Nursing competence in the global market

Philippine Daily Inquirer First Posted 01:39:00 05/13/2009 Allow me to share my views on the present nursing curriculum and its impact on our nurses? education and global competitiveness. The present four-year nursing program includes three summers. If a summer is equivalent to a semester, then the present nursing program is actually five-and-a-half years long. Therefore, the proposal of the Commission on Higher Education (CHEd) to add one more year to what is at present a four-year course?that is a five-year course without summers?is better for two reasons: (1) nursing students can enjoy a much-needed respite during summer, and (2) their parents will be given time to save money for the following semester. However, we should not worry so much about the length of the program or the tuition fees to be paid. Let?s rather focus on the proper implementation of the curriculum per se. The present curriculum is a well-researched program that was carefully developed by our country?s dedicated deans and noted nursing academicians in consultation with different nursingsectors and specialty groups. In fact, our nursing curriculum?s conceptual framework has been hailed as a blueprint for excellence and has been adopted by many Asian and western countries. And it has been presented at numerous international conventions and accepted by our nursing colleagues globally. Given its content, the curriculum can be said to be in parallel with the global standards of nursing care and practices. As one of the many Filipino nurses given the chance to teach nursing subjects in the United States for more than 15 years, this is my observation: even though the US nursing program has two entry levels, the predominant one is the Associate Degree in Nursing(ADN), a two-year nursing program with barely 600 actual nursing hours in the clinical areas; and it yields amazingly and consistently a very high passing performance in the nursing licensure (NCLEX-CAT) examination. As to the Filipino nurses? global competitiveness, to this day they remain the number one choice of other countries trying to make up for their acute nursingshortage. Our nurses may be noted for being inherently caring, respectable and compassionate, but more employers (nursing homes and hospitals), especially in the United States, are now so concerned that the nurses they hire are truly trained in the westernnursing practices and standards, or globally competent. Nursing competence (not the BSN degree or passing or topping the mandatory examinations) is very crucial in the effort to prevent and totally eliminate nursing malpractice/negligence. It?s a known fact that the United States is one of the most litigious countries in the whole world and yet it is a favorite [1] destination of our nurses for long-term work tenure.

Schools buck new nursing curriculum May 23, 2008 05:54:00 Kristine L. Alave Philippine Daily Inquirer MANILA, Philippines -- The largest consortium of private schools on Thursday demanded that the Commission on Higher Education (CHEd) immediately stop implementation of the new nursing curriculum, saying its imposition was done without consultation and the curriculum posed too much of a burden on students. The Coordinating Council of Private Educational Associations (Cocopea) described CHEds Memorandum Order No. 5 released last week which directed nursing schools nationwide to add new subjects and increase hospital hours for students starting this school year, as a disastrous policy that would do more harm than good. The order had added 28 units and three summer classes to the nursing curriculums 169 units. Practicum hours would also increase to 2,703 hours from the current requirement of 2,142 hours, Cocopea said. CHEd said the new policies were aimed at further honing students technical knowledge and skills, making them more competent and competitive to employers.

Unfair to students But Cocopea said the imposition of additional subjects was unfair to schools and students. It also accused CHEd of failing to consult schools and colleges about the new policies. Due process was clearly not observed, the organization said. Fr. Rod Salazar, Jr. SVD, Cocopea chair and president of the Catholic Educational Association of the Philippines (CEAP), urged the suspension of the order until after all stakeholders had discussed ways of improving nursing education. We are appealing to CHEd to suspend the implementation until we have considered in depth and at length how we can truly improve the quantity and quality of the nurses we educate, Salazar said. The additional units would also increase the financial burden of students and parents and cause a logistical problem to hospitals and colleges, the group said. It pointed out that there might not be enough hospitals to satisfy students need for hands-on learning. We have barely two months to go before the academic year will start and we, as heads of our respective institutions and educational associations, feel that the implications of the proposed changes in curriculum are too heavy for our educational system to implement this

soon, Salazar said. Cocopea officials said implementation of the curriculum may prompt many students to discontinue pursuing nursing careers. Fr. Joel Tabora SJ, CEAP regional director and president of the Ateneo de Naga University, said, It is a disastrous policy. It will make us choppy and will force students to drop out. Cocopea is composed of 2,500 schools, colleges and universities.

