School Nurse: Liaison of School Healthcare

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1066school_nurseWhat is?

The school nurse is considered as the leader in the school community to foresee school health programs, policies and activities. The school nurse serves in a pivotal role to promote expertise and oversight for the program of school health services and promotion of health education.Strengthening and facilitating the educational process are done through improvement and protection of students’ health statuses.

Relevance to History

The history and importance of school nursing was recorded in Oct. 1, 1902, in the United States, when Lina Rogers, the first school nurse, was hired to reduce absenteeism by interveining with students and families regarding health care needs related to communicable diseases. After a month of successful nursing interventions in the New York City schools, evidence-based nursing care made a positive remark across the city. Since then, the school nurse’s role has expanded greatly from its original focus yet the essence and goals of the practice remains intact.

Need of the School

A student’s ability to learn depends directly on his/her health status. The educational process is hindered once a student’s health needs are unmet. The school nurse supports student success by providing healthcare through assessment, intervention and follow-up for all students within the school setting. Addressing the physical, mental, emotional and social health needs of students and supporting their achievement in the learning process are all tasks of the school nurse. The school nurse not only provides for the safety and care of students and staff but also addresses the need for integrating health solutions into the educational setting.

Roles and Functions

The school nurse works to:

  • Facilitate normal development and positive student response to intervention.
  • Provide leadership in promoting health and safety, including a healthy environment.
  • Provide quality care and intervene with actual and potential health problems.
  • Use clinical judgment in providing care management services.
  • Actively collaborate with others t o build student and family capacity for adaption, self-management , self-advocacy, and learning.images
  • Provide additional roles as needed to meet needs of the school community.

Conclusion

The school nurse is indeed an important entity at school or in most organizations. Aside from teachers and guidance councilors, the school nurses are also the second parents of students who work to nurture the next generation of professionals and society’s bright future.

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Government’s Response Towards The Marginalized Profession

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RNheals join now!

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 Logo

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.

Weighing Efforts

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.

Nursing: The Onset of a National Dilemma

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Every year, since the last 10 years, the surge of the youth taking up Bachelor of Science in Nursing (BSN) in most colleges and universities of the country became rampant. Why was this so? The true explanation regarding the phenomenon is still unknown but relative reasons could have been due to the point that the United States of America opened its doors to nurses internationally due to high demands in healthcare manpower.

Filipinos who were lucky enough to be hired as a nurse in the US were able to receive very good salaries, benefits and incentives from their respective hospitals unlike in the many hospitals of the Philippines. Some Filipino nurses who became US-RNs were able to uplift themselves and their families from poverty. Hence, at that time, the nursing profession in the Philippines boosted its prestige both the country and the world market.

When a Filipino nurse comes home from abroad, it really was a big fiesta like most any other oversees foreign worker (OFW). Like seamen, they brought home big sum of foreign money and when converted to the local currency, say hello to a millionaire. Spend here and there; spend everywhere an OFW would do. They would spend for infrastructures such as renovation or building of bigger houses for their family. Invest on lands and businesses so that their money would still move even while abroad. These amazing progresses caught the attention of many other families. While the US was still opening its doors to foreign nurses, interested families grabbed the opportunity by sending their children to colleges and universities to take up BSN.

After a few years of waves of registered nurses passing the board, suddenly the US experienced an economic crisis and closed its doors for foreign nurses and started its new health care reform under the presidency of Barack Obama who took the presidential seat last 2008 and re-elected  for his second term last 2012. When the halt for employment of foreign nurses in the US initiated, it was already too late because many schools in the Philippines were already producing nursing graduates at an alarming rate and the establishment of more nursing schools and the addition of the BSN curriculum in many colleges emerged as well. The US became very strict due to problems that some foreign countries were producing incompetent nurses. Many agencies and foreign employers made job descriptions harder for Filipino nurses to get an employment. With the economic crisis and the closing of its doors to foreign healthcare workers, the nursing students and the other licensed nurses in the Philippines lost a very big investment. Then, later did the Philippine government realize the distress of the presence of so many licensed nurses but very few employment opportunities in their own country for a formal nursing job.

A lot of organizations, especially the hospitals, were quandary on what to do with so many licensed nurses in the Philippines. Some hospitals, in order to help the newly registered nurses (RNs), hired some RNs to work as a volunteer staff in their institutions. While others, like the Business Processing Outsourcing (BPO) companies, opened such jobs that can fit the qualifications of nurses.

Today, almost half of the nursing population are unemployed. Some are working but not in relation to their field of expertise. Some, too desperate to go out of the country, apply as domestic helpers in the Middle East or in other parts of the world just to achieve the dreams of their families for them which was to work abroad, earn foreign money and send it back to the Philippines as remittance.

Until today, the nursing profession in the Philippines is still in its dark days. If no strategic plans will be made by both the public and the private sectors then the healthcare economy will be in peril and the unemployment rate will just go higher resulting to increased poverty.

