Nursing issues

Philippine setting

1. Worsening “toxic” work condition of Filipino nurses

- “Toxic” meaning hazardous; may be overload of patients, multiple serious cases and
prolonged working hours
- Nurses working in a public hospital for 16 hours just to earn experience
a. Salary
- Accdg. To Colmenares, based on SSL (Salary Standardization Law) 3, a Nurse 1 position has
an equivalent monthly salary of P 18,000 but private hospitals are not covered by this. Some
of the nurse may even get P 6,000 monthly. (Philstar, 2015)
- President Aquino vetoed a bill that would increase that basic salary of local nurses to Salary
Grade 15 or P 26,000 per month. (Philstar, 2016)
b. Understaffing
- Forced to be on duty longer than the legally mandated eight hours because the hospital
lacks nurses . With less than 30 nurses in the 120 bed capacity hospital, If there is no reliever
--they cannot go home.
- There are times when there is only one nurse in the ER and one nurse in the ward ---
severely affects the treatment of patients.
c. Poor quality of care to clients
-
2. Pay to work: Volunteer nurses
- Newly graduated nurses still find themselves paying in order to work.
- Their workload is identical to that of paid nurses but few of them are hired by their hospitals
after their internship ends.
3. Patronage system
- Some of the hired nurses, despite their absenteeism, are hired because someone backed
them up in the application.
- “Backer system” in the hospitals
4. Low government budget for health workers
- Nurses are most exploited.
- Accdg to Presidential Communications Operations Office Secretary Coloma, government
must be fair to all workers and that nurses’ appeal for higher wages, along with teachers
and other employees, had been addressed through performance-based compensation.
(Philstar, 2016)
- “They can have their desired bigger compensation if they perform their jobs well.”

Top issues for staff nurses according to American Nurses association (ANA, 2015)

1. Safe staffing levels - issue of both professional and personal concern. Inappropriate staffing
levels threatens patient health and safety, lead to greater complexity of care, but also
 impact on RNs' health and safety by increasing nurse pressure, fatigue, injury rate, and
ability to provide safe care.
2. Mandatory overtime - Staff nurses across the nation are reporting a dramatic increase in the
use of mandatory overtime as a staffing tool. This dangerous staffing practice, in part due to
nursing shortage is having a negative impact on patient care, fostering medical errors, and
driving nurses away from the bedside.
3. Safety on the job - Staff nurses work hard on the job, but they shouldn't have to risk their
health to do so.
- greater education and training, increased use of assistive equipment, and efforts to reshape
government ergonomics policies to protect nurses.
a. Safe Needles - Safer needle devices and procedures will keep you safe. ANA has
information on this important program through our Safe Needles Save Lives campaign.
b. Preventing Workplace Violence - No staff nurse should have to deal with violence in the
workplace, whether from staff, patients or visitors.
c. Replacing Hazardous Products - Hazardous chemicals, toxins, and dangerous waste
products may be a part of the workplace, but there are ways to reduce and replace
them. ANA's environmental health campaign has collected information and procedures
to protect your environment.
d. Safe Patient Handling - Back injuries are always a danger, so ANA mounted a profession-
wide effort to reduce them. This campaign includes greater education and training,
workplace information on increased use of assistive equipment, and efforts to reshape
government ergonomics policies to protect nurses.

Nine common problems in the nursing profession

The nursing profession can be very rewarding but it is equally challenging. In some cases, there is a lack
of universal legislation to address these issues at the organizational, state, or national level. And
problems arise since these issues exist or when they intensify.

Here’s a snapshot of the 9 problems that nurses universally face:

1. Staffing

As healthcare costs increase, decreasing the number of staff nurses is often seen as the logical way to
combat it. Inadequate staffing and/or increased job responsibilities both cause problems and stress for
nurses. This is especially true for those staff nurses facing a variety of patient acuities. In response, some
states have adopted legislation to mandate a fixed nurse-to-patient ratio.

2. Inter-Professional Relationships

Conflicting views and feeling that you are being disrespected often cause problems. These conflicts in
nursing relationships can arise between nurse and their patients, their co-workers, partner physicians,
and/or administrators.
3. Patient Satisfaction

Nurses are already stretched too thin to accommodate staffing issues. But patients still have needs and
expectations. Unfortunately, meeting these are difficult. This is especially true as healthcare conditions
become more chronic, and the number of personnel decreases.