Consultations were held on new nursing program 3 years ago May 23, 2008 21:19:00 Katherine Evangelista INQUIRER.net MANILA, Philippines -- Contrary to claims of a consortium of private of schools, the Commission on Higher Education (CHEd) said Friday consultations had been held before it ordered the implementation of a new nursing curriculum. Maria Teresita Sy-Sinda, chairperson of CHEds Technical Communication on Nursing Studies, said nursing school owners, parents and related institutions were consulted during the drafting of the program. CHEds Memorandum Order No. 5 released last week mandates nursing schools to add new subjects and increase the hospital hours of nursing students starting this school year. It will be applicable only to incoming freshmen nursing students. The Coordination Council of Private Educational Associations on Thursday demanded that CHEd immediately stop the implementation of the revised curriculum, saying its imposition was done without consultation and it posed too much of a burden on students. Meetings with stakeholders about the new program of study were held as early as three years ago, Sinda said. The original proposal, according to Sinda, was to turn the nursing degree into a five-year program to ensure graduates competence. This, she said, was turned down by the stakeholders, citing the additional costs it would entail. Sinda said the new program is better because it integrates review for licensure exams. As a dean, I feel that it is my responsibility to ensure the quality of education of my students. Why should I pass it on to a review center? She said the integration was done to ensure the program is airtight to prevent a repeat of the scandal-tainted 2006 nursing board exams. Private review centers now have to comply with the strict standards set by CHEd if they wish to

continue operating, Sinda said, adding nursing schools that fail to meet the minimum passing rate for three years could be closed down. They should get their acts together, she said. At the same time, Sinda said the new nursing curriculum is CHEds response to address the growing concern over the declining quality of nursing graduates. In the beginning, there was clamor among our consumers that the nurses that we are producing in the Philippines [are] not competent, she said. In a primer provided during the 2008 National Conference on Health, statistics showed that from an annual passing rate of 62 percent in 1981 and 1988, nursing board exam passers dropped to 48 percent in 2002 to 2006. The new curriculum also gets rid of special courses for professionals applying to nursing schools. Before, professionals can finish a nursing degree within 18 months because of the special courses offered by schools. If a doctor wants to be a nurse, she should go through the whole process in order to become a nurse, explained Sinda.[2]

Flawed nursing curriculum

MINI CRITIQUE By Isagani Cruz | Updated November 6, 2008 - 12:00am

Why is Panitikang Filipino required in the new Nursing (BSN) curriculum (CMO No. 5, series of 2008)? CHEDs Technical Panel for Humanities, Social Sciences and Communication abolished that course a decade ago. Why did nurses, who we can presume do not know as much about literature as literature teachers, suddenly resurrect a course that even literary scholars themselves no longer consider legitimate? CHED must amend CMO No. 5, series of 2008, immediately. The course is being offered in the Second Semester in numerous nursing schools in the country, ensuring that our future nurses will be miseducated as far as literature is concerned. The correct description of Filipino 2 should have been what it is envisioned to be in the General Education Curriculum (GEC), namely, Filipino for Nursing Students (Filipino for Specific Purposes). That makes a lot more sense than wasting one entire semester making first-year nursing students read Tagalog literature (which, literary scholars now know, forms only a small part of Philippine literature). Our nursing students, when they graduate, will spend a lot more time explaining health issues in Filipino to their patients than reciting Florante at Laura. Far be it from me to downplay the importance of literature in the general education of anyone, least of all health sciences students that need to understand what makes human beings heal themselves. But literature is taught elsewhere in college anyway. Philippine literature itself (not just Tagalog literature) is taught in Literature One, which is on The Literatures of the Philippines, which may be taught in Filipino, English, or any of our hundred languages. Strangely, the nursing curriculum does not even have this course, which is required of all college students. What it has is a Humanities course entitled World Civilization and Literature. Even as a literature scholar, I am appalled by the idea that literature represents world civilization. We literary scholars may be arrogant, but we are not that arrogant! The whole point of a GENERAL Education Curriculum is that it is for everybody, regardless of major. Why did the so-called curriculum experts in Nursing fool around with the GEC? Nursing educators may be geniuses in nursing, but they are clearly idiots when it comes to literary studies. Here is a case where CHEDs left hand does not know what its right hand is doing. It is time for newly-appointed CHED Chair Emmanuel Angeles to make things right. Right now!

