First Philippine Nursing Townhall Meeting a huge success

The inaugural Philippine Nursing Townhall Meeting last 29 May 2020 was a huge success.

The event was envisioned as a major annual high-level meeting dedicated exclusively to advancing nursing in the Philippines. It brought together key nursing decision makers -- Dr. Linda Buhat (ANSAP), Dr. Leah Paquiz (ANG NARS) & Dr. Irma Bustamante (PNRS) -- from the Philippines. Facilitated by Prof. Rozzano Locsin, the historic virtual event encouraged timely debate on emerging issues related to the profession in the light of the recent launching of the “State of the World’s Nursing Report”.

For participants from 9 countries, it provided an important forum to secure a coordinated, multi-leveled response to address the emerging nursing issues.

Highlights of the Meeting

The Master of Ceremonies, Dr Joel Acob started the meeting with an Invocation.

Messages were delivered from Commissioner Dexter Galban (Commission on Population and Development) and Commissioner Sandy Montano (Philippine Commission on Women) towards the successful conduct of the Town Hall Meeting.

Dr Violeta Lopez (President, Filipino Nursing Diaspora Network) welcomed the guests and participants to the meeting which has special significance in celebrating 2020 as the Year of the Nurse and Midwife with the focus on Nurses being at the forefront for health policy and practice. The occurrence of the worldwide COVID pandemic provides a more complex and challenging scenario on the evolving role of nurses in the delivery of quality health care. She briefly indicated that current workforce issues, nursing practice and policy options in education, research and leadership, which are explicated in the WHO 2020 State of the World Nursing Report, shall guide the proceedings of our Town Hall meeting.

The MC introduced the facilitator for the Town Hall Meeting, Dr Rozzano Locsin.

First Speaker: Dr Maria Linda Buhat (ANSAP National President)

The importance of safe staffing to produce desired level of quality care is reflected in patient outcomes, clinical outcomes and safety outcomes. She discussed this in the context of patient care related, staff related and institutional/organizational related principles. Dr Buhat presented detailed data on Nurse to Patient/Bed staffing ratios from 2016, 2018 up to current COVID pandemic times. She provided insight on the implications of the numbers including several exceptions to the published ratios. She also indicated that since 2017, nursing-wise we are “shorthanded” and comprehensively presented recruitment & retention issues and challenges (e.g. increased international demand for nurses, cap on salaries, difference between local and international wages, silent underemployment). Her parting message was “to take good care of our nurses!”

Comments and questions:

Fritz Jaminit added that nurses working in non-nursing roles/ teaching outside of nursing should return to Nursing roles (he inquired re strategies to entice them to return to nursing work; Speaker response is the use of non-nurses [aides] so RNs can focus on Nursing work.). He suggested to recommend to CHED to actively promote nursing as a degree of choice to address low number of graduates and the quick turnover rates. He queried how to Integrate modalities of care to staffing issues (Speaker responded that in their recent meeting re capping issues, the Chief Nursing Officers reported on scheduling changes & pursuing support provision from diff organisations & govt institutions e.g. DOLE, DOH).

Belle Rogado raised state of global world in coping with COVID and provided incisive comments (positive and negative) focused on frontliners (e.g. nurses access to resources, some affected/demise; appreciative of support & assistance for nurses but awareness of physiological/psychosocial issues emerging); how to retain nurses, care of nurses and how far is the govt/national policy making an effort towards such challenges.

Ericson Batan pointed out at with nurse shortage, non-nurses to be pulled back and queried the strategy to do so – hospital to retrain (at whose expense?). The speaker response: due to the dearth of nurse applicants, programs of re-skilling are being conducted by hospital and pointed out that the salary issue is good in government hospitals, and some private hospitals are also providing the salary raise.

Byron Opinion inquired about the possibility to be enrolled with insurance when employed in hospitals and the Speaker replied that it is an important issue and currently being looked at.

