INTRODUCTION

“Filipino nurses put their heads high

and the whole world of the greatness
of the Filipino spirit… resiliency at its
best in Philippine Nursing… because
we are not alone… we have new
found partner: DOLE, CFO, DFA,
DOH, PhilHealth and.. we have each
other!”
GLOBAL HEALTH CARE SCENARIO
THE MILLENIUM DEVELOPMENT GOALS (MDGs) : 2015

1. Eradicate extreme poverty and hunger

2. Achieve universal primary education
3. Promote gender equality and empower women
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV/AIDS, malaria and other diseases
7. Ensure environmental sustainability
8. Develop a global partnership for development
GLOBAL HEALTH CARE SCENARIO
GOAL 4: Reduce child mortality
 Target: reduce under-five mortality rate by
two-thirds between 1990 & 2015
GOAL 5: Improve maternal health
 Target : reduce maternal mortality ratio by
three quarters, between 1990 & 2015
GOAL 6: Combat HIV/AIDS, malaria and
other diseases
 Target: have halted and begun to reverse the
incidence of malaria and other diseases
PHILIPPINE HRH
SITUATION
The Philippines is producing more and better human resources
for health, compared to most Asian countries

Human resources for health are enormous but unevenly

distributed in the country

The Philippines is a major source of health professionals to other

countries
* leading exporter of nurses to the world
*Second major exporter of physicians

Large exodus of nurses and physicians (as nurses) in recent

years has been unparalleled in the migration history of the
country
PHILIPPINE HRH
SITUATION
High unemployment rate for new nurses

Migration of trained nurses

Inward migration to urban centers
High employment in urban areas
Low employment at rural areas
Outward migration abroad

High training expenses of new nurses for local

employment as replacement to those who
migrated abroad
 LOGO

 According to the Bureau of Labor and

Statistics, Registered Nursing is among
the Top Ten Occupations with the Largest
Job Growth
LOGO
Nurses
 Promote health
 Prevent diseases
 Help patients cope with illness.
 Have a unique scope of practice and
can practice independently
 Collaborate with all members of the
healthcare team to provide the care
needed by each patient as an
individual
 Are hands-on health professionals
 Focused highly personalized care
LOGO
Nurses
 Serve as advocates for:
patients
families
communities.
 Develop and manage:
nursing care plans
instruct patients and their
families in proper care
help individuals and group take
steps to improve or maintain
their health
1. Ethical Recruitment in bilateral and multilateral
arrangements on foreign deployment of human
resources for health (HRH) that will guide the
recruitment and deployment of HRH between
contracting parties, given the following examples:

1. Philippine -United Kingdom MOU

2. Philippine – Saskatchewan (Canada) MOU
3. Philippine – Bahrain MOU
4. Philippine – Kuwait MOU
5. ASEAN MRA for Nursing
2. Reciprocity and mutual benefits in bilateral and multilateral
arrangements/agreements between the Philippines as
sending country and countries of destination of Filipino HRH
such as but not limited to: benefit package that consists of
resources or technical support to health education, training,
facilities and systems; priority benefits for the public health
system

1. Philippine – Saskatchewan (Canada) MOU

2. Philippine – Bahrain MOU
3. Philippine – Palau MOU
4. Philippine – Viet Nam MOU
Initial Requirements in the Philippines
 Nurses should finished
 Bachelor of Science in Nursing (BSN)
Then:
 Master of Arts in Nursing (MAN)
 Doctor of Philosophy (Ph.D)
 The field has a wide range of career
opportunities, ranging from entry level Staff
nurse to Doctoral-level researcher

LOGO
 Once you are a professional nurse, you
might choose to focus on a particular
specialty.

 specialty options:
Critical Care Nurse
Emergency Nurse
Hospice/Palliative Care Nurse
Labor and Delivery Staff Nurse
Neonatal Nurse

LOGO
Nephrology Nurse
Nurse Educator
Nurse Executive
Oncology Nurse
Orthopedic Nurse Perioperative
(O.R) Nurse
Psychiatric Mental Health Nurse
School Nurse
Staff Nurse
Women's Health Nurse
Practitioner
LOGO
Nursing has four Advance Practice
clinical professions
Clinical Nurse Specialty
Nurse Anesthetist
Nurse-Midwife
Nurse Practitioner
- each of which requires a
master’s degree and separate
certification.
 Roles in Service Delivery

