End of the Phillipine nursing profession in the States--2013


Nursing Philippines: End of the Demand

The American Nursing shortage is over

Kenneth Mann.......http://icedragon7.hubpages.com/hub/Nursing-Philippines-End-of-the-Demand#

A Lost Generation

  • Origins: A difficult life in the Philippines

The surge began in early 2002, or probably earlier. Philippine parents and students noticed that suddenly, nurses were leaving for the biggest land of prosperity for this former colony of America. The chance to immigrate via a US greencard, away from the terrible economic misery of the Philippines that awaited the majority of nurses beckoned to all. The United States was suddenly set square in the target sights of every parent as the dream destination for their children. Almost everyone had heard of someone (a neighbor, a friend) who used to be a lowly RN working in some local hospital but now in the USA with a fat signing bonus, a brand new house and one or two cars. Local Sunday papers began to fill with advertisements from recruiters coming to hire PH RN with mouth watering benefits: free airfare, relocation bonus and housing. From a mere 7,000 or so candidates passing each RN licensure exam, the numbers rose to awesome levels, reaching a high of more 90,000 examinees at the height of the nursing bandwagon frenzy. It is hard to believe that overnight, tens of thousands of PH students had become advocates of the caring profession. Suddenly, every Filipino high school graduate wanted to become a nurse, whether by choice or by parental pressure. The Me Too scramble had begun.

Schools were flooded with veritable armies of students in white, scenes that were replicated in campuses all over the nation. Dubious new nursing schools sprouted all over the nation like mushrooms to meet (and cash in) on the insatiable need for Filipinos to try her his/her hand at nursing. For the first time, more males were also taking up this female dominated career. Other courses lost their student populations, that would surely affect the workforce in those fields in the years ahead. Engineers, lawyers and other non-medical professionals joined the rush, hoping that with their multiple entry US visas they could jump the line after graduation by adjusting status in America. The PH beat India, China and all other countries with regard to the number of RNs taking the CGFNS and NCLEX - two examinations needed to practice in the US. The PH PRC, who gave the biannual licensing examination earned record fees from the tens of thousands of examinees. As greed set in, the quality of RN education became affected, with substandard schools opening overnight to meet the demand. This would eventually result in a scandal that would taint PH nurses - a board examination leakage of test questions. There is one Board of Nursing in the US whose staff had verbally declared that they are using a magnifying lens on the transcript of all PH applicants as "they are all suspected of being FRAUDULENT".

  • Law of statistics

Tens of thousands of students who probably didn't even think of nursing as a career were goaded, pushed and pressured by classmates, friends, relatives and starry-eyed parents to take up the course, that presumably would land them at once a job in America. Little did those who were down the line know that with only 10,000 immigrant visas allocated to the PH per year for all professions under EB3, it was a statistical impossibility akin to the lotto that everyone would land in the milk of honey as an RN. An NCLEX examination center even opened in Manila to accommodate the massive number of applicants. CGFNS, another company whose VisaScreen is vital to be issued an immigrant visa was undoubtedly reaping bundles from the thousands of PH applicants. On top of these, the nurse had to take English examinations to be qualified. Not only was the path to getting the coveted US greencard financially arduous, it demanded a lot of tests to be passed, whose validity often had to be renewed due to the long wait times for EB3 visa approvals.

What goes up... the law of supply and demand

But as with all fads, several events would crush the dreams of more than half a million PH RNs - the exhaustion of immigrant visas and the great Recession that struck the US in 2008.When a nurse with a spouse and three children, five visas would be granted to them. The four visas given to the dependents would mean these were taken away from nurses waiting in line. With tens of thousands applying for EB3 visas under which RNs are classified, the result is a backlog of five to six years. This includes RNs waiting in the PH, other countries and those who were allowed to enter the USA as tourists and adjust their status. This was termed 'RETROGRESSION" by the State Department. With the collapse of the Housing Market, the US economy wasn't in a hiring mode, and many hospitals laid off their workers. This included nurses. Things were never the same again for PH RNs.

New Zealand, Australia, the UK, Canada, Singapore, Norway and the Middle East would become alternative destinations for RNs, who due to their excessive numbers had saturated the job market in the PH. RNs were now even paying hospitals just so they could gain certificates for training experience. Call centers saved most jobless RNs as competition for every single post in hospitals had reached epic proportions.

Endgame: Retrogression, Recession, Concurrence

Now, in the US, more new RNs have joined the workforce, and the shortage has eased significantly and has even been questioned as moving into the realm of myth. Most recruiting agencies had closed down, hospitals abandoning their petitioned nurses still in the PH due to the economic Recession and more US grown RNs entering the workforce. Very few companies were willing to hire a nurse from the PH when the whole process would take 5 to 6 years. A new graduate from the US would be preferable. American nursing schools were catching up with the demand now and pouring more nurses into the system.

Take the case of the Board of Nursing of California: an applicant needs to have a valid Social Security Number (SSN) in order to apply. So you have to be an immigrant or a citizen to be eligible. This effectively eliminates the PH nurses from ever applying to CA. And now, the CA BON has enforced another existing ruling called CONCURRENCY to include all PH graduates. If you are from the PH, forget about applying to CA.

