Angelite Nurses

Philippine-born NFL star to set up hospital

2012-01-15T10:48:00.000+08:00

Tim Tebow, one of America's hottest new sports heroes, will help pay for a children's hospital in the poverty-stricken Philippines where he was born, his charity partners said Friday.
The $3 million, 30-bed facility will open in the southern city of Davao in mid-2013, the US-based charity CURE said in a statement on its website where a video message from the Denver Broncos quarterback was also posted.
"I've always had a a special place in my heart for the country in which I was born and I'm very excited about this project," Tebow said in the message as he appealed for the public to join him in donating to the hospital's fund.
"This hospital will change the lives of thousands of children in the Philippines."
The Tebow CURE Hospital will specialise in bone disease and injuries for children, with about of a third of the young patients expected to be charity cases.
The hospital will house a "Timmyâs Playroom" to be used by children who undergo surgery.
The Tim Tebow Foundation, established in 2010, plans to build playrooms in children's hospitals around the world, and the Davao one will be the first.
CURE spokesman Matt Shandera told AFP on Friday that preparatory work was under way to build the hospital this year.
"We have people working on this project there," he said in a telephone interview from the United States.
Tebow, a devout Christian dubbed by some in the press as "God's quarterback", is known for late-game heroics leading to seemingly miraculous, come-from-behind victories for the Broncos in the National Football League.
Tebow was born in 1987 in Manila, the Philippine capital, where his Baptist parents were then serving as missionaries.
CURE, based in Philadelphia, is a faith-based charity that runs hospitals in health programmes in 20 countries for patients who are unable to afford medical care.

Filipino nurses sought in Bahrain

2011-05-13T12:51:00.001+08:00

MANILA, Philippines – Bahrain is hopeful to fill up its urgent need for nurses with Filipino medical professionals —this is the good news that the Department of Foreign Affairs (DFA) announced recently.

Meanwhile, Bahraini Social Development Minister and Acting Health Minister Dr. Fatima Al Balooshi will communicate with the Embassy the Kingdom's health manpower requirements as soon as possible.

The Bahraini government expressed that Filipino medical professionals are highly regarded in Bahrain because of their professional competence.

In a recent meeting with Philippine Ambassador to Bahrain Ma. Corazon Yap-Bahjin, Dr. Balooshi , in addition, promised to look into the possibility of facilitating the recognition of the Filipino doctors' credentials as medical specialists .

The Philippine government is optimistic that Filipino doctors will also be able to practice their profession as such and receive remuneration corresponding to their professional and educational qualifications.

6 Filipinos back from Libya

2011-05-11T12:49:00.002+08:00

MANILA, Philippines—Six more Filipinos trapped in the violence-racked Libyan city of Misurata arrived in Manila on Thursday night, the Department of Foreign Affairs (DFA) said Friday.

The DFA also said seven Filipino nurses earlier reported missing in Libya have been accounted for, with five of them returning home with other Filipinos from the strife-torn north African country.

The six Filipinos, five of them nurses and an engineer, were fetched and rescued in Zitlin by Philippine officials led by Foreign Secretary Albert Del Rosario after being trapped in Misurata for 23 days.

Zitlin is the town closest to Misurata, Libya's third largest city. From Zitlin, the group traveled to the capital of Tripoli, then crossed the country's border with Tunisia.

With the six were three other Filipinos who were earlier brought out of Tripoli through the Tunisian border and flew out of Djerba on Tuesday, the DFA said.

The Filipinos were welcomed on their arrival by DFA officials and by a representative from the International Organization for Migration.

The six Filipinos were identified as Evangeline Garcia, Evjoalyn Calam, Catherine Galue, Valerie Joy Ventura, Celeste Canbangay, and Vincent Sanchez.

The nurses also confirmed that two other nurses, Bernadette Pavurada and Lilian Rosales, had sent them an e-mail saying they are safe and are now in Benghazi. They were part of the group of nurses working at the National Oncology Institute in Misrata who were earlier reported missing.

In the morning of March 18, Libyan government forces stormed the area where the six Filipinos were residing and camped beside their residence, just across the street where opposition forces were stationed, they told the DFA.

“What followed were days of non-stop fighting,” the DFA said of their ordeal.

“The Filipino workers were unable to leave because snipers from either side readily shot anyone seen on the street,” the DFA said.

“The nurses tended the wounds of the soldiers. Two of them said that they had to break into an abandoned pharmacy across the street to get medicines and tools to treat and even perform surgical procedures on the casualties,” the DFA said.

Their service prompted Libyan government troops to transfer the Filipinos to a safer place. “Twenty-three days later they found themselves in Zitlin, the town closest to west of Misrata where they were rescued by embassy officials,” the DFA sai

Why Do Nurses Eat Their Young?

2011-05-10T08:06:00.000+08:00

More and more Nurses are getting involved and looking for solutions that will end the scourge that has persisted for so many years and tarnished the good work and dedication of all Nurses everywhere.

Have you heard that phrase before? I graduated my Nursing Program way, way, back in 1955 and it was around even then. The perpetrator is usually a senior nurse with longevity but could be a new graduate bursting with new knowledge and techniques and anxious to give them a workout or it could be a Supervisor or someone with a higher or lower rank than the victim. Regardless who is creating the problem it is interesting that old cliché is still around in this the 21st Century.

I first encountered it when as an eighteen-year-old nursing student who had never been in a hospital had no idea what a hospital ward looked like. I was born at home, and my tonsils were removed on my Grandmother’s kitchen table when I was five. That was way, way, way, back, in 1935. So imagine my surprise to learn the "Ward" my Mother talked about when she had my brothers and sister, was not a long hallway with beds on either side, as I had envisioned, but a long hallway with rooms on both sides and it even had a kitchen. Yes, I remember it well.

We spent the first three months of our training in the classroom learning the basics of bedside nursing-bed making, vital signs, bed baths, enemas, along with medical terminology, anatomy, and other basic preparations for our initiation to "The Ward". We never got further than the lobby of the Hospital and the Cafeteria until the end of those first three months. Finally, the day came with the notification our schedules were changed. Starting immediately, we would spend four hours in the classroom every morning and four hours on the Ward in the afternoon. After class, we reported to our assigned Ward, and introduced ourselves to our R.N., Supervisor.

Miss G. was about four feet, ten inches, tall and weighed about ninety-eight pounds. She looked impressive in her starched, white uniform, white stockings, white, polished, shoes with clean, white, shoelaces, and perched on top of her head a starched, white, crinoline cap with a ruffled edge, with a black band around it. She wore her accessories with authority. Her school pin perfectly placed on her right chest, her nurses’ watch with its black, leather band and her black, winged, glasses, which she wore at the end of her nose so she could look directly into your eyes when she spoke. She was a retired Army, Staff Sergeant, probably in her middle thirties, and Single. Yes, I remember her well.

It was the first day of my first four- hour shift. Everyone gathered in the kitchen while the R.N. Supervisor dished out the diets on to a tray, from a warming cart, which we took to the bedside. I was assigned to feed a very ill young man, hooked up to an I.V. and too ill to feed himself. My patient had a bowl of Pea Soup, a glass of water, a cup of hot tea, a packet of sugar, and a glass straw. This was my first patient and the first time I would feed someone. I was scared to death.

I rolled his bed up, placed a napkin on his chest, told him my name, what I was about to do and asked him if he was comfortable. He nodded his head. I placed the glass straw into the bowl of pea soup and brought it to his lips. He was too weak to draw the soup up through the straw so I told him I would get a spoon and I would be right back.

Once in the hallway I forgot which way to the kitchen. I started back toward the Nurse’s Station and ran into Miss G. "Where do you think you’re going?" she said. "I’m looking for the kitchen." I said. "You mean to tell me you’ve been here an hour and a half and you don’t know where the kitchen is?" I looked at her with total surprise. "Yes.", I replied. She gave me directions and I was on my way.

There were lots of cupboards and drawers in the kitchen and I had no idea where they hid the tableware. I started opening drawers when I heard a sound behind me. Miss G. was standing in the doorway watching me. "Can you tell me where they keep the spoons?" I asked. "Don’t they teach you anything in that classroom? You were just in this kitchen. You don't remember where the spoons are. What kind of nurse do you think you will be if you can’t remember from fifteen minutes ago?" That was my intro to Miss G. and it was just the beginning. I finally got back to my patient but by that time, the soup was cold. I went back to the kitchen to get some warm soup. I’ll give you three guesses who was there and what happened next. The first two don’t count.

That was fifty-eight years ago. Do nurses still eat their young? Yes, they do and there is plenty of evidence to support its existence right here on the internet. Just go to any Nurse Blog or Forum and you will find page after page of comments from nurses, young and old, male and female, R.N.’s, L.P.N.’s, C.N.A;s, all venting their frustrations about the treatment they endure from NURSES WHO EAT THEIR YOUNG. Why do they do it? They do it because they can.

Fortunately, there is hope for the future. Due to Nursing Forums like this one, more and more Nurses are getting involved and looking for solutions that will end the scourge that has persisted for so many years and tarnished the good work and dedication of Nurses everywhere. Now if only someone would start teaching "How to build a team" or "Teamwork is the answer" that would be a place to start.

I Want to be a Nurse, I Want to Make a Difference

2011-05-09T08:05:00.000+08:00

My inspirational patient

During my clinical rotation in the nursing home, I was assigned a gentleman in his 70's (we'll call Mr. Smith), as my patient. Mr. Smith had severe Alzheimer's disease, which had progressed very quickly. He had gone from sailing solo from the coast of Maine to the coast of Florida, to not being able to remember his name or that he could no longer walk, in just a few short years. This was even more depressing when I learned that he was a retired geologist, who had implemented clean drinking water systems in third world countries.

Today, he just sits in his chair, day in and day out. He can no longer care for himself, and due to what the Alzheimer's has done to his mind, neither can his wife. She visits every couple of days, but he doesn't recognize her. In his room, are a few pictures of he and his wife and of his sailboat. Although these pictures were only taken a few years ago, his looks have totally changed. Mr. Smith has a history of being combative and gets nervous when around a lot of people. Mr. Smith doesn't get a lot of attention from the staff for these reasons. I made up my mind that I was going to spend as much time interacting with Mr. Smith as I could and hopefully make a difference to him.

This was going to be difficult because Mr. Smith has trouble communicating, he is hard to understand because he mumbles and stutters. Even when you can understand him, he answers inappropriately or get tripped up on his words, get frustrated and shut down. Four days of reading his magazines to him, pointing out pictures and making small talk, had left me feeling pretty useless. He almost seemed to look right through me and I never felt like I was making a connection.

On our fifth day together, the day went like all the rest. I took him outside to sit in the courtyard, smell the fresh air and flowers and listen to the birds chirping. I helped him eat his lunch and complete his ADLs. We sat in his room, looking at his magazines and talking, of course talking meant that I was doing all the talking and he was just looking off into the distance.

When it was almost time for us to leave for the day, my instructor came into the room and spoke to us for a moment, kneeling down in front of Mr. Smith. When he left the room, Mr. Smith surprised me by saying, "He's a nice man, isn't he?" He said it so clearly and with so much meaning, it caught me off gaurd. I told him that I thought he was a nice man too. Then Mr. Smith did something I never expected and will never forget. He turned and looked me in the eyes, touched my chin and said, "And you're just the sweetest thing."

That was such a heartwarming and sentimental moment, I had to choke back a tear. I'll never forget Mr. Smith and our time together. He confirmed my desire to be a nurse so that I can help someone. To help that someone, who so many have given up on.

I really got through to him, I really made a difference.

The Ethics of Managing Your Personal Time

2011-05-08T08:04:00.000+08:00

Ethics involves more than how we treat our patients; it involves how we treat our coworkers as well.

There’s a lot said about ethics in nursing, and much of it -- most of it, probably -- pertains toward the ethical treatment of patients. Not charting meds you haven’t given or procedures you haven’t done, admitting your med errors and setting about to mitigate the damage just as soon as you realize you’ve made an error, truth and honor in communicating with other members of the health care team. Those are all examples of nursing ethics and I won’t denigrate their value. But it seems to me that managing your personal time is as much about ethics as any of those other topics.

Nursing, especially hospital nursing, is a job that must be covered 24/7/365. Nights, weekends, holidays and the night of the biggest blizzard or biggest tornado of the year notwithstanding, our patients must be cared for. If your nurse manager is getting married and everyone wants to be there, someone still has to work. If a valued colleague is being buried and everyone wants to be there, someone still has to work.

I will never forget the day a popular night nurse was being married and 7 of the 13 nurses scheduled for the night shift developed sudden cases of the flu. Six of them were front and center trying to catch the bouquet when the manager snapped a picture . . . and all of them were sitting in her office on Monday morning signing letters of reprimand.

Most of us have so many hours of sick time. We’re supposed to use it to cover actual illnesses, although many have extended that to cover mental health days as well. That’s great if you can manage it. Our hospital’s attendance policy is so strict and so unreasonable that it mandates coming to work sick even while the written policy explicitly forbids it. If you’re disciplined for using more than three sick days a year and you’ve already had food poisoning, an abcessed tooth with a fever of 104 and a child who broke their arm jumping off the roof just as you were leaving for work, you’re either going to come to work with the flu or risk being disciplined. You’ll probably base your decision less upon how contagious you might be and more upon how many occurences you’ve already had, where you are in the disciplinary continuum and how much of a rule-follower you are.

It seems to me that ethics ought to be about managing our personal time off -- and I’m mostly talking about sick calls here -- in such a manner that you’d be happy to explain your decision making process on “Sixty Minutes” , to your priest in the confessional or to St. Peter. If you’re not sick on Christmas Day, please don’t call in sick and force the rest of us to work short. None of us want to be there on Christmas, either, and we’d appreciate a chance to sit down for lunch to enjoy the potluck we’ve all contributed to. If you’re not scheduled off the day of the unit picnic, and you can’t arrange to trade shifts with someone who isn’t interested in going, please show up for work. Calling in sick that day is just not cool. Nor is it ethical.

If your water heater explodes giving you second degree burns, by all means, call in sick. That’s what sick time is for. But most people never have that experience and I find it difficult to believe you’ve had it happen three times so far this year. Ditto with the death in the family excuse. How many grandmothers did you have, anyway? Even if we counted step-grandparents and great grandparents, eight seems to be a bit excessive.

It ought to go without saying that we treat our co-workers with honor and integrity. Unfortunately, it needs to be said.

Don’t blow off your call shifts. Saying “I forgot” just does not fly -- especially the second and third time it happens. If you’re not in the ER or the funeral home, come to work on your scheduled Christmas and Thanksgiving and if your grandmother isn’t dying, don’t say she is so you can avoid work. There are times it sucks to be a hospital nurse and come to work when everyone else is having a good time. That’s what we signed up for, though, so that’s what we ought to do.

Compassion: A Dirty Word

2011-05-07T08:03:00.000+08:00

Language evolves, sometimes in unanticipated directions. The word "compassion", once used in a positive manner, now seems to be used mainly in bemoaning it's lack.

I’m beginning to feel as though the word “compassion” is a dirty word. Maybe it’s the way people use it these days. It doesn’t seem to be about an actual feeling of empathy toward a patient, family member or even a colleague. It seems to be more about “ME ME ME.” The word is used more as a bludgeon to impugn someone’s character, motives or behavior than as a descriptor. It’s used to induce -- or to attempt to induce -- feelings of guilt rather than to praise or validate.

“I’m pregnant and I don’t think I should have to bend, lift, take isolation patients or work twelve hour shifts. My co-workers aren’t helping me at all. Where is the compassion?” (Perhaps the co-workers are tired of being dumped on, of doing all the bending, lifting, taking isolation patients and doing 12 hour shifts while Princess is languishing at the nurses’s station complaining about her nausea and regaling all with tales of her latest OB visit.)

“A mistake was made and a patient didn’t die, but they’re firing me anyway and I can’t get unemployment. Why no compassion for me?” (Of course *I* didn’t MAKE the mistake -- it just happened. Or if I did make it, it was because the charge nurse was mean to me, my Granny is in the hospital, I didn’t get much sleep because the neighbors were so noisy and no one taught me how to give meds anyway. Just a wild guess, but no compassion for you because you’re so busy feeling sorry for yourself that you’re not taking personal responsibility for MAKING the mistake in the first place, and you don’t seem to grasp the potential ramifications of the mistake.)

“The nurse wouldn’t give me extra water after that doctor made me NPO, find a charger for my cell phone or a bed for my girlfriend to spend the night with me. She/he was polite and professional and all, but she/he wouldn’t put out the warm fuzzies and the pillow fluffing. That nurse has no compassion!” (This usually comes after the patient in question has verbally and/or physically abused the nurse and questioned his/her parentage and sexual proclivities. Nurses, being human and all, aren’t usually inclined to go above and beyond for people who aren’t nice to them.)

“You are all MEAN! You’re just jealous because I’m so much younger, smarter, better educated and more beautiful than you. It’s true that nurses eat their young. And I thought nurses were supposed to be compassionate!” (Is it really “eating your young” if the “young” is so obnoxious, entitled, lacking in basic social graces and self-centered they cannot interact as adults and professionals with the adults and professionals around them? Trust me, Honey, if you were nicer to those old, fat, dumb, uneducated and ugly nurses who work at the same place you do, you might not have cause to complain about they way they treat you. Not that that would stop you from complaining anyway . . . . .)

“It has always been my dream to be an ER nurse, but you people are all scaring me! I never want to be as jaded and cynical as you! You should all quit and find another career because you have no compassion!” (Yes, it is my mission in life to avoid scaring anyone reading a vent thread and I’ll hop right on that change of career thing -- as soon as the mortgage is paid, the bills go away and I have time and money to go back to school to learn to be something that requires no compassion!)

It’s been a long time since I’ve seen anyone use the word “compassion” in a positive way. It’s getting so I cringe when I see the word in type or hear it -- usually in a complaint because someone didn’t get everything they wanted or felt entitled to.

2011-05-05T19:17:00.000+08:00

PH: 1 of 3 countries on Norway’s watch list for health personnel

By Macel Ingles, ABS-CBN Europe News Bureau
The Philippines landed on Norway’s state authorization office watch list for being a problem area when it comes to recruitment of health workers.
In a recent report by Norway’s national broadcaster NRK, it was revealed that an employee of the Statens Autorisasjonskontor for Helsepersonnell (SAFH) sent a letter to the health department alleging that many foreign health workers have slipped through the control of SAFH and had been authorized to work in Norway despite lack of medical training and qualification.
The letter also said that the Philippines along with Serbia and Romania had the most number of applications from health personnel with dubious credentials to work in Norway.
Confronted with the report, acting SAFH Director Jørgen Holmboe denied any knowledge of the letter and said that his office only has few cases of applications with dubious credentials.
However, he admitted that his office is overwhelmed by the number of cases being processed by the office. The SAFH has 20 employees and processes 22,000 applications for authorization to work as health personnel every year.
Hølmboe took over from SAFH’s former director Per Haugum who stepped down from his office in May this year after heavy criticism from the health department following media reports of cases of foreign health personnel authorized by SAFH to work despite lack of proper health education and training credentials.
Reacting to the report, Philippine Nurses Association-Oslo President Cesar Dela Cruz told ABS-CBN Europe in an email interview that he disagrees with the report.
“Since I began working as a nurse in 2001, I only knew one (Filipino) who applied for licensure with a falsified board certificate,” Dela Cruz wrote.
Filipino nurses Alfredo Morte and Rosemarie Ruiz who were interviewed by NRK in the same report confirmed that a number of Filipino nurses in Norway do not have proper medical credentials to work as health personnel.
“I don’t understand why these Filipinos continue to ruin our credibility in the media without any move of contacting us in the PNA so as to discuss these things and find solutions among us Filipinos. I strongly challenge these people to show us concrete evidences and I promise that they’ll get my support,” Dela Cruz further wrote.
However, Dela Cruz said that PNA is willing to cooperate with Norwegian authorities if they are deputized to do so. He also said his organization will support the call for withdrawal of visas and work permits to personnel found to have submitted fake papers to the authorization office “after they have undergone due process.”
“I can say that they can be threats to the health system of Norway and at the same time a shame for our nation,” Dela Cruz added.
Norway recruits thousands of nurses from the Philippines each year. The Philippine embassy in Oslo is currently negotiating for a bilateral agreement with the Norwegian government for the recruitment of health personnel.

CA orders freeze of 41 bank accounts

2011-05-04T19:17:00.002+08:00

By Rey G. Panaligan
The Court of Appeals (CA), on request of the Anti-Money Laundering Council (AMLC), has ordered a freeze for 20 days on the 41 bank accounts of an overseas employment agency on charges of illegal recruitment.
Ordered frozen were the bank accounts of the Makati City Base International Students Advisors 4U, Inc. (ISA 4U) that specializes on a “study and work program” for Filipino nurses and other professionals for deployment in the United Kingdom.
The CA identified the accounts of ISA 4U as those in the Metropolitan Bank and Trust Co. (Metrobank), Hong Kong and Shanghai Banking Corp. (HSBC), Banco De Oro (BDO), Philippine Savings Bank (PSB), Citibank, and Union Bank.
In a resolution written by Associate Justice Japar Dimaampao, the CA said that “…the obtaining facts and circumstances tellingly demonstrate a well-founded belief that the bank accounts in the names of respondents are related to or involved in an unlawful activity or money laundering offense.”
The freeze order, the CA explained, would prevent the banking institutions from allowing ISA 4U to withdraw, transfer, or deplete the existing funds in the accounts.
The banks were directed to submit to the CA and to AMLC a detailed return within 24 hours from receipt of the resolution stating compliance with the freeze order and specifying relevant information on the bank accounts.
The CA set a hearing on the AMLC’s request at 2 p.m. on May 5 “to determine whether or not the instant freeze order should be modified, lifted or extended.”
ISA 4U was charged with illegal recruitment in a complaint filed by the Philippine National Police-Criminal Investigation and Detection Group (PNP-CIDG).
The PNP-CIDG said ISA 4U is a domestic corporation engaged in providing advisory, marketing consultancy services of training courses, college courses and university courses of other foreign countries. - via www.mb.com.ph

What nursing will be like in the FuTuRe!

2011-04-26T21:20:00.000+08:00

In a time where our economy is shaky, government is uncertain, and a customer service driven terminally ill health care system, we all tend to wonder out of fear and anxiety what our field will be like in the future.

Let's face it ladies and gents, at the rate we're going at I don't believe many of us will be retiring as soon as we'd like to as our careers continue on unnaturally, many years from now I can easily see the following:

1) It will become common place for 90 year old nurses to be hoofing it up and down the halls of the med/surg floor comments such as, "Is it time for my lunch break yet? I'm having Jevity 1.5 tonight!" and "Damnit, go get the charge nurse I'm leaking embalming fluid again." are certain to be heard. Hospitals will have long been smoke free, but to show compassion to their nursing staff with COPD smoke breaks will be replaced with 2 ten minute nebulizer and Solu-Medrol breaks.

2) To receive health care in this town is to revieve health care YOUR way! That's right, ER's will have a drive through option! I can just hear it now...
"Hello sir, I would like a monitored telemetry bed for the #2 Pneumonia and CHF combo with a large dose of Avelox, a medium dose of Lasix with extra duonebs. And my daughter would like a non telemetry bed for the nausea, vomiting, abdominal pain triple, Dilaudid and Phenergan only please, oh and let's make her admission a 23 hour obs, she's got a date tomorrow night."

3) Nursing Homes will be exactly that, homes for nurses who are too demented to continue working, they'll still be allowed to dress in scrubs and be encouraged to continue "working" within the safe confines of an ill-reputed rest home. Picture all the granny nurses feeding their doll babies ice cream saying things such as "You'll eat your full liquid diet and like it, sonny!" The staff will actually be security guards charged with the duty of keeping us under control, after all by this point we nurses will have become quite violent after all the crap we've gone through.

4) Back at the hospital, fall risk assessments will be for employees only. Hospital visitors will be encouraged to assist any nurse they see with an armband that says "FALL RISK", please assist that nurse to the next room so that she/he may continue performing their duties on the next patient SAFELY!

5) Risk Management will be renamed "Disc Management" in an attempt to help all the aching backs of their loyal health care workers and to determine "who's at risk for slippin' a disc!"

In all seriousness, I do worry tremendously about never being able to retire, working until I'm literally too feeble physically or mentally to work anymore, and about the general state of health care. However, I do find that making light of it makes the worry less intense. Please feel free to add your vision of what futuristic health care will be like!!!

Nursing Ethics: About The Weather

2011-04-25T21:20:00.000+08:00

What happens when the nurse who doesn't believe in calling in sick......calls in sick.

Come to think of it, I guess this could have been called "Bashed by Bronchitis", or "Flattened by the Flu", because elements of both illnesses have reared their ugly little heads during the past few days. It started out as a head cold and quickly evolved into fever, sore throat, body aches, and a cough that's turned my chest into raw hamburger; in short, I feel like I've been run over by a truck. While it's nothing like the pneumonia I had in February of 2010 (actually, there isn't much that IS like that, thank God), after spending this entire winter feeling like something the dog found under the house, I am, quite literally, sick and tired of being sick and tired.

I've long prided myself on my stellar immune system, which used to be strong enough to fight off the squirrels in the front yard. While everyone around me was dropping like flies, I soldiered on, taking care of the sick and the weakened, my invisible coat of armor protecting me from all invaders. I figured that I owed it all to being a nurse; after all, we get exposed to just about everything under the sun, and if it doesn't kill us, it makes us almost invincible.

Almost.

Which has made it increasingly difficult to stick to my policy of never calling in sick unless I can't get my head a) out of the toilet, or b) off the pillow. Today, I wasn't totally flat on my back, but the potential consequences of spreading my pestilence to the residents and staff at my ALF were too horrible to be contemplated......and if truth be told, I really didn't relish the prospect of having to exchange my warm, comfy sweats for chilly polyester and making that 40-mile commute.