4. On the Job Hazards and Job Safety

Overflowing sharps containers and slippery floors can pose risks for staff members. Similarly, lifting
heavy patients can pose a physical challenge. And since we do work with those patients who are “sick,”
there is a likelihood of contracting their illness.

These hazards also include the behavior of other people. In some cases, nurses report feeling
threatened by angry patients. That lack of respect and/or verbal abuse may also come from
administrators, physicians, and other members of the care team.

5. Mandatory Overtime

There are also cases when nurses have to go on mandatory overtime. This can be the result of
insufficient staffing levels and/or high patient acuity.

6. “Ask the Nurse”

We don’t know everything about healthcare and related diagnoses simply because we are nurses.
However, friends and family still feel free to call us at any given hour to ask our perspective on a
symptom or prescribed medication, just because we are in the nursing profession.

7. Patient Relationships

It is easy to develop a close relationship with our patients. When that patient struggles or even dies, we
feel their pain and we feel that loss. So maintaining a healthy, professional relationship with the patient
is a must.

8. Advances in Technology

As technology advances, so do our career roles. For example, with the growth of the Internet and
smartphones, our roles and duties have changed. Documentation and databases are now mostly
electronic. Using Skype to communicate is also common. As professionals, keeping abreast with these
advances is essential.

9. Certification

Demonstrations of competence are a must. Maintaining continuing education hours and related
certifications are often required. And while these equate to safer patient care that adhere to best
practices, maintaining the required certifications are often overwhelming when you’re juggling a full-
time position and personal responsibilities.
Leadership roles and management functions with collective bargaining, unionization, and
employment laws

LEADERSHIP ROLES
1. Is self-aware regarding personal attitudes and values regarding collective bargaining and
employment laws.
2. Recognizes and accepts reasons why people seek unionization.
3. Creates a work environment that is sensitive to employee needs, thereby reducing the need for
unionization.
4. Maintains an accommodating or cooperative approach when dealing with unions and
employment
legislation.
5. Is a role model for fairness.
6. Is nondiscriminatory in all personal and professional actions.
7. Examines the work environment periodically to ensure that it is supportive for all members
regardless of gender, race, age, disability, or sexual orientation.
8. Immediately confronts and addresses sexual harassment in adopting a zero tolerance approach
to the problem.
9. Embraces the intent of laws barring discrimination and providing equal opportunity.
10. Actively seeks a culturally and ethnically diverse workforce to meet the needs of an increasingly
diverse client population.

MANAGEMENT FUNCTIONS
1. Understands and appropriately implements union contracts.
2. Administers personnel policies fairly and consistently.
3. Works cooperatively with the personnel department and top-level administration when dealing
with union activity.
4. Promotes worker identification with management.
5. Immediately and fully investigates all complaints regarding violations of the collective bargaining
contract and takes appropriate action.
6. Creates opportunities for subordinates to have input into organizational decision-making to
discourage unionization.
7. I s alert for discriminatory employment practices in the workplace and intervenes immediately
when problems exist.
8. Ensures that the unit or department meets state licensing regulations.
9. Understands and follows labor and employment laws that relate to the manager’s sphere of
influence and organization responsibilities.
10. Ensures that the work environment is safe.
11. Works closely with human resource management when dealing with employment legislation
issues.

References:
Adel, R. (2015). P25,000 salary increase for nurses pushed. Retrieved from
http://www.philstar.com/headlines/2015/05/18/1456140/p25000-salary-increase-nurses-
pushed
American Nurses Association. (2015)
Calica, A. (2016). Palace defends veto on nurses’ minimum pay. Retrieved from
http://www.philstar.com/headlines/2016/06/19/1594443/palace-defends-veto-nurses-
minimum-pay
Nine (9) Common Problems in Nursing profession Jennifer Ward. May 14, 2014
http://www.nursetogether.com
Rudin, D. (2013). Worker find ways: The volunteer nurse. Retrieved from
http://www.rappler.com/business/26568-workers-find-ways-nurses-professional-volunteers
Umil, A. M. (2015). The worsening ‘toxic’ work condition of nurses. Retrieved from
http://bulatlat.com/main/2015/03/31/the-worsening-toxic-work-condition-of-filipino-nurses/