Many PH RNs now resort to marrying American citizens (fiancee visas) whether for real or not - just to be able to enter the US legally. As for those carrying multiple entry visas, adjustment of status in the US is no longer an option, as there are no employers willing to hire. So most tourists go back to the PH empty handed, or try their luck by overstaying and transforming into illegal immigrants working as caregivers, separated painfully from their families back home by decades. But there are still lucky ones, like many pinoys who came to America after getting Family-based immigrant visas. Most of these already finished their BS Nursing, and when the petitions by their parents in America came through, they breezed through immigration, ready to work in the US.

Advice to parents and children

The Demand is now over for PH RNs. There is no nursing shortage, at least in the US that needs any more PH immigrant nurses. Now, more than ever, parents in the PH must acknowledge this fact and turn away from a profession whose long term employment prospects appears dim for a decade or more. Continuing on this path would lead to wasted cash on tuition fees that could be used more productively in other endeavors.This would also save the future of their children (and avoid misery) who would rather be interior designers, engineers, lawyers, business men or nautical graduates. Doing otherwise would result in a jobless, unfulfilled, lost generation of professionals numbering close to a million.

A positive result of this oversupply though, is that healthcare could conceivably improve as there are more RNs among the population. Medical school enrollment might also increase as jobless RNs decide to proceed to take up Medicine instead. Call centers will have an abundant pool of workers to hire. For the rest, a lot of time, effort and money had been sacrificed for the dream or chance of immigrating.

2013 Board Exams for Nursing

The June 2013 Board Examination Result for Nurses in the PH shows a steady and perceptible trend - a rapid decline in examinees. From a high of more than 90,000 takers at the height of the perceived "nursing shortage in America", only 37,887 took the test this June 2013.

Pinoy parents have begun to wake up and accept the fact, that the "craze" is now over and being a nurse in the PH means joblessness, even if you are a topnotcher in the exams. It doesn't matter, you're still one nurse among more than half a million queuing up for scarce positions in both the public and private sectors.

DISCLAIMER MEMO: I did NOT write this, this was passed on to me by another person. I don't know who the actual writer is, she didn't tell me, but it was passed on to her from another friend. But definitely the original writer deserves all the credit for coming out and describing exactly what has been happening from a historical standpoint to present day issues from the frauds to the concurrency to the current job market


11 Posts

very well said! The American Dream for Pinoy nurses is close to impossible. Even though you get your green card and RN license in the US, it is still hard to get a job. Many employers in the US do not accept or consider Philippine nursing experience. They prefer those with US experience.


60 Posts

Specializes in Nephro-Dialysis / Intervention Radio. Has 6 years experience.

That's a nice article that should and must awaken my fellow Filipino nurses to the reality of nursing in the US. I got into nursing exactly as described at the beginning of the text, persuaded by my parents and relatives who promised to financially support my education but sooner or later was nowhere in sight a year after I shifted from Information Management to Nursing.

Eventually I graduated and passed the Philippine Nurse Licensure Exam, but had to work in a bank for almost 2 years since there were no local hospitals that were hiring staff nurses simply because of the oversupply of newly licensed RN's in the Philippines. With the help of friends, I luckily got a slot for a "training program" at a nearby tertiary hospital and eventually got hired, and selected for specialization after a couple of years. And here I am now, a dialysis nurse working in the Caribbean, with 5 years of experience and counting. But it won't stop there. I'm planning to get my Master's in the next couple of years, and would do my graceful exit in the clinical aspect of nursing and level up to administration and management, or public health.

The thing is, even if I got sucked into a terrible system dictated by economic needs, there are still ways to jump out of it. America is not the only place where nurses can have a flourishing career, there's Canada, Australia and the UK. There's a whole big world out there. So if America is closing its doors, then look somewhere else. If the situation is not to your advantage, then instead of waiting for your papers in the pile thanks to Retrogression, it might be more practical to go look for other options.

loriangel14, RN

6,931 Posts

Specializes in Acute Care, Rehab, Palliative.

Other countries are also tightening up their requirements for foreign educated nurses. Canada has taken nursing off the list for Federal Skilled Worker visas.The US is not the only place that no longer needs to recruit for nurse from outside their borders.


8,343 Posts

Has 18 years experience.

Zero: Australia, Canada and the UK are no longer looking off shore for qualified nurses. Read these countries threads on this forum. Locally educated new grads are having a hard time finding full time work. Governments are cutting healthcare spending which results in layoffs.

Nursing isn't the golden ticket some people think it is.


1 Article; 369 Posts

Specializes in Occupational Health; Adult ICU.

Great article, thank you.

"Many PH RNs now resort to marrying American citizens (fiancee visas) whether for real or not - just to be able to enter the US legally."

How very true. And this happened to me.

