly can be the best medicine when it comes to cheering up patients or breaking the ice with their family and friends. Nurses have quite a few tools in their “bag of tricks” and have a knack for using the right one at the right time.
8. How to be in nine places at once: Nurses don’t need any Star Trek technology to seemingly be in all their patients’ rooms at the same time. It’s all about mastering the act of juggling with finesse – and really comfortable shoes.
9. Drug Dealing: This is where all those math skills come in, because if one decimal point in the medication dosage calculation goes awry, a patient’s life could be in danger. The average nurse has an impressive bank of information about hundreds of different drugs, their most common dosages, side effects and more.
10. Delegating: Registered nurses (RNs) in particular often oversee license practical nurses (LPNs), certified nurse’s aides (CNAs) and even nursing students during a typical shift. The ability to apply critical thinking and decide which individual is best for which task is a mission critical skill.
11. Customer Service Skills: It may not seem like it sometimes, but health care is a business, the patient is a customer and since the nurse has the most direct and frequent contact with the patient, customer service is key to the job.
12. Patient Teaching: Once the doctor gives his or her medical spiel and leaves the room, the patient (and their family) often looks to the nurse to answer questions, fill in the blanks, reiterate the most important parts and generally break it all down layperson’s style.
13. Alternative/Holistic Medicine: They may technically work in the west, but nurses are trained in many of the essentials of eastern and other types of “alternative” medicine.” These may include everything from acupuncture, herbs, and chiropractics to music therapy, massage, and biofeedback
14. They can “feel your pain”: Nurses are extensively trained in assessing and managing a patient’s pain. They have the skills to observe whether a patient is in pain based on breathing, vital signs, gestures and facial expressions, without the patient ever saying a word.
15. Accessorizing: In the movie ‘Office Space’ servers at a family restaurant learn the important of “flair” – fun, colorful buttons tacked onto their otherwise uniform uniforms. Nurses have the same instinct, adding colorful jewelry and vests to their whites and selecting colorful scrub tops that fit their personality – all in good taste of course.
16. Improvising: Believe it or not, there isn’t always a medical device or procedure for every single that can happen with patients during a shift. As a nurse, I saw remarkable examples of creative problem solving by my colleagues (I was even known to do a little bit of it myself).
17. How to switch gears quickly: A nurse may have their entire shift organized at the beginning, by which patients need what and when. This plans usually lasts for about fifteen minutes. One new post-operative patient or another patient having a sudden crisis, and these patients become the new focus of the shift, while the nurse still attempts to juggle everything else in the original plan. This goes well beyond the definition of multi-tasking.
18. The infamous poker face: The rule of thumb is – even if you haven’t seen it all yet, pretend you have. No, nurses are not supposed to be unfeeling robots. However, they are able to keep their composure in the face of stressful situations enough to hold their own against the stony faced competitors in a poker tournament.
19. Handwriting interpretation: Yes, with electronic medical records, the classic issue of figuring out what the doctor actually meant to write on the patient’s chart is less of a problem. But the reality is, as long as the human beings are doing the care giving, and not the computers, a certain amount of a nurse’s job will involve deciphering a doctor’s hasty scribbles.
20. Learning new machines at the speed of light: Medical technology is moving faster than patients can find new ways to get sick. Therefore, most of a nurse’s training on machines like IV pumps, feeding tubes, heart monitors and other gadgets, comes after nursing school, on the job and quickly.
21. Writing: Ever wonder why so many nurses become bloggers (he-hem), authors of research studies and books, and journalists? Between countless nursing care plans in nursing school (a detailed plan of care for each patient), research papers and nursing notes, nurses have no choice but to develop a working passion for the written word.
22. Research: Contrary to the beliefs of many, nursing is about much more than simply following doctor’s orders and treating patients. Nurses, RNs especially, are expected to have an understanding of why they are doing what they’re doing; the intended effect on the patient and how to know if something has gone wrong. This means keeping up with the latest medical research studies and newest data in the field of health care.
23. Cutting through the media healthcare hoopla: As we learned in nursing school, the average mainstream newspaper story may get those all important numbers right from the latest New England Journal of Medicine study, but the actual health implications for patients? That’s a different story.
24. Speed reading: This is an academic survival skill picked by nurses back in nursing school just to get through the sheer volume of required science and clinical reading. Yikes – think I just had a flashback of those 10 pound textbooks!
25. Astute powers of observation: Along with pain assessments, nurses are trained to look for the little details that come from seeing the patient more than any other caregiver – color, changes in vital signs, mental status and much more.
Essentially, the individual in those nurse’s whites is a CEO, customer service manager, crisis coordinator, and medical professional all rolled into one. Be sure and thank a nurse next time you have the opportunity – we need them!