NEXT EXPORT MAJOR: Now that the nursing boom seems to be over and high school graduates are still dreaming of working overseas, universities should start rethinking their education courses and make these export-oriented. Education courses right now are geared towards producing teachers for the public school system. DepEd Secretary Lapus, however, has announced that, for 2009, the department can hire only 10,000 teachers. Even if DepEd were given the extra money it is asking from Congress, it would need only 40,000 teachers to fill all its vacancies. We produce a lot more than 10,000 or even 40,000 education graduates. Where will these graduates go? Instead of ending up as domestic helpers in other countries, education graduates should be trained to teach abroad. This means, for example, adding courses such as American History, American Educational System, British Educational System, Chinese Educational System, Chinese History, Mandarin, and Arabic to our present Education curriculum, perhaps not as required courses but certainly as electives. There is no question that the country needs foreign remittances. If the remittances from nurses will no longer be forthcoming, we could export our teachers. The United States has already indicated that it needs almost a million (mostly foreign) teachers to teach mathematics, science, and special education.[3]

Two New Subjects Added in BSN Curriculum

Nursing students have to go through two more subjects before they get their much coveted college diploma. The Commission on Higher Education (CHED) recently ordered the inclusion of two new nursing subjects in the nursing curriculum to guarantee that the Philippines will be able to produce high caliber nurses. The subjects added are the following: Theoretical Foundation in Nursing and Fundamentals of Nursing Practice which aims to instill to first year students the ethics and commitment of the nursing profession. The CHED Order Number 5 series of 2008 requires implementation of the revised curriculum on the next school year 2008-2009. The CHED executive director, Dr. William Medrano emphasized that the addition of new subjects was not because of the canister scandal at the Vicente Sotto MemorialMedical Center in Cebu. It was recommended by Technical Committee on Nursing Education composed of distinguished personalities in the field of nursing according to CHED executive director. Medrano said, The order was issued before that scandal. The move to add the two subjects came as a result of a recommendation made by the Technical Committee. This development was favored by deans of nursing school and hospital administrators specifically the Association of Deans of the Colleges of Nursing of the Philippines and the Association of Private Hospitals in thePhilippines. However school owners and administrators view it negatively. The Coordinating Council of Private Educational Associations (COCOPEA) and its affiliate private schools associations are demanding for the suspension of the new CHED order.

Schools ask CHED to defer memo for new nursing curriculum

MANILA, Philippines - School representatives on Thursday called on the Commission on Higher Education to scrap its memorandum order no. 5, the directive that imposes a new curriculum for nursing schools. In a press conference, the leaders of the largest consortium of private colleges and universities in the Philippines and the umbrella organization of five educational associations described the CHED order as "disastrous" and called on the government agency to defer the implementation of its order. The group also lashed out at CHED for its unilateral decision to add more subjects to the nursing curriculum. Fr. Rod Salazar, Jr. SVD, COCOPEA chair and president of the Catholic Educational Association of the Philippines (CEAP) said that he already sent a letter to CHED chair Romulo Neri requesting for the immediate suspension of the new curriculum. Should CHED refuse to heed their plea, he said the association will explore all possible legal remedies to halt its implementation.