Now, calling in sick---even when I'd have to get better to die---is harder for me than giving a speech in front of a roomful of people. I lay there in my recliner, cell phone in hand, rehearsing my excuse over and over again, feeling as guilty as if I were sneaking off to the beach instead of being genuinely ill. And when I finally scared up enough courage to hit the speed-dial button (it's "2" on my Favorites list) and talk to my boss, he........wasn't in yet. I wound up talking to the marketing director, who said something like "Oh, my gosh, I didn't even recognize your voice---you sound TERRIBLE!" and promised me she'd let him know that I wasn't coming in today.

Instantly, I felt even worse: what if she forgot to tell him? What if he thought I just didn't bother to show up, like the last nurse who worked in this building? This is my dream job, I don't want to lose it by being considered a no-show, maybe I should just pull myself together and go in anyway.........

Next thing I knew, it was two hours later. I probably would've slept even longer had I not begun coughing up what felt like part of a lung, and wheezing so audibly I could barely hear myself think. I wished for a dose of the wonderful cough syrup they gave me when I was so sick with the pneumonia last year. I wanted to reach down my throat and scratch until it bled. My tongue itched. My teeth were furry and disgusting. Even my husband didn't want to kiss me. My son, the CNA and newly-minted medication aide, suddenly appeared and loomed over me with his six-foot-one-inches, peering at me with a practiced eye: "Mom," he said cheerfully, "you look like crap."

"I love you too," I retorted. He was the one who'd caught this bug from his fiancee and promptly passed it along to his aunt, his dad, and now me.......and yet, he hadn't missed a day of work. So why did I feel so lousy then?

"That's because you're older and you're a diabetic," he pronounced, looking extraordinarily pleased at his expert assessment as he pecked me on the forehead. "You've just got to take better care of yourself, Mom. Gotta go to work now, see you later!"

I wanted to smack him for his impertinence, but I was moving too slowly to do more than swat at him as he sailed out the door. Smart-aleck kid.....he's got just enough medical knowledge to be a huge PITA. Can't imagine where he came by it. But when I dragged my sorry carcass into the bathroom and got a good look at myself in the mirror, I had to admit he'd been right about one thing: I did look like crap. More to the point, I looked like something the dog had not only found under the house, but tossed around the yard for awhile, buried, dug up again, and deposited on the living-room rug.

This evening, I'm feeling marginally better......still sneezing and wheezing and freezing, but now that the gunk in my lungs is breaking up and I've been able to eat some soup and toast, I think maybe I just. might. live.

Anybody know where I can get my hands on some Phenergan-with-codeine cough syrup??

University's student visas halted

2011-04-24T21:18:00.000+08:00

(UKPA) – 1 day ago

A university has been suspended from sponsoring foreign students after concerns were raised that the student visa system is being abused.
Glasgow Caledonian University is the first university to have its international licence suspended by the UK Borders Agency (UKBA).
It is understood concerns were raised over the amount of time nursing students from the Philippines were spending working during their course following an inspection by UKBA last week.
The university now has 28 days to demonstrate to the Home Office that it has addressed the concerns or it may have its licence revoked.
Phil Taylor, UKBA regional director in Scotland and Northern Ireland, said: "I can confirm that Glasgow Caledonian University's tier 4 licence has been suspended following concerns about abuses of the immigration system.
"Highly trusted sponsors bringing in international students must ensure that they are attending the course for which they are enrolled and that they are complying with the requirements of the immigration rules. The UK Border Agency makes regular checks on sponsors, and where we find evidence that they are not fulfilling their duties, we may suspend their licence."
New rules governing student visas, including stricter entrance criteria and limits on work entitlements, came into force in the UK on Thursday.
A Glasgow Caledonian University spokeswoman said: "GCU (Glasgow Caledonian University) is co-operating with the UK Border Agency to address issues specific to a group of international students on the BSC nursing (professional development) and we expect to have these resolved in the near future.
"As conversations are ongoing, the UKBA has asked the university to implement a 28-day suspension of our processing of immigration paperwork, as their processes require.
"While we feel that this action is disproportionate, we are working with them to fully understand the issues and implement any changes needed as a result. Our duty of care to our students is our absolute priority and they have time and again recognised that by voting us top in Scotland for international student support. We are proud of that and will ensure it remains the case as we make any changes requested of us."
Copyright © 2011 The Press Association. All rights reserve

Pinoy nurse, teen win Twitter Shorty Awards

2011-04-23T21:17:00.002+08:00

Filipinos were among the winners in the 3rd annual Shorty Awards, said to be the “Oscars” of Twitter, according to The New York Times.
The Shorty Awards gives recognition to people and organizations doing short-form and real time social media content.
The winners are chosen based on the number of votes garnered on Twitter and the votes cast by members of the Real-time Academy of Short Form Arts and Sciences.
In the new “Nurse” category this year, the Nurse of the Year Award was to be given to someone they said is “making a difference through social media.”
Two winners were picked for this category. One is Matthew Browning, chief executive officer of yournurseison.com
The other winner is Filipino nurse Ronivin Pagtakhan, an educator.
Pagtakhan, who teaches nursing at Mapua, uses Twitter to help other people.
“Para sa akin, sa tingin ko, kaya ako napili kasi nakakatulong talaga ako sa nursing profession,” he said.
Pagtakhan is happy about the international award as it can help uplift the image of the Pinoy nurse.
“Sana sa pagkapanalo ko na ito ay makatulong ako sa image ng Pinoy nurses para naman makakuha pa tayo ng mas maraming mga job opportunities kasi alam kong marami tayong nurses na walang trabaho,” he said.
Aside from Pagtakhan, Ann Li of “PBB Teen Clash” also won a Shorty Award.
The teen won in the fashion category. – Report from TJ Manotoc, ABS-CBN News

First newspaper for docs, health care professionals out soon

2011-04-22T10:45:00.000+08:00

To keep doctors, nurses and other health care professionals abreast of all new developments which impact health care delivery in the country, FAME Inc. is coming out with Vital Signs, the first of its kind newspaper for them.
Vital Signs will include opinions, commentaries and views of respected leaders in the medical profession and government who all share the common vision of better health care for all Filipinos, especially those belonging to the marginalized sectors.
The list of columnists of Vital Signs include Sen. Edgardo Angara; Health Secretary Enrique Ona; former Health secretary Esperanza Cabral; Dr. Oscar Tinio, president of the Philippine Medical Association; Dr. Ramon Abarquez Jr.; Dr. Saturnino Javier; Dr. Anthony Leachon; Dr. Maya Santos; and Dr. Cynthia Cuayo-Juico.
The newspaper will feature articles and commentaries from some of the country’s top doctors and medical practitioners.
This would also allow doctors and other health care professionals to know what their respected colleagues say on current scientific, socioeconomic, political and other issues that impact healthcare in our country.
It will also serve as a medium for local medical societies to disseminate updates regarding their advocacies and activities.
“We hope to empower doctors, dentists, nurses and other health care professionals with scientific, socioeconomic, legislative and other news which are relevant to their practice,” says Dr. Rafael Castillo, Vital Signs editor.
He added that the insights and opinions of respected columnists can also help guide the readers of Vital Signs in various decisions they need to make as health care stakeholders aiming to improve the practice of their respective professions and health care delivery in the country.
Vital Signs comes in three sections. The main section contains hard news and commentaries, opinion columns, activities of hospitals, medical organizations and the pharmaceutical industry.
The second section is called Hippocrates which contains scientific and clinical updates, nursing updates, and medical issues and controversies.
The third section, called Off-Duty, is the lifestyle section which includes articles on dining, travel, fashion, motoring, finance and sports.
Vital Signs is published by FAME Inc., which also publishes several full-color glossy magazines such as H&L (Health & Lifestyle), Zen Health, Travel Plus, DiabetEASE and Disney. - via philstar.com

Filipino nurses working in Wales tell their stories

2011-04-21T10:43:00.000+08:00

Katherine Casaban-Rose

Last year 8,500 nurses and midwives came from abroad to work in the UK, many from countries such as India, Pakistan and the Philippines. This year, with foreign recruits set to outstrip the number of newly-qualified British nurses for the first time, Clare Hutchinson spoke to nurses who travelled from the Philippines to work here in Wales
KATHERINE Cabasan-Rose was 26 when she first moved to the UK a decade ago.
At first it was a strain to leave family and friends behind but the money, she said, was worth it.
Ten years on and 36-year-old Katherine has a Welsh husband, a five-year-old daughter and earns a decent wage as a ward manager at the burns unit at Morriston Hospital in Swansea.
It is a far cry from life in her more “primitive” homeland, where the average monthly wage for a nurse is around 700 Philippine Pesos, the equivalent of £100.

Katherine trained as a nurse in Tuguegarao City, in the far north of the country.
Nurses in the Philippines, she said, are trained to work hard and fast because of the sheer numbers of patients who come through the country’s private healthcare system on a daily basis.
Emphasis is on getting the patients “in and out” and it is this work ethic, and the attraction of wages, that makes the Philippines such fertile ground for NHS recruitment.
When Katherine moved to the UK after three years in Saudi Arabia she saw it as a stop-off point on her way to the USA.
“I wanted to move to the UK because I thought it would be easier to get to the States from there,” she said.
“I came straight to Wales and when I arrived I found I liked it – wherever you go people smile and chat with you.
“I went to New York for a holiday to see what it would be like working there and the people seemed to be snappy and I thought, ‘maybe I don’t want to work here after all’.”
Katherine now lives with her Welsh husband Andrew, 39, and their daughter Elizabeth in Llandough, near Penarth, where she plans to stay until she and Andrew retire, after which they will spend their summers in Wales and winters in the Philippines, because, she said: “The one thing I can’t get used to here is the weather.”
She stays in touch with her classmates from Tuguegarao City on Facebook and finds them scattered around the world in countries as far-flung as America and Australia.
When Katherine first came to Wales, she said, the language barrier was hard and it was sometimes difficult to mix socially with her non-Filipino colleagues.
But now on a works’ night out she is happy to be the only non-drinker and on a recent international day at her daughter’s school she spent 20 minutes telling the children about the Philippines and letting them taste its traditional dishes.
She said: “I’m happy here because I have been given a good opportunity, we have a good standard of living and I have friends here.
“It is an opposite culture to back home, which is a bit primitive, although it is becoming more Westernised.
“I go home every year because it is the only time I can see my family, but it is like my mum says, ‘love your life, but don’t forget us’.
“I do love my life and I love my job – as far as I’m concerned it is the best job in the world.”
Jaime Menor moved to Wales from his country’s capital, Manila, in 1999.
The dad of one, who works in the intensive care unit at the University Hospital of Wales, took a job in the UK for financial reasons.
It is part of Filipino culture for working people to help their families by sending money to parents, cousins, aunts and uncles – whoever is in need.
Jaime, 38, who lives in Llanrumney with his Filipino wife Mary, 31, and their four-year-old son Elijah, said: “I responded to the recruitment drive at the time primarily for financial reasons, because the wages here are much better than back home, and also as a way to help my family.
“I was apprehensive to start with because I didn’t know what to expect or what life would be like here.
“I knew it would be an expensive place to live, but the worst thing for me was being away from my family.”
When Jaime arrived in the UK he came straight to Cardiff, where he has stayed ever since.
“It is very good here,” he said.
“Cardiff in particular is not a big city but it has a cosmopolitan life and at the same time you can get out of the city and experience the country.”
When it comes to his work, there are some striking differences between the private healthcare system in the Philippines and public NHS in Wales.
“Obviously you are treating people with the same conditions and in similar ways, but you find that because in the Philippines it is all private, once you get better you are out of there because the longer you stay the more you spend.
“Here, because of the NHS, you stay as long as you need to.
“As a nurse working in the Philippines you just treat people and discharge them, but here you are looking at the total needs of the patient.
“You look at how old they are and ask will they cope? Are they living alone? Are they safe? If they aren’t then you talk to certain agencies. And, of course, there is lots and lots of paperwork. That is what I found difficult adjusting to at first.
“It is much better here in the UK, but I think we can still improve, for example waiting lists for surgery are still very long, but then if it is something acute, if you are unwell, you can go to the emergency unit and get treated straight away, which is wonderful.”
Up until January, Jaime was working at the smaller intensive care unit at Llandough Hospital where, he said, he had a good relationship with his colleagues.
He said: “We really enjoyed each others’ company and we knew each other very well.
“There has been a bit of a change and I work in the Heath now and I am having to get used to new people and new equipment, but everyone is very helpful and supportive.”
Jaime’s wife Mary, who is also a nurse, moved to the UK four years ago after the couple met in the Philippines during one of his annual visits.
But while both have family back home, they have no intention of leaving their adoptive country.
“I have invested too much here in Wales,” said Jaime.
“I have got a mortgage, a little boy, I know people here and I’ve established friends – Filipino and Welsh.
“We are more or less settled and I think this will be it, although if I win the lottery I will buy a much bigger house.
“I’m an adopted Welshman and I’m here for good.”

Nurses recruited to offset shortage

2011-04-20T10:31:00.003+08:00

Hala Khalaf and Ramona Ruiz

Recruitment agencies are to hire hundreds of nurses in coming months after a surge in demand from new health care facilities caused a nationwide shortage.
Nurses are being recruited from countries including the Philippines, Lebanon, Jordan, Syria and India to staff new medical centres as well as three hospitals opening this year in Sharjah, Fujairah and Ajman.
Dr Sanjiv Malik, the executive director at DM Healthcare Group in Dubai, said the expansion in health care required not only more workers, but workers with new skills.
"New hospitals are opening and there are new specialities coming up in the UAE," he said.
"Ten years ago, people used to travel overseas for treatment, but health care is becoming bigger and better here."
The recruitment drive complements efforts to woo Emiratis into the sector by combating perceptions of nursing being a low-wage, low-status job with limited career opportunities.
A forum will be held on Monday at the American Hospital in Dubai to outline a framework allowing nurses to pursue specialisities, such as paediatrics or geriatrics, that offer higher salaries and better career prospects.
The shortage of nurses is a "global phenomenon" that made hiring nurses extremely competitive, said Dr Malik.
"It exists in countries such as the US, England and even in India, with the majority of the nurses there leaving the country to work overseas."
In February, Al Qarain Healthcare Centre opened in Sharjah, with facilities including two dental clinics, a radiology and laboratory department and a pharmacy.
Five further medical facilities are being built in Sharjah, Ajman and Ras al Khaimah, which are expected to cost a total Dh1.25 billion, according to the ministry.

The UAE's medical recruitment drive will involve the hiring of more than 700 staff at the University Hospital - Sharjah, the emirate's first teaching hospital, which is due to open at the end of this month, according to sources at the hospital.
Peteromy Dominic Palacio, 28, who works as an HR co-ordinator at the hospital, said they were hiring nurses from the Philippines, the Indian subcontinent and Arab countries. Last year, the Philippine Overseas Employment Administration in Manila approved the hospital's request to hire 70 nurses through a recruitment agency.
Edna Rance, a business development manager at Reach Consulting in Abu Dhabi, helped the hospital recruit 50 nurses from the Philippines in June last year. It was one of several recruitment projects she worked on for the Abu Dhabi Health Services Company and the federal Ministry of Health.
"Several new hospitals are opening in the UAE," she said. "This year, we expect to hire at least 200 nurses on behalf of our clients."

In January last year, her group helped the Ministry of Health hire 100 nurses from Jordan and 228 nurses from the Philippines for Masafi Hospital in Fujairah. A delegation from the Ministry of Health flew to both countries to conduct the licensing exam and interview applicants.
Private nursing companies also contribute to the demand for nurses. Al Hilal Nursing and Medical Services in Dubai said in February it planned to hire 200 nurses to add to its staff of 30 nurses and three physiotherapists. The company outsources nurses to schools and private clinics and provides home care to Emiratis and expatriates in Dubai. Half of the staff will be sent to schools, private clinics and homes. The rest will work at a private hospital in Dubai that is due to open in June.
Recruitment is only the first hurdle to overcome. In the UAE, nurses cannot be hired directly after passing their licensure exams. Employers must check their credentials, including their university degree and experience certificates, which can take up to six months.
"While it ensures the quality of nurses that are hired and that all their credentials are correct, it may lead to an artificial manpower shortage," Dr Malik said.
rruiz@thenational.ae
hkhalaf@thenational.ae
* With reporting by Mitya Underwood and Bana Qabbani

DOLE honors 1st Pinoy passer of Japanese nursing exam

2011-04-19T10:29:00.000+08:00

Being the first Filipino to pass the Japanese Nursing Licensure Examinations, the Department of Labor and Employment (DOLE) honored Ever Gammed Lalin as the Woman OFW Achiever of 2011.
“Ever Lalin made history being an exceptional woman achiever in migration. She had proven that Filipino nurses, and OFWs in general, are professionally competent and skilled as they join the world labor market,” DOLE Secretary Rosalinda Dimaplis-Baldoz said in a press statement.
Baldoz said the department cited Lalin’s achievement as the Japanese Nursing Licensure Examinations is “famed for its difficulty.”
Lalin was the only passer of the exam taken by 254 foreign board takers.
Baldoz, along with POEA Administrator Carlos Cao Jr., welcomed Lalin’s family in an awarding ceremony at the DOLE Building in Intramuros, Manila, last week.
Aside from the award she accepted, Lalin also received an overseas exit clearance (OEC) from the DOLE, which frees her from the lengthy clearance processing. - (Edward Sumile/Philstar.com trainee)

More Pinoy nurses heading to Japan for licensure exam

2011-04-18T10:29:00.000+08:00

Despite a devastating earthquake and tsunami that hit Japan this month and the ensuing nuclear accident, a third batch of over 80 Filipino nurses are scheduled to go there on May 30 for a language training in preparation for that country’s tough licensure examinations.
In a press briefing, Japanese Ambassador Makoto Katsura said a total of 82 Filipinos will leave for Japan to undergo intensive Japanese language training there, after a two-month preparatory language course in Manila to be conducted by Japanese instructors.
“Although I have no doubts that you will be able to fulfill your duties and responsibilities as healthcare professionals in Japan, I am also aware that one of the most difficult obstacles for passing the Japanese nursing licensure examinations is the language barrier,” Katsura said at the formal launch of the training course.
This is the first time that Japan is implementing a preparatory language course prior to the applicants’ departure for Japan. Only two of the 139 Filipino nurses in previous batches passed that country’s licensure exam.
Apart from the preparatory course, Japan has also revised its licensure exam for foreign nurses and caregivers to boost the passing rate of health workers. (See: Japan cuts Filipino nurses some slack)
The revisions include the use of English words for medical terms originally in Japanese, like diabetes, cataract and pulmonary tuberculosis.
Since 2009, the Philippines has sent a total of 139 nurses and 299 caregivers to train in Japan through the controversial Japan-Philippines Economic Partnership Agreement (JPEPA) signed in 2006.
Various groups had earlier questioned JPEPA’s constitutionality before the Supreme Court, saying the treaty violates constitutional provision on trade, natural resources, labor, education, mass media legislation, public utilities and foreign policy. (See: Groups question Jpepa constitutionality at SC)
The Japanese Embassy said it has been taking steps to help Filipino nurses maximize employment opportunities for Filipino nurses under the treaty.
“This demonstrates the perseverance and dedication of both countries to take initiatives in improving the standing of Filipino candidate nurses in particular, especially in successfully integrating them, through language,” Katsura explained.
Nurses who fail Japan’s licensure tests in Japan can only re-take the exam within the period they are allowed to stay in Japan.
If they still fail the examination, the nurses would have to return to the Philippines to apply again for training.
Apart from the six months of paid language training, Filipino nurses and caregivers are employed in Japanese hospitals and care-giving facilities for three years and four years, respectively, to familiarize themselves with the country’s healthcare system.
During that time, nurses undergoing work-training receive an average monthly salary of 130,000 yen to 220,000 yen (about P68,000 to P115,000) For caregivers, the monthly salary ranges from 125,000 yen to 185,000 yen (about P65,000 to P96,000).— With Jerrie M. Abella/JV, GMA News

Nurses Press Government for Jobs, Decent Pay and Outright Ban of ‘Volunteer for a Fee Training’ Scheme

2011-03-29T23:06:00.000+08:00

MANILA – After a House resolution was passed last month urging President Benigno Aquino III to halt the “exploitative practice of collecting training fees from professional and registered nurses under various forms of ‘volunteer training programs’ by public and private hospitals”, hospitals reportedly got alarmed. “They stopped for a while, but now they’re coming back with different methods of ‘volunteer training for a fee’”, said nurse Leah Paquiz, president of an organization of nurses called Ang Nars.
Some hospitals have also retaliated against young nurses who exposed the volunteer/training-for-a-fee scheme.
“Forty-six of us nurses who had paid the hospital for our ‘training’ were dismissed when we made it known to the country that we are ‘volunteers’. It’s very wrong but nurses can’t speak out for fear of being blacklisted,” said Philip So Chan. Chan has a visa and could have opted to work abroad but he chose to remain in the country to “develop health care here.” His noble intention was repaid by being forced to swalow the volunteer-for-a fee scheme so that he could gain work experience to qualify for a full-time regular nursing job.
Under the guise of specialty training, some hospitals today have continued the “volunteer for a fee training scheme,” which has been happening in the Philippines for more than a decade now. This highly irregular scheme was exposed only recently and is being opposed more strongly and openly by nurses’ groups with the support of progressive lawmakers.
This so-called volunteerism has “prostituted” the concept of bayanihan or voluntary cooperation as a Filipino tradition, said Dr Teresita I. Barcelo, president of the Philippine Nurses Association. Under the detested scheme, nurses who have already been trained and licensed are still being forced to submit to another layer of “training” in hospitals.
It is a very “clear unfair labor practice on two grounds”, said Barcelo. One, registered and licensed nurses already have “the necessary skills and knowledge to perform regular nursing functions in the hospital.” As such, undergoing a ‘volunteer for a fee’ as training is “not a prerequisite for hiring.” Two, Barcelo said, registered nurses doing volunteer work concretely augment the deficit of nursing staff in many hospitals where the standard 1 : 10 nurse-patient ratio is not being met.
Public and private hospitals are reportedly making a killing through the scheme, because they are reaping profits and they do not have to hire the required number of regular or permanent nurses. They are taking advantage, instead, of the newly licensed nursing graduates who not only work for them without salaries and hazard benefits, but even pay certain amount of fees.
The fees can cost from P1,000 ($23.11) to P10,000 ($231) per month, for a one-month to three-months “training.”
No Surplus Nurses, Only Exploited Nurses
“Too many nurses are suffering today,” said Paquiz. “All over the country, major stakeholders are private hospitals – they don’t open new positions. (They) Do not hire regular workers. Nurses could not oppose this arrangement. Often they have no choice but to submit themselves to this arrangement. From three months to three years, they work as ‘volunteers’ but they are still not absorbed as regular nurses in hospitals”.
“If you take the proper nurse to patient ratio in this country,” Paquiz said, “more than 364,000 nurses are actually needed, meaning the more than 200,000 unemployed nurses can easily be absorbed.”
All over the country, the services of nurses is needed especially in community hospitals and rural health clinics, but owing to the volunteer-for-a-fee practice of private health facilities, compounded by the low government budget for health, which had also meant reducing rather than increasing the number of employed nurses, the Philippines finds itself today “in a situation where it seemingly has surplus nurses but it also has a pressing need for their services”, said the group Nars ng Bayan.
Following the progressive partylist representatives’ series of house resolutions against the practice, Rep Edgar S. San Luis filed House Bill 767, seeking to penalize all hospitals, both public and private, which demand payment from graduate nurses in exchange for actual nursing experience gained while working in a particular hospital.
Rep Philip Pichay, also the chairman of the committee on health, promised the nurses that he would support this bill, because, he said, “For as long as we don’t remove those volunteers, the hospitals will always take advantage of them. There will always be unemployed nurses. If you’re going to still have that, and you’ll implement SSL-3, the government will lose out. It’s not as if the nurses are really being trained…. They’re being treated worse than a servant, and yet they’re the ones paying the hospital, I find that revolting,” said Pichay during the roundtable discussion with Gabriela and nurses.
Deterioration of Healthcare System, Nurses’ Working Conditions
If hospitals can find ways to save on wages and even earn from nurses, it can also find ways to scrimp on the labor cost of the regular or permanent health personnel they have. There is now also a “phenomenon of outsourcing” in the nursing profession in the country where hospitals employ lower-paid “agency hired nurses,” said Jocelyn Andamo, a registered nurse who had worked as community nurse since she graduated in 1993.
As a community nurse, Andamo said she and her fellow nurses from Nars ng Bayan (Association of Community Health Workers and People’s health Advocates) have seen first-hand the vicious cycle of poverty and ill-health and the need for nurses in many underserved communities.
“While there are thousands of qualified nurses, the irony is that many poor sectors and communities especially those in remote areas continue to be underserved and deprived of even basic health care services,” said Eleanor M. Nolasco, president of Nars ng Bayan, in a statement. The group disputed the claims of labor department secretary Rosalinda Baldoz that plantilla positions for nurses in the public health system are already filled up.
“The fact remains that there is an acute need for more nurses and other health professionals to serve in the communities and in public hospitals that are generally ill-equipped and seriously understaffed,” said Nolasco.
The nurses’ group urged Health Secretary Enrique Ona to ban outright this “illegal, unethical, and exploitative practice of ‘volunteerism for a fee’ and at the same time, to provide employment opportunities for nurses with corresponding professional development and advancement programs.”
The nurses’ groups criticized as mere stop-gap the government’s various short-term, low-paying programs supposedly to ease the nursing unemployment problem. These programs include the RN HEALS, which like its predecessor, NARS or Nurses Assigned to Rural Service, “falls short of compensation for the nurses who are expected to do critical development work and provide quality nursing care in a community setting,” said Andamo of Nars ng Bayan.
Most nurses groups are united in saying that the government should adequately increase the national health budget to ensure quality health care at the same time ensuring the just compensation for nurses and other health workers.

Behind the nursing glut

2011-03-28T12:50:00.000+08:00

For Filipino nurses and nursing students, the promise of a better future is hinged on the perceived huge demand for nurses abroad. As of late, however, it appears that this no longer holds true.