 As seen in the Project NARS (or “Nurses Assigned in

Rural Service”): “warriors for wellness”
 Initiator of primary health, school nutrition, maternal
health programs, and first line diagnosis;
 Teacher of community water sanitation and other
environmental practices
 Epidemiologist –health surveillance
 Health Advocate –immunizes children and mothers
 Roles in Service Delivery

 Change Agent –promote hygiene and sanitation

and the control of infectious disease like influenza
AH1N1 as well as helminth infestation;
 Counselor –provides nutritional assessments and
advises patients on the proper diet; provides pre-
marital family planning counselling
 Supervisor –as Public Health Nurse, supervises
the rural health midwives
 Logistics manager –ensures that logistics are
available for health facility operations (vaccines,
syringes, medicines, etc)
 Roles in Service Delivery
In hospitals,
 Provider of Care –carries out treatment plans
 Health Teacher –instructs patients/relatives on
patient care
 Epidemiologist –as part of Infection Control Team
 Health Advocate
 Supervisor/Manager –supervises team members
and provides needed resources of staff
 Leader –can lead a whole department later in
his/her career
Role in Health Regulations
 Regulatory officer –as part of team of regulatory
officers, assesses compliance of the health facility
to the requirements of the nursing department in
terms of resources and operational needs
 Accreditation officer –as part of the team of
accrediting team of PHIC, assesses compliance of
the health facility to the requirements for
accreditation of the nursing department
 Technical assistance provider –orients/teacher
health facilities new issuances or requirements
related to licensing
 Policy Maker/Researcher –participates/initiates
policy development related to licensing
LOGO
 Role in Healthcare Financing
 Resource Mobilizer –as part of management
functions, sources out funds for increased
budgetary allocation/investment for health

LOGO
 Role in Governance
 Supervisor/Management –assesses
performance of staff
 Teacher/Trainer –of both facility staff and
patients; gets training needs of staff
 Logistics/Finance Manager

LOGO
Specific challenging and
rewarding roles assumed by
nurses includes:

 care provider
 teacher/ counselor
 patient advocate
 leader/manager
 consultant
 researcher
Clinical Nurse Specialists (CNS)
 Advanced Practice nurses who hold a Master’s or
Doctoral degree in a specialized area of nursing
practice. Their area of clinical expertise may be in:
 A population (ex. Pediatrics, geriatrics, women’s health)
 A setting (ex. Critical care, emergency room)
 A disease or medical subspecialty (ex. Diabetes,
oncology)
 A type of care (ex. Psychiatric, rehabilitation)
 A type of health problem (ex. Pain, wounds, stress)
Nurse Practitioners (NPs)
 Advanced Practice Nurses who provide care to patients
throughout the lifespan, from premature newborns to the
elderly
 They perform:
comprehensive and focused physical examinations
 diagnose and treat common acute illnesses and injuries
Provide immunizations
Manage high blood pressure, diabetes, depression and other chronic health
problems
Order and interpret diagnostic tests such as X-rays and EKGs, as well as
laboratory tests
 Ambulatory Care
Nurses
• Treat patients of all ages with acute or
chronic illnesses or injury on an episodic,
outpatient basis
 Treatment includes:
- Screening
- Triage
- patient education
- pain management
- case management
- discharge planning and other interventions to
restore
- maintain or promote patients physical health
 Certified Nurse
Anesthetists

Provide anesthesia to patients during surgical

or obstetrical procedures, providing
preoperative and postoperative care as well.
In addition to minimizing pain, nurse
anesthetists
Explain procedures and options to their
patients
Monitor their vital signs, response and
recovery from anesthesia.
Cardiac Rehabilitation Nurses

Work with adults with cardiovascular

disease or those who are at risk.
 Promotes cardiac wellness by:
- helping patients
- alter their lifestyles such as:
 decreasing stress
eating low-fat
low-cholesterol meals
exercising stop smoking
CASE MANAGEMENT

The primary role of a case manager is to:

- coordinate continuity of care

- ensure that patients get the proper treatment at the
proper time
- maximize health and minimize
hospitalization
CASE MANAGEMENT

