NARS: The Feeble Response
Finally, in 2009, the Philippine government launched a program to address the increasing number of unemployed nurses in the country. President Gloria Macapagal Arroyo said the government would spend P500 million for the program called NARS.
Under the Nurses Assigned in Rural Service (NARS) program, some 5,000 to 6,000 nurses will be hired by the government to serve as “warriors of wellness” in poverty-stricken areas. They will be assigned in their hometowns and will be tasked to implement the following (1) initiate health and nutrition programs and first line diagnosis (2) to inform communities about water sanitation and health surveillance (3) immunize children and their mother. They shall also serve as roving nurses for rural schools. This program will enable nurses to gain the necessary training and experience needed for overseas employment. Hired nurses will work for 6-12 months and will receive a monthly allowance of P8,000 plus P2,000 counterpart fund from the local government units. In the Multi-Sectoral Jobs Summit at the Heroes Hall in Malacañang, President Arroyo said the NARS program mainly targets fresh nursing graduates who have passed the board examination but lack work experience to find jobs abroad.
Meanwhile, Health Alliance for Democracy (HEAD) Secretary General Geneve Rivera said short-term measures such as temporary and low-paying jobs will only cause bigger problems not only for workers, but also for the economy.
“It only provides temporary jobs for nurses. They are only given six months to one year to work. After that period, they won’t have jobs again, and the provinces will again lack nurses and health care professionals,” she said. “Our nurses will be getting very low wages. According to the Nursing Act of 2002, a nurse’s beginning salary should be P15,000 or salary grade 15. The government’s offer is P8000 from the national government, and a P2000 stipend from the local government. It’s way too low. And we all know that the local government doesn’t have enough budget to provide compensation,” she said.
As much as what General Geneve Rivera said was right, the program was one of the only solutions that the government can do at that present situation. It was a feeble response made by the government but it was better than no solution at all. Unfortunately, the program had its loop holes and issues. Such as, (1) distribution of stipends was terribly late; (2) some local government units, although a collaborator with the program, didn’t mind or give much attention to the nurses employed under the NARS program; (3) besides having work descriptions, nurses were dreadfully abused by their supervisors in terms of work and reports.
RN HEALS: A Labour Band-Aid
The program, as any other programs by a certain administration was abolished but the next president, Benigno Aquino III who took office last June 2010, still continued the essence of the program but with a new name and with some modifications. The restructured program was called RN HEALS.
The RNheals Program was planned and implemented to continue the aid for unemployed and marginalized registered nurses (RNs) in the country. The program started as the exact NARS procedures but when the second batches of nurses were employed, they changed the policies due to troubles in orientations and supervision. Thus, instead of the 6-month hospital and 6-month community, it became a 1-full year of either hospital or community healthcare service. While the rest of the policies remained kind of the same from the previous ones.
Despite the below minimum stipend that each employed nurse is receiving per month, the program has helped a lot of nurses. The program truly enriched the knowledge, skills and attitude of its participants. RNheals nurses were able enjoy the idea of working and gaining per month. They were able to learn more and involve themselves in the various programs of the government relating to health and social welfare.
The ideal setting of the program was that every year, nurses will be assigned in various healthcare facilities. Some will be assigned in the hospitals while some in the rural health facilities. The application is done on-line and successful ones will receive a reply from the DOH human resource department.
Once the assigned number of nurses per area is occupied, the DOH offices of every place will conduct an orientation for the successful applicants and this is the time when work descriptions are specifically discussed and the persons to be familiar with throughout the program. The nurses will also be lectured on the DOs, DONTs and benefits. This 2-day orientation period also includes the contract signing to make things official. After the 2-days orientation, the nurses in each area will meet with their DOH representatives for the instructions on how to go about and the rest is history.
Every end of the month, the nurses must provide an accomplishment report of the things he did. It could be the number of pre-natal and post-natal clients, mothers and children vaccinated seen and served, and new cases of community diseases recorded such as dengue, tuberculosis and measles. The nurse is obliged to pass this and have it signed by its immediate supervisor in the area.
Every month this will be the routine of the nurse until he finishes the whole years’ worth of duty under the RNheals program. The nurse will also participate in LGU celebrations of its city or district. The nurse will work in assigned barangay stations as his area of responsibilities. He will do this until the end of his 1-year RNheals service.
Unfortunately, things were not what they seemed. In some regions, the LGU doesn’t support the program with its share of added compensation and demanded more work from the RNheals nurses. The LGU used the RNheals as regular casuals giving them work that are not listed on their job descriptions.
Additional experience by helping out in some work not listed in the accomplishment tool is okay but forcing to do it is just sad and as if the LGU is doing its part in supporting the program. Also, the stipends of the RNheals nurses are always delayed. Example, the September stipend can be obtain somewhere after not just 2-3 weeks but 1-2months of waiting.
The most troublesome part of the issue is when the RNheals nurses are obliged to travel at far flung areas to ride and walk on the mountains and the less visited of barangays. This is known to be one of the essence of the program but as mentioned, the LGU themselves are not supporting the program thus it is very risky for the participants. Furthermore, one of the reasons why the program was created was to produce competitive nurses locally and globally, but sad thing is that in abroad it is not considered as work experience. Lastly, it was stated that after the RNheals program, the nurse will be a priority in terms of employment in other agencies of the government but still it’s the same treatment as before. After the program, it is game over. No more post-implementations like job opening fairs, continuous special services or new employment opportunities for its participants. After a full year of service for the government, they are back to their former situation, unemployed.