He said they might even ask Pres. Arroyo to intervene on the matter. According to Salazar, the schools reject the implementation of CMO 5 due to several reasons: The first, he said, was that no public hearings were conducted by CHED. This is in violation of CHEDs mandate that the recommendations of the agencys panel of experts is subject to public hearing. Due process was not clearly observed," Salazar said. Second, he said that the decision will unduly burden nursing students as they will have to endure more than 28 additional units which would also mean an additional three summers of schooling. In effect, what is being presented as a four-year course actually runs to five years," he said. The third reason, he said, was that the required learning experience (RLE) would be increased by 561 hours or 11 units from the present 2,142 hours. Considering the great difficulties of finding suitable hospitals and places for the RLE, the increase logistical problem of schools, under the old nursing curriculum, there are already NOT ENOUGH hospitals for the required clinical hours,"he said. This seems untimely when the whole country is reeling from other equally pressing problems," Salazar said, referring to it as the fourth reason. Another reason for their opposition, Salazar said, was that the new curriculum adds nursing subjects on the first two years, replacing General education subjects. This will break 2-year General Course and will force higher educational institutions to terminate contracts of their faculty. This is also not good for about 50 percent of the first year nursing students who usually decide to shift to another course on the third year," he claimed. The group dubbed the new set of guidelines for the nursing curriculum as "disastrous''. "Legally speaking, there is a defect in implementing the new proposed policies since it did not go through a genuine public hearing. We are appealing to CHED to suspend the implementation until we have considered an in depth and at length how we can truly improve the quantity and quality of the nurses we educate,'' said Salazar. Salazar said there is also a possibility that the nursing enrollees in private colleges will dwindle with the new CHED proposed policies. "We have barely two months to go before the Academic Year will start and we, as heads of our respective institutions and educational associations, feel that the implications of the proposed changes in curriculum are too heavy for our educational system to implement this soon,'' said Salazar. For his part, Fr. Joel Tabora SJ, CEAP regional director and president of the Ateneo de Naga also expressed opposition to the plan. "It is a disastrous policy. It will make us choppy and will force students to drop out and to corrupt,''he said.[4]

Group hits commercialization of nursing education MANILA, Philippines - An organization of nurses blamed yesterday the commercialization of nursing education for the low passing rate in the local nursing licensure examination. The group Ang Nars lamented that there are now 400,000 nurses that are either unemployed or underemployed in the country. Ang Nars president Leah Paquiz said the quality of nursing education has suffered with the mushrooming of schools offering nursing courses in the past decades. If you put up a nursing school for business or to earn money, you will not be able to give your students a good education. They will suffer in the end, she said. Paquiz added that a nursing school that is profit-oriented would not be able to get good teachers, good curriculum, and good training programs for their students. Based on the results of the licensure tests for nurses given by the Professional Regulation Commission (PRC) in December 2012, only 16,908 passed out of 49,066 examinees. A majority of the examinees turned out to be repeaters. A few years ago, leaders in the nursing profession expressed alarm over the increase in nursing schools due to the huge demand for Filipino nurses abroad. The quality of nursing education suffered because of this. The purpose of many nursing students was not to serve Filipino patients but to migrate to higher paying jobs abroad. Overseas employment, however, slowed down, particularly in the United States in the past five years because of the already saturated foreign labor market and the competition from other countries deploying nurses. There are still countries that hire foreign nurses like Saudi Arabia and the United Arab Emirates, but they require a certification that you have working experience of at least four years, said Paquiz, former president of the Philippine Nurses Association. Paquiz said that there is an oversupply of Filipino nurses and there are not enough local private and government hospitals or clinics to hire them.[5]

CHED adds 33 more units to nursing curriculum May 21, 2008 2:34am MANILA, Philippines - Nursing students may spend more time in schools and hospitals under Commission on Higher Education's new curriculum due for implementation in School Year 2009 - 2010, GMA news 24 Oras reported Tuesday. Under the CHED memorandum circular No. 5, another 33 units will be added to the present nursing curriculum's 169 units, adding three summer classes to the present 8-semester course. Meanwhile, the number of hours for practicum will increase to 2,499 from the present 2,142hour requirement. Kailangan pang hasain sila sa clinical experience dun sa practicum," explained by Dr. Dr William Medrano, said CHED executive director. An association of more than 33 private schools (out of the about 1,000 schools offer BS Nursing Program) has opposed the new curriculum. Ines Basaen, program officer of the group Cocopea, said the additional units and hours of practicum entail additional cost for both students and schools. Six to eight hours a day and six days a week. If this will over burden the students, were not producing quality students even if you say that the curriculum or program is quality in terms of content or program," Basaen said. But Medrona stressed that Basaen's concern was already considered by the committee on technical education, saying they conducted public hearing on the matter. Medrona said that CHED has given the schools one year to implement the new curriculum. The new curriculum will also require a change some items in the licensure examination. - Fidel Jimenez, GMANews.TV[6]