The foreign markets' demand for Filipino nurses remained strong up until the middle of the last decade.

The Philippine Nurses Association, Inc. (PNA) has noted that the demand from top destinations such as the US and the UK already plateaued in 2006 when quotas for visas in the US had already been filled up.

In the UK, the policy shift favoring homegrown health workers also resulted in fewer Filipino nursing recruits.

Data from the Philippine Overseas Employment Administration (POEA) showed that about 34,000 nurses were deployed abroad from 1995 to 2001. In 2001 alone the country sent nearly 14,000 nurses to 131 countries.

More recently, in 2009, the number of nurses sent abroad grew by only 6.7% to 13,456 from the previous year. This was much lower than the 40% increase from 9,004 in 2007 to 12,618 in 2008. The decline was attributed to the global economic slowdown -- a sign of the market's susceptibility to external shocks.

Still, Philippines continues to produce more nurses than the domestic and global economies can absorb.

Unofficial estimates now place the oversupply of Filipino nurses at around 150,000 as of 2008. The PNA earlier noted that as many as 1,500 qualified nurses were waiting to be employed by major hospitals in 2008. The waiting period for employment ranges from six to 12 months.

Observers cited the rapid increase in the number of nursing schools in the country for the glut. Blogger and nursing researcher Jessie Simbulan reported that there were 460 accredited nursing schools in the country in 2008.

Of particular concern, too, is the proliferation of schools offering Licensed Practical Nursing (LPN) programs, a two-year non-degree course that focuses only on the basics of nursing.

This, despite the apparent preference by foreign employers for graduates of the four-year college-degree nursing course over the two-year program.

There are a number of ways to address the glut, but many proposals revolve around ensuring the quality of the nursing curriculum to produce qualified graduates. To do this, there is a need to close down under and non-performing nursing schools.

The Commission on Higher Education has identified 112 non-performing schools out of the over 400 nursing schools in the country. It is said that only less than 20% of their graduates are passing the nursing board exams.

The PNA has already asked the Commission on Higher Education to put a stop to the proliferation of underperforming schools and move to establish new or improve the quality of the existing Licensed Practical Nursing (LPN) programs.

Despite these efforts, the glut of Filipino nurses is expected to persist. Recent reports put the number of new nursing graduates this year at 40,000, most of whom will likely join the ranks of the underemployed and unemployed.

With this, it seems that the nursing program is no longer a reliable option to exit out of poverty.

The Institute for Development and Econometric Analysis, Inc. (IDEA) is an economic think-tank based in the University of the Philippines - Diliman. For inquiries on IDEA, please contact Eduard Robleza at edjrobleza@idea.org.ph

48 Filipinos missing in quake-hit Japan

2011-03-27T12:49:00.002+08:00

Of the 4,500 Filipinos in the northern part of Japan, 48 remain unaccounted for according to the Website of the Philippine Embassy in Tokyo, following the 9-magnitude earthquake that flattened the northeast area of Honshu Island on 11 March.
Among the missing is a five-month-old, in a report by Malaya.
The 124 Filipino nurses and 249 caregivers in the Tohoku area were reported to be safe, the Philippine Overseas and Employment Administration said.
The Embassy may be reached through their 24-hour hotline numbers (03)5562-1570, (03)5562-1577 and (03)5562-1590 or through email: emergency@philembassy.net.
There had been no reported fatalities to this time, said the report.
According to emissary Manolo Manuel Lopez, the Embassy is waiving the processing fees for Filipinos in the four prefectures that were heavily hit by the disaster: Fukushima, Ibaraki, Iwate and Miyagi in a report by ABS-CBN.
Lopez added that the government could not shoulder the travel expenses of Filipinos who want to return from Tokyo to Manila.
Earlier today, the ANC reported that the Embassy has waived overseas employment certificate fee, which means overseas Filipino workers will not have to pay travel tax and terminal fee.
It was also reported that some foreign governments have advised their citizens within the 80-kilometer radius of the Fukushima Dai-Ichi to evacuate the area.
An additional two more buses will be deployed today to fetch more Philippine nationals from Fukushima to Tokyo. This will reach out to between 100 and 120 people.
Six Filipino sailors returned to Manila from the devastated country.
Meanwhile, Presidential Spokesman Edwin Lacierda said on 16 March that pending Tokyo's confirmation, the country will be sending a C-130 plane to the disaster-hit country to bring relief goods like water and noodles. Noodles?
"For those who would want to leave Japan but has no means, the C-130 could be used to bring them home," Lacierda said.
The plane is expected to land at the Narita International Airport and will wait for Filipinos who want to be repatriated although there is no schedule yet.
Japan is currently at Alert Level 2, which means that the state is allowing for voluntary repatriation.
If the alert were raised to the highest, which is 3, the repatriation becomes the government's responsibility, according to Department of Foreign Affairs acting Secretary Albert del Rosario.
Del Rosario further said that the Philippine government is prepared to shoulder the travel of expenses of the 300,000 Filipinos in Japan, 200,000 of whom live in the capital city in the event the alert were raised to 3.
A bus sent by the Embassy carrying 42 Filipinos from Sendai arrived in Tokyo on Wednesday. They are seeking refuge at a Catholic Church in Kichijogi.
Fr. Resty Ogsimer from the Franciscan Chapel Center in Tokyo, posted these messages on Facebook, "With your prayers and support, the 43 evacuees, 23 adults and 20 children are all okay. Their meals are settled until dinner tomorrow. Thanks to all who have volunteered and shared their resources and time. In the meantime, we need volunteers who speak Japanese who can entertain and play with the children. Thank you!
"For those who are willing to donate money via Postal Services, here is the account: Post Office Account, Number: 00150-5-120640, Catholic Tokyo International Center Sanjokai- Jishin. This is free of charge. Any amount will do as long as it is from the heart. Thank you!" from Fr. Ogsimer.
Watch the attached YouTube video showing the negotiations between Filipino residents in Sendai and Embassy officials in the thick of the action.

Filipino health workers draw praise in Libya

2011-03-16T23:03:00.000+08:00

Manila: While most overseas workers in Libya had been trying to leave, Filipina nurses in the embattled North African country are drawing praise for their commitment to their vocation.
Reports reaching Manila said that thousands of Filipino nurses and medical staff have chosen to brave and wait out the several weeks of political strife out of professional commitment.
Foreign Affairs Undersecretary Esteban Conejos said that despite a move by the Philippine government to offer repatriation to Filipinos who volunteer to get out of Libya, some 8,000 nurses and other medical workers chose to stay despite the obvious risk to their lives.
"Our nurses deserve our admiration and also, I guess it's the reason Libyan people love Filipinos there," he said recently upon his return to Manila at the end of a two-week visit to Libya and Tunisia.
There are 1,300 Filipino nurses employed by the Tripoli Medical Centre — one of the largest hospital in Libya — and a further 600 at the Benghazi Medical Centre
Strategic areas
The fighting between government forces of Muammar Gaddafi and rebels had been largely confined to strategic areas in Tripoli and Benghazi and medical facilities in these locales are hard-pressed attending to civilian as well as military casualties. Conejos said that because of the commitment shown by Filipino medical workers, they have earned the respect of not only the Libyans, but other foreign nationals as well.
Prior to the outbreak of protests against the government of Gaddafi, the Department of Foreign Affairs said there were 26,000 Filipinos in Libya at any given time.
These Philippine nationals include skilled workers, information technology professionals, engineers, oil field workers, technicians as well as medical workers.
As of Friday, the DFA said nearly 14,000 Filipinos have left Libya. Of this number, more than 6,000 are already in Manila.
Earlier, Labour and Employment Secretary Rosalinda Dimapilis-Baldoz said her department's National Reintegration Centre for Overseas (NRCO) Filipino workers is ready with appropriate programmes for returnees, particularly those who have arrived and those yet to arrive from Libya.
She said mechanisms to ensure their smooth reintegration to mainstream Philippine society are in place.
Reintegration initiatives
"Even before this crisis in Libya erupted, the NRCO has already established various reintegration programmes for OFWs (Overseas Filipino Workers)," said Dimapilis-Baldoz, adding that as early as November last year President Benigno Aquino instructed the Labour Department to set aside one billion pesos (Dh84.5 million) for the reintegration programme.
At least one out of every 10 Filipinos is employed in jobs overseas and with the current situation in North Africa and the Middle East, the Philippines could be forced to adapt measures that will allow its remittances-dependent economy to catch up with the rapidly developing changes abroad.

Nursing dream fades for Filipinos as UK jobs dry up

2011-03-14T11:36:00.000+08:00

By Sarah Boseley - guardian.co.uk
Just over 10 years ago, in a major speech to a nursing conference in Brighton, Tony Blair promised to boost a desperately short-staffed NHS with 20,000 extra nurses. Not even Blair, though, could claim to be able to magic up that many British nurses – training takes at least three years – so instead, the NHS began importing them in huge numbers from across the globe.

They came in droves – particularly from India and the Philippines, where hundreds of private nursing schools were set up to meet this new demand from the UK, and also the US. Before long, every Philippine higher education institution had to have a nursing school or face closure from lack of business. A multitude of recruitment agencies were spawned there too, offering to sort out job, travel and visa for nurses lured by the promise of a lucrative salary on the other side of the world.

A decade later, however, the picture is very different. Britain has retrenched. Cutbacks, coupled with the European Union’s rules on free movement of labour, mean few nursing vacancies for anyone from outside Europe these days.

Yet in the Philippines the production line continues to roll. Last year an estimated 100,000 nurses were in training there, the vast majority attracted by false promises of jobs in the west. Many of the country’s recruitment agencies – often employing British advisers – are flirting with, if not flouting, the law, taking a fat fee for the promise of a job they cannot deliver.

One case, in particular, has gained national attention there. Two Britons, Simon Paice and Nicholas Vickers, have been charged along with four Filipinos with running an illegal, unlicensed recruitment agency and making false promises to clients – allegations they all deny.

Locked up in Camp Crame, the police detention centre in Quezon City (part of what is known as Metro Manila), the six stand accused of making 1.7 million pesos (more than £24,000) in job placement and visa arrangement fees from 12 student nurses who say they were promised places in care homes and domestic work, but got none.

NSN Worldwide Advisers – a recruitment agency said to be owned by the two Britons – has its office in Makati, the upmarket business district of Manila. When the Guardian visited recently a concierge confirmed that NSN had closed. Asked why, he chuckled and said the owner had been arrested. But hundreds of recruitment agencies are still offering to help Filipino nurses get to the UK.

The NSN investigation had been carried out by the Philippine government's taskforce against illegal recruitment, headed by the country's vice-president, Jejomar Binay. "Let this serve as a warning to illegal recruiters and those who intend to take advantage of our OFWs [overseas Filipino workers] through illegal recruitment," Binay was reported to have said. "Remember, your days are numbered."

Of the 50,000 or so nurses who qualified in the Philippines last year, no more than 13,000 are thought to have found a job abroad. "That leaves 37,000 nurses who are qualified with a big uncertainty, as there is no shortage of nurses in this country," said Henk Bekedam, regional director of health service development at the World Health Organisation's Manila base.

"Worse, about 100,000 families on an annual basis are putting their daughter – usually a daughter – into training, with the big hope that in four years she will get a job. This costs a family an average of $10,000. Your daughter is your hope for the future; many of them will be disappointed."

Unable to secure jobs for nurses in the UK, many Philippine recruitment agencies – often unregistered – have reinvented themselves as education consultancies. Typically, the thousands of trained but jobless Filipino nurses are encouraged to study top-up courses in the UK, which, they are led to believe, will get them jobs afterwards. The reality is different.

According to Michael Duque, president of the Philippine Nurses Association of the UK, many Filipino nurses arriving on a student visa struggle to cope. If their family cannot send money to support them, they end up breaking immigration rules which used to allow 20 hours work a week for students, but have recently been changed to permit only 10.

"Most would be working more than the 37 hours of an average working week, doing extra housekeeping jobs, cleaning jobs," he said, adding that if the nurses can find a nursing home prepared to give them illicit out-of-hours work, they will do that – but such an arrangement can put the employer at risk too.

Some end up on the streets. "They don't have any place to live. They can't pay for accommodation," Duque said. Although the Filipino community is supportive and will take people in, there are those who just disappear. "Some, when their visa has run out, will go underground instead of going home. Some even end up in prostitution. They can't go back because they owe a lot of money back home."

Duque would like to open a "halfway house" where Filipino nurses who get into real difficulties can stay until they sort themselves out, but his voluntary organisation doesn't have the funds.

On NSN's locked glass door in Manila, a poster still claims that "your dreams are our responsibility". In another agency in the same office block display panels in the smart reception area are covered with postersfor British universities and colleges.

Melissa Dujali, a bright, 32-year-old woman living in Manila, has been brought up to understand her destiny. The second of four children, she has the brains and aptitude to secure a good nursing job overseas and support the rest of the family. So far though – and her story is very familiar in the Philippines – her efforts have led only to debt and disappointment.

"I'm the breadwinner. I took nursing to support my family," she explained. "My father is a diabetic patient so our business is not doing well. We are not a well-off family."

In April 2009 Dujali went to one of the many agencies that call themselves education consultancies. She was told she could take a two-year course in the UK, which she could fund from the 20 hours' work she would be permitted to do while she was there. The agency fee, for arranging her application to a British college (a BTEC higher national diploma in health and social care) as well as her student visa, was 75,000 pesos (£1,065). The college offered her a conditional place and asked for a down-payment of £1,000 towards the tuition fee.

The agency told her she would have to give the British embassy proof that she could afford the tuition fee and living costs, which would be an estimated £350-£500 a month. "I provided all the requirements," Dujali said. But in November 2009 she was told her application had been declined. Embassy officials did not believe she had sufficient funds.

"The agency said it would be OK," she said. "They showed me the many approved visas, so I asked them to appeal." But nothing had happened by January 2010 when the course was due to start, so Dujali pulled out. The agency fee was non-refundable. She has been told by the agency that she will get some – though not all – of the £1,000 paid to the college, but as yet, a year later, has had nothing.

Such stories, and the promises made by the agencies – which are legal, according to the UK Home Office, but not within "the spirit of the law" – are one reason for the British government's recent promise to crack down on student visas, making it much harder for overseas jobseekers to get into the UK through the student route.

For her part, Dujali now realises the rosy prospects that were painted of earning good wages in the UK to cover her costs and send money home were false.

A survey in 2006 by Professor James Buchan of Queen Margaret University, Edinburgh found that about half of Filipino nurses in London were sending between 25% and 50% of their income back home to their families. Most were the major or sole breadwinner in their family. Almost all (96%) had used a recruitment agency in their home country and nearly three-quarters had paid for their services.

Ira Pozon, legal counsel and international relations officer in the vice-president's office, is a key player in the crackdown on such agencies – which are, he said, involved in "under-the-radar illegal recruitment. Their promise is a student visa, but face to face they say we can help you get a job."

Pozon, who is in his early 30s, estimates 40% of his classmates went into nursing. His advice to compatriots interested in such a career now? "If an agency is asking for a lot of money, walk away," he said. "But the poorest of the poor believe them. They sell their property, thinking in six months I will have earned back everything I spent. They never get deployment. It is a basic scam."

Japan twits Philippines over nurses’ access under JPEPA

2011-03-13T11:34:00.000+08:00

By Jessica Anne D. Hermosa - bworldonline.com
The Japanese government yesterday countered complaints of Philippine officials over alleged barriers preventing Filipino nurses and caregivers from enjoying the perks of a market-opening deal.

Licensure exams have already been made easier for non-Nihonggo speakers in 2010 and the number of vacancies reserved for Filipinos this year have been hiked, the Japanese embassy told reporters yesterday.

The issue was raised as both countries prepare for a mandated review this year of how the Japan-Philippines Economic Partnership Agreement (JPEPA) has been implemented since it came into force in late 2008.

A batch of 187 Filipino professionals–102 nurses and 85 caregivers–are slated to enter Japan before the second semester to undergo the Tokyo-sponsored training and paid internship, the spokesperson said. The figure is 46% higher than the 2010 slots but less than the 310 slots provided in 2009.

The number of vacancies reserved for Filipinos are determined “depending on how many are offered by hospitals,” the spokesperson said.

Nurses under this program provided by JPEPA can work in Japan up to three years while caregivers stay for a longer four years. They will then have to pass the national licensure exam there if they want to extend their contracts.

Only one Filipino nurse has passed the Nihonggo-based exam ever since the program was implemented two years ago, a concern which the Philippine side has said it will raise at the coming JPEPA review.

“But we are trying to improve this implementation by doing basically two things: we have made those exams more passable for foreign applicants since 2010 by replacing difficult words with easier words in Japanese…and using both Japanese and English words for medical terms,” the Japanese embassy spokesperson said.

Tokyo will also provide two to three months language training here in the Philippines on top of the six months training in Japan which it already subsidizes for program participants, the spokesperson added.

‘Nurse hiring in UK stable despite budget cuts’

2011-03-12T11:32:00.000+08:00

By Patrick Camara Ropeta, ABS-CBN Europe News Bureau
Filipino nurse recruitment in Britain should remain stable amid cuts on immigration and public spending in the UK, said the Philippine embassy in London.

Speaking from an event at the Princess Alexandra Hospital in Essex, embassy officials welcomed newly recruited nurses and reassured other nurses from the Philippines that job opportunities in the UK should continue to become available.

“So far, the UK is not shutting its doors to foreign workers,” said Atty. Jainal Rasul, Labor Attache at the Philippine embassy in London, in an interview with The Filipino Channel.

He continued: “It has not declared any ban in the hiring of foreign workers, especially nurses. There will be reductions, of course, due to some changes, but in the long term, there will be more nurses coming in due to shortages of nurses right within the UK.”

He added that recent changes in British immigration policies should not alarm Filipino migrants who are already in the UK.

“As announced by the UK Border Agency, for those already in the UK - nurses, senior carers, and other professionals - they will not be affected by the proposed interim or permanent limit of the UK government,” he explained.

In 2011, the British government will implement changes over immigration and public spending, both of which could affect overseas recruitment in the UK, including nurses and other skilled workers from the Philippines.

Media reports suggest that an immigration cap will be implemented in the UK from April 2011, which means that only 21,700 skilled workers from outside the European Economic Area will be allowed entry into its borders, a cut of approximately 6,300 compared to 2009.

The government will also dramatically reduce its public spending budget, including a cut of £2.3 billion from the National Health Service, which funds most of the hospitals in the UK.

The cuts are fueled by financial problems caused by the recent global recession.

World-Class Nurses

Despite the cuts, the Philippine embassy is optimistic in the stability of nurse recruitment from the Philippines due to the quality of work delivered by Filipino nurses.

“The feedback has been very positive. We’ve heard officials of the UK government commending us on the hard work, dedication and competence of our Filipino nurses, and we’re very happy about those comments,” revealed Reynaldo Catapang, Charges d’Affaires at the Philippine embassy in London.

There are currently 50,000 Filipino nurses working in hospitals all over Britain, including 100 nurses at the Princess Alexandra Hospital (PAH).

“We’ve successfully recruited a whole batch of Filipino nurses 10 years ago. A lot of those nurses are still with us, and enjoying their period with us,” said Gerald Coteman, Chairman of PAH.

He added: “They’ve learnt a great deal and they’re contributing significantly to services that we provide here. We’ve gone out a second time to recruit from that source, and we’re very pleased with the Filipino nurses that joined us 10 years ago that we felt we’d have more of the same. We really welcome these additional nurses, and hopefully they’ll be fitting in and enjoying their time with us.”

Terry Lopez-Bishop from Bataan is one of the success stories at PAH. Trained at Saint Louis University in Baguio City, she has consistently impressed her employers and colleagues since her recruitment in 2000. She has been promoted consistently and is now a ward manager at the hospital.

“At first, it was a shock, because it’s totally different from back home,” she revealed. “The important thing to remember is we have to learn from each other - what you can give and what you can learn from another culture - and put it all together to whatever will be helpful to the patients and the hospital as well.”

She added: “Filipino nurses are able to adapt well, I believe, with the culture in here, and integrate well into the hospital and how it works in meeting standards and the needs of the patients and of the country.”

Opportunities

Thousands of Filipino nurses continue to aspire to work in the UK and other Western countries for the life-changing opportunities it affords.

“I would like to adapt here, have career progression, and inspire others, especially my colleagues back in the Philippines,” explained Sheila Dalubar, one of the newly recruited nurses at PAH.

She continued: “I wanted to come in here and explore the job opportunities that the UK is offering, and to some day bring my family here as well to enjoy the life that I’m enjoying right now. It’s been good so far because most of the people in here are really supportive and approachable, especially in the ward that I’m working in.”

According to Lopez-Bishop, the key to success as a nurse is an “open mind” and a helpful attitude.

“My advice is just be open. Do not unlearn what you have learned before. Meet halfway, and see what you can contribute, what you could do to help, and learn more as well. Have an open mind, because nursing itself is dynamic, it evolves. You just have to accept that the changes will be for the better of delivering services to the patients,” she concludes.

Nursing continues to be a popular career choice for young Filipinos who wish to work overseas, and despite the recent changes in UK policies, nurse recruitment from the Philippines should remain stable in the foreseeable future.

550 applicants in Japan placement shortlist

2011-03-11T11:30:00.000+08:00

By Samuel Medenilla - mb.com.ph
The Philippine Overseas Employment Administration (POEA) has reported that 550 applicants have made it in the shortlist for the third batch of its placement program with Japan under the Japan-Philippines Economic Partnership Agreement (JPEPA).

POEA Administrator Carlos Cao said in the media forum that 300 of the applicants were nurses, while 250 were caregivers. He said the number of applicants will be further reduced to 137, which is the target number of nurses and caregivers to be deployed in Japan.

Meanwhile, POEA Welfare Deployment Office Director Nimfa De Guzman said in an interview that about 145 of the applicants for this year are from provinces in the Visayas and Mindanao, which is higher compared to the previous two batches.

JPEPA is an elaborate bilateral economic cooperation pact signed by the Philippines with Japan in 2008. This includes a job order of nurses and caregivers. Under the agreement Filipino nurses and caregivers are required to undergo six-month training in Japan and take a mandatory licensure exam before they are permanently employed in Japanese hospitals.

Cao said they expect a higher number of applicants will be able to finish the direct-hiring scheme, after the Japanese International Corporation of Welfare Services (JICWELS) representatives said it will implement reforms in the language training program and mandatory examination.

“We have asked our Japanese counterparts to make adjustments without necessarily lowering the standards but to make it reasonable for Filipino applicants,” he said.

Among the reforms implemented for the program are the additional Japanese language training here in the Philippines aside from the classes, which will be held in Japan, and the inclusion of English translation of some technical terms in the Japanese licensure exam for nurses and caregivers.

De Guzman said the interview of the applicants will start on Feb. 3 to 7 at their regional centers while the deployment to Japan of the final list of candidates will be in May.

52 Fil-Am employees sue hospital for discrimination and harassment

2011-03-10T11:29:00.000+08:00

A GROUP of 52 former and current Filipino-American hospital employees filed a lawsuit against their employer, Delano Regional Medical Center (located in the Central Valley) for discrimination and harassment on the basis of national origin.

The complaint was filed in the United States District Court, Eastern District of California last December 7, 2010.The action was filed against Central California Foundation for Health/ Delano Regional Medical Center and Delano Health Associates, Inc. (collectively referred to as “DRMC” or “Defendants”). The employees are represented by the Asian Pacific American Legal Center (APALC), a member of the Asian American Center for Advancing Justice.

The complaint states that DRMC discriminated against its Filipino-American employees because of their national origin and subjected the Filipino-American workers to severe and pervasive workplace harassment. DRMC prohibited Filipino-American employees from speaking Tagalog and other Filipino languages under a broad-reaching, English-only policy. DRMC singled out only Filipino-American employees in enforcing the policy.

Among all their employees of various ethnicities, defendants required only Filipino-American employees to attend mandatory meetings with management. During these meetings, DRMC management told the Filipino-American employees that they were prohibited from speaking Tagalog and other Filipino languages at the workplace.

DRMC reprimanded them, threatened to monitor them with audio surveillance and threatened to discipline and suspend employees who will be caught speaking Tagalog. Defendants also encouraged other employees to report Filipino-American employees to supervisors, which created tension and hostility among employees. Filipino-American employees were monitored, chastised and threatened by supervisors and other co-workers who constantly told them to speak English.

During the press conference held at the APALC office in Los Angeles December 7, two of the plaintiffs, Wilma Lamug and Elnora Cayme, spoke about the unfair treatment they received from DRMC management.

“DRMC’s actions made us feel humiliated, isolated, and unvalued as employees. Many of us, including myself, had worked hard for DRMC for ten or twenty years. Despite our loyalty and years of service, we were shocked that DRMC singled out Filipino-American workers and blatantly discriminated against us,” said Plaintiff Wilma Lamug, a Licensed Vocational Nurse at DRMC for more than ten years.

Elnora Cayme, a licensed vocational nurse and respiratory therapist who has worked for DRMC for 27 years, said amid tears, “I have lived in Delano since I immigrated to the States in 1978 with my parents and siblings. DRMC is our community hospital. A majority of the hospital’s staff was made up of Filipino health care professionals. I don’t know why they treated us so unjustly, even if we were all so loyal and devoted to our jobs.”

“DRMC enforced an overly restrictive and draconian English-only policy against only its Filipino-American employees that cannot be justified by a business necessity. As a result, DRMC created a workplace environment that was hostile towards its Filipino-American employees and unfortunately increased tensions between Filipino and non-Filipino employees,” said Julie A. Su, Litigation Director at APALC.

APALC, on behalf of the employees, is moving to intervene in a lawsuit that was filed by the US Equal Employment Opportunity Commission (EEOC) on August 18, 2010. The EEOC’s lawsuit alleges that DRMC’s acts of national origin discrimination and harassment violate federal law (Title VII of the Civil Rights Act of 1964).