A Premiere Authority On Healthcare in Iloilo City

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TMC

The Medical City of Iloilo held a forum on the prevention and treatment of coronary artery disease entitled, “A Healthy Heart for the Busy Man,” at Hotel Del Rio, Iloilo City. It also served as an opportunity to market their new service in the hospital, the Cardiovascular Centre.CareNow

The Medical City Hospital, formerly known Great Saviour International Hospital, with their slogan “Where Patients Are Partners”, is considered as one of the country’s premiere authorities on healthcare. Equipped with state-of-the-art medical innovations and competent healthcare team, the hospital truly pushes itself on becoming the country’s most trusted healthcare facility for everyone, regardless of social status. More complex medical services, usually available only in developed countries like the US and Germany, are being made available and reachable for the Filipino people.

Interesting news during the forum was the announcement of the “CareNow Healthy Heart System.” It is a system which involves the utilization of a CareNow ECG mobile device. Yes, a device, not an app. It is truly a mobile phone where you can call and text using any telecom network but with an added ingenuity. The device, which came from Singapore, allows the user to record his heart rhythm and transmit this recording to the TMC’s 24-hour concierge, who can determine if medical assistance is needed. Every time a patient uses the ECG reading feature, the result is transferred to a CareNow Virtual Health Folder that can be accessed from anywhere in the world through the internet. Truly a first in the Philippines!

The Ignored Nurses’ Rights in the Philippines

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Nursing, nowadays, in the Philippines, is like a viral disease that infects many people. Every one wants to enroll in this profession so that after they graduate they would be able to work in a decent hospital, give nursing care to people and then go to abroad to earn big bucks. Hey, what can I say, I’m just presenting reality to every one especially the parents who has no complete background about the profession but only thinks of the $$$ and the sure bright future that they will have once they have a nurse in the family.
As you can experience, nursing is no longer a unique and in-demand profession in the country. It’s dignity as a vital profession that shapes up the nation’s health status has downgraded through the years. Now, people treat professional nurses in a different way. They treat them the same way as they treat servants and maids, ordering them around like they are mere helpers who follow their every command.
Doctors, on the other hand, are still treated with much respect because they have stabilized their profession’s dignity to be as such. People and patients would look up to families with doctors as intelligent breeds. But before nurses in the family was also looked up as such but now it’s like a normal occurrence.
It is a fact that patients in the hospital have rights, such as:
  1. Right to appropriate medical care and humane treatment.
  2. Right to informed consent.
  3. Right to privacy and confidentiality.
  4. Right to Information.
  5. Right to choose health care provider and facility.
  6. Right to self-determination.
  7. Right to religious belief.
  8. Right to medical records.
  9. Right to leave.
  10. Right to refuse participation in medical research.
  11. Right to correspondence and to receive visitors.
  12. Right to express grievances.
  13. Right to be informed of his rights and obligations as a patient.
With all these rights, nurses have their own rights too, such as:
1.      Nurses have the right to practice in a manner that fulfills their
obligations to society and to those who receive nursing care.
2.      Nurses have the right to practice in environments that allow them to act
in accordance with professional standards and legally authorized scopes of
practice.
3.      Nurses have the right to a work environment that supports and
facilitates ethical practice, in accordance with the Code of Ethics for
Nurses and its interpretive statements.
4.      Nurses have the right to freely and openly advocate for themselves and
their patients, without fear of retribution.
5.      Nurses have the right to fair compensation for their work, consistent
with their knowledge, experience, and professional responsibilities.
6.      Nurses have the right to a work environment that is safe for themselves
and their patients.
7.      Nurses have the right to negotiate the conditions of their employment,
either as individuals or collectively, in all practice settings.
8.      Nurses have the right not to be abused in any form by physicians, pharmacists, administrators or nursing directors. Any abuse that occurs should be dealt with in a professional and impartial manner by the nurse’s employer.
9.      Nurses have the right not to be exploited and abused by being floated to areas of practice that they are not familiar with.
10.  Nurses have the right to refuse any assignment that they feel is unsafe. Such as when a nurse is assigned a patient load he/she feels is unsafe. A nurse is assigned to work in an area of nursing in which he/she is not familiar. A nurse knows that equipment/supplies are inadequate or not available.
These solid rights are not much implemented in the country. It could either be that nurses themselves are ignorant of their own rights or that they are too afraid to strengthen their rights because they fear that they’ll be given a negative remark in their institution. Nurses in the Philippines are becoming a bunch of scary cats who only cower in their comfort zones ‘til one brave soul fights for it.
It’s not a matter of waiting for someone to die as heroes for those rights. Nurses must start with themselves and implement their rights in any workplace they are assigned to. Nurses must have pride in themselves because nursing is not just any four-year course but a crucial profession that will save lives of thousands and at the same time save much on national budgets. Act now, nurses!