Keep in mind that as part of my nursing function I do accident/incident investigation. Now I may not be the sharpest guy but looking back -- there was every indication that the Filipina that I married was truly and deeply in love with me. But the reality: Nope, it was all a clever scam, a type called a "coached scam." Exactly 35 days after being married USCIS (Immigration) accepted my wife's AOS (Adjustment of Status). The next day she disappeared. Then beyond the cost of bringing her here was the cost (and stigma, for annulment in NH is not available) of Divorce, exacerbated by how do you serve someone who has disappeared? So if you're thinking "stupid man," that's ok, sometimes I feel that way, but it was so cleverly done I still say: "how could I have known?" I've found out, it works in reverse too. This common and difficult to tease out scam works East to West (Asia to US with women immigrants) and seems to work mostly West to East with men (for instance Turkey or an African Nation marrying an American woman.

You don't hear about it because most are to embarrassed to have been "taken" to tell.

Which brings me to the rest of the story which does directly affect nursing:

"...or try their luck by overstaying and transforming into illegal immigrants working as caregivers, separated painfully from their families back home by decades."

Armed only with my then wife's sister's phone number I traced it to a 4 square mile area in Phoenix, Arizona. I found a name too and later figured out that it was a fake name but which used real elements. The husband's name was listed first, and Ate's (Ate means: "the elder sister", TOS does not allow real names) name was listed last, partially. With this, by checking public real estate records I found that the couple had a few house purchase/sales and so found the correct full names.

Since the family had told me that Ate in Arizona, who was illegal (many years in overstay) was an LNA I thought I'd check the Arizona BON. Bingo--there she was, "LNA test attempted four times--failed four times." Now I'd been told that Ate worked as many hours as she wanted and made $20/hour. This made sense because the family had proudly pointed out to me: "Ate bought that house" (in Cebu City) or "Ate bought that house over there" (in Carcar City, Cebu, Philippines), or "Ate bought that land on the island of Bohol". Well, I had presumed that Ate and her husband were rich. Oddly I never knew exactly where Ate lived and oddly Ate never would speak on the phone when she called my then wife, but I figured she was just shy.

No, it seems that Ate is not shy; it appears that she simply didn't want to talk to the host (as in parasitic host). So now I knew where my then wife had gone to and also believed that Ate was the "coach." Ate had made one fatal error, but it really did not matter much as you'll see. Years earlier leaving one's spouse after acceptance of AOS still allowed the immigrant a path to citizenship. That path has mostly been closed and I did what was necessary so that hopefully the scammer will not attain legal status.

But legal status is not necessary. What, you say? How can this be? Well, consider: if Ate works a plain 40 hour week her take home pay (no taxes under-the-table) is about $41,000/year. If my (ex) wife also works under the table, then annual income, tax free is $82,000 per year. For comparison, a high school teacher in the Philippines makes about $6,000/year or every year in America = 7 years earnings in the Philippines.

Let's look at OP's quote again:

"...immigrants working as caregivers, separated painfully from their families back home by decades."

Painfully separated? If so, how was it that Ate returned annually to the Philippines to spend her cash? The answer is simple, though I can never prove it. From reading I now see there must be thousands if not tens of thousands of "improper/illegal" H-1B Visas. A few years ago the going rate was about $2500 for a 3 year H1-B, renewable for 3 more years. Since H-1B's require certain skills which clearly Ate does not have I must assume that Ate's H-1B states that she is something like "health educator," or "IT specialist," or maybe "Healthcare IT Specialist," or perhaps "Bowel Movement Engineer." Who knows? Yet since she travels freely she must have an illegal H-1B, for I know of no other way.

This too explains how brother proudly told me that when he finished his schooling in Cebu, Philippines that Ate would bring him to America too, but how? Auto Mechanic is not an accepted skill for an H-1B, ah but "Combustion efficiency engineer" just might be. What's $2500 for a 3 year H-1B? Not a big deal. So it seems that Ate saved $2500 at my expense. I suppose it beats having malaria or schistosomiasis (parasitic diseases), or maybe not--both can be cured for less than $1000.00, a fraction of what I expended.

But now I start to wonder. How is it that Arizona BON never even questioned whether a person taking the test even belongs here? Ah, but how is it that last week, in my small state of New Hampshire 10,500 people went to work--all illegal. And how is it that in Massachusetts a person can get a driver's license and register a car and be an illegal (ok to be politically correct: undocumented) alien?

The answer is simple. There is a big demand for illegal immigrants and many Americans benefit too. I'm betting that throughout the US there is a network of healthcare workers, probably mostly for homecare and it goes like this: "Yes, we can come and care for your elderly parent, we'll send an LNA and it will cost you $35/hour." Or "Yes we can come and care for your elderly parent, we'll send a Certified Caregiver (and show you the Philippine cert) and oh by the way this excellent caregiver is not yet documented, and so we only accept cash, but our cost is $23/hour." See how it works?

Will anything be done? Will or have ICE (Immigration and Customs Enforcement) done anything about my case? I'll never know, they do not tell. In my case Ate made a fatal error. Some years ago the scam would have worked perfectly but at least the laws have changed some and now if a marriage ends shortly after AOS acceptance, the path to citizenship ceases. But as you see above, no matter, for my (ex) wife, will pass the CNA, of that I have no doubt. And if she stays here even in overstay as an illegal, and works 5 years, she will have earned (and been able to save) more than she could working 35 years in the Philippines.

It's a crazy world.