APALC’s complaint alleges that DRMC violated federal law as well as California state law, specifically California ’s Fair Employment and Housing Act. The lawsuit seeks an injunction to prevent future discrimination, as well as financial compensation from defendants for the employees.

According to EEOC, the hospital prohibited Filipino staff from speaking Tagalog while allowing non-Filipino employees to speak other languages, such as Spanish. “Employers must ensure that company policies are applied equally,” said Anna Park, regional attorney of the EEOC’s Los Angeles Dustrict Office. “Targeting workers of a particular national origin is not only illegal, it also erodes company morale – pitting groups against one another.”

Wilma Lamug said other Filipino-Americans who are victims of discrimination should not be afraid to speak up. “Don’t keep your mouth shut. Seek help like we did,” Lamug said. Elnora Cayme added, “Huwag kayong matakot o mahiya (Don’t be afraid or embarrassed.) Speak up for your rights.”

“An employer like DRMC with a diverse clientele should view an employee’s ability to speak another language as an asset, not a disadvantage. It is reprehensible that our clients were singled out for enforcement of the English only policy and harassed. Employers need to know that this type of discrimination and harassment on the basis of national origin is illegal,” said Carmina Ocampo , a staff attorney at APALC. “We hope this case encourages other immigrant workers to do as these workers did, and stand up publicly and demand their rights.”

(www.asianjournal.com)

CHED imposes moratorium on nursing, 4 other courses

2011-03-09T11:26:00.000+08:00

By Jerrie M. Abella/KBK - GMANews.TV
The Commission on Higher Education (CHED) has imposed a moratorium on the opening of new programs in nursing, business administration, teacher education, hotel and restaurant management, and information technology (IT) education effective school year 2011-2012.

The moratorium, contained in CHED Memorandum Order 32, covers undergraduate and graduate programs in the following courses:

1. Nursing (Bachelor of Science, Master of Arts/Master and Doctor of Philosophy)

2. Business Administration (Bachelor of Science, Master and Doctor in Business)

3. Teacher Education (Bachelor of Elementary and Secondary Education, Master of Arts, Doctor and Doctor of Philosophy)

4. Hotel and Restaurant Management (Bachelor of Science, Master of Science and Doctor of Hotel and Restaurant Management, and Hospitality Management)

CHED cited the increase in the number of institutions offering these programs as one of the reasons for the moratorium.

“There is already a proliferation of Higher Education Institutions (HEI) offering Undergraduate and Graduate Programs in (these courses), which if allowed to continue unabated would result in deterioration of the quality of graduates of these five higher education programs,” the commission said.

CHED also said the results of the Evaluation of Graduate Education Programs, and the licensure examinations for teachers and nurses, confirmed not only the worsening quality of graduates in these programs, but the worsening of the programs themselves too.

The commission also pointed out the “problem of mismatch currently being experienced by (a) significant number of business administration, hotel and restaurant management, and information technology graduates.”

The moratorium shall cover all public and local universities and colleges, and private HEI including those which were granted autonomous status by CHED.

The commission likewise said the moratorium on maritime education imposed last year is still in effect.

DOLE supports moratorium

In a statement, Department of Labor and Employment (DOLE) Secretary Rosalinda Baldoz said she is supporting the moratorium, saying it is part of the government’s efforts to shift focus to college courses that will help graduates land jobs.

“The moratorium, I believe, is a decisive action on the part of the CHED to mitigate potential oversupply of graduates in certain disciplines, and in the process, to encourage incoming students to opt for courses that offer the best chances of employment after graduation,” Baldoz said.

She said the moratorium complements the efforts of the DOLE to ensure employment of graduates, which include educating students on what courses are in demand in the labor market.

The DOLE is formulating a Philippine Human Resources Development framework which will outline strategies to attain quality graduates who will find jobs after college, Baldoz added.

Philippine Nurses Association 88th Foundation Anniversary and 53rd Nurses’ Week Celebration at the Historic Landmark Manila Hotel on October 26-28, 2010

2011-03-08T11:25:00.000+08:00

The vital role of nurses in addressing the threat of chronic diseases to global health and well-being highlights the celebration of the 88th Foundation Anniversary of the Philippine Nurses Association and the 53rd Nurses’ Week on October 26-28, 2010, at the historic landmark Manila Hotel, with the theme “Delivering Quality, Servicing Communities: The Challenge for the Filipino Nurse Leading Chronic Care,” which has been adopted from the goal being pursued by the International Council of Nurses (ICN).

The Philippine Nurses Association (PNA) is responding to the challenge of the ICN for all nurses worldwide to lead the fight against chronic diseases, by making sure that Filipino nurses are given every opportunity to provide utmost attention and care to people with chronic conditions. With the rising trend of chronic illness, there is the need to make available appropriate and affordable care for the sick, giving them renewed hope and strength.

Chronic diseases – diabetes, cardiovascular diseases, respiratory illness, cancer, and lately, Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) – are the world’s biggest killers, causing an estimated 35 million deaths each year, of which 80 percent are in developing countries. These diseases may be preventable, if detected early, but if they do occur, the needs of the patients must be met with compassion, care, and attention.

The celebration provides an opportunity for Filipino nurses to renew their vision and commitment to the uplift of their profession and the improvement of the conditions of those afflicted with chronic illness. It will also be a chance to discuss new trends and breakthroughs in the nursing profession and exchange ideas with their visiting foreign counterparts.

We congratulate the Philippine Nurses Association, headed by its President Dr. Teresita I. Barcelo, its Officers and Members, on the occasion of their 88th Foundation Day and 53rd Nurses’ Week Celebration.

We wish them all the best and success in all their endeavors. - via www.mb.com.ph

Phl seeks easing of Japan nurse hiring requirements

2011-03-07T11:24:00.000+08:00

By Elisa Osorio - philstar.com
The Philippines will be asking for the relaxation of some of the entry requirements of Filipino nurses to Japan during the renegotiation of the Japan-Philippine Economic Partnership Agreement (JPEPA) scheduled this year.

Under the current JPEPA rules, only one Filipino nurse was able to go to Japan.

“Something has to be done about this. Qualifications must be relaxed,” a ranking government official said in an interview.

Other issues that may be raised are the reduction on sugar tariff and the increased access of the country’s agricultural products such as chicken to Tokyo.

The official said the mandated renegotiations of the JPEPA have not yet started. Under the JPEPA, there must be a renegotiation five years after the agreement was signed.

However, in spite of the pressure to renegotiate, the official said it may be beneficial for the country to wait because there are also issues that the Philippine government is avoiding. For instance, the official said that the Japanese would like to bring down the tariff of 3,000 cc vehicles and below.

The official said that although the JPEPA is clear that the two governments must discuss the tariff on 3,000 cc vehicles, the agreement does not specifically say when the negotiations should be. “There is no deadline for this (negotiations on 3,000 cc vehicles),” the official said.

“The Philippines is avoiding this because we do not want to lower the tariff because it will be bad for our local manufacturers,” the official said.

Currently, the vehicles produced here are 3,000 cc and below. Once the tariff is lowered or even removed, imported counterparts may be cheaper thus killing the local auto manufacturing industry.

“We cannot afford to allow all small cars to enter without tariff,” the official said.

In an earlier interview, Assistant Trade Secretary and Director of the Bureau of International Trade Relation Ramon Vicente Kabigting said the Philippines is asking for some help from the Asian Development Bank to come up with a study on JPEPA so that the government could be guided during the review.

Kabigting explained that the five-year prescriptive review period started in September 2006 when then President Gloria Macapagal-Arroyo and then Japan Prime Minister Junichiro Koizumi signed in Helsinki, Finland the agreement and not in December 2008 when JPEPA became effective following the ratification of the Philippine Senate.

However, he cleared that the review will not lead to the Philippines’ abrogation of the treaty. He said there may be some people who would like to modify the deal.

DOH offers 10,000 nursing jobs in poor communities

2011-03-06T11:23:00.000+08:00

Filipino nurses looking for a job can apply for a new Department of Health program that will deploy unemployed nurses to poor communities in the country.

Health Secretary Enrique Ona said the project RN HEALS addresses the shortage of skilled and experienced nurses in 1,221 rural and unserved or underserved communities for one year.

“It seeks to make essential health services available to all Filipinos by training and deploying 10,000 unemployed nurses in communities to be identified by the DOH in collaboration with the Department of Social Welfare & Development,” he said in a statement.

Ona said nurses chosen for the project will receive P8,000 monthly allowance from the health department. He encouraged local government units where the nurses will be assigned to give an additional P2,000 worth of allowances and benefits.

Registered nurses who are physically and mentally fit, and willing to serve in their municipalities may apply online at the DOLE website (www.dole.gov.ph http://www.dole.gov.ph/) from January 17 to February 4 this year.

Preference will be given to residents of the municipalities covered by the Health Facilities Enhancement Program of DOH and Pantawid Pamilyang Pilipino Program or the Conditional Cash Transfer of the DSWD.

“Eventually, these nurses will be part of the pool of competent nurses for later employment or absorption in health facilities, thus addressing the inadequate supply of skilled nurses and increasing the nurses’ employment rate,” the health secretary said. - via abs-cbnNEWS.com

DFA warns Filipinos vs fake online nursing job offers in UK

2011-03-05T11:21:00.000+08:00

Filipino jobseekers were warned on Tuesday against falling for dubious online job offers promising employment as nurses in the United Kingdom (UK).

The Department of Foreign Affairs (DFA) said a report on the offers from the Philippine Nurses Association-UK prompted the warning from the Philippine Embassy in London.

“The new illegal recruitment scheme involves online job offers sent by email to prospective victims, mainly nurses, who have previously submitted their resumes in public job search websites,” the DFA said in an article posted on its website.

The DFA said the modus operandi involves the supposed employer and/or his solicitor (lawyer) sending the victim successive emails.

The emails contain a job offer, a Contract of Agreement with a very attractive package of wages and benefits, a Certificate of Employment, and a blank Certificate of Good Moral Character.

Once the victim submits the required documents, he or she will then be sent detailed payment procedures of processing fees via wire transfer.

The supposed solicitor-lawyer usually identifies himself or herself as a member of a prominent legal firm or as an employee of the high court.

“In some cases, the employer sends photographs of his family in the UK via email in an attempt to assure the applicant that the process is legitimate,” the DFA said.

However, once the applicant pays the fees, the so-called employer and solicitor cut all contact.

The DFA noted this modus operandi is similar to other online scams earlier reported by the Embassy involving job offers for nannies, au pair, hotel staff, store managers, salespersons and engineers.

It advised the public to always verify job offers to the UK with the Philippine Overseas Employment Agency (POEA).

They may likewise send a request for job offer verification to the Philippine Overseas Labor Office (POLO) at polo.london@yahoo.co.uk or embassy@philemb.co.uk, the DFA added. - via GMANews.TV

DOH to probe fees collected from nurses

2011-03-04T11:19:00.001+08:00

By Mayen Jaymalin
The Department of Health (DOH) will look into reports that Filipino nurses are paying hospitals to allow them to gain experience in order to work abroad.

Health Secretary Enrique Ona said the department has not received any formal complaint from nurses, but would nonetheless investigate the reports and impose appropriate sanctions on hospitals abusing the free labor of nurses.

“We been receiving such reports, but until this time we have not recorded any formal complaint. So we are calling on the nurses who were forced to pay the hospitals for volunteer work to report such cases to us so we can investigate,” Ona said.

He said complainants need not disclose their identity. They should just submit a complaint letter to the department or provide information through the DOH website.

Many licensed but unemployed nurses are forced to work as volunteers in tertiary hospitals to gain work experience.

Ona noted that the trend resulted from an oversupply of nurses in the country and low overseas demand because of the prevailing economic slump.

“(But) the hospitals should not take advantage of the surplus and let abuses be committed against our nurses. If indeed there are abuses we will impose sanction,” he said.

Labor Secretary Rosalinda Baldoz said, however, that hospitals accepting volunteer nurses are not committing a violation.

“If the hospitals really do not need additional staff and would just allow volunteers who would want to gain experience, it is really not a violation. What we should look into is if the training in the hospitals is really adequate to comply with the requirement of foreign hospitals,” she said.

Militant group Partido ng Manggagawa (PM) called on hospitals to stop charging nurses seeking on-the-job-training.

The group said trainee nurses should be treated as probationary employees who are guaranteed minimum wage and other benefits, with the opportunity to become regular nurses after a six-month temporary status. - via philstar.com

Nihonggo course for nurses mulled

2011-03-03T11:18:00.001+08:00

By Samuel Medenilla

The Philippine Overseas Employment Administration (POEA) is considering adding a Japanese language course in the pre-departure orientation of medical workers bound for Japan.

During a media conference, POEA Administrator Jennifer Jardin-Manalili said the proposal came from the Japanese government and will be discussed during the review of the Japan-Philippines Economic Partnership Agreement (JPEPA) next year.

“One of the topics, which will be discussed in the review, is the request from the Japanese government to include pre-departure language training in the Philippines,” Manalili said.

She said Japan made the proposal after Filipino nurses and caregivers received a low passing rate in their licensure exam due to their difficulty in understanding the Nihonggo language or the character-based writing system used in the test.

Manalili said the POEA presented a counter-proposal requesting Japanese representatives in the review to consider conducting some parts of the six-month mandatory language training for medical practitioners in Japan here in the Philippines at their own cost to minimize the time of separation of the applicants with their families.

JPEPA is an elaborate bilateral economic investment cooperation pact signed by the Philippines with Japan in 2008.

Among the provisions included in the trade agreement is the reduction or elimination of tariffs to some exported products to the Philippines and a job order for nurses and caregivers. - via www.mb.com.ph

Legarda seeks inquiry into concerns of nurses and their profession

2011-01-03T11:41:00.002+08:00

Senator Loren Legarda has sought an inquiry into urgent concerns of Filipino nurses and the nursing profession, noting that the problems faced by the country’s health professionals reflect a failure on the part of government to promote the people’s right to health.

Through Senate Resolution No. 304, Legarda urged the Senate Committee on Health and Demography to conduct an investigation on the serious concerns of the country’s nursing sector with the end in view of protecting the rights of nurses and their profession.

“Our nurses are hindered from efficiently performing their duties as primary health care providers. One of the most serious concerns is the anomaly in the hiring of nurses who, instead of getting remuneration for their work, have to pay in exchange for work certification and training experience,” Legarda said.

The Senator also voiced concern on the lack of plantilla positions for nurses in government hospitals; contractualization of nurses; lack of supervision over the condition of Filipino nurses working abroad resulting to delayed assistance; and the non-implementation of decent wage and due benefits according to law.

Legarda explained that under the Nursing Law of 2002 (RA 9173) and the Magna Carta of Public Health Workers (RA 7305), the entry salary of a nurse in the government should be at Salary Grade 15 or about Php25,000, and that they are entitled to benefits such as hazard pay, subsistence allowance and night shift differential.

She also explained that the lack of budget for the health sector affects the delivery of health services especially for the very poor and those in far-flung communities.

“The government has to take immediate, concrete steps to resolve these problems that affect our health workers so that they can efficiently fulfill their duties without having to worry about how to make ends meet,” Legarda said.

“Unless we provide the adequate protection to our nurses, we cannot enforce the guarantees expressed in the 1987 Constitution to promote the people’s right to health, much less achieve the Millennium Development Goals, to which we have committed,” she concluded. - via pia.gov.ph

1 Percent of Deaths Worldwide Due to Secondhand Smoke

2010-12-01T11:17:00.000+08:00

MONDAY, Nov. 29 (HealthDay News) -- An estimated 1 percent of the deaths that occur in the world annually are due to passive smoking, and many of these deaths are in children, according to research published online Nov. 26 in The Lancet.

To calculate the worldwide degree of secondhand smoke exposure and its disease burden on children and adult nonsmokers, Mattias Öberg, Ph.D., of the Karolinska Institute in Stockholm, Sweden, and colleagues used data from 192 countries during 2004 to estimate deaths and disability-adjusted life-years (DALYs) based on estimates of population proportions exposed to secondhand smoke.

The researchers determined that 40 percent of children and approximately a third of adult nonsmokers were exposed to secondhand smoke. The researchers attributed an estimated 603,000 deaths (about 165,000 in children) -- from ischemic heart disease, lower respiratory infections, asthma, and lung cancer -- to this exposure. This figure equaled about 1 percent of worldwide mortality. Secondhand exposure-linked DALY loss reached 10.9 million.

"These estimates of worldwide burden of disease attributable to secondhand smoke suggest that substantial health gains could be made by extending effective public health and clinical interventions to reduce passive smoking worldwide," the authors write.

New Nursing Jobs Dwindles but Nurses are Now Paid More than Before

2010-11-29T22:28:00.000+08:00

While reading along for new nursing jobs that may help our Filipino nurses find one, I stumble upon a very interesting news online. Read this Pinoy nurses and maybe you will salivate on the prospects of getting to the US again.

According to the most recent data from the US Bureau of Labor Statistics, the averageregistered nurse (RN) salary is $66,530 in the United States. Despite the fact that the economy today is worse than it was during that same time period, this is $7,000 higher than the average nursing salary five years ago .

This is good news for those interested in healthcare professions as it shows thathealthcare is fairly recession proof although the demand for nurses really seems to plateau lately. While the bad economy in the US seems to have affected the majority of professions, other medical fields, aside from nursing, are also doing well.

The average Physician Assistants salary is $84,830; Pharmacists are making $106,630. There are many more average medical salaries you can check on the US Bureau of Labor website. In addition to the above average salaries, the medical industry is expected to increase an estimated 22 percent over the next 7 years, which would be about 600,000 new jobs including nurses. This number can increase significantly if the economy rebounds sooner than expected.

In general registered nursing seems to be one of the more popular professions people are choosing these days but medical assisting and medical billing also pay well and are in demand. Most of the hiring today and in the future is expected to come from private medical practices rather than public hospitals.

Healthcare is clearly a field that will always need servicing no matter what the economic situation. Nurses and Doctors will always be needed worldwide. However, nursing jobvacancies are not yet available in the US. But according to this report, there is some light in the horizon. The economic factors need to align to such conditions to prepare our newPinoy nurses for better jobs and better pays. Let’s wait for Obama to turn things around. Maybe or maybe not. Who knows?

Hope you like this update. Till next time.

Nurses jobs now in ample supply in Hawaii adding to the oversupply issue

2010-11-28T22:25:00.000+08:00

The longtime nursing shortage in Hawaii has now turned into an oversupply, leaving many recent graduates without jobs, and the economic slowdown is to blame, nursing executives here say.

This is further aggravated by the fact that nurses who were scheduled to retire or move to other jobs have postponed their plans, some because their spouses lost jobs or because of substantial losses in retirement savings.

Nurse turnover at Hawaii Pacific Health — the state’s largest health care system, employing nearly 1,600 nurses — has dropped to around 4 percent a year from 18 percent just three years ago, said Gail Lerch, HPH’s executive vice president and a registered nurse.

Overall, the demand for medical services in the Hawaii and mainland US also dropped in recent years as people lost their jobs and health insurance. Also, many people opted to stop or delay their elective procedures. Financially troubled medical facilities such as Hawaii Medical Center have reduced beds, further diminishing nursing jobs.

There are hundreds of recent nursing graduates that entered the job market just as thisoversupply was brewing, leaving many aggravated and anxious to find work in the profession. They are now forced to take on jobs not related to nursing.

The stakes are high for the new nursing graduates. Finding a job normally takes between six months to two years for most registered nursing graduates. If they are lucky to enter thehealthcare sector for the interim, many are working as lower-paid aides, technicians, clerks and other medical-related positions while they look for work. Nurse aides currently earn about $15 an hour, roughly half the pay for an entry-level registered nurse.

Health officials predict the oversupply of registered nurses to be short-lived as a substantial number of working nurses are expected to retire in the next five to 10 years.

According to local officials, the current surplus considered a blip on the radar screen, a phenomenon that caught everyone by surprise when the economy changed. This phenomenon of new graduates not getting jobs is all over the United States — it’s not just a Hawaii issue. It’s very much economically driven.

In the coming years and decades, demand for nurses will increase with the wave of baby boomer retirees. By 2025, Hawaii’s seniors population will represent 21 percent of the total, up from 14.5 percent now.

The current excess of nurses is in part a result of nursing schools significantly boosting enrollment in recent years to alleviate what had been called a severe nursing shortage.Nursing students typically take two to four years to graduate.

Certain that more nurses will be needed in the future, medical facilities and nursingschools are exploring ways to keep recent graduates in the job pipeline by creating bridge programs.

Medical centers and nursing schools also are exploring creation of the first nurse residency program in Hawaii that would be sponsored by the Hawaii State Center for Nursing.

Turning Knowledge Into Wisdom: Being an Effective Advocate

2010-11-27T22:24:00.000+08:00

Is your patient an effective advocate? Here are some tips for empowering your patients to be effective and powerful advocates.

Sue has a serious chronic medical condition and visits many different doctors each month. She is on top of her medical situation and sometimes brings in new research papers to discuss with her team. When a new doctor prescribed her a medication without explaining what and why, she gently but firmly told him, "I am happy to follow doctor's orders as long as I understand them. When would be a good time to answer my questions?"

Sue is an advocate. She seeks accurate medical facts and information. She empowers herself with knowledge. But knowledge is only half of the story. What good is knowledge without wisdom? Wisdom is knowing how to use knowledge effectively.

Sue sees herself and her doctors as a team. She believes in a collaborative approach to her medical care. But her style is not without conflict. There have been times when busy doctors with a brusque bedside manner didn't particularly like being "second-guessed." But Sue has a great way about her and it's hard not to like her. She is able to detect when she is starting to get some resistance and goes into her "Conflict Resolution Mode":

Step 1. Show empathy and understanding for the other person's position. "Ohhh, it looks like you are super busy today and probably don't have time for my questions. I can understand that."

Step 2. State your position using "AND" and "I" language: "And I can take much better care of myself if I understand the reasons behind your decisions here."

Step 3. Suggest alternatives: "Is there a time that we could talk about this later by phone or even email? I won't take much of your time, I promise. I just have a few basic questions about what you are suggesting. Thank you for being willing to help me out."

Sue is a successful advocate for her healthcare because:

1. She is knowledgeable about her medical condition. She actively seeks accurate information from reliable sources.
2. She stands up for herself and isn't afraid to be assertive.
3. She is calm and respectful even in the face of resistance or conflict.
4. She doesn't take abrupt (some say "rude") medical professionals personally.
5. She is not demanding or threatening.
6. She doesn't tell others what they have to do but instead shares what her needs are.
7. She understands that having an effective approach is in her own best interest so she works hard at learning good communication skills.
8. She tries to be appreciative of the doctor's knowledge and expertise (even if she doesn't like the doctor as a person).
9. She understands that being an advocate is not the same as being pushy or aggressive.
10. She uses a collaborative approach to solving problems.

Sue knows that her good health is ultimately up to her and the choices she makes. And, as an effective advocate, she is prepared and empowered to make good decisions that will impact her life, and those who love her, for years to come.

R.P. training nurses in Japanese / Caregivers sent to Japan under EPA get hand to overcome language hurdle

2010-11-13T12:37:00.000+08:00

Shuichi Inagaki / Yomiuri Shimbun Correspondent

MANILA--The Philippine government has begun language classes to help nurses wanting to go and work in Japan overcome the high language barrier, and even pays them to enroll.
The project is aimed at boosting the rate of Philippine applicants who pass Japan's national nursing examination and increasing the number of nurses seeking a career in Japan under the economic partnership agreement (EPA) between the two countries.
During one recent Japanese class, a teacher held up a panel with kanji for difficult words, such as "roasha" (the hearing impaired) and "nenza" (sprain), while the students read the words aloud in unison.
The Philippines' Technical Education and Skills Development Authority conducted a four-month Japanese course on a trial basis, ending in early September. Most participants studied while working at hospitals. During their language training, they acquired basic Japanese conversational skills, and learned medical terms and about Japan's workplace culture.
Participant Ana Melissa Cana said she received a job offer from a Japanese hospital based on the EPA deal, but declined it shortly before leaving for Japan. She said she was suddenly scared by the thought of living in Japan and taking the examination in Japanese.
However, the 31-year-old nurse is now determined to try again, as she still wants to work in Japan, which is known for its excellent medical technology.
But the first step, she said, is tackling the Japanese language.
Manila apparently has growing concerns that it may fail in its role of sending nurses to Japan as outlined in the economic partnership agreement, prompting it to take action. In February, 59 Philippine nurses made their first attempt at Japan's national nursing exams; only one passed. If nurses on the EPA program fail to pass the exam for three straight years, they must return home.
Questions have been raised over the current EPA arrangement, which offers foreign nurses only six months of Japanese language lessons.
To turn the situation around, the Philippine government has allocated 2.2 million peso (4.4 million yen) to launch the Japanese program and has paid as many as 75 participants in the program an allowance of 6,000 peso a month.
The government now appears to be considering participation in the program when selecting nurses to be sent to Japan. It hopes this will encourage capable nurses to go to Japan, which is a less popular destination than Western nations--where English is used more commonly--among many nurses.
Manila also is reportedly considering inviting more applicants and increasing class time.
The EPA between Japan and the Philippines took effect in December 2008. In May last year, the Philippines began dispatching nurses and caregivers to Japan. Under the EPA deal, Japan accepts up to 1,000 such nurses and caregivers for two years, but only 436 have been sent so far.
In Japan, the high cost of getting foreign nurses up to speed because of the language hurdle has deterred some potential employers from hiring them. The EPA will be reviewed next year, and Tokyo likely will seek to tweak the current system.
Viveca Catalig, a deputy administrator at the Philippine Overseas Employment Administration, acknowledged his country's own effort has its limits, and said he hopes Japan will consider expanding its language training and easing requirements for nurses in order not to disappoint motivated Philippine applicants.