Group endorses stronger BSN program, wants practical nursing courses halted MANILA, Philippines - The Philippine Nursing Association (PNA) on Tuesday endorsed the governments move to strengthen the Bachelor of Science in Nursing (BSN) program but opposed plans to institutionalize practical nursing programs. In an interview, PNA national president Leah Primitiva Samaco-Paquiz said the group said that if school implement the curriculum embodied in Commission on Higher Education (Ched) memorandum order No. 5, which provides for an additional load of 43 units and related learning experience (RLE) for the BSN program, students may no longer need the services of review centers. The RLE is the internship or hands-on learning education of all nursing students prior to graduation. With the competency appraisal 1 and 2, these institutions can now assess their students before they can graduate. These subjects are included in the curriculum so that right before graduation, students can decide whether they need help from review centers or not," Paquiz explained. Paquiz stressed that nursing students really dont need review centers," saying that it is their schools priority to mold their students in time for the examinations. During our time, we didnt have these review centers. All the students needed to take the exam was stock knowledge and what the school taught them.. Now, it is the obligation of the schools to ensure that they are qualified, and this is the role of the CMO 5," Paquiz said. Paquiz said that the implementation of the memorandum is meant to ensure the improvement of the national passing rate of students taking the nursing board exams and to produce quality nurses. Earlier, Ched Commissioner Nona Ricafort warned that schools who fail to implement the revised nursing curriculum next school year risk having their license to operate revoked. Ricafort, citing reports indicating a 30 percent compliance of all nursing schools across the country, said the remaining institutions have only until June 2009 to comply. The Commission admitted that the low rate of compliance was due to an appeal to Malacanang by the influential Coordinating Council of Private Education Associations (Cocopea), a consortium of private education institution in the country with more than 2,500 member schools including five major school associations. The Cocopea wanted the Ched memorandum nullified. Ricafort said Malacanang has directed Ched technical panel to submit its position paper refuting issues raised by Cocopea in objecting to the implementation of the revised curriculum. Practical nursing On the other hand, the PNA wants a moratorium on the operation of existing practical nursing (PN) programs and that serious review of the program be undertaken in consultation with

stakeholders. Paquiz said the group is opposing the institutionalization of PN based on three points: there are no local demands or positions for practical nurses within the Philippine health care delivery system; there is no global demand for foreign-trained PN, only for professional nurses; and there is no licensure of PN provided for in the Philippine Nursing Act. We deplore the moves of the government and other sectors to impose upon the nursing profession, critical proposals like PN program that gravely impact our profession already saddled with a host of serious problems that need immediate meaningful intervention," Paquiz said, noting that there is already an oversupply of health workers in the country - with nurses comprising the largest portion. We are convinced that the proposal to introduce the PN may be ill-advised economic strategy that will not lead to the creation of more jobs but to more exploitation by unscrupulous businessmen who will see this as another income opportunity," she added. Paquiz noted that there were about 65, 000 newly registered nurses in 2007 and that the agency is expecting some 100, 000 new hopefuls in the coming years. This number will be from the 460 nursing schools in the country, many of which will be unemployed. This does not even consider the vast number who do not pass the board exams," Paquiz said. The government's efforts to institutionalize PN programs are not harmonized" with the development philosophy of the Human Resource for Health (HRH). There is definitely a global demand for professional nurses, (but) not for practical nurses," Paquiz said. Many countries like the USA, Canada, and UK are currently considering adopting a single standardized nursing program. In this view, introducing PN program is a global trend regression and untenable... Institutionalizing PN is a step backward in progress, not forward," she added. Hiring slowdown Paquiz noted, however, that the demand for licensed nurses in the global market flat-lined in 2006 due to US visa retrogression and UK policy change, which signaled the shift of home grown health workers instead of recruiting from overseas. Worse, she said, the domestic demand is not also increasing. In the US alone, the quota for visas has been filled up resulting in delayed processing of visas with current efforts focused on 2006 accepted applicants. While the domestic market is now oversaturated with nursing pools in major hospitals as high as 1500 and with employment waiting times ranging from six to 12 months," she explained. Nursing pools refer to those considered qualified by hospital employers but waiting to be

formally employed. In St. Lukes Medical Center alone, an average of 20 applicants per day applied as walk-in and 10 per day applied through e-mail. SLMC has a pool of 300 nurses who finished a three-month pre-hire training, but the vacancy is only 6-10 persons per month since October 2007. In the Philippine Heart Center, hiring has slowed down because the turnover rate decreased to 10 percent since 2006. In 2007, turnover rates remained with nursing pool of 1,500. The Philippine General Hospital has a waiting time of 10-12 months with a nursing pool of 200250. There are 100 applicants per exam conducted every 2 months, with only about 20-25 percent passing. PGH, however, had a high turnover rate of .83 percent last year. Paquiz said that the current nursing employment market is a buyers market", which allows current employers to be highly selective and quality job seekers are closely scrutinized. GMANews.TV[7]

CHED warns nursing schools vs non-compliance with new curriculum June 26, 2008 3:35pm MANILA, Philippines - Nursing schools who will fail to implement the revised nursing curriculum next school year are likely to have their licenses to operate revoked, the Commission on Higher Education (CHED) warned Thursday.