Case management framework:

-assessmentplanning
-implementation
-evaluation
-interaction

 Specializes in a particular area such as:

-HIV/AIDS
-rehabilitation or geriatrics
Clinical Nurse Specialists
 Advanced practice nurses who provide
expert patient care:
• facilitate clinical research to improve patient
outcomes
• act as role models to less experienced staff
 Have advanced clinical expertise in a
particular specialty. Depending on that
specialty
 Work with patients of all ages and diagnoses
COMMUNITY / PUBLIC HEALTH NURSE
and COMMUNITY REHAB NURSE
 Focus is on the population as a whole
 Interaction may includes:
- epidemiology
- environmental health
- wellness
- health promotion
- evaluation of population-focused
programs
- health maintenance
Critical Care Nurses

Care involves complex assessment

 High intensity interventions involving
sophisticated technology.
 Attends to the
psychosocial/emotional needs of
- patients
- families
- significant others
 Diabetes Education
Nurses
 Educate patients to monitor their
lifestyle including:
 nutrition
 exercise
 blood sugar monitoring to lessen the
need for medication and hospitalization
 increase health and well-being
 Forensic Nurses
 Work with law enforcement officials as well as
perpetrators and victims of crime.
 The specialty includes:
 death investigators
 correctional nurses
 nurse attorneys
 domestic violence specialists
 human rights advocates
 sexual assault nurse examiners
 Duties may includes:
 collection of clinical evidence
 determination of origin or circumstances of trauma
 evaluation and alleviation of crime victims’ injuries and
rehabilitation of criminals
 LOGO
Gerontological Nurses

Care for the physical and

psychosocial needs of older adults.
Focuses on maximizing:
functional abilities
as well as promoting
 maintaining
 restoring their physical and mental
health
 LOGO
AIDS/HIV Nurses
 Delivers:
 educational
 Therapeutic
 supportive interventions for those infected with or affected
by HIV/AIDS.
 Deal with the physical and psycho-social aspects of
the disease
 Helping patients minimize their pain
 Maximize independence.
 Advocate for patients
 Teach techniques to help prevent the spread of the
disease
Provide episodic or continuous care in the
patient's place of residence for people of all ages
and varied diagnoses.
 Care includes:
providing patient and family education
monitoring technical interventions
 coordinating referrals
 handling other interventions to restore or maintain
patients' physical or psychosocial well-being.
Nurses may supervise home health aides.
Care for the physical and emotional
needs of dying patients and their
significant others.

Interventions may include:

pain management
 palliative care
 symptom management
emotional support
Infection Control Nurses
Prevent and track the spread of
infections by:
 developing
 maintaining strict procedures to
prevent infections
 investigating how infections
originated and spread

Duties:
immunization programs to
developing bioterrorist response
protocols.
 Intravenous Nurses
 Experts in infusion therapy such
as:
providing fluids,
nutrition
medication or transfusions

The specialty requires knowledge

of:
pharmacology
standard nursing practice
infection control and technology
MED/SURG NURSE
 Care for adults with acute health
conditions, whether in:
 outpatient facilities
 hospitals
 long-term care facilities.
 Elements of care includes:
patient education
pain management
case management
discharge planning
 interventions to restore or maintain
patients' physical and psychosocial health
 Care for patients with renal disease
or dysfunction, includes:
undergoing dialysis or
transplantation

 Focuses on:
 preventing disease
 minimizing dysfunction
 restoring function
 dealing with both the physical and
psychological complications of kidney
failure.
 Work across the healthcare continuum to
help patients of all ages deal with:
 physical
 psychosocial response to neurological
impairments including:
 spinal cord injuries
 head injuries
 movement disorders
 CVAs and other neurological diseases and
disorders.
 Goal maximize function and independence,
while minimizing pain
and discomfort.
Meet nurses continuing education
needs.
Providing educational opportunities
outside the academic environment
Develop, enhance and promote
improved patient care
Professional development
 lifelong learning
 attainment of career goals among the
nurses they serve.
 Promote
maintain
restore workers’ health and safety
within their place of business.