Switzerland starts hiring Pinay nannies

2010-11-12T12:36:00.000+08:00

By Danny Buenafe - ABS-CBN Europe News Bureau
The close coordination between the Department of Foreign Affairs (DFA) and Swiss authorities proved fruitful as there is now a gradual phase-in of new recruits for Filipino au pairs or nannies in Switzerland.
Ambassador Teresa Lazaro relayed the good news adding that almost 50 newly hired nannies have started working with their respective Swiss employers.
“There’s actually a demand for our Filipina au pairs. We seemed to be very good with languages and very good in taking care of the young children,” said Lazaro.
Under the agreement, there is no placement fee for the applicants, and the average take home pay is almost 1,000 Swiss Francs or almost P43,000 every month.
According to Lazaro, the applicant must meet certain qualifications. Her age should be 18 to 25 years old. She must also be single, and should learn the German language which will be paid up by her employer.
The work contract, as stipulated in the law, will only be for 18 months or one-year-and-a-half and with no renewal.
For those interested, Lazaro said they need to coordinate with the Philippine Overseas Employment Administration (POEA).
“There are certain offices, agencies, here that are specializing on Filipino au pairs,” she said.
Meanwhile, Lazaro is also pushing for the training agreement with Swiss government to allow the recruitment of Filipino nurses to Switzerland.
“Switzerland is already in need of health workers,” Lazaro said.
It is possible, she said, that the recruitment of Filipina nurses would start next year as there is now a big demand in various university hospitals in Switzerland.

Gov’t urged to find migration balance

2010-11-11T12:34:00.001+08:00

By Nathaniel R. Melican - BusinessWorld
The Philippines should determine the “optimum level” of migration for different professions to prevent either a shortage or surplus in the country’s human resources.
Such an exercise will benefit both the country and its labor force by ensuring that the economy is well supported and at the same time providing the workers ample opportunity to recover their investments in education, Winfred M. Villamil, dean of the De La Salle University School of Economics, told BusinessWorld in an interview.
Migration for better work abroad is not bad in itself, Mr. Villamil said.
“People who would otherwise not invest in a college degree or in learning a new skill will be encouraged because of the prospect of working abroad and earning more. A certain optimum amount of migration will therefore raise the welfare not only of the migrants but also of the people left behind,” Mr. Villamil said.
But the migration rate must be monitored as an imbalance will have a negative impact, he said.
Mr. Villamil said signs that migration in a particular profession has breached the optimum point is when shortages occur and when average productivity of workers in the profession is declining. Another sign is when there is a surplus of workers in the profession.
Such an imbalance can be observed in the nursing profession, Mr. Villamil said.
“When nursing became in demand abroad and a lot of people were being hired as nurses abroad, you saw all these nursing schools sprout and you see all these people enrolling in nursing schools,” he said, noting that this sudden outflow of nurses temporarily caused a shortage of nurses locally.
“Today, I think we are now experiencing a surplus [of nurses],” he said.
Similarly, the number of Philippine workers in the maritime industry might also be breaching the optimum mark, as the demand abroad is now for more skilled workers.
“In terms of crews for ships, I think the demand is starting to decline.
We are also facing competition from other countries. I think the trend now is more toward the higher skilled level, for people who are going to be officers in ships,” he said.
Mr. Villamil said once the national government determines the optimum level of migration in different sectors, it can encourage people to develop skills in professions where labor supply has not reached the optimum mark, so they can enhance their employment opportunities abroad.
“The government should also think about ways to control migration so that the flow is optimal, but without infringing on the right of people to go where they want to go,” he said.
But Rene E. Ofreneo, professor at the University of the Philippines’ School of Labor and Industrial Relations, is cautious of the promotion of migration, saying this produces a “vicious cycle” that will end in the depletion of the country’s human resources.
“Our dependence on migration drains us of many high-end workers, such as engineers. This will slowly but surely affect the local industry and could even lead to the failure of local industries and even mission-critical services, such as health care,” Mr. Ofreneo said in a telephone interview.
He urged the government to focus on developing the local job market.

Hospital condemned for discriminating vs Pinoy nurses

2010-11-10T12:26:00.000+08:00

By Henni Espinosa - ABS-CBN North America Bureau
Filipino nurses, advocates and community groups flocked to the headquarters of the California Pacific Medical Center (CPMC) Wednesday to condemn the hospital chain for discriminating against Filipinos.
“We are here because we are concerned for the Filipino nurses. We have been advocates for the Filipino nurses for many years,” said Lilian Galedo, Executive Director of Filipino Advocates for Justice.
Last August, the California Nurses Association (CNA) filed a class action grievance against CPMC after some former nurse managers complained that they were told not to hire Filipino nurses because “they’re hard to understand.”
CNA cited that in 2008, Filipinos comprised 48% of new hires among nurses at St. Luke’s, one of CPMC’s hospitals. The union said that number decreased to 10% today.
Filipino nurse Ron Villanueva was up for promotion when he said he heard the Vice President for Nursing say that she should stop hiring foreign graduates.
Villanueva said, “I didn’t prod or anything. The mere fact that she said, I was already discouraged. What was the point of me applying?”
Two months after the Filipino nurses and CNA filed a class action grievance, CPMC management agreed to meet with Filipino community leaders, except for complainants like Villanueva.
“That just means they’re really guilty of discrimination. Why can’t they face me and others who personally witnessed what they said against us Filipinos?” he asked.
Terry Valen, Executive Director of the Filipino Community Center, said CPMC’s management denied that discrimination ever took place.
“They told us that they have conducted an internal investigation on this. And we have yet to see the results of that investigation,” Valen said.
Filipino nurse Marilen Logan was also present at the meeting. She said there is no truth to claims of some of her kababayans that CPMC discriminates against Filipinos.
“When I heard about this, I thought it was a joke that came from the rumor mill. People at CPMC hire a lot of Filipino nurses. I just don’t see what they’re saying.”
But protesters stood by their word that CPMC targets Filipino nurses. Community leaders said that unless CPMC corrects this, they will support the Filipino nurses in filing a class action lawsuit against the hospital chain.
Jane Sandoval, a nurse at St. Luke’s Hospital for 25 years and a union leader said, “This is not just a fight for Filipino nurses. This is a fight against discrimination. Whoever feels abused, we will make sure to back them up.”

A REAL Nurse

2010-11-09T12:25:00.000+08:00

When Dad was ill, my sister went to the hospital and told everyone that she was a nurse and she'd be watching them. She is a nurse -- sort of. She's a "Gucci nurse". She comes to work in her Gucci suit and her Prada heels carrying her designer handbag and her Coach briefcase and sits in her corner office with the gorgeous view making policy for a chain of hospitals. She hasn't been near a patient in over 25 years (except for that time where her "fire most of the RNs and hire non-licensed personnel instead" policy caused the remaining RNs to strike . . . ) She arrived to visit Dad wearing $100 blue jeans, a cashmere sweater and carrying the designer handbag and Coach briefcase. I’m sure that her hair and make-up were perfectly done as well. She didn't like Dad's room and insisted he be moved closer to the nurse's station, and then wanted a cot installed for my mother to sleep on and the food on the trays wasn't appetitizing enough and . . . . Nothing, it seemed, was good enough. She was ever so polite, I’m sure, while making it excrutiaitingly obvious that no one was quite as good as she, either.

I arrived a day later in rumpled jeans and sweater and bleary eyes from an overnight flight. I got to the ICU about 6 AM and, having heard from my sister about the 24/7 visiting hours, went directly to the nurse's station to ask if it was a good time to visit my father, Mr. Farmer. "WHO is your father?" asked the nurse rather strangely. "Mr. Farmer," I said. "My sister said he was in CCU."

"Oh," she said. "I'll get your father's nurse."

And so the nurse came hesitantly out of Dad's room, peering around the corner obviously looking for my always impeccably dressed and groomed sibling and seeing only rumpled, overweight and dowdy me. "Did your sister fill you in on your Dad's condition?" he asked. "She says she's a nurse."

I laughed and said, as I always do when asked about what my sister does for a living, "She's a Gucci nurse." This guy didn’t seem to require the explanation about the Gucci suit, designer accessories and corner office with a view.

Dad's nurse began using layman's terms and a gingerly manner, to fill me in on Dad's MI. Turns out it was The "Big One." I asked questions, he provided answers and before either of us quite realized how it happened, he was giving me a nurse-to-nurse report using the big words and everything. For the first time since my mother’s frantic phone call that Dad had chest pain and she was driving him to the hospital, I had a clear idea what was going on. I sat with Dad until physician rounds started and then, out of courtesy, I got up and started gathering my things to leave. My ICU didn’t encourage family to stay for teaching rounds, and I wasn’t going to expect “professional courtesy.”

Dad's nurse surprised me by telling me I should stay for rounds. And then he introduced me to Dad's doctor. "This is Mr. Farmer's other daughter, Ruby," he said to the group. "This one's a REAL nurse."

I never got invited to participate in rounds again -- I was never there at the inhospitable hour of 6AM again. But Dad’s doctors made a point of seeking ME out for the “family updates” and more than once, when my sister was highly visible on the unit, called me to their offices for a private conversation. It was probably far easier to talk to me, a CCU nurse who actually understood what they were saying than to either my mother -- who was probably already sliding into dementia -- or my sister the Gucci nurse. I’ve often regarded that introduction -- as “a REAL nurse” -- one of the nicest compliments I’ve ever recieved!

Teacher turned Nurse

2010-11-08T12:24:00.000+08:00

Nursing and Teaching are alike, and not alike.

I miss teaching. I miss summer vacation. Christmas vacation, Easter break, President's day. I miss the bell that says "go home", or the one that signals the end of a horrible class. I miss teenagers, the chatter, the hang-dog looks, the laughter, the tons of long healthy hair.

Even cafeteria duty which used to be a punishment. Listening in on pre-pubescent conversations to get a hint of what the next generation is thinking. Standing in the corner looking bored so they don't know I'm taking it all in.

I miss teaching. Seeing that light bulb go on, hearing myself explain something I really know and looking into young eager eyes that want the information. Priceless. The feeling that something good and real and valuable has happened here today. Sitting quietly with a 14 year old whose friends have decided to 'hate' her today. I miss it.

And yet--nursing the elderly has it's moments too. No doubt it's worthwhile. I still get to intimately connect with other human beings. Only this time it feels like most of the learning is on my part. I've been a teenager, I know what they feel, how they think. But old is something yet to be for me. I can only imagine how old feels. I love hearing the stories when they can tell one and when I have the time. The "good-old-days" when there were no TV's computers or pollution. When people connected in ways we nostalgically wonder about. When Sunday was a day of rest and that meant sitting in the parlor talking. Think about that for a minute.

Looking into old eyes I see the child, the teen, the young man or woman. The lights are still on and someone is in there. They look to me for care, understanding and sustenance. They shake their heads sadly when I just don't get it and I'm frustrated. I can ease their aches for awhile, give them the gift of my time, or a magazine, some cream on their feet. I can try to listen and empathize. They need me, well maybe not me exactly but they need the connection with a younger generation just as we all need connections with people older and younger than ourselves. We are all teachers and we are all students learning how to live how to-be.

So yes I miss teaching and school, but the world is school and learning never ends. Sometimes though I just wish the bell would ring.

A Physician's View: I Taught for an LPN to RN Company- What I Want You to Know

2010-11-06T12:24:00.002+08:00

Calling the Code - a coping mechanism in 14 lines

2010-11-06T12:22:00.002+08:00

It all started simply enough – a usual day at the station house. We checked in, we checked out the rig, we did our station duties and filled out the logbook; we looked up our duty roster for the day and we even started working on CE’s. There are mornings that the calls come right away, and days you actually get to unpack your gear; some days you might even be able to have a cup of coffee and relax for a bit – but the calls always come. When the calls come, you never know what it’s going to be when you get there or what you’re going to see. You don’t know whether the person you’ll be dealing with even wants you there, or if someone else called on their behalf. You don’t know whether it’s a life-or-death situation, or a stubbed toe. None of that matters. When the calls come, we roll.

Some days you never forget. Some cases stay with you throughout an entire career; you may never remember a name, or a date, but you always remember the faces. A blur of activity, a rush of frantic haste, and then the silence that comes at the end of a futile race to a foregone conclusion. And at the center of it all, one calm, still, angelic face.

When it all comes crashing down on us, how do we cope? How do the comforters ask for comfort? How do you bear the unbearable? Some of us write letters, write articles, or write blogs. Some of us talk. Some of us cry. Some of us punch walls; some of us turn inward and turn mean. Some of us drink. Some of us do some combination of all of these things and more.

Some of us – as silly as it seems – well, we write poetry.

I see her as I'd wish, this stranger's child.
Her smile alive, her childhood still intact,
her purity of skin left undefiled.
The trace of time's caress could not detract
from beauty that was hers by birth and right.
I see her thus. Not as I saw her last,
surrounded by the remnants of my fight
to bring her back - her final struggle past.
Pale lips curved, an enigmatic smile.
Those lips I vainly sealed with mine to breathe
the life back into her. So for a while
I stood -- abashed, exhausted and bereaved,
silenced, for all my furious battle, lost --
Compelled by those who live to hide that cost.

Ted D.

Pinoy nurses accuse travel agency of scam

2010-09-27T13:25:00.000+08:00

A group of Filipino nurses expressed disappointment after their supposed European trip a week ago did not push through.
The group said the 13-day trip had been planned for 2 years. They said they had paid for everything–more than $6,000 each to the American Academy of Family Medicine–a travel agency that claims to specialize on trips for nurses and doctors.
However, when they were packed and ready to go, the group never received their tickets from their agent.
“It’s very hurting and unfair. We gave them want they want. They charged us and we paid them on time. But they did not give us anything in return,” said Alice Chavez.
Francis Gonzales, Chief Executive Officer of the American Academy of Family Medicine, reportedly sent out an email to the travelers, saying that added costs in airport and hotel fees caused the postponement of their trip.
In the email, Gonzales reportedly wrote, “As an appreciation for the inconvenience, we will send you a travel coupon valued at $1,000.”
But Gonzales asked for another $600 per person to pay for added costs to the trip, which the company will consider a loan.
“That company is Filipino-owned and operated. Yet they scam fellow Filipinos. I’m very disappointed. We cannot trust them,” said Joy Rosete.
The travelers said the only reason why they bought the tickets was because of the agency’s buy-one-take-one deal.
Ranielle Manzano said this experience taught her to be careful of too-good-to-be-true deals.
“You have to do your research. If you don’t get any trip confirmation from the agency, it’s probably not legitimate,” said Manzano.
The travelers now have 3 weeks off with no vacation and nothing to do.
Class suit
They plan to use the time to file a class action lawsuit and individual small claims suit against the American Academy of Family Medicine.
“We want to recover what’s rightfully ours from the scammer,” said Johnson Lim.
These travelers said they also plan to report the American Academy of Family Medicine to the Better Business Bureau to stop them from scamming other people.
The American Academy of Family Medicine has denied these scam allegations. Gonzales said that the payments they received could not cover all the costs, and he had no choice but to postpone the trip and ask for additional fees. Gonzales said those who do not wish to take a trip at a later time will be reimbursed.
Gonzales also reiterated that his company has been around for 30 years, and has brought several thousands of medical professional in tours and meeting all over the world.

Japan nursing exam won’t be in English – POEA

2010-09-26T13:23:00.002+08:00

The Philippine Overseas Employment Administration (POEA) has clarified that the Japanese licensure examination for nurses will not entirely be translated into English. The clarification came from a representative of the Japan Ministry of Health, Labor and Welfare (MHLW), according to the POEA, even as foreign applicants are struggling to pass the difficult exam.
According to the POEA, the MHLW is still studying recommendations from focus group discussions (FGD) that it conducted among stakeholders.
Participants in the FGDs include hospital presidents, officials and professors of nursing schools, and other interest groups in the field of nursing, along with the Institute of Human Language.
“Among the suggestions from the said FGDs were to paraphrase certain difficult words or expressions into easier terms, provide Japanese hiragana characters for certain difficult kanji characters, include the subject and object in the Japanese sentence construction, and annotate special nursing terms and names of diseases in English including internationally recognized abbreviations,” the POEA said.
Hiragana and kanji are Japanese writing systems, with the former being used for traditional Japanese words and the latter being ideographs borrowed from Chinese characters.
The Department of Labor and Employment (DOLE) earlier pushed for intensified language training for Japan-bound nurses and caregivers to give them a better chance of passing the difficult examinations there. (See: DOLE wants intensified Japanese language training for caregivers, nurses)
Labor Secretary Rosalinda Baldoz cited recent reports that no foreign applicant passed last year’s exams and only 1.2 percent of foreign applicants passed the most recent exams.
She said this was due to the difficulty of the examinees in understanding kanji and technical terms written in Japanese.
Maria Luz Talento, Philippine Overseas Labor Office (POLO) in Tokyo officer-in-charge and welfare officer, meanwhile said the language program should focus on communication skills more than simply language skills.
Talento said that while candidate nurses and caregivers are able to speak Japanese, they have problems with oral and written communication with their co-workers and immediate superiors in their place of work.
Filipinos have been hired as nurses and caregivers in Japan under the Japan-Philippines Economic Partnership Agreement or JPEPA, which critics fear will result in further abuse of Filipino nurses in addition to trampling on the country’s sovereignty. (See: Jpepa to legalize abuses vs Pinoy nurses – CBCP) - via GMANews.TV

UK Catholic bishops support Pinay nurses

2010-09-25T13:23:00.002+08:00

Catholic bishops in the United Kingdom will help push for the retention of Filipino nurses and carers despite budget cuts in the National Health Service or NHS attributed to the prevailing global recession. His Reverend Patrick Lynch, Auxiliary Bishop of Southwark is one of the influential church leaders of England and Wales because he is responsible for all migrant workers including Filipinos.
Also in charge of asylum seekers in England, Bishop Lynch takes an active role in the forthcoming state and pastoral visit of his holiness, Pope Benedict XVI, starting September 16 to 19.
Bishop Lynch believes in the strong Christian values of Filipino migrants and their sense of professionalism towards work especially those working in hospitals and caring homes.
Like Bishop Lynch, some 30 archbishops in the UK acknowledge the huge contribution rendered by Filipino nurses in the NHS.
They oppose any move to retrench Filipino nurses and carers due to continuing cutbacks in government services.
If by chance, Bishop Lynch and other church leaders will discuss with the Holy Father the good traits of Filipinos and their big contribution to the UK workforce.
Whatever happens, Bishop Lynch thinks the support of the Holy Father would carry an enormous impact on UK government.
There are 6 million Catholics in Scotland, England and Wales.
While certain groups are already protesting the Pope’s arrival, Bishop Lynch believes the police can manage and security preparations will go smooth.
Many Filipinos have lined-up a number of religious activities during the 4-day visit of the Pope. - via ABS-CBN Europe News Bureau

NLE RESULT JULY 2010

2010-09-05T11:38:00.000+08:00

Manila, Philippines - The Professional Regulation Commission (PRC) announced that 37,679 out of 91, 008 (41.40%) passed the Nurse Licensure Examination also known as the NLE RESULT JULY 2010 or the Nursing Board Exam Result July 2010 given by the Board of Nursing on July 3-4, 2010 in all PRC Regional offices.

The members of the Board of Nursing are Carmencita M. Abaquin, chairman; Leonila A. Faire, Betty F. Merritt, Perla G. Po, Marco Antonio C. Sto.Tomas (inhibited), Yolanda C. Arugay and Amelia B. Rosales (inhibited), members.

The results of examination for five examinees were withheld pending final determination of their liabilities under the rules and regulations governing licensure examination.

Those who will register are required to bring:

duly accomplished Oath Form or Panunumpa ng Propesyonal,
current Community Tax Certificate (cedula),
2 pieces passport size picture (colored with white background and complete name tag),
1 piece 1” x 1” picture (colored with white background and complete name tag),
2 sets of metered documentary stamps, and 1 short brown envelope with name and profession; and to pay the Initial Registration Fee of P600 and Annual Registration Fee of P450 for 2010-2013.

Successful examinees should personally register and sign in the Roster of Registered Professionals.

The oathtaking ceremony of the new nurses, as well as those who have not taken their Oath of Professional will be held before the Board on Monday and Tuesday, September 20 and 21, at 8:00 a.m. and 1:00 p.m. at the SMX Convention Center, SM Mall of Asia, Pasay City.

All must come in their white gala uniform, nurse’s cap, white duty shoes, without earrings, hair not touching the collar and without corsage.

Oathtaking tickets for the National Capital Region (NCR) and nearby regions will be available at the Philippine Nurses Association (PNA) at 1663 F.T. Benitez Street, Malate, Manila, from September 1 - 20, on a “first come first serve” basis.

VIEW NLE RESULT

Filipino Health Workers Struggle in Filling Eldercare Gap

2010-07-03T21:50:00.000+08:00

New America Media/Philipine News, News Feature, Maricar C. P. Hampton, Posted: Jun 16, 2010

This is the second of two articles by Maricar Hampton resulting from her 2010 New America Media Fellowship, supported by The Atlantic Philanthropies. You can read part one here.

Nurse Edel Pimentel believes that Filipino health care providers will be especially able to deal with the demands of the 78 million aging boomers in the United States -- plus their elderly parents -- once they enter a healthcare facility, because Filipinos are “natural caregivers.”

In the Philippines, she said, “We tend to take care of our loved ones ourselves until they die. We don’t put them in nursing homes; we just don’t have that,” said Pimentel.

The role of foreign-born health care workers is especially important now because the United States is facing severe shortages of nurses and other eldercare workers. One in six nursing aides and one in nine nurses in the United States are foreign born, according to a 2004 study by the Immigration Policy Center in Washington, D.C.

The Philippines has been especially important, because its health care education programs have long been patterned after that in the U.S. Also, American long-term care providers actively recruit health care personnel there, even though immigration concerns in the United States have slowed State Department approvals of work visas to a seven-year backlog.

A report by the Philippine Embassy on Filipino medical staff for the year 2008-2009, shows that a total of 1,887 nurses, 1,450 physical therapists and 229 occupational therapists in the Philippines have been recruited by, or have job orders to work for, different hospitals and nursing home facilities all over the United States. However the embassy is not sure whether these people made it to America or are still waiting back home.

Immigrants Fill U.S. Eldercare Shortages
Pimentel was only 23 when she was recruited away from her job as a hospital nurse in the Philippines by Potomac Valley Nursing and Wellness Center to come to its nursing facility in Maryland.
Like many of her colleagues, she initially found it difficult to adjust to her new circumstances. “When I came here it was a struggle; it was depressing being in a nursing home and working with them,” said Pimentel. Over the past 16 years, though, she became a nursing supervisor and data coordinator, and came to love her job.

Today, Pimentel is fortunate to be among the thousands of Filipino nurses and aides, who find satisfaction in providing long-term care to millions of older Americans. Many others who venture abroad as caregivers tell awful stories of abuse, harassment and broken dreams.

Even in non-abusive situations, long-term care staff can find themselves stuck on double shifts and assigned to too many facility residents. Despite doing the most difficult tasks direct-care nurses’ aides typically get paid hourly wages of $10 an hour or less, frequently without benefits.

Immigrants in nursing are particularly needed in geriatric care, because the fragmented U.S. system of long-term care attracts few health care providers, according to Robyn I. Stone, executive director of the Institute for the Future of Aging Services at the American Association of Homes and Services for Aging, in Washington, D.C.

Stone, a former head of the U.S. Administration on Aging, noted, “We have a coalition here in Washington called the Eldercare Workforce Alliance, a group of various associations that are all focused on really trying to get a better geriatric training, education and support for nursing and other health care professions.”

But until the United States finds ways to fill the shortages, Stone said, immigrants skilled in health care will continue to be vital in both institutional and home or community-based care, she said.

Not only registered nurses such as Pimentel, but nursing caregivers in long-term care, also known as direct care workers, have always played a key role in American eldercare. In nursing facilities, homecare or community-based programs, such as assisted living, direct caregivers provide most of the hands-on care.

In many states on the East and West coasts, caregivers are predominantly from other nations. A 2008 article in the Gerontologist, a journal of the Gerontological Society of America, Globalization, reported that the Philippines has become a major source of long--term care workforce for the U.S., Canada, and European countries and others. Many others come from Africa, the Caribbean and other developing regions.

Grueling Tasks
Direct-care workers in long-term care often perform grueling tasks, such as bathing and feeding frail elders, helping them use the bathroom, cooking, cleaning and serving meals. In addition, they administer basic first aid and, in some cases, are licensed to dispense medications and participate in the care planning process for residents.

For Ted Melon, a caregiver at Maple Ridge, in Rockville, Md., providing real care to seniors greatly depends on resident-staff relationship.

“It’s all about interpersonal relationships with the residents,” he said. Mallon takes time to talk with residents, because “that personal touch” enables him to note subtle changes in a resident’s character that might tip him off to emerging issues in their care.

Direct-care workers, such as Melon, are the lowest paid employees in long-term care. Few work in settings that involve them on the caregiving team, or provide them longer-term career development.

That’s why turnover among direct care workers ranges from 40 to 75 percent annually nationwide, according to the 2009 Direct Support Professionals Wage Study, conducted by ANCOR, a trade group for direct-care providers. A 2001 report by the U.S. Government Accountability Office found that turnover has been as high as 100 percent in a year in some facilities.

Direct caregivers typically need one or more other jobs simply to make ends meet. Such is the case with Melon, who does private-duty caregiving on weeknights, and works in a group home on the weekends.

“I used to work in the mortgage industry. But with the real estate market going down, I had to look for an alternative source of income, which is in healthcare. But even then I still have to have two jobs,” Melon said.

Edita Baua, a patient-care unit manager , is one of Edel Pimentel’s nursing co-workers at Potomac Valley Nursing and Wellness Center in Maryland. “I came here as a tourist and wasn’t planning on staying for good,” she said. When a friend persuaded her to remain, she applied at Potomac Valley, where an administrator welcomed her and said the organization would sponsor Baua to become a legal U.S. resident.

Tess Orlina, director of nursing at Potomac Valley added, “We directly recruit our staff from the Philippines or sponsor them. Our administrator goes to the Philippines and directly interviews nurses from there.”

Currently, Potomac Valley has petitioned the U.S. State Department for three nurses to receive American work visas. But the visas are yet to be approved because of the virtual “freeze” on them, Orlina said.