Step back to nine in the morning on 4 December 2009.
Six patients are ready for surgery at three different hospitals across the UK.
It is the culmination of months of preparation and a remarkable event in the history of live organ donation in this country.
This is a three-way kidney swap between couples who've never met.
In Aberdeen, 54-year-old Andrea Mullen suffered sudden kidney failure three years ago.
It had a devastating impact on her life. She had to have dialysis three times a week.
She said: "It was just an existence, it really was.
"It was terrible being ill all the time. As far as I was concerned it just ruined my life. It just totally ruined my life and I hated it."
Her husband Andrew, 53, was prepared to donate one of his healthy kidneys but he wasn't a match.
Six hundred miles away in Hastings on the south coast of England, there was a similar story. Chris Brent, 42, also needed a transplant.
His sister, Lisa Burton, who is 45, was happy to give him one of her kidneys, but again there was no match.
And in St Albans in Hertfordshire, newly-wed Lynsey Thakrar, 30, wanted to donate one of her kidneys to her husband Teemir, but she too wasn't a compatible donor.
Precious gift
The solution - to pair up the couples - has only been possible since a change in the law in 2006.
Under strict supervision the Human Tissue Authority now allows so-called pooled transplant arrangements - matching up couples all over the country.
When Chris Brent heard about the change he was desperate to be involved. "I jumped at the chance to get a new kidney," he said.
Teemir felt the same. "Even though I knew I wouldn't be getting my wife's kidney, you're effectively going to be getting a kidney from somebody that is doing the same for their loved one. So it was just an amazing thing that could happen."
The surgery took place at two hospitals in London - Hammersmith and Guy's and St Thomas' - and the Royal Infirmary in Edinburgh.
It required enormous planning. Three kidneys removed from healthy patients, transported all over the UK and transplanted into the recipients on the same day.
Vassilios Papalois, consultant renal surgeon at Hammersmith, said: "The surgery was a success and I hope we can do more paired and pooled transplants. In the US they are already doing up to 12 pairs at once - so that's something to aspire to."
The result of the surgery has been dramatic. Three months on all six patients are doing well.
Quality of life
In Hastings, Chris Brent, who had seven years on dialysis, lost his job and became depressed, says the transplant has given him a chance for a new start in life.
"Literally as you wake up out of the anaesthetic you feel better," he said.
"I just want to live a fairly normal life again. Go back to work, get out and about more. Have a life rather than just existing."
In Aberdeen, Andrea and Andrew are planning their first holiday in years.
"I feel like I've got my life back," said Andrea. "I've got more energy. I'm eating better and it's great."
And in St Albans, Teemir and Lynsey, who were married last year, say they are now ready to start a family.
"Now that I'm off dialysis," says Teemir, "the future is a normal family life. In time we hope to have children. It's something we couldn't contemplate this time last year."
As for the donors, they all say they are proud to have given up one of their kidneys - even if they have ended up in strangers they've never met.
"I'm absolutely delighted that Chris can have a normal life now," says his sister Lisa, "and all the other people can as well. It's a threefold thing really so it's a real good feelgood factor all round."
"It is a little odd," says Lynsey. "But in the end it wasn't that I didn't give any thought to donating my kidney. It was that I didn't need to give it any thought. He's the man I love. He's the man I want to spend every day of my life with. I want him healthy and if it means giving my kidney to a stranger so be it."
Vicki Chapman, director of policy and strategy at the Human Tissue Authority, said: "These are the first transplants of their kind to happen in the UK. The HTA has to pay particular attention to these types of donation as the issues are particularly complex when more people and more centres are involved."
There are 7,000 patients currently on the waiting list for a kidney transplant in the UK.
One in three kidneys used in transplants now comes from a living donor.