CHED issued the warning after receiving reports indicating a measly 30-percent compliance of all nursing schools in the country for CHED Memorandum Order No.5, which gives 28 additional units to the current nursing load as well as additional number of hours for related learning experience. By June next year everybody must comply and implement the new curriculum, otherwise the commission may be constrained to revoke their license, CHED Commissioner Nona Ricafort said.

Ricafort stressed that a one-year deadline is enough time for all nursing schools to consider the implementation of the new curriculum.

Under the new curriculum, Bachelor of Science in Nursing (BSN) will remain a four-year course but with additional three summers to accommodate the 28 additional units, and extended related learning experience (RLE).

The RLE was described as the internship or the hands-on learning education of all nursing students prior to graduation.

CHED admitted that the low rate of compliance was due to an appeal to Malacaang by the influential Coordinating Council of Private Education Associations (COCOPEA), a consortium of private education institutions in the country with more than 2,500 member schools.

COCOPEA has opposed the CHED order and called on the government agency to defer the implementation of its order.

Ricafort said they are set to submit to Malacaang their position paper refuting issues raised by

COCOPEA in objecting to the implementation of the revised curriculum. She also pointed out that Malacaang has the final say whether the new curriculum will be implemented or not. GMANews.TV[8]

CHED gives failing nursing schools 3 years to shape up

By Philip Tubeza Philippine Daily Inquirer First Posted 19:02:00 06/01/2010

MANILA, Philippines?Shape up or close shop. The Commission on Higher Education (CHEd) warnednursing schools with dismal board examination passing rates to shape up within the next three years or close shop. CHEd Executive Director Julito Vitriolo said on Tuesday that "more than 100 nursing schools" around the country would be closed by 2013 if their average boardexam passing rate for the next three years remained below 30 percent, the minimum set by CHEd Memorandum Order (CMO) No. 14 Series of 2009. "Starting this school year, we will be monitoring them and if their passing rate remains below 30 percent by 2013, then their nursing program will be phased out," Vitriolo said in an interview. "We will implement the closure by 2013, based on CMO 14. We are already monitoring 16 government schools that offer nursing but are not performing well. The private schools will follow," he added. CHEd on Monday said around 55 percent of nursing schools in the country?253 out of 464 nursing schools?had a passing grade that fell short of the 40.70 percent national passing average. This figure was based on the licensure examinations the Professional Regulations Commission (PRC) supervised in June and November 2009. "In NCR alone, 47 nursing schools were identified to be among the low-performing nursing schools," the commission said in a statement. It directed interested parties to visit the PRC website (www.prc.gov.ph) for "a more complete list of lowperforming nursing schools per region." Vitriolo said that out of the 253 "low-performing" nursing schools, "more than 100" got a passing grade of below 30 percent. CHEd chair Emmanuel Angeles said they would continue to monitor and "evaluate the performance of nursing schools nationwide and to ensure the quality of nursing education in the country." Meanwhile, CHEd also announced the names of the top performing schools offering the Bachelor ofScience in Nursing programs in the country for 2009. These schools? passing rate was higher than the 40.70 percent national average. For those that had 1,000 or more examinees, the top three performing schools were Far Eastern UniversityManila, Centro Escolar University-Manila and Manila Central University-Caloocan City.

For those with 100-999 takers, the top three wereTrinity University of Asia (Trinity-QC), University of Santo Tomas and Chinese General Hospital College ofNursing and Liberal Arts. For those with 10-99 examinees, University of the Philippines-Manila, Philippine-Christian University-Manila and Saint Paul University-Quezon City came on top. REF: http://newsinfo.inquirer.net/breakingnews/nation/view/20100601-273277/CHED-gives-failing-nursing-schools-3years-to-shape-up