Why Nursing?
The Philippines is the number one source country of nurses globally. Why do many Pilipino/as choose to become —not as a dentist nor a doctor—but a nurse, and then to leave their home country to work elsewhere in nursing? Pilipino/as choose to enter the Nursing field for a variety of reasons, especially for economic reasons. As a developing country, the Philippine government heavily invests in the education and recruitment of nurses to fuel its economy. The Philippine government expects overseas nurses to send money back to their families in the Philippines, an influx of foreign currency that will benefit the developing country’s economy. In 1996, for instance, Philippine families received US$800 million from relatives working overseas (McElmurry et al., 2006). A problem with this international exchange, however, the influx of money often does not go back to the Philippine health care system, which is detrimental to the home country (McElmurry et al., 2006).
The nursing profession is popular in the Philippines because of the country’s intertwined history with the United States. The United States introduced new professions such as nursing and education to the Philippines under its colonial rule. The introduction of the nursing profession specifically propelled the development of a new overseas labor force to benefit the nursing shortages in the United States (Choy, 2003). American nurses helped immigrant Pilipino/a nurses obtain a higher education in nursing that led to good salaries in the US, in turn benefiting the immigrant nurses’ families in the Philippines. The colonial and transnational relationship between both countries presented new opportunities for Pilipinos, especially for Pilipinas, paving the way towards making the Phillipines a source country. Before colonial rule, Pilipinas were not allowed to achieve a higher education; however, with the introduction of the nursing profession in the Phillipines and accompanying gender expectations for female nurses, the field and the “American Dream” became an appealing option for Pilipinas (Choy, 2003).
The motive to send money back home is not only closely linked to economic circumstances, but also to cultural values. The Pilipino culture highly esteems “the family” as a source of pride and identity, and it is expected to provide and care for one’s own family (Wolf, 1997). This cultural value is the reason why many Pilipino/as choose to pursue a profession that will guarantee a stable job and salary to help sustain the family. Utang na loob, which literally means debt/reciprocity in Tagalog, is another cultural value, as one is expected to tend to a neighbor’s need whether that assistance is needed or not. This value embedded in Pilipino/a behavior influences why Pilipino/as choose nursing, as it is a profession based on care.A rising issue among Pilipino/a immigrant nurses is the pursuit of exclusively nursing as opposed to other professions. Many Pilipino/as who obtained degrees in the Philippines in fields such as medicine and education choose to change their careers to nursing because of the dire nursing shortage in America. A surgeon in the Philippines earns less than a Registered Nurse in another country, and filling in the nursing shortage void is much easier than striving for a profession (such as in medicine) where there is not a high demand. The fact that a nursing education takes fewer years than for other fields is another motive for Pilipino/a immigrant nurses for they will have a stable source of income for their families sooner if they pursue a career in nursing (Danieljbmitchell, 2007).
As Pilipino/a nurses are choosing to work in America and numerous other foreign countries, the healthcare system and in turn the economy of the Philippines is in danger, similar to other countries that export citizens to fuel another country’s economy. By understanding what is happening all over the world in the nursing field, we will be able to understand the inequalities in healthcare systems around the world and be motivated to find solutions to these problems. 
Moreover, for those who are nurses of Pilipino/a descent, it is important to be conscious of one’s own personal and cultural values in order to protect health care delivery from the bias of negative stereotypes. This decreases ethnocentrism, which is viewing another’s culture in the context of your own. Ethnocentrism creates cultural conflict especially in giving care (Burkhardt & Nathaniel, 2008). Knowing one’s own culture will enable one to better facilitate the process of understanding a patient’s culture, which inarguably affects his/her health and well-being.If Susan Meyer had understood the political, economic, and cultural forces behind healthcare education in the Philippines, perhaps she would have been assured that her health was in good hands.
References
Burkhardt, M. & Nathaniel, A. (2008). Ethics and Issues in Contemporary Nursing. New York: Delmar Learning.
Choy, C.C. (2003). Empire of Care: Nursing and Migration in Filipino American History. Durham: Duke University Press.
Daniel, B.M. (2007). California’s Nursing Shortage [video]. Retrieved March 1, 2008 from http://www.youtube.com/watch?v=DEt6m9oB7-M
Lorenzo, F., Galvez-Tan, J., Icamina, K., Javier, L. (2007). Nurse Migration from a Source Country Perspective: Philippine Country Case Study. Health Services Research (42) (3p2), 1406–1418.
McElmurry, B., Solheim, K., Kishi, R., Coffia, M., Woith, W. & Janepanish, P. (2006). Ethical Concerns in Nursing Migration. Journal of Professional Nursing (22), 226-235.
Norwindetalla. (2007). Teri Hatcher's Comment Against Philippine Med School [video].
Retrieved December 1, 2007 from http://www.youtube.com/watch?v=6LMA25i1jFs