Your request is being processed... Lisa Hofstra Settles With City For $78K: Nurse Handcuffed By Cop For Not Drawing Blood On Command

A nurse who was handcuffed by a Chicago Police Officer when she refused to draw blood from a drunk-driving suspect fast enough for him in August settled her lawsuit against the officer for $78,000.
The Chicago Sun-Times reports that Lisa Hofstra, a nurse at Advocate Illinois Masonic Medical Center, sued Officer Marcelo Rodriguez and the city after Rodriguez allegedly became "belligerent" when she told him the hospital could not draw blood until the driver was admitted as a patient.
Rodriguez then handcuffed Hofstra and forced her to sit in the back of a squad car for 45 minutes, the Sun-Times reports.
"He snucked up behind me grabbed my arms," Hofstra told ABC Chicago in September. "I didn't even realize what was happening...I just saw the faces of the people in front of me before I realized I was in handcuffs."
"Literally he held her hostage until there was a blood test done," Hofstra's attorney Blake Horwitz, told ABC.
Horwitz told the Sun-Times Tuesday that Hofstra understands the need for officers to obtain blood samples, but "it just has to be done through proper means."
The blood samples the officer wanted involved a drunk driving case that goes back to court March 10. The Sun-Times reports:

The driver, Raquel Wright, 47, was arrested for allegedly striking 24-year-old motorcyclist Alexandru Foamete with her Volvo at 3:05 a.m. Aug. 1 at Ashland and Wilson on the North Side. She failed a field sobriety test and refused further tests, police said. Foamete died Aug. 7. Wright has been charged with reckless homicide and aggravated DUI.

Exodus of health workers paves way for bilateral pacts

Seeing no end to the outmigration of Filipino nurses and doctors, a former health secretary has taken steps to “tame the exodus” and achieve a win-win situation for both the Philippines and foreign countries employing our medical professionals.

For a number of years now, Dr. Jaime Galvez-Tan, former Department of Health (DoH) Secretary, has been working for partnerships among countries recruiting Filipino nurses and doctors.

Tan, who initiated an extensive study on the exodus of medical professionals and its effects in the Philippine healthcare system, has formulated ways to improve the situation by seeking bilateral agreements with receiving countries such as Canada, Finland and Australia, among others.

“I have accepted globalization and I have accepted that Filipino nurses are bound to go. Let us tame the exodus; you cannot stop them; that is their human right. Let us tame it,” said Tan, an educator at the University of the Philippines (UP) College of Medicine and founder of Health Futures Foundation, Inc., which trains community health workers nationwide.

Though lacking official government backing, Tan was able to secure on-going negotiations from recruiting countries such as Finland, Canada, Australia and Bahrain to establish a trust fund for health human resources development.

“We can turn migration into a positive force rather than a negative force.”

The proposed RP-Partner trust foundation seeks the adoption of a Philippine region such as Iloilo, Surigao, Agusan del Norte and Agusan del Sur with the recruiter pouring direct investments in its health system.

Tan is also negotiating for employed nurses to return to the Philippines after two years of service abroad to share their knowledge among Filipino nurses for a period of six months. “I call this brain circulation,” he said.

For nurses who may opt to stay and teach in the Philippines, Tan has asked recruiting countries to provide a Masters Degree scholarship to be provided by the state or the hospital where the nurse is employed.

Other negotiations in the “win-win” bilateral agreement include the provision of three nursing scholarships in a Philippine nursing school partner for every Filipino nurse recruited by the state or the hospital and the improvement of a healthcare facility for every 10 nurses recruited.

For 20 nurses recruited, a nursing school should be improved and for 50 recruited Filipino nurses, Tan seeks for the improvement of a training hospital.

Tan’s research shows the Philippines remains the top exporter of nurses to the world and the number two exporter of doctors, following India.