Pimentel remains hopeful. For Filipino caregivers, she said, the U.S. provides “fertile ground. There are a lot of opportunities for you to move up in this profession. A lot of Filipino nurses thrive and do well because it’s innate in us to be hard working, patient and caring which, in this job, is very much needed.”

As for those nurses trying to emigrate here, she, Pimentel said, “Yes, there is a big need for nurses in this country, but it is limited because of the government restriction. But I hope the U.S. will give them the opportunity to come here too and fill the shortage.”

The Filipino Factor: Dispelling the Filipino worker stereotype

2010-07-02T21:48:00.000+08:00

They're not just live-in caregivers. Many are nurses who want to live and work in Canada.

For many Canadians, the image of a Filipino worker is one of a nanny pushing a baby carriage. But the reality is quickly changing. Lawrence Santiago, a Trudeau scholar doing his doctorate at the University of B.C., wants to dispel some stereotypes about Filipino workers in Canada.
As he puts it, only about 12 per cent of the total Filipino population in Canada arrives via the Live-In Caregiver program.
To make his case, Santiago chose to study health care workers from the Philippines.
B.C. has not recruited nurses en masse from the Philippines the way the Prairie provinces have in recent years. But they apply to come anyway. The province's College of Registered Nurses gets more applications for licences to practise nursing from the Philippines than it does from any other country.
Santiago set out to hear the voices of these workers, understand what happens when they leave the Philippines, and see how they eventually fit into Canadian hospitals and clinics.
His project started in a small Saskatoon house, returned to his native Philippines, and this month looped back to B.C.
His research has illuminated the many challenges involved with widespread migration, both here and in the Philippines.
On a personal level, nurses who emigrate for a brighter economic future are often wracked with homesickness and guilt for leaving their families.
Globally, the large-scale exodus of health care workers also takes a toll. The country they leave loses some of its best and brightest nurses and doctors, harming both the quality of health care and training for the next generation.
Last summer, Santiago camped out for several months with five nurses from the Philippines. They were all on temporary work visas, living in Saskatoon, the first batch of recruits hired by the Saskatoon Health Authority in 2008. His initial source was a childhood friend.
"Before he left for Canada, we met regularly in our town and at the community church," said Santiago.
From there, Santiago fanned out to meet and do in-depth interviews with other Filipino nurse migrants in Saskatoon.
"I lived with them in the same household, so I cooked, cleaned, played and did anything that a typical housemate would do," he explained.
His ability to speak to the nurses in Tagalog - and as the son of a middle-class, migrant construction worker himself - allowed him to "jell very quickly" with his subjects. Still, at times it wasn't easy to draw the line: when to be an objective observer and when to be a fellow Filipino.
One day while helping one of the migrant nurses Skype with an ailing father, Santiago wondered how exactly he should handle himself.
"I can eavesdrop in their private family conversation like an ethnographer who takes advantage or exploits his subjects' emotional circumstances, or I can simply stay away from the scene," wrote Santiago. "I decided to do what a friend would do instead. I cooked him sopas or milk macaroni soup, which he has been requesting from me to cook for the last few days because of the rainy weather here in Saskatoon.
"Managing one's emotions is one of the most difficult things migrants face while they're abroad. In situations [such as] when one's loved ones are sick, or worse, just died, the migrant feels a strong sense of fate's betrayal," he noted.
This April, Santiago moved his research to the Philippines to learn what happens on that end when nurses leave in large numbers.
"There is a huge strain on health care delivery in Philippine hospitals. The boom of nursing colleges in the Philippines has become a major business opportunity for many private entrepreneurs and institutions, enabling further migration," said Santiago. "But it has led to a deterioration of the quality of nursing education, since most of the best trained nursing faculty and clinical instructors are leaving the Philippines as well."
Over the next few weeks, Santiago will conduct focus groups with Filipino nurses who are working in B.C. (Some come on temporary work visas to take hard-to-fill positions, often in more remote locations. Some work first in other countries, such as the U.K., the U.S. or in the Middle East, before coming to Canada on temporary work visas or as immigrants under federal skilled worker programs. Still others come first via the live-in caregiver program and then go through many qualifying hoops to work as nurses again once they are permanent residents.)
Eva Mendez, a consultant at Health Match B.C., which places doctors and nurses throughout the province, hopes Santiago will focus on how these Philippine-trained nurses are doing at work.
"Do your peers relate to you as a member of the team as opposed to [being] a temporary foreign worker? If it's a matter of 'You're an RN, but you're not really one of us,' it can lead to a total breakdown of work dynamics. Satisfaction at work is the linchpin."
To promote his research, Santiago is organizing conferences and collaborating on a multimedia, documentary film project. His great hope is that all the players in this story of migration from the Philippines to Canada will somehow "meet" via his project and think of ways to improve education, health, labour and migration policies.
jlee-young@vancouversun.com

Pinoy nurses in CNMI hit delayed, partial wages

2010-07-01T21:45:00.001+08:00

By Haidee V. Eugenio
At least 22 Filipino nurses and auxiliary personnel in the Commonwealth of the Northern Mariana Islands (CNMI) have complained they have not been paid on time for as long as three months now.

Some nurses received partial payments for their salaries, but are still uncertain whether they would get paid in full or if they would get paid after all in the next pay period.

The 22 overseas health workers are employed by a private employment agency, Saipan Employment Agency and Services, for work in the CNMI, a U.S. territory some three hours away from Manila.

These Filipino nurses are assigned to the CNMI government-run Rota Health Center and Tinian Health Center, located in two other major islands of the CNMI.

In the CNMI’s capital island of Saipan, nurses in the government-run hospital are directly employed by the government and do not experience salary delays.

Most of the government nurses in Saipan and in the whole Northern Marianas are Filipinos.
“Nagi-stay pa rin kami dito dahil ayaw naman naming iwanan ang mga pasyente namin. Pero sana maayos na itong problema namin. Sana ma-hire na kami directly ng gobyerno. Hindi na namin makakayanan kapag ‘di pa kami makatanggap ng sweldo,” one of the Filipino nurses at the Rota Health Center told GMANews.TV.
(We’re staying here because we don’t want to abandon our patients. But we’re hoping that our problem would be addressed. We hope we’d be hired directly by the government. We can’t stand it any longer if we still don’t receive our wages.)

Filipino nurses in both Tinian and Rota do not want to be identified, fearing retaliation from either the employment agency or the CNMI government.

Since March 2010, nurses in Rota received payments covering only the hourly $4.55 minimum wage of their salaries, and not their complete hourly salary of $8.93 to $9.20 an hour.

These nurses’ employment agency, SEAS, has also been permanently barred and disqualified from hiring, renewing or employing foreign workers in the CNMI because of labor violations.

SEAS appealed the decision, but the CNMI Department of Labor upheld the debarment and disqualification. The agency can still appeal the latest decision.

The employment agency likewise said it has not been receiving payments from the CNMI government and, as a result, could not pay these Filipino nurses for the services they render at the government health centers.

CNMI lawmakers stepped in to identify funds to pay the nurses salary. However, the funding appropriated by lawmakers and approved by the governor could only cover partial payment of the salaries.

The Philippine Consulate General in Saipan could not be reached as of posting time.

Records from the Philippine Overseas Employment Administration show there are over 3,200 Filipino workers in the US territory as of 2009.

4 Pinay nurses sue Baltimore hospital for discrimination

2010-06-30T21:43:00.000+08:00

Four Filipino nurses filed a discrimination complaint before the US Equal Employment Opportunity Commission (EEOC) against a hospital that allegedly fired them for speaking their native language at work.
Nurses Corina Capunitan Yap, Anna Rowena Rosales, Hachelle Natano, and Jazziel Granada claimed the Bon Secours Health System terminated them without due process and dismissed them solely for speaking in their native tongue.

The hospital’s policy states that English is the principal language and must be the exclusive language spoken and written by all employees while on duty in the emergency department.

However, the nurses, who are being represented by the Migrant Heritage Commission, said that they do not recall speaking in Tagalog in front or while providing patient care in the Emergency Department. They admitted speaking in their native language only during breaks at the Nurses’ Station.

The nurses’ lawyer, Atty. Arnedo Valera had asked the EEOC to investigate the complaint and if the hospital’s English-only rule in the workplace violates the Civil Rights Act.

Valera cited prior findings of the EEOC which did not favor this rule, “There were previous findings of the EEOC that this is burdensome as a condition of employment because it creates a disparate treatment which leads to discriminatory practice”.

Valera added that based on the nurses’ claims, speaking Tagalog during break time does not impede their work.

He added that should the EEOC find probable cause in the nurses’ complaint, the commission will issue a right to sue, after which they will file a case against the hospital before the district court and seek punitive damages of up to $500,000 for all four nurses. - via Balitang America

Norway may hire Filipino health workers

2010-06-29T21:43:00.002+08:00

The possible deployment of Filipino health workers to Norway will increase the country’s intellectual capital and wealth, the Department of Labor and Employment (DoLE) said on Saturday.

Labor Acting Secretary Romeo Lagman made the statement after disclosing that Filipino nurses and caregivers may likely be deployed to Norway as soon as labor and health officials of Norway and the Philippines finalized talks on the matter.

“There are still apprehensions on the part of Norway particularly on the issue of ‘brain drain’ and the language training,” Lagman said in an interview.

“But we have 60,000 nurses produced every year, and enrollment for such course is not going down. We have an oversupply of nurses and we do not see a draining in our medical pool by increasing our deployment overseas,’’ he said.

According to Lagman, most European countries are now looking at the impact of social migration and do not want to take advantage of countries that are experiencing the brain drain phenomenon.
Norway labor and health officials are expected to visit the Philippines within the year to continue talks on ways to create employment for Filipino health workers.

Norway is open for employment and has huge requirement for nurses, said Lagman.
Should the deployment of Filipino nurses to Norway pushes through, he said the Philippines will be gaining so much not only from the job opportunities but also from the skills learned by the workers while in that country.
Currently, he said the country offers good compensation for health workers ranging from $3,000 to $7,000 per month.

Earlier, Norway had opened its doors to Filipino engineers and offering salaries ranging from $5,000 to $7,000 per month.

Apart from Norway, Lagman said Denmark is also open for Filipino workers although details on possible employment are yet to be discussed. - via www.mb.com.ph

Limiting Nurse Workloads Good for RNs and Patients

2010-05-01T10:46:00.000+08:00

April 21, 2010 — A law passed in California in 2004 limiting the number of patients that can be assigned to a nurse has contributed to lower mortality rates among general surgery patients and increased job satisfaction among the state's nurses, according to the first comprehensive evaluation of the legislation, published online April 9 in Health Services Research.
The California law, the first in the nation, specifies that nurses may care for no more than

5 patients in a medical-surgical unit,
4 pediatric patients,
2 intensive care patients,
6 psychiatric patients, or
3 patients in labor and delivery.

Linda H. Aiken, PhD, RN, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing, Philadelphia, and colleagues examined general surgery outcomes data and hospital staffing information from California in 2006, 2 years after the law was enacted. The researchers did the same in Pennsylvania and New Jersey — 2 states without mandated nurse staffing requirements — and compared how nurse and patient outcomes are affected by differences in nurse workloads across the hospitals in these 3 states.
The analysis included 22,336 hospital staff nurses working in 604 adult nonfederal acute care hospitals in California (n = 9257 registered nurses [RNs] in 353 hospitals), New Jersey (n = 5818 RNs in 73 hospitals), and Pennsylvania (n = 7261 RNs in 178 hospitals). Small (<100 beds), medium (101 - 250 beds), and large (>251 beds) hospitals were represented.
The authors report that average workloads were significantly lower (P < .05) for RNs in California than in New Jersey and Pennsylvania (mean patients per shift, 4.1 in California vs 5.4 in New Jersey and Pennsylvania). The percentage of California nurses on medical-surgical wards who reported overseeing 5 or fewer patients on their last shift, as mandated under California law, was 88%; the same was true of only 19% and 33% of medical-surgical nurses in New Jersey and Pennsylvania, respectively. On medical-surgical wards, California RNs cared for 2 fewer patients on average than New Jersey RNs and 1.7 fewer patients than Pennsylvania RNs.
"Sizeable" Effects on Surgical Inpatient Mortality
Dr. Aiken's team used logistic regression models to estimate the effects of nurse staffing on 30-day inpatient mortality. The results suggested that there would have been 13.9% fewer deaths among surgery patients in New Jersey and 10.6% fewer in Pennsylvania if hospitals in those states had been staffed at the same average level as California hospitals .
"In these two states alone, 468 lives might have been saved over the 2-year period just among general surgery patients if the California nurse staffing levels were adopted," Dr. Aiken notes in a university-issued statement. "Because all hospitalized patients are likely to benefit from improved nurse staffing, not just general surgery patients, the potential number of lives that could be saved by improving nurse staffing in hospitals nationally is likely to be many thousands a year," she predicted.
Better Work Environment
The survey also found significantly and consistently greater job satisfaction among California RNs. Higher percentages of nurses in California than in New Jersey and Pennsylvania reported that

their workloads are reasonable (73% vs 59% and 61% for New Jersey and Pennsylvania, respectively),
they receive substantial support in doing their jobs (66% vs 53% and 55%, respectively),
there are enough staff RNs to provide quality care (58% vs 41% and 44%, respectively),
there are enough staff RNs to get their work done (56% vs 40% and 44%, respectively), and
30-minute breaks are part of their typical workday (74% vs 51% and 45%, respectively).

All of these differences were significant to the P < .01 level.
In addition, a smaller percentage of nurses in California than in New Jersey and Pennsylvania reported that their workloads caused them to miss changes in patient conditions (33% vs 41% and 37%, respectively; P < .01). There was also evidence that a significantly lower proportion of California RNs experience high burnout (29% vs 34% and 36%, respectively).
Dr. Aiken's team notes that although nurse self-reports of workloads may be prone to bias, in previous research they found them to have "considerable predictive validity and better predictive validity than [American Hospital Association] measures of nurse staffing." The researchers also say they rigorously controlled for a variety of nurse characteristics that might affect the data, such as education and experience, as well as patient and hospital characteristics that might affect the results.
"The California experience may inform other states that are currently debating nurse ratio legislation," Dr. Aiken and colleagues conclude, noting that Massachusetts, Minnesota, New Jersey, Illinois, and Oregon are among 18 states currently evaluating nurse staffing issues.
The study was supported by the National Institute of Nursing Research, National Institutes of Health, the Robert Wood Johnson Foundation, and AMN Healthcare Inc. The authors have disclosed no relevant financial relationships.

Better Nurse-Patient Ratios Could Save Thousands of Lives Annually, Says Study

2010-04-30T10:57:00.000+08:00

If California's mandatory nurse-patient ratios had been in effect in Pennsylvania and New Jersey hospitals in 2006, those states would have seen 10.6% and 13.9% fewer deaths among general surgical patients, according to a Pennsylvania researcher's analysis.

That equated to 468 lives that might have been saved, says Linda Aiken, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing and the study's lead author.

Her report was published in the journal Health Services Research, and is considered the first comprehensive evaluation of California's controversial 2004 nurse staffing ratio mandate and may inform decisions in 18 other states that are considering lowering their nurse-staff ratios, such as Massachusetts, Minnesota, and Illinois.
Aiken's study received funding support from the Robert Wood Johnson Foundation and the National Institute of Nursing Research at the National Institutes of Health.

Aiken, a registered nurse and a well-known nursing workforce investigator, says that the difference between staffing at hospitals in California versus New Jersey and Pennsylvania "is very large, about two more patients per nurse [in medical surgical units]. And that's very significant."

To explain the decline in California mortality that she attributes to better nurse-patient ratios, Aiken says, "Nurses are the main surveillance system in hospitals.

"Nurses detect the majority of complications; the majority of medication errors that are detected by anyone are detected by nurses first. And nurses can distinguish between patients who are shivering after surgery because the operating rooms are cold, or who are shivering because they are in shock and are going into multiple organ failure that can't be reversed if it isn't caught early enough."

"All hospitalized patients are likely to benefit from improved nurse staffing, not just general surgery patients," Aiken says, adding that "the potential number of lives that could be saved by improving nurse staffing in hospitals is likely to be many thousands a year."

A spokeswoman for the California Hospital Association, which opposed the patient-nurse ratios and has criticized their effectiveness, said the organization was reviewing the report, but did not yet have a comment.
However, officials for the 155,000-member California Nurses Association were delighted with the report because it sponsored the law that mandated the lower ratios.

"This research documents what California RNs have long known–safe staffing saves lives," says Malinda Markowitz, CNA and National Nurses United co-president. "We see the effects every day at the bedside in improved patient care, an enhanced quality of life for patients, and nurses able to more safely practice the profession to which we have dedicated our lives."

Her study compared patient outcomes data reported by hospitals to state agencies and surveyed 22,236 hospital staff nurses in those three states. The report was long anticipated because California remains the first and only state to implement minimum nurse-patient staff ratios in its acute care hospitals, as of Jan. 1, 2004.
The law says a nurse must care for no more than five patients on a medical-surgical unit, four pediatric patients, two in intensive care, six in a psychiatric unit, and three in labor and delivery.

According to a table in Aiken's report, adjusted 30-day inpatient mortality in California was also significantly lower than in New Jersey or Pennsylvania.

Also, Aiken reported, 88% of nurses surveyed in a medical-surgical unit reported having five patients, but in New Jersey only 19% and in Pennsylvania only 33% reported those ratios. The rest had higher ratios.
Similar disparities were seen for nurses working in intensive care, telemetry, oncology, labor and delivery, and pediatric units, according to Aiken's report.

Aiken's surveys of nurses in those three states revealed that in California, nurses had better job satisfaction, less burnout, and said they provided better quality of care than did nurses who responded in Pennsylvania and New Jersey. "California nurses were more likely to rate quality of care as excellent than nurses in the other two states," she says.

Aiken's report from 2002 found that each patient added to a nurse's workload added 7% to the mortality rate for patients undergoing common surgeries. Also, she reported, higher nurse to patient ratios were also associated with more nurse burnout, job dissatisfaction, and precursors of voluntary turnover.

Since 2004, the state has increased the number of actively licensed RNs by more than 110,000, tripling the average annual increase before 1999 when the law was enacted, and five years before it took effect.
"From a policy perspective, our findings are revealing," Aiken wrote in her conclusion. "The California experience may inform other states that are currently debating nurse ratio legislation."

McAfee antivirus program goes berserk, freezes PCs

2010-04-29T10:56:00.001+08:00

NEW YORK – Computers in companies, hospitals and schools around the world got stuck repeatedly rebooting themselves Wednesday after an antivirus program identified a normal Windows file as a virus.
McAfee Inc. confirmed that a software update it posted at 9 a.m. Eastern time caused its antivirus program for corporate customers to misidentify a harmless file. It has posted a replacement update for download.
McAfee could not say how many computers were affected, but judging by online postings, the number was at least in the thousands and possibly in the hundreds of thousands.
McAfee said it did not appear that consumer versions of its software caused similar problems. It is investigating how the error happened "and will take measures" to prevent it from recurring, the company said in a statement.
The computer problem forced about a third of the hospitals in Rhode Island to postpone elective surgeries and stop treating patients without traumas in emergency rooms, said Nancy Jean, a spokeswoman for the Lifespan system of hospitals. The system includes Rhode Island Hospital, the state's largest, and Newport Hospital. Jean said patients who required treatment for gunshot wounds, car accidents, blunt trauma and other potentially fatal injuries were still being admitted to the emergency rooms.
In Kentucky, state police were told to shut down the computers in their patrol cars as technicians tried to fix the problem. The National Science Foundation headquarters in Arlington, Va., also lost computer access.
Intel Corp. appeared to be among the victims, according to employee posts on Twitter. Intel did not immediately return calls for comment.
Peter Juvinall, systems administrator at Illinois State University in Normal, said that when the first computer started rebooting it quickly became evident that it was a major problem, affecting dozens of computers at the College of Business alone.
"I originally thought it was a virus," he said. When the tech support people concluded McAfee's update was to blame, they stopped further downloads of the faulty software update and started shuttling from computer to computer to get the machines working again.
In many offices, personal attention to each PC from a technician appeared to be the only way to fix the problem because the computers weren't receptive to remote software updates when stuck in the reboot cycle. That slowed the recovery.
It's not uncommon for antivirus programs to misidentify legitimate files as viruses. Last month, antivirus software from Bitdefender locked up PCs running several different versions of Windows.
However, the scale of this outage was unusual, said Mike Rothman, president of computer security firm Securosis.
"It looks to be a train wreck," Rothman said.

California hospital plans to use 100 Apple iPad

2010-04-28T10:53:00.000+08:00

A California hospital plans to distribute more than 100 Apple iPads among its health care workers to allow them look at X-ray images, EKG results and more on the portable touchscreen device, according to a new report.

Nick Volosin, director of technical services at Kaweah Health Care District in Visalia, Calif., told Network World that he bought three iPads for testing, and plans to implement more than 100 at the facility in the next two months. Various patient monitoring programs will be accessed through Citrix virtual desktop and application delivery software. Using the Citrix Receiver, the hospital will be able to have its workers access desktop applications without writing proprietary software for the iPad.

The iPads will be distributed to home health care and hospice workers, nurses, dietitians and pharmacists. Because tight supply has forced Apple to turn down volume orders, the hospital had to work with Apple directly to make such a large purchase.

Volosin told author Jon Brodkin that the iPad and its 10-hour battery life will replace a laptop for many employees, particularly because it will eliminate the need to charge multiple times throughout the day, and it doesn’t need to be turned on and off. In addition to patient-related services, employees will also be able to use the device to do traditional office tasks like check their e-mail.

Another selling point for the iPad: the price. Starting at $500 for the 16GB Wi-Fi model, Volosin reportedly said that it is a more affordable option when compared to a traditional touchscreen tablet, which can cost as much as $3,000.

In addition to Volosin’s three test units, about 20 doctors have purchased their own iPads to use at the office. One kidney specialist said the device has made him more efficient and also improved patient safety.

Many hospitals have eyed Apple’s iPad since the device was first announced earlier this year. Some health care workers believe tablet computers help doctors and nurses spend more time with patients. One San Francisco program dubbed “Destination Bedside” uses tablet computers to provide X-rays, charts, prescriptions and notes.

In February, one study found that one in five physicians intended to buy an iPad, just days after it was announced. Epocrates Inc.’s survey of more than 350 clinicians found that 9 percent would buy an iPad when it became available, while another 13 percent intend to buy one in the first year. Another 38 percent said they were interested in the iPad, but wanted more information before they would decide whether or not to purchase.

Stress Hormones May Promote Ovarian Cancer Metastasis

2010-04-27T10:52:00.000+08:00

FRIDAY, April 23 (HealthDay News) -- In patients with ovarian cancer, focal adhesion kinase (FAK) modulation by stress hormones -- especially norepinephrine and epinephrine -- may contribute to tumor progression, according to research published online April 12 in the Journal of Clinical Investigation.

Anil K. Sood, M.D., of the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues studied human ovarian cancer cells which were exposed to either norepinephrine or epinephrine, and mice with a model of human ovarian cancer which were subjected to restraint stress. They also examined 80 cases of invasive epithelial ovarian cancer to assess the role of stress-induced FAK activity.

The researchers found that cancer cells exposed to the hormones exhibited lower levels of anoikis. In the mice, they found that the associated increases in norepinephrine and epinephrine protected the tumor cells from anoikis and promoted their growth by binding with the β2-adrenergic receptor and activating FAK. In the human cases, they found that 67 percent had increased FAK expression and that 50 percent had heightened levels of phosphorylated FAK. Three-year survival was significantly lower in those with increased FAK expression or heightened levels of phosphorylated FAK (30 and 15 percent, respectively) than in those with low FAK expression (65 percent).

"These findings also imply that the neuroendocrine 'macroenvironment' may play a significant role in shaping cellular activity in the tumor microenvironment in ways that ultimately facilitate cancer progression," the authors write. "Thus, protective interventions targeting the neuroendocrine system might simultaneously modulate multiple molecular pathways involved in tumor metastasis (e.g., anoikis, angiogenesis, and invasion)."

Nursing our way out of a doctor shortage

2010-04-26T10:49:00.001+08:00

Give non-physicians more freedom to help patients.

Thanks to health care reform, millions of previously uninsured Americans will have policies enabling them to go to the doctor when necessary without financial fear. But it's a bit like giving everyone a plane ticket to fly tomorrow. If the planes are all full, you won't be going anywhere.

There are not a lot of doctors sitting in their offices like the Maytag repairman, playing solitaire and wishing a patient would drop by. Most of them manage to stay plenty busy. Nor is there a tidal wave of young physicians about to roll in to quench this new thirst for medical care.

On the contrary. The Association of American Medical Colleges says that by 2025, the nation could be 150,000 doctors short of the number we need. Meanwhile, the number of med students entering primary care, the area of greatest need, is on the decline.

It's hard to quickly boost the supply of physicians, since the necessary training usually takes at least seven years beyond college. The result, as an AAMC official told The Wall Street Journal: "It will probably take 10 years to even make a dent into the number of doctors that we need out there."

That, of course, is assuming that the new health insurance system doesn't drive aspiring or existing doctors out of medicine, which is entirely possible. Regardless, there seems to be no doubt that it will get harder to find someone to treat you, it may cost more and you'll spend two hours in the waiting room instead of one.

Or maybe not. What people with medical problems need is medical care, but you don't always need a physician to get treatment. You might also see a different sort of trained professional — say, a nurse practitioner, physician's assistant, nurse or physical therapist.

Not every ailment demands Dr. McDreamy, any more than every car trip requires a Lexus. If you have a sore throat, earache or runny nose, you probably don't absolutely require a board-certified internist to conduct an exam and dispense a remedy.

But it may not be up to you to decide who is suited to provide the care you want. Different states have different rules on what these clinicians may do. In many places, a nurse practitioner has to be under the supervision of a doctor. In others, she may not prescribe medicines or use the title "Dr." even if she has a doctorate (as many do).

