AMAT Educational Series
Cultural Conversations –
Understanding Filipino Nurse History
and Working with Filipino Families
Hosted by the AMAT Asian Pacific Islander Committee
Chair: Sabrina Ho
Objectives
• Develop an understanding of Filipino
nurse history from the Philippines to
United States
• Explore Filipino nursing culture
• Overview of Filipino culture surrounding
death/dying
• Best practices when working with Filipino
families
A History of Filipino Nurses
in the United States
Professor Catherine Ceniza Choy
University of California, Berkeley
Department of Ethnic Studies
Presentation Objectives
• Give an historical overview of Filipino nurse migrations to the
U.S.
• Identify some of the current developments of this phenomenon
• Reflect on Filipino nurse cultural beliefs surrounding medicine
Empire of Care:
Nursing and Migration in Filipino American
History
• Co-published by Duke University Press and Ateneo de Manila University
Press in 2003
• Documents the creation and development of a Philippine professional nurse
labor force for international export
• Places a “human face” on the phenomenon of Filipino nurse migration
Why focus on Filipino nurses?
• Since the late 1960s, the Philippines has been the leading
exporter of nurses to the United States
• By the late 1970s, the Philippines became the world’s leading
exporter of nurses
• A 2005 study noted that Filipino nurses make up almost 40%
of the internationally trained nurses in the US, with about
100,000 nurses or 3.7% of the total US nursing force.
Historical Overview of Filipino Nurse
Migration to the United States
• Filipino nurse migration to the United States is not a 21st
century phenomenon
• originated during the early U.S. colonial period in the
Philippines
• U.S. colonial government created an Americanized training
hospital system
“1915 Class and the Superintendent of the School of
Nursing, Philippine General Hospital School of
Nursing,” 1915-1916
“Senior Class Receiving Instruction in OperatingRoom Techniques,” from Philippine General Hospital,
1915-1916
Maria Abastilla Beltran (left)
prior to her departure to America in 1929
Historical Overview of
Filipino Nurse Mass Migrations
• Recruitment of Filipino nurses to alleviate U.S. nursing
shortages began in the 1950s and continued throughout the
second half of the 20th century
•
•
•
•
1950s-1960s
1960s-1970s
1970s-present
1990s-present
Exchange Visitor Program
Occupational Immigrant Visas
Temporary Work Visas (H-1)
EB-3 immigrant visas
1965 Advertisement in Philippine Journal of
Nursing: “Travel as a simple route to
happiness”
1969 Advertisement in PJN Targets
Exchange Nurses for Permanent U.S.
Employment
Changing Attitudes About the Significance
of Filipino Nurse Migration
• In the early 1900s, Philippine nursing was conceptualized as a
form of nation-building
• In the 1960s, Philippine government criticizes exchange nurses
who remain in the U.S. as national traitors
• Beginning in the 1970s, Filipino overseas nurses are
conceptualized as national heroes
Past and Present Challenges
Faced by Filipino Nurse Migrants
• Fraudulent recruitment practices
• Exploitive work conditions
• Resentment between “foreign” and “home-grown” nurses
• Language issues (testing; English-only)
Current Developments and Resources
• International export continues
• Reports of Philippine doctors enrolling in nursing degree
programs to work overseas
• Ethical dilemmas continue
• Multiple generations of Filipino nurse migrants exist
• Philippine nursing organizations abroad are important
resources (Philippine Nurses Associaton of America or PNAA)
Cultural Beliefs Surrounding Medicine
Filipino nurse training in and incorporation of Western medical
practices is dynamic
•Persistence of traditional beliefs; for example, the significance
of keeping the body intact for viewing and burial
•Fear of the unfamiliar and unknown
•The need for new narratives, educational resources, and
community support
Catherine Ceniza Choy
Contact information
Please feel free to contact me by email at
ceniza@berkeley.edu
The link to my faculty webpage can be found at
http://ethnicstudies.berkeley.edu/faculty/
Michael Munoz-Romero RN CCRN CPTC
Procurement Transplant Coordinator
05/16/2013
How does Philippine law
define “death”?
•
j) “Death” - the irreversible cessation of circulatory and respiratory functions or the
irreversible cessation of all functions of the entire brain, including the brain stem. A
person shall be medically and legally dead if either:
(1) In the opinion of the attending physician, based on the acceptable standards of
medical practice, there is an absence of national respiratory and cardiac functions
and, attempts at resuscitation would not be successful in restoring those functions.
In this case, death shall be deemed to have occurred at the time those functions
ceased; or (2) In the opinion of the consulting physician, concurred in by the
attending physician, that on the basis of acceptable standards of medical practice,
there is an irreversible cessation of all brain functions, and considering the
absence of such functions, further attempts at resuscitation or continued
supportive maintenance would not be successful in restoring such natural functions.
In this case, death shall be deemed to have occurred at the time when these
conditions first appeared.The death of the person shall be determined in
accordance with the acceptable medical practice and shall be diagnosed
separately by the attending physician and another consulting physician, both of
whom must be appropriately qualified and suitable experienced in the care of such
patients. The death shall be recorded in the patient’s medical record.
Superstitious Beliefs
• Have grown in number throughout the various regions
and provinces in the country.
• These beliefs have come from the different saying and
superstitions of our ancestors that aim to prevent
danger from happening or to make a person refrain
from doing something in particular.
• These beliefs are part of our culture, for one derives
their beliefs from the influences of what their customs,
traditions and culture have dictated to explain certain
phenomena or to put a scare in people.
• Some are practiced primarily because Filipinos believe
that there is nothing to lose if they will comply with
these beliefs.
Superstitious Beliefs about
death
Superstitious beliefs
•
When a member of the family has persistent fever, the spirit of a deceased relative is
presumed to remind the family of an unfulfilled obligation to the departed soul.
•
To scare the spirits away and to cure those afflicted by the evil spirits, the curative
practices are: to flog the patient, put signs of the cross on his forehead or at every
post of his house, and make all kinds of noises; sacrifice some live animals or offer
some food, buyo and oil to appease the offended spirit; and wear amulets
(anting.anting) to neutralize the machinations of the devil.
•
When a sick person is seriously ill or is pronounced by reputable physicians as
hopeless or incurable, he and his family have that instinctive urge to resort to the cure
of the magicians, wizards, sorcerers, voodoos, mystics, conjurers, manghihilot (sprain
curer), herbokirios, or faith-healer, be it of dubious value. Remorse comes if they do
not resort to such a practice because as a result of breaking away from old beliefs
and practices, someone in the family might keep saying ever afterward, If only we
had done this, the patient might have pulled through.
Some more:
• After a person dies, his soul wanders around, for a
time at least, before it goes to its final assignment.
To keep this soul from molesting the bereaved
family, relatives, and friends, and to coax it to go
to its resting place, a novena should be recited for
nine consecutive days.
• Friday the 13th is an unlucky day-doubly unluckyfor anyone who does any business, work, or
operation.
ASSESS THE FAMILY
EXPLORE
Further explore
Organ Donation in the Philippines
Organ Donation
The Stolen-Kidney Myth
• The original story comes from a "friend of a
friend/cousin/neighbor" who is supposed to have
walked into a bar and met an extremely beautiful
girl who allows herself to be seduced by the
friend. After a few drinks they go to a nearby
hotel/motel. The next thing he remembers is
waking up in a bathtub, filled with ice and a fresh
incision scar on his back. Consulting his doctor he
finds out that one of his kidneys had been
removed and is