 Deals with productivity:

disability/accessibility
 ergonomic
 workers’ compensation issues.
Care for the surgical patient through:
Preoperative
Intraoperative
Postoperative procedures

OR nurse performs a number of duties including:

patient assessment,
creating a sterile environment
monitoring patients' mental and physical status
coordination of care and provision of resources
Provides care for children and
adolescents

Focuses on:
mental
physical aspect of health and
illness.
Care for:
 physical
 psychosocial needs of women:
 before
 during
 after giving birth

Duties may includes:

 teaching natural childbirth techniques

 monitoring pregnancies

 providing physical and emotional support during

labor and delivery

 promoting healthy mother-child bonding after birth
Perinatal nurses care for:
 physical

 psychosocial needs of women

 before
 during
 after giving birth.
Duties may includes:
 teaching natural childbirth techniques

 monitoring pregnancies

 providing physical and emotional support during

labor and delivery

 promoting healthy mother-child bonding after birth
Promote and enhance the mental
health of patients of all ages with
acute or chronic psychiatric needs.

Intervention includes:
 use of therapeutic interpersonal skills
 case management
 discharge planning
 disaster response
Promote the pulmonary
health of individuals

Respiratory Nursing can

be:
 preventive
Critical

 acute or rehabilitative
Care for patients of all ages
requiring emergency care

Work to restore:
- vital signs
- to arrest further loss of function
- to prevent complications or
death
Has the capabilities for providing basic
nursing care to any type of patient,
among which are:
assessment of:
physical conditions
interpretation of the significance of his/her
findings as basis for planning the nursing care
identification of:
emotional
social factors and relating these to signs and
symptoms observed
application of scientific principles in the
performance of nursing techniques
working with patient’s family so that
they gain understanding of his/her
illness and cooperate towards promoting
early recovery of the patient
utilization of laboratory and diagnostic
tests in promoting progress of care and
enhancing his/her own usefulness as a
health teacher and counselor
 knowledge and recognition of:
 pharmacological effects of drugs and
medications, their implications for
nursing actions as needed
 interpretation of doctor’s orders
concerning medicines and treatments
and communicating the same
effectively to the patient and carrying
them out promptly and accurately with
understanding of cause and effects.
Telephone Triage Nurses

 Using protocols and independent judgment,

provide patient education
 advice via the phone to patients of all ages and
diagnoses
 They rank patients according to urgency of need,
directing them to further care as necessary.
 Goal is to advise the patient on:
right level of care at the appropriate time to
reduce unnecessary physician's appointments or
trips to the emergency room.
Nursing Informatics
Combines nursing and computer
science.
Use computers to build or implement
systems to support or automate
nursing care.
By:
Collecting
 organizing
 measuring and representing data
 nurse informaticists improve the efficiency
and quality of patient care.
Military Nursing

 Ensures that soldiers, his family, and other

significant groups will have:
- adequate personal care
- maintenance, safety, and comfort.
 Works at different health settings with
various levels of responsibilities.
 Consultants use their nursing expertise to
help:
 attorneys
 clients investigators, juries and judges
understand and interpret medical issues
and documents.
 Role includes:
 legal nurse consultant may include:
 testifying on standards of care in depositions
 interrogatories or trials
 organizing medical records
 acting as a liaison with other medical personnel.
 Work with children in their academic setting
 They may be responsible for:
mandated services (such as vision and
hearing screening)
immunization compliance
emergency care
illness and injury prevention
community relations
health counseling
health education, promotion and prevention.
Career opportunities in nursing education
are better today than ever before.
There is a chronic teacher shortage in all
nursing education programs.
 Nurses who like to consider teaching as
their field of expertise will have to consider
some qualifications.
Combine their nursing background
with:
business savvy
 creativity and ingenuity to start
their own businesses.
Provide leadership and direction in:

designing and managing care

 planning and developing policies and
procedures
allocating resources

Seek to improve patient outcomes

and bring about positive staff
development.
LOGO “Just as there is a sense of
greatness in every Filipino…
there is also much more
sense of Greatness in the
Filipino nurses, NOT JUST
FOR SENDING DOLLARS
HOME BUT IN MAKING THE
FILIPINO PROUD OF THE
CARING INNOVATIONS
AND CHALLENGES. The
Filipino nurses are willing to
take in order to serve
BETTER