Second speaker: Dr Leah Paquiz (ANG NARS Party List and former Congresswoman)

Achievement of delivery of safe quality care will only result by doing nursing work under the leadership of nurses. Otherwise, nurses and nursing will be heading towards a “perfect storm”. She gave an extensive discussion of the role of Chief Nursing Officer and Nursing Office & repeatedly expressed the importance of establishing a separate CNO & Nursing Office (hopefully NOT under the supervision of a higher non-nurse administrator). Much of her productive work for Nursing was undertaken as the elected ANG NARS Party List member of Congress in 2013. Her presentation detailed the many initiatives she pursued & focused on the bill she authored & presented to Congress in 2013 and was approved by both Houses– the Comprehensive Nursing Law Bill. Details of the Bill indicated the importance of having independent nurse leaders to achieve delivery of better care to Filipinos. Unfortunately, due to lobbying against the Bill & lack of support from some politicians, the Bill was vetoed by then President Ninoy Aquino. Although the Ang Nars Party lost in the 2016 & 2019 elections, she has continued in pursuing several nursing endeavours (e.g. maternal & child health, paid training of RNs, needs of nurses working overseas, PhilHealth issues) and concluded her talk with a very inspiring Call to Action declaration!

Comments and questions:

Johanna Zehender - role of the nurse as a team player not only a team leader (pitfall of being too dependent; must work towards an “interdependent” work dynamic (CNO not encroach on CMed Officer) work harmoniously authentic interdisciplinary – acknowledge needing others but the leader must be a nurse. Raised a question on possibility to have one named group to represent nurses. Speaker’s answer: yes, by work together but “Shangrila’ for us, as of today.

David de Jesus realises we still have a long way to go as to who should lead – different nursing labels abound. Shared 19 years of experience in the Middle East where an autonomous working dynamic exists (Nurses independent of Doctors; cooperate with Drs but Nurses’ role and leadership are recognized). He strongly supports Dr Paquiz’ Call to Action.

Arlene Navarro comments on lack of unity of Filipino nurses, highlight need for one voice; empowerment in nursing not evidenced today; call for support of CNL. Recommends change in curriculum due to COVID (emphasise infection control) and improve treatment of nurses during COVID through quality management.

Kristine Luzano queried the existing travel ban/deployment and its effect on nursing morale including the unequal pay between nurses employed in government hospitals vs private. Speaker informed that ANG NARS is pursuing DOLE that categorises employment as either agriculture or no-agriculture, to initiate a different category that will be appropriate for nurses.

Third speaker: Dr Irma Bustamante’s (President, Philippine Nursing Research Society) brief but comprehensive talk covered general Nurses Perceptions towards Research and provided a list of research topics done by nurses (e.g. continuing studies on specialty nurses areas, employment and job issues, emerging new diseases). A discussion on How Research help in Health Care included improvements in health education/ OBE-dized curriculum, dissemination of nursing work in different venues and use of media in many forms. She concluded her talk with a note on the compassion and love involved in nursing work and a call for nurses to unite and do research to improve practice.

Comments and questions:

Jonathan Monis raised the issue of dearth of work at the level of policy making and asked how researchers could be encouraged to address evidence-based studies on decision making (advocacy/political economy). He commented that with the COVID pandemic, impact of the “new normal” on research (digital health) and risk management for future disasters (worse case scenarios/contingency plans) should be addressed.

Joemer Maravilla raised several research issues – aligning research towards evidence synthesis not just evidence production; move towards innovation and emerging fields including mental health, vulnerable populations, social determinants of health; recognise that the field is saturated with published works that requires a clear dissemination plan; move towards translational research/implementation science; involvement of stakeholders during the conduct of research. He inquired as to what extent translational research is happening in the context of capacity building of academics, clinicians and students and what strategies could be used to motivate nurses to undertake research. The Speaker responded that one should “befriend” the would-be researcher and not to live in research “ivory towers”.

Andrew Pepito commented that nurses’ involvement in the 4th Industrial Revolution necessitate experienced researchers to reach out to those who do not have the capability to do research themselves by acting as research mentors and conducting research training or programs.

Robert Bautista concluded the discussion on capability building strategies by linking involvement with incentives such as providing one workday a week for research or paying for attendance in a conference.

The meeting was closed by the Master of Ceremonies Dr Joel Acob expressing appreciation of the participation of the speakers and commentators and an invitation to the next Town Hall Meeting (TBA, please check the FiND Network website).

Our readers are encouraged to review the uploaded recording (see FiND Network website) of the 1st Town Hall Meeting (29 May 2020) for content which are not detailed in this condensed highlights of the proceedings.

Prepared by Dr Maria Cynthia (Cindy) Leigh

Director FiND Professional Development