Medicare typically reimburses nurse practitioners at a lower rate than physicians. In Chicago, an office visit that would bring $70 to a doctor is worth only $60 to a nurse practitioner.

But the need for more primary care is forcing a welcome reassessment of these policies. So 28 states are reportedly considering loosening the regulations for nurse practitioners, on the novel theory that any competent professional health care is better than none.

Private enterprise is already responding to what consumers want. Walgreens, for example, has established more than 700 retail health clinics staffed by nurses, nurse practitioners and other non-doctor professionals. CVS has its own version. The number of these facilities is expected to soar in the next few years.

You might fear that this sort of treatment is inferior to what you'd get from your personal doctor. Your doctor might agree. The American Medical Association, reports The Associated Press, warns that "a doctor shortage is no reason to put nurses in charge and endanger patients."

But put your mind at ease. A 2000 study published in the Journal of the American Medical Association found that where nurse practitioners have full latitude to do their jobs, their patients did just as well as patients sent to physicians. Other research confirms that finding, while noting that retail clinics provide their services for far less money than doctors' offices and emergency rooms.

Obviously, if you wake up with crushing pain in your chest or fall out of a second-story window, you'd be well-advised to see a specialist. But for common ailments that are mainly a nuisance, a physician may be a superfluous luxury.

Obama's health care reform rests on the assumption that expanding access demands a bigger government role. But even its supporters should be able to see that sometimes, it helps to get the government out of the way.

Steve Chapman is a member of the Tribune's editorial board and blogs at chicagotribune.com/chapman

schapman@tribune.com

NCLEX HOT TOPICS

2010-04-25T11:19:00.000+08:00

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Nursing shortage: 1 in 5 quits within first year, study says

2010-04-25T10:23:00.000+08:00

MIAMI — Newly minted nurse Katie O'Bryan was determined to stay at her first job at least a year, even if she did leave the hospital every day wanting to quit.

She lasted nine months. The stress of trying to keep her patients from getting much worse as they waited, sometimes for 12 hours, in an overwhelmed Dallas emergency room was just too much. The breaking point came after paramedics brought in a child who'd had seizures. She was told he was stable and to check him in a few minutes, but O'Bryan decided not to wait. She found he had stopped breathing and was turning blue.

"If I hadn't gone right away, he probably would have died," O'Bryan said. "I couldn't do it anymore."

Many novice nurses like O'Bryan are thrown into hospitals with little direct supervision, quickly forced to juggle multiple patients and make critical decisions for the first time in their careers. About 1 in 5 newly licensed nurses quits within a year, according to one national study.

GOING EXTINCT?:Primary care physicians in short supply

BETTER LIFE: Shortage of general surgeons also looming

That turnover rate is a major contributor to the nation's growing shortage of nurses. But there are expanding efforts to give new nursing grads better support. Many hospitals are trying to create safety nets with residency training programs.

"It really was, 'Throw them out there and let them learn,"' said University of Portland nursing professor Diane Vines. The university now helps run a year-long program for new nurses.

"This time around, we're a little more humane in our treatment of first-year grads, knowing they might not stay if we don't do better," she said.

The national nursing shortage could reach 500,000 by 2025, as many nurses retire and the demand for nurses balloons with the aging of baby boomers, according to Peter Buerhaus of Vanderbilt University Medical Center. The nursing professor is author of a book about the future of the nursing work force.

Nursing schools have been unable to churn out graduates fast enough to keep up with the demand, which is why hospitals are trying harder to retain them.

Medical school grads get on-the-job training during formal residencies ranging from three to seven years. Many newly licensed nurses do not have a similar protected period as they build their skills and get used to a demanding environment.

Some hospitals have set up their own programs to help new nurses make the transition. Often, they assign novices to more experienced nurses, whom they shadow for a few weeks or months while they learn the ropes. That's what O'Bryan's hospital did, but for her, it wasn't enough.

So more hospitals are investing in longer, more thorough residencies. These can cost roughly $5,000 per resident. But the cost of recruiting and training a replacement for a nurse who washed out is about $50,000, personnel experts estimate.

One national program is the Versant RN Residency, which was developed at Childrens Hospital Los Angeles and since 2004 has spread to 70 other hospitals nationwide. One of those, Baptist Health of South Florida in the Miami area, reports cutting its turnover rate from 22% to 10% in the 18 months since it started its program.

The Versant plan pairs new nurses with more experienced nurses and they share patients. At first, the veterans do the bulk of the work as the rookies watch; by the end of the 18-week training program, those roles are reversed.

The new nurses must complete a 60-item checklist. They must learn how to put in an IV line and urinary catheter; interpret different heart rhythms and know how to treat them; monitor patients on suicide watch and do hourly checkups on very critically ill patients; know how to do a head-to-toe physical assessment on a patient, as well as how to inform families about the condition of their loved one.

For Yaima Milian, who's currently in the program at Baptist, this is markedly different from the preparation she got at her first hospital in New Jersey. She left after a six-week orientation because she didn't feel ready to work solo.

While Milian was paired with a more experienced nurse at the New Jersey hospital, they didn't see patients together; they split the workload. Her first week on the job, Milian was charged with caring for several patients with complicated issues — those on ventilators and with chest tubes — and she felt thoroughly unprepared.

"It just didn't feel right, it felt very unsafe," Milian said.

Besides the residency's professional guidance, which includes classroom instruction, new nurses also get personal support from mentors — people they can call after a bad day or to get career advice. The new nurses also gather with their peers for regular debriefing, or "venting" sessions.

"Here you have this group that is pretty much experiencing the same things you're experiencing," Milian said, "and it makes you feel better."

To be sure, not all the nurses who leave do so because of a rocky transition. But for nurses who do leave because of stress, these programs seem to help.

The American Association of Colleges of Nursing and the University HealthSystem Consortium teamed up in 2002 to create a residency primarily for hospitals affiliated with universities. Fifty-two sites now participate in that year-long program and the average turnover rate for new nurses was about 6% in 2007.

"We believe all new graduates should be given this kind of support system," said Polly Bednash, the nursing association's executive director. "We are facing downstream a horrendous nursing shortage as a large number of nurses retire from the field... So you need to keep the people you get and keep them supported."

The federal government has jumped on the bandwagon. Since 2003, it has awarded $17 million in grants for 75 hospitals to start first-year training programs.

The National Council of State Boards of Nursing is considering a standardized transition program. It cited a study showing a link between residencies and fewer medical errors, but also pointed to the inconsistency among current efforts.

That's something O'Bryan, the Dallas nurse, knows about. Her hospital — which she declined to identify because she didn't want to be seen as complaining about a former employer — had a three-month program, in which she attended weekly classes and was assigned a nurse to shadow. After that period was over, though, O'Bryan was abruptly alone, even as she continued to face new situations that she wasn't sure how to handle.

"When things are going good and I'm not overwhelmed and I'm able to help people, I love it," she said, recalling the gratification of seeing a bedridden patient finally manage to take a few steps.

"There are always those moments," she said, "but they're interrupted pretty quickly."

The 27-year-old is currently looking for a new job. She's not sure it will be in nursing.

Nurses Masquerading as Doctors

2010-04-24T10:23:00.002+08:00

by Dr. Keith Ablow

The growing shortage of medical doctors, which will be made much worse by health care reform, will mean more and more patients are cared for entirely by “nurse specialists” and nurse practitioners, instead of physicians. Nurses are lobbying for increased prescribing privileges and for the right to be addressed as “doctor” in health care settings.

This substituting of nurses for physicians is evidence of a two-tiered system of health care in America sure to become more obvious in the wake of Obama-care.

People who can afford to bypass insurance altogether and simply pay to see doctors will increasingly do so. Why? It’s simple: Doctors go to medical school, which is much more rigorous academically and intellectually than nursing school. They also were admitted to medical school, which is a much more competitive process than being admitted to nursing school. The average doctor has more training, relevant experience and raw intellect than the average nurse–period.

Saying such things plainly isn’t popular, of course. The fact that the health insurance premiums of Americans won’t even get them access to the minds of doctors in many clinics and ERs and even ORs (where nurse anesthetists work behind gowns and masks, just like anesthesiologists) is one of the “dirty, little,” gigantic secrets of how our health care system is giving consumers less for more. No one is supposed to offend anyone with the truth, anymore, after all.

Want a little truth right now? No man or woman in his or her right mind would prefer to routinely talk to an on-call nurse when his or her child is sick, rather than a doctor. No one sensible would want a nurse, rather than a doctor, assessing whether to get an MRI or CT scan or neither one after an episode of head trauma. No one would want a nurse, rather than a doctor, to decide whether to get a cardiac stress test in the setting of chest discomfort.

How come? Because doctors are the gold standard behind the devalued currency of your health insurance dollars. Everyone knows it, but people are too political to just say it.

How come no one is flying into an American city today to see a famous nurse, while people arrive from countries around the world to visit with noted American physicians? How come no one in Congress would be able to tell you a story about that incredible nurse who diagnosed the rare condition in his or her child? How come nurses either failed to be admitted to medical school or didn’t try? You think it’s because they thought nursing school would train them better to take care of patients? C’mon. It’s because nursing school is easier–as in, 10 times easier.

I almost feel sorry to be so blunt. I don’t want to hurt anyone’s feelings. If nurses stop impersonating doctors, I’ll stop writing about them impersonating doctors.

Until then, just follow the money; people with enough of it will hire physicians, every single time, when they have real health concerns. The vast majority of Americans, on the other hand, whose health insurance is rapidly costing more and buying them less, will see health care workers who chose not to go to medical school and probably would have been turned down, anyhow.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement including www.livingthetruth.com. Dr. Ablow can be emailed at info@keithablow.com.

200 hospitals shut down on nurses’ lack

2010-03-13T08:43:00.002+08:00

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

2010-03-11T09:27:00.002+08:00

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!

2010-03-10T10:33:00.001+08:00

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."
Complex
"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

2010-03-09T10:27:00.001+08:00

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

2010-03-08T19:09:00.002+08:00

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.

D.C. hospital fires 11 nurses, 5 staffers for snowstorm absences

2010-03-04T19:25:00.001+08:00

The District's largest private hospital has fired 11 nurses and five support staff members who failed to make it to work during the back-to-back snowstorms that paralyzed the region earlier this month.

Dozens of staff members at Washington Hospital Center face internal investigations, union representatives say, and it is unclear how many employees will lose their jobs. On Friday, the nurses union, Nurses United of the National Capital Region, filed a class-action grievance with the hospital.
"I see it as so unfair and uncaring," said Shirley Ricks, a 57-year-old nurse who has spent her entire career at the hospital. "That's it. You call in one day in the biggest snowstorm in history and you're out. No ifs, ands or buts about it. . . . You go from getting a salary every two weeks to nothing. It's scary."
In a letter sent to the staff on Friday, hospital President Harry J. Rider sought to quell rumors that hundreds of people had been fired. He said he expects fewer than 20 people will be dismissed.
"Sadly, we did experience some issue with associates who did not show the same commitment as most of their co-workers to the community, our patients and their fellow associates. They are the few who turned away from their scheduled shifts and who tried -- and are still trying -- to turn the focus on themselves rather than the thousands of Washington Hospital Center workers who fulfilled their commitment to their patients and colleagues, and made it to work," he wrote.
Hospital spokeswoman So Young Pak said she could not comment on specific cases or personnel issues, but "we do not terminate any associates without a fair process. We always review the entire situation with the final decision based on all facts and circumstances."
Union representatives said about 250 of the hospital's 1,600 nurses did not make their shifts at some point during the storms that pummeled the area between Feb. 5 and Feb 11. Pak could not confirm that number but said on the Monday after the first blizzard, 759 employees who were scheduled to work did not show up. On a typical weekday, the hospital has between 3,100 and 3,350 employees working. The nurses earn an average of $40 an hour.

The hospital continues to examine the circumstances of staffers who did not make it into work, Pak said.
Hoping for sympathy

Officials at other local hospitals and unions that represent critical personnel, such as emergency responders, said they had not heard of staffing problems elsewhere or of disciplinary action against employees who were unable to make their shifts. The Transportation Security Administration last week reversed an initial decision to consider Dulles International Airport security screeners AWOL if they had not made it to work during the snow emergency.
Ricks said she hopes the hospital will show similar sympathy and give her back the job she held for 35 years.
Ricks was scheduled to work Feb. 8, but looked at her unplowed street in Upper Marlboro the previous afternoon and knew she was likely to miss her shift. "My husband had gotten the driveway clear, but that was as far as we could go," she said.
She said she called the hospital to explain her situation and reported to work Feb. 9, as soon as her street was passable. On Feb. 10, she spent the night at the hospital to ensure a second storm wouldn't cause her to miss work the next day.
She was dismissed, effective last Tuesday.
"Now I got to get out there and see who wants to hire an old lady," she said.
Some streets impassable

Washington Hospital Center's "Declared Weather (Or Other) Emergency" policy, does not mention termination as a consequence for failing to get to work. It does state: "Unscheduled absences and late arrivals occurring during a declared weather emergency are not counted when addressing attendance issues, nor are authorized early departures."
Pak said the hospital provided transportation for employees during the storm, but union representatives said it was not available at all times. In any case, they said, the vehicles could not reach every street. Stephen Frum, chief shop steward for Nurses United, said some nurses have photos that show their streets were impassable.
Frum said he has reviewed the records of at least half the fired nurses, and none had prior disciplinary problems. He and others question the timing of the firings. The union is scheduled to begin negotiations with the hospital on a new contract Monday.
Pak said the terminations have "nothing to do with the contract and everything to do with our responsibility and commitment to our patients and their families."
Deepa George, 33, mother of a 5-year-old and an 18-month-old, was not able to make it from her Bowie home to the hospital on Feb. 6, as the first blizzard raged all day. But on Feb. 7, she said she drove the family's sport-utility vehicle down her neighborhood's unplowed roads. She left at 4 p.m. for a shift that started at 7 p.m.
"I just prayed to God to take care of my kids and take care of me as I was driving because I didn't want to leave them orphaned," she said.
She had heard rumblings over the last few weeks that nurses had been fired, but it wasn't until Monday that she received her notice. She had worked at the hospital for eight years. "I hope the hospital realizes no one did this on purpose," she said.
Highs and lows

Geri Lee said she received two pieces of mail this month that represent the highest and lowest moments of her 31-year nursing career. One was a thank-you card from a woman who credits Lee with saving her son's life. The other was a letter of termination from the hospital that informed Lee she was fired for "gross misconduct."

Lee said she showed up at the hospital for her Feb. 11 shift prepared to stay the night. But when her shift ended Friday morning, she said she didn't see a need to stay because the snow hadn't started falling. She went home to Silver Spring.
The next day, Lee, 54, said she tried for an hour and half to get out of her neighborhood before calling the hospital to say she could not make it in. That night, she was placed on indefinite suspension. Six days later, she received a termination letter.
"I was devastated," Lee said.
Lee's last performance review, dated September 2009, says she "volunteers to care for the most challenging patients and is helpful to her peers in sharing her expertise and assisting when needed." Last year, she was recognized as one of the hospital's "Superstars" and her photo was hung on the hospital's "Wall of Fame."
Two days after she was terminated, she said, she opened her mailbox to find a card from Adreion Packer. Twenty-two years earlier, on the day Packer's son, Corey, was born, Lee noticed that his coloring was off and insisted something was not right. The child was found to have a congenital heart defect.
The card was addressed to what Packer has called Lee since that day: "Corey's Guardian Angel."

There's a lot of bad blood between docs, nurses

2010-03-03T09:55:00.000+08:00

Whether they portray churlish docs like Perry Cox of "Scrubs" and Gregory House of "House M.D," or rule-defying RNs like Showtime's "Nurse Jackie," the actors who play health-care workers on TV reflect a troubling reality: there are some not-always-so-nice people working in hospitals and medical clinics.

A number of surveys and studies in the past decade suggest that bad blood - and bad behavior - between and among doctors and nurses is rampant.

Some behavior is so extreme that it could result in assault charges -- the surgeon who hurls a scalpel across an operating room in a fit of anger, the internist who attempts to stuff a nurse into a trash can or the nurse who squirts a used syringe in a co-worker's face or amends a chart to sabotage a doctor.

But, as one nurse surveyed by the American College of Physician Executives last year put it: "The worst behavior problem is not the most egregious. It's the everyday lack of respect and communication that most adversely affects patient care and staff morale."

That survey of more than 2,100 nurses and doctors - about two-thirds of the respondents were nurses - found that 98 percent of both professions had witnessed behavior problems between physicians and nurses in the past year. Ten percent said they see bad behavior every day.

The most common complaint, cited by 85 percent, was degrading comments. Seventy-three percent said they had heard yelling between colleagues. Other common problems included cursing, inappropriate jokes and refusing to work with one another.

A 2002 survey of nurses at 50 hospitals found that 94 percent had witnessed a physician acting in a disruptive manner.

But a 2004 survey that included hospital pharmacists found that while doctors were most likely to engage in intimidating behaviors such as threatening to complain to a worker's boss, nurses were nearly as likely to make threats or refuse to answer phone messages about pharmacy orders.

Of course there are outbursts and mutterings among and about co-workers on every job. But relatively few workplace dustups endanger lives and long-term health.

The nurses-only survey found that 60 percent were aware of adverse medical events that could have occurred due to disruptive behavior. And the 2004 survey, done by the Institute for Safe Medication Practice, found that 40 percent of clinicians have remained silent or passive rather than question possibly dangerous orders issued by a doctor or nurse who has a reputation for intimidation.

All this plays out in an often-stress-filled setting of odd, long shifts and charged emotions among workers, patients and their families.

One survey of emergency nurses found that half had experienced physical violence on the job that included being hit, kicked, scratched or spit on. Other surveys that have covered more hospital departments report violence rates of more than 13 percent, and 30 percent to 50 percent reporting verbal abuse from patients.

With health-care workers caught in such crossfire, it's hard to focus on quality.

But with mounting evidence that lack of a team approach to medicine is hurting patient care, organizations like the Joint Commission (the nation's main accrediting agency for hospitals and other health facilities) are taking note.

The commission early last year set a new standard that hospitals must have in place - a code of conduct that defines acceptable and inappropriate behavior and sets up a process for dealing with disruptive behavior.

Many hospitals already have codes or policies for staff conduct, but may have left enforcement to supervisors or peer committees. By putting complaints in the framework of patient safety, the commission envisions disruptive behavior being taken more seriously.

At the same time, many medical educators are trying to make doctors, nurses and other professionals better team players by setting up "shadow days" and seminars to help them understand one another's responsibilities and treat each other with greater respect.

Ottawa Hospital to cut nursing jobs

2010-03-02T09:55:00.000+08:00

Officials dispute nurse union's numbers as spectre of longer patient wait times loom

The union representing nurses at The Ottawa Hospital says it has been told 190 positions, or about five per cent of the institution's total nursing staff, will be eliminated.

Union officials said the hospital has formally informed them Thursday that 70 nursing jobs will be cut, and another 120 job vacancies will remain unfilled.

The union characterized the cuts as the largest to date by an Ontario hospital.
"This is as big as it gets in Ontario that I've seen in the last six months," said Linda Haslam-Stroud, president of the Ontario Nurses Association, which represents the hospital's 3,900 registered nurses.

Haslam-Stroud said the cuts amount to about 300,000 hours of lost nursing care to patients, who will inevitably face ever longer delays for emergency care and elective surgery.

Hospital officials dispute the union's numbers, saying it has so far only given notice of cuts to 70 nursing positions, including 48 jobs that would be eliminated through early retirement, reassigning nurses to other duties, or layoffs. The remaining 22 positions are vacancies that would remain unfilled.

"We have 48 people who are affected, and that is before we go through all the steps in our redeployment and early retirement process," said Michael Cuddihy, the hospital's vice-president of human resources.

Cuddihy said the hospital has notified its three unions of a total of 133 jobs that are to be eliminated.
In a statement posted to its website the hospital said:
"Under the current economic circumstances, hospitals, like every other sector, must provide responsible stewardship of scarce public resources. That is why certain vacancies have been closed.
"As of now, no employee has lost their job," the statement continued. "Most, in fact, will continue working at TOH even after the reorganization. We have simply provided our unions with appropriate notice, at the beginning of the restructuring process, as required by collective bargaining."

The Canadian Union of Public Employees Local 4000, which represents 3,200 hospital support staff and nurses at the hospital, said it has been told of cuts that will affect 58 hospital orderlies, registered practical nurses and the medical transcriptionists who convert doctors' notes into patient records.

CUPE local president Bruce Waller said 27 registered practical nurses have already lost their jobs, the result of 28 hospital beds that are being phased out as some elderly patients are transferred to Valley Stream Manor, a privately run retirement home.

A third union, representing 2,300 paramedical staff, has been told eight therapists, representing the equivalent of four full-time positions, will lose their jobs. Rick Janson, spokesman for the Ontario Public Service Employees Union, said most of the employees affected work in the mental-health program.

Collective agreements require the hospital to give its unions five months of notice ahead of any final decision on staffing cuts. Union officials said cuts would start in July.

Waller said CUPE was told "there may be further staff impact."
The cuts are being made in an effort to balance the hospital's $970-million budget. Heading into the 2010-11 fiscal year, which starts in April, The Ottawa Hospital faces a shortfall of $19 million, and that's based on a best-case scenario of a two-per-cent provincial funding increase, said Cuddihy.

Haslam-Stroud said the nurses who remain after the cuts will inevitably have even more patients added to their workloads, compounding their existing stress levels.
The cuts could also increase a patient's risk of being a victim of a medical error or contracting an infection while in hospital, said Haslam-Stroud.

She pointed to the pressures facing both The Ottawa Hospital and Queensway Carleton Hospital, which announced this week that they were temporarily cancelling a number of elective surgeries and accepting fewer patients from other hospitals because of an overload of patients.

"Those pressures are only going to get worse," said Haslam-Stroud.

UK’s stricter student visa regulations to hit Pinoy student nurses

2010-02-28T18:03:00.001+08:00

With the United Kingdom set to implement more stringent student visa guidelines to prevent “abuse by economic migrants,” a recruitment consultant expressed fears that the thousands of Filipino student nurses in the British isles may be negatively affected.

The Department of Foreign Affairs (DFA) said Tuesday the UK will effect the changes to Tier 4 (Student Visa) Regulations in March under its new Points-Based System of Migration, based on earlier announcement by UK Home Affairs Minister Alan Johnson.

“The Philippine Embassy in London reiterates its advice for all prospective applicants under Tier 4 to secure updated information on new regulations, procedures, and requirements from the UK Embassy in Manila,” the DFA said in a release on its website.

The DFA said the initial announcement outlines broad measures resulting from a comprehensive review of the Tier 4 scheme as initially relayed by UK Prime Minister Gordon Brown in November 2009.

In the Ministerial Statement/Notes released by the UK Home Office, the UK Government announced the modifications were aimed at achieving a “a balanced and targeted package of measures to tackle the abuse of Tier 4 by economic migrants whilst at the same time continuing to safeguard the ability of genuine international students to come to the UK to benefit from our world class education system and bring benefit to our economy.”

New setup

Under the new setup, students will only be allowed to work during the school term for 10 hours a week instead of the present 20 hours a week.

Students registered in courses of six months or less can also no longer bring dependents with them to the UK.
Further, dependents will not be permitted to work unless they qualify in their own right under Tier 1 (General) as a highly skilled migrant or as a skilled worker under Tier 2 (General worker, sportsperson or Minister of Religion).

The DFA said the changes will apply to adult students coming to the UK to study below degree level in the further-education and English-language sectors.

But it said these changes will not apply to students coming to the UK for a foundation degree (broadly the equivalent of the first two years of a Bachelor’s degree), courses at degree level or above, and those coming in as children at independent or private schools.

The changes will come into force on March 3 and all Tier 4 applications submitted on or after this date will be subject to the new restrictions.

Uncertainty for Pinoy student nurses

Recruitment consultant Emmanuel Geslani said the changes may place in uncertainty the status of about 10,000 Filipino health workers, most of whom are nurses, who entered UK from 2007 to 2009.
Majority of these health workers availed of the study-and-work plan offered by various consultancies and are presently taking awards, certification and diploma courses, also known as National Vocational Qualifications (NVQ).

Further, more than half enrolled only in certificate courses lasting for six months, while at the same time working in care homes.

“Ten hours per week and the new rule which prohibits their dependents the right to work will make it difficult to cope with the living expenses like food, rent and taxes, with the high standard of living in the UK,” Geslani said.

Geslani further disclosed that the NVQ, which is set to be replaced this year by a yet to be determined program, only allows a stay of one year and will not allow the workers to remain as permanent residents.
“Many of these nurses will be forced to return to the Philippines if they cannot shift to higher education courses like degree programs in universities,” Geslani explained.

Geslani, however, said that despite this, Filipino students from all fields may take advantage of taking a one-year degree in the UK. This will allow the students to stay and do paid work for up to two years without studying further, which will in turn lead to securing a work permit.— via GMANews.TV

Scientists Unravel Mysteries of Intelligence

2010-02-27T18:03:00.000+08:00

-- It's not a particular brain region that makes someone smart or not smart.
Nor is it the strength and speed of the connections throughout the brain or such features as total brain volume.
Instead, new research shows, it's the connections between very specific areas of the brain that determine intelligence and often, by extension, how well someone does in life.

"General intelligence actually relies on a specific network inside the brain, and this is the connections between the gray matter, or cell bodies, and the white matter, or connecting fibers between neurons," said Jan Glascher, lead author of a paper appearing in this week's issue of the Proceedings of the National Academy of Sciences. "General intelligence relies on the connection between the frontal and the parietal [situated behind the frontal] parts of the brain."

The results weren't entirely unexpected, said Keith Young, vice chairman of research in psychiatry and behavioral science at Texas A&M Health Science Center College of Medicine in Temple, but "it is confirmation of the idea that good communication between various parts of brain are very important for this generalized intelligence."

General intelligence is an abstract notion developed in 1904 that has always been somewhat controversial.
"People noticed a long time ago that, in general, people who are good test-takers did well in a lot of different subjects," explained Young. "If you're good in mathematics, you're also usually good in English. Researchers came up with this idea that this represented a kind of overall intelligence."

"General intelligence is this notion that smart people tend to be smart across all different kinds of domains," added Glascher, who is a postdoctoral fellow in the department of humanities and social sciences at the California Institute of Technology in Pasadena.

Hoping to learn more, the authors located 241 patients who had some sort of brain lesion. They then diagrammed the location of their lesions and had them take IQ tests.

"We took patients who had damaged parts of their brain, tested them on intelligence to see where they were good and where they were bad, then we correlated those scores across all the patients with the location of the brain lesions," Glascher explained. "That way, you can highlight the areas that are associated with reduced performance on these tests which, by the reverse inference, means these areas are really important for general intelligence."

"These studies infer results based on the absence of brain tissue," added Paul Sanberg, distinguished professor of neurosurgery and director of the University of South Florida Center for Aging and Brain Repair in Tampa. "It allows them to systemize and pinpoint areas important to intelligence."

Young said the findings echo what's come before. "The map they came up with was what we expected and involves areas of the cortex we thought would be involved -- the parietal and frontal cortex. They're important for language and mathematics," he said.
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In an earlier study, the same team of investigators found that this brain network was also important for working memory, "the ability to hold a certain number of items [in your mind]," Glascher said. "In the past, people have associated general intelligence very strongly with enhanced working memory capacity so there's a close theoretical connection with that."

ICU room assignment can affect survival

2010-02-23T19:49:00.000+08:00

"Very sick patients require close monitoring by healthcare professionals," Dr. Phillip H. Factor from Beth Israel Hospital, New York, told Reuters Health by email. "Relying on electronic monitors is not sufficient in the sickest of the sick; these patients require direct observation."

Factor was the senior researcher on a study of 664 patients in a medical ICU (as opposed to a surgical ICU). Roughly two-thirds of the patients were assigned to rooms with unimpeded visibility from the central nursing station. The remaining third were in corner rooms that couldn't be seen clearly from the nurses' station.

In the journal Chest, Factor and his coauthors report that overall, there was no difference in survival rates between patients in the rooms with good visibility and those that couldn't be seen as easily.

The researchers also considered whether the severity of patients' illnesses affected their risk in the different rooms. They used a standard tool known as the APACHE II score to judge how sick the patients were.

They found that the very sickest individuals - those with APACHE II scores above 30 - had a higher likelihood of dying while in the ICU, or while still in the hospital, if they were assigned to a low-visibility ICU room. This was true no matter what disease they were hospitalized for.

Why more deaths occurred among severely ill patients in the low-visibility rooms isn't clear yet. "Whether they are due to late identification of...deterioration or less time spent by healthcare providers at the bedside or other undiscovered variables is unknown and requires additional study," the authors wrote.

In a phone call with Reuters Health, the lead author, Dr. David Leaf from Columbia University College of Physicians and Surgeons in New York City emphasized, "This is the first article that addresses this issue, so the results should be interpreted cautiously."

But, Leaf continued, "It's both intuitive and now supported by some evidence that corner rooms with low visibility may be associated with poorer outcomes and therefore should be avoided whenever possible in the case of extremely sick patients."

His colleague Dr. Factor pointed out that some ICUs may have special routines in place to improve the care of patients in lower-visibility rooms, such as increased nurse-to-patient ratios.

Even so, Leaf said, in the case of extremely sick patients, "if there is an empty room closer to the nurses' station, it wouldn't be unreasonable to ask to have the patient moved."

No Country For Young Nurses

2010-02-21T23:36:00.002+08:00

By OLGA KHAZAN

The nursing profession takes a certain dedication to love. After all, most office jobs don't involve standing for 12 hours at a time, scarfing a bite of lunch between "clients" or handling gallons of bodily fluids on a daily basis. But for years, nursing schools lured students with the promise that they would be snapped up by prestigious hospitals upon graduation, remunerated for their hard work with good pay and enviable job security.
And they were right - until now, that is.
It's a paradox straight out of "Freakonomics:" Even though California still faces a shortage of nurses, up to 40 percent of nursing school graduates will be unable to find jobs, according to the California Institute for Nursing and Health Care.
The recession set off a domino effect that has caused California hospitals to virtually stop hiring newly-minted nurses. The Institute estimates only half as many nurses will be hired this year as in 2008.
It's all thanks to Botox, healthcare reform and other people's husbands.

Back from retirement

Nine years ago, a severe nursing shortage was giving policy-makers night sweats. In 2001, national vacancies in nursing reached 13 percent, and over 120,000 nursing positions went unfilled, according to a report by the American Hospital Association. The numbers were especially dire in California, and in 2005 the state began funding and aggressively promoting nurse education.
"With this new initiative we are going to improve the quality of health care everywhere in our state. We are going to provide more classes, more teachers and more resources to expand the ranks of nurses in California," Governor Schwarzenegger said in a press release at the time.
It worked. California nursing schools saw enrollment rise by 70 percent over four years as the profession became increasingly touted as "recession-proof."
But the recession found a way.
A funny thing happened when the economy began to crumble. Peter Buerhaus, a nursing expert at Vanderbilt University, found that an astounding number of experienced nurses left their non-hospital jobs to work in hospitals.
Though only about 60 percent of nursing jobs are in hospitals, recent nursing graduates often rely on resource-rich hospitals to provide them with the extensive training they need to be considered ready to work with patients. In addition to having the best training opportunities, hospitals also happen to have the best pay, the best benefits and the best shifts.
"In two years, hospital employment grew by 243,000. That's a world record. That's astounding," he said. "People were coming in from all over. I mean, we've got nurses coming down from Uranus, from Pluto, waiting to get clearance to come down."
As one of the perks, many hospitals give nurses the option of changing a standard full-time schedule to three 12-hour shifts per week, which allows some nurses to pick up a second job on their free days.
It's a life-preserving strategy for when their spouses (70 percent of nurses have one) lose their jobs, as millions of Americans have since the recession hit.
Retired and part-time nurses all over the country have been returning to work full time when their spouses' jobs were threatened, or eliminated. Faced with the option of hiring an experienced nurse or a novice who needs training, the choice for hospitals is clear.
Or as a Marina Del Rey hospital representative said, "We are not hiring new grads at all. With the employment market the way it is right now, we don't have to."
And nurses who were going to retire decided to stay put.
"The turnover is almost nil," said UCLA nursing school Dean Suzette Cardin. "They're just not leaving. Everyone's afraid to leave."
These older, returning nurses have crowded out novice nurses who need training. And they've done so in greater numbers in California, where the economy has tanked harder and where there tends to be more workers nearing retirement age.
"There may have been a bigger reservoir of older nurses that weren't working in California," Buerhaus said, "and you had a very strong reaction of nurses getting back in the labor market."

Fewer implants, greater uncertainty

One of the first casualties of the recession was disposable income and all the luxury items - watches, cars, and errr...silicone - that it buys: Allergen saw sales of Botox and breast implants plummet in 2009.
And as job loss led to health insurance loss, people were re-thinking not just nose jobs, but knee surgeries.
The decline has led to less demand for nurse assistance during some procedures. "Elective surgeries are down, so patient days are down," said Deloras Jones of the California Institute for Nursing and Healthcare.
On top of that, hospitals are reluctant to beef up their staffs while the healthcare debate rages on. Hire too many nurses now, and in a few months they might be stuck paying more in salaries while getting reimbursed less by insurance companies.
"Hospitals are uncertain about what their near-term future is," Buerhaus said. "It's taxes one day, payment reductions the next. Given that uncertainty, it's slowing their employment decisions."

Pumping a dry well

Taken together, these factors have shattered the popular narrative of nursing jobs that are easy to come by. Cedars-Sinai hospital cut their job openings for new grads from 250 last year to 100 this year. UCLA's hospital typically has two new graduate intake sessions - one in the spring and one in the fall. This year, the spring session has been canceled.
"A lot of nurses have applied to the UCLA new grad program in August," said Kathy Carder of the California Nurses Association. "But in the meantime, they're wondering how they're going to feed their families."
It took Cedric Lara seven months and 40 applications to find a job after he graduated with an associate's degree in nursing from Whittier's Rio Hondo college in May 2009.
"When I was in school, I was looking at jobs and seeing the well dry up," Lara said. "Even hospitals where I looked during clinical rotation - Kaiser, Downey Regional, Presbyterian - by the time I graduated, they had hiring freezes."
In Northern California, the prospects are even worse. Jessica Martin graduated with a master's degree in nursing from the University of San Francisco in December, and she said just six of the 25 people in her cohort have gotten jobs so far. Those who have relied mainly on personal connections.
"It was pretty misleading," she said. "The people that graduated before me were getting jobs easily, and people were recruiting them. But then I graduated, and there's nothing."
Martin is hoping for an operating-room job, but so far the only hospitals admitting new grads are those like Stanford, where there are 600 applicants for three to six open positions.
"I'm sending my resume out into the ether, and nothing is coming of it," she said. "It's fairly hopeless right now."
For some, hope lies in less sought-after jobs outside of hospitals and doctors' offices.
"Before, a new grad had 20 offers, but this is forcing them to seek other opportunities than what they thought," said Kathy Lopez of the National Association of Hispanic Nurses. "Some students may have to start in a convalescent home, or maybe doing flu clinics."
Some, like Martin, are looking out of state. Her student loans are coming due, and the alternative is moving back in with her parents.
"I'm 28 years old and I might be financially dependent again," she said. "I'm trying not be be bitter and angry about it, it just takes time."
Ironically, California is still projected to have a nursing shortage in 2020, especially since the older nurses are likely to swiftly re-retire after the economy rebounds.
Until that time comes, however, a pool of cash-strapped nursing school grads wait with increasing frustration. Healthcare experts hope they don't give up before the recession does.
"We've been working hard to build our capacity, and we're worried that if new grads can't find jobs, we'll lose the gains we've made," Jones said. "Because if they leave California, they may not come back."

2010-02-20T22:21:00.000+08:00

The Toronto Teen Survey Report on teen sexual health, released Tuesday, said the young women and men were most likely to seek sexual-health information from friends, but that both groups would prefer to get it from professional sources, such as doctors, nurses and teachers.

As one province grants parents the right to pull their kids from classes on controversial topics of sex and religion, a major new study is calling for more — not less — sex education to keep teens from risky behaviour.
A survey of 1,250 teens from diverse backgrounds in Toronto found that what youth want more than anything else is information, said lead researcher Sarah Flicker, a York University professor of environmental studies.
The Toronto Teen Survey Report on teen sexual health, released Tuesday, said the young women and men were most likely to seek sexual-health information from friends, but that both groups would prefer to get it from professional sources, such as doctors, nurses and teachers.
The study, one of the country's largest surveys of young people's sexual health, also found both young men and women said they fear feeling judged when they access sexual-health care.
"I think access to sexual-health education is a basic human right," Flicker said.
"We know, through research, that lots of young people are sexually active, and many of them don't ask their parents' permission."
Their fear won't be lessened, she said, by legislation such as Alberta's Bill 44, which passed a tense vote in the provincial legislature early Tuesday after hours of heated debate.
The bill, which writes protection against discrimination on the basis of sexual orientation into Alberta's human-rights law for the first time ever, also gives parents a controversial escape clause for classroom discussions that clash with their religious or moral beliefs. The bill enshrines parents' right to withdraw their children from classes on sexual orientation, sexuality or religion.
Critics said the bill could force teachers and school boards to defend themselves before quasi-judicial human-rights commissions for discussing sexual orientation and religion in the classroom.
A "chill" against discussing controversial issues might set in among teachers, opposition parties alleged.
The Conservative government of Premier Ed Stelmach insisted the bill would not stifle casual classroom discussion of sexual or religious topics, and offered to head off frivolous complaints against teachers to the provincial human-rights commission.
Flicker said any law that throws up walls between kids and the sexual information they need will only lead some to make uninformed, risky choices.
"It's clear that one-size-fits-all prevention strategies don't work; we need to be tailoring our health-promotion and prevention strategies to meet the needs of diverse young people," she said.
"We need to be addressing issues of racism, of sexism, of homophobia, in our curriculum, and talking about how these harmful messages can often impede our ability to make really good choices."
Among other things, the survey suggested that what most youth want is information about how to have healthy relationships.
Flicker said the challenge now is to figure out how to provide that information.
"It's really about starting with open, honest and clear communication with young people — about their bodies, about their rights, about their choices and opportunities," she said.
Offshoots of the study are focusing on exactly how youth define "healthy relationships." Researchers have just finished 18 focus groups on the matter, and are now analyzing the data.
Flicker said she's hopeful changes are coming in Ontario, where the health-education curriculum is currently under review, but worries that teens across Canada may not have access to the services they need.
"Even in this great urban centre, where we have amazing services for young people, we're still seeing these challenges," she said. "It's got to be that much worse in rural or remote environments."
The Toronto teen survey report on sexual health found:
- 83 per cent of respondents, ages 13 to 18, said they had never visited a health-care provider for any sexual health-related reason;
- Healthy relationships, HIV/AIDS and sexual pleasure were the areas in which teens thought the current curriculum is lacking;
- 69 per cent of participants reported kissing a partner, 25 per cent reported giving or receiving oral sex, 27 per cent reported vaginal intercourse, seven per cent reported anal sex, and 24 per cent per cent said they had never engaged in any sexual experience;
- Youth who were less likely to engage in higher-risk sexual activity were younger, female, not born in Canada, or identified as Muslim, Asian or East Asian;
- Those who were more likely to engage in higher-risk sexual activity (vaginal/anal intercourse) were older, male, not exclusively heterosexual, and received sex education in multiple locations;
- Young women who have accessed sexual-health care are most likely to go for birth control, pap smears and pregnancy tests; and
- Young men who have gone to services are most likely to go for free condoms, information about safer sex, and HIV or STI testing.

Dying Trenton woman granted honorary nursing license

2010-02-19T22:12:00.000+08:00

Katie Viger, a 23-year-old who is dying of brain cancer, has been granted an honorary nursing license by the Michigan Department of Community Health.

The license is expected to be signed today by the Michigan Board of Nursing and could be delivered to the Viger family at their home in Trenton as early as tonight, according to state Sen. Ray Basham (D-Taylor).
“We are thrilled,” said Cathy Wakefield, who was Viger’s nursing instructor at Henry Ford Community College. “It’s exactly what we wanted.”

Viger graduated from the Henry Ford nursing program in May. She was diagnosed with a brain tumor in August but was unable to take the test to become a registered nurse. Over the last two weeks, Wakefield has led a push to get Viger an honorary license.

With the help of Basham, Wakefield has campaigned to enact Katie’s Bill, which would change state law to allow the nursing board to issue honorary licenses in situations like Viger’s, where there are extenuating circumstances like an illness.

Friends and supporters started a Facebook group called “Give Katie Viger her honorary nursing license.” Forty-eight hours after it was started, 800 people had joined. After the Free Press told Viger’s story on Wednesday, the group swelled to 4,350 members. Many readers called their state lawmakers, expressing support for the bill.

Basham said the Department of Community Health agreed to grant the honorary license because there is pending legislation with strong bipartisan support, and because of the need for urgency. Viger is now in the hospice care.

“How can our family ever thank everyone for all the love and support you have shown to our very, very special daughter?” Viger’s mom, Cathy Viger, said in a post this morning on Facebook. “I have never seen our government work so fast and it is because of all of you! Everyone will forever be in our hearts. Again, we can never thank you all enough. Love, The Overjoyed Viger Family.”

Joe Viger said the license is a wonderful, symbolic gesture.

At the same time, he and his wife are living the horror of watching their daughter go through extreme pain.
“She just can’t get comfortable,” he said. “We are maxed out right now on what we can give her. We are getting ready to call hospice to see what we should do.”

When the Nurse Is a Bully

2010-02-18T22:08:00.000+08:00

It was the end of my shift, and I listened as one of my co-workers was being hassled over the phone for the second time that day. The computer wouldn’t release a patient record, and a nurse in another department was blaming her.
“Why are nurses so mean to each other?” I blurted out.
“Well yeah,” my co-worker said, “It’s that whole ‘Nurses eat their young’ thing.”
Nurses eat their young. The expression is standard lore among nurses, and it means bullying, harassment, whatever you want to call it. It’s that harsh, sometimes abusive treatment of new nurses that is entrenched on some hospital floors and schools of nursing. It’s the dirty little secret of nursing, and it needs to be publicly acknowledged, and just as publicly discussed, because it’s keeping us down.
The phrase was on my mind that shift, because earlier in the day, a nursing student on the floor had told me about the time she had to make an emergency room visit because of kidney stones, which made her late with a class assignment. Despite a doctor’s note, her nursing instructor didn’t accept the excuse, telling her, “You need to make better life choices.”
I’ve heard similar stories coast to coast, and I’ve experienced hostile treatment myself. In my first nursing job, some of the more senior nurses on the floor lied about work I had or hadn’t done, refused to help me at times when I really needed it, and corrected my inevitable mistakes loudly and whenever possible, in public. By the time I left, I felt like I had a huge bull’s-eye on my back, and once I became a target, it was difficult to be an effective nurse.
The Seattle nurse and consultant Kathleen Bartholomew explores the back-stabbing, intimidation and sabotage that are all too common on some nursing floors in her book “Ending Nurse-to-Nurse Hostility: Why Nurses Eat Their Young’’ (HCPro, 2006). Ms. Bartholomew notes that because nursing “has its fundamental roots in caring,” it’s often hard for nurses to admit that they could be hurting one another. But studies show that 60 percent of new nurses [pdf] leave their first position within six months because of some form of verbal abuse or harsh treatment from a colleague.
The nurses in my present job treat one another with respect and compassion, and I couldn’t get through my shifts without their support. But in my hospital and in others where I’ve worked, I have seen a petty meanness in how some nurses interact with one another, and with other hospital staff members.
The technical term for such behavior is “horizontal violence.” We all know that nurse. It’s the one who picks a fight with an I.C.U. nurse in front of a patient who, frightened and suddenly struggling to breathe, is on his way to intensive care. It’s the nurse who insists on calling repeatedly to ask why you haven’t done something — given a drug, started a transfusion — a task that, for a number of valid reasons, you haven’t been able to complete. It’s the nurse who boasts about giving a hard time to the interns — the doctors in training — and makes clear how enjoyable it was to pick on them.
Are most nurses like this? Of course not. But it’s a common enough problem that a search in Google or the medical journal database PubMed will turn up academic studies on the phrases “nurses eat their young,” “bullying in nursing,” and “nursing and horizontal violence.”
Floor nursing is a hard job, in part because shifts are so unpredictable. Stable patients can become unstable in the blink of an eye. The portable phones we carry ring constantly and insistently. The timing of tests, procedures and scans is rarely coordinated with other aspects of care. And a staff absence requires the nurses on the floor to pick up the slack by taking extra patients.
Doctors, I have to admit, can also be rude. Phrases like, “Why are you calling me?” “We’ll get to it when we get to it,” and “That’s not important” are undermining and disheartening because they shut down doctor-nurse communication. I don’t hear such phrases often at work, but I have heard them, and they make coordinating patient care difficult.
Spending our shifts feeling pulled in an impossible number of directions, day after day after day, can in the end be too much. A lot of nurses find a way to regroup and stay, while some burn out and quit. But a few nurses will, like cornered animals, bare their teeth and fight back.
The problem is that they don’t fight back against the people who put them in the corner. These overwhelmed and angry nurses take their frustration out on the rest of us stuck in the corner with them, or on anyone — like interns — they perceive as being less powerful than they are.
The nurse researchers Cheryl Woelfle and Ruth McCaffrey speculate on why nurses attack their own in their article “Nurse on Nurse.” “Nurses often lack autonomy, accountability and control over their profession,” they write. “This can often result in displaced and self-destructive aggression within the oppressed group.”
A big problem with remedying nurse-on-nurse hostility is that although it happens, nurses don’t like to talk about it openly.
“It is embarrassing and so remotely removed from our idea of the perfect nurse that we shudder to think it may be true,’’ writes Ms. Bartholomew. “There is an unspoken fear, warranted or not, that acknowledging the problem will make it worse.’’

Ms. Bartholomew argues that the best antidote is open discussion, and I agree. A majority of nurses do not bully on the job, and that majority needs to set a new tone. We have to come out of the corner, stop allowing our co-workers to tear at one another’s flesh and instead speak up. We obviously have a lot on our minds.

Fewer Filipino nurses sought work in US in ‘09

2010-02-16T08:46:00.000+08:00

MANILA, Philippines—As the United States still had to allow the massive influx of foreign nurses to its shores due to a severe lack of nurses, the number of Filipinos that sought to enter America’s nursing profession plunged by 26 percent in 2009, the Trade Union Congress of the Philippines (TUCP) said in a statement Sunday.

A total of 15,382 Filipino nurses took the NCLEX for the first time from January to December 2009, a decrease of 5,364 compared to the 20,746 that took the examinations in the same 12-month period in 2008, according to former senator and TUCP secretary general Ernesto Herrera.

The NCLEX refers to the US National Council (of State Boards of Nursing) Licensure Examinations.
Compared to the record number of 21,299 Filipino nurses that took the NCLEX for the first time (that is, excluding repeaters) in 2007, Herrera said the 2009 figures were also down 28 percent or by 5,916.

TUCP’s disclosure came shortly after the Philippines' Professional Regulation Commission bared the results of the November 2009 eligibility examinations for nurses. Only 37,527 or less than 40 percent of the 94,462 nursing graduates that took the licensure test passed—the poorest performance since 2000.

To build up the competitiveness of Filipino nurses in foreign labor markets, Herrera pushed for:

* The immediate shutdown of 152 nursing schools previously classified as "substandard" by the Commission on Higher Education;

* The annual rating of the remaining 308 nursing colleges (net of the 152 to be closed down), based on the performance of their graduates in the local licensure examinations over the last five years, and the yearly publication of the rating of every college so that buyers of nursing education may be guided accordingly;

* The provision of free intensive second foreign language training, via the Technical Education and Skills Development Authority, to nursing graduates seeking employment in non-English speaking countries such as Japan and the Middle East; and

* The strengthening of the capabilities of all state-owned hospitals, whether run by the Department of Health or by local governments, to provide superior clinical training to junior and senior nursing students.

On account of the overwhelming number of Filipino nursing students, Herrera lamented that many of them are not getting adequate clinical training or "related learning experience" in hospitals.

"Hospitals can no longer accommodate all our nursing students in emergency rooms, operating rooms, intensive care units, and delivery rooms. There are just too many of them waiting in line to observe procedures," Herrera said.

RP, Canada to renew job accords

2010-02-15T08:44:00.001+08:00

Canada is set to renew existing agreements with the Philippines that seek to provide training and employment opportunities to Filipino nurses and other workers, the Department of Labor and Employment (DoLE) said Wednesday.
Director Salome Mendoza, head of the Canada desk of DoLE, said that the provinces of Skatschewan, Manitoba, Alberta and British Columbia, all in the Western part of Canada, are reviving its memorandum of understanding (MOU) with the Philippines along with its implementing guidelines this year.
“The MOU for Manitoba is scheduled to renew this month, while Skatschewan and British Columbia are set to revive their MOUs within the first quarter of the year,’’ Mendoza said in an interview.
“For Alberta, although the MOU will expire on October, the implementing guidelines are already set for approval within the year as well,’’ she added.

FEWER PINOY NURSES SEEK WORK IN U.S.

2010-02-14T08:42:00.000+08:00

MANILA, FEBRUARY 9, 2010 (STAR) By Sheila Crisostomo - For the last three years, the number of registered Filipino nurses taking the US National Council Licensure Examination (NCLEX) has been declining, indicating that fewer Filipino nurses are seeking work in the United States, a labor organization said. Trade Union Congress of the Philippines (TUCP) secretary-general Ernesto Herrera said only 15,382 took the US licensure exam for nurses in 2009, compared to 20,764 in 2008. In 2007, 21,299 Filipino nurses took the NCLEX.
The former senator said there is a need to “build up the competitiveness of Filipino nurses in foreign labor markets.” One way is to shut down the 152 nursing schools previously classified by the Commission on Higher Education as “substandard.”
Herrera also proposed that nursing schools publish their passing rates in the annual licensure exam “so that buyers of nursing education may be guided accordingly.”
He said the Technical Education and Skills Development Authority (TESDA) should also provide free second-language training to nurses seeking employment in non-English-speaking countries.
Herrera also said that many nursing students do not get proper clinical training in hospitals because there are too many of them.
“Hospitals can no longer accommodate all our nursing students in emergency rooms, operating rooms and delivery rooms. There are just too many of them waiting in line to observe procedures,” he said.
“The capabilities of all state-owned hospitals, whether run by the Department of Health or by local governments, to provide superior clinical training to junior and senior nursing students (must be strengthened),” he added.

Filipino caregivers deserve better

2010-02-13T08:41:00.000+08:00

The Economic Partnership Agreement that Japan has with some countries, especially the Philippines, has placed many Filipino nurses and caregivers working in Japan in a miserable situation where they are subjected to unfair labor practices, extreme pressure to pass licensing exams in Japanese within three years, cramped living conditions and poor salaries.

With net pay (monthly) of only around ¥60,000, an often unsupportive work environment because of the lack of programs, and constant comparisons between the local and foreign workforce, employment in Japan has become a nightmare for many foreign health workers. The Japan International Corporation for Welfare Services has not done anything to remedy the situation. Nor has it transferred foreign workers to fairer and higher-paying hospitals. Yet, it is getting ready to recruit the second batch of unsuspecting nurses and caregivers.

Japan must stop hiring overseas workers only to subject them to extreme poverty and unfair labor conditions. If it values the service that these devoted health workers provide to Japanese society, nurse licensing exams must appear in an easier format that includes furigana phonetic guides for kanji so that the workers can pass them in three years. An effective Japan nurse orientation program for newcomers would also help.

The opinions expressed in this letter to the editor are the writer's own and do not necessarily reflect the policies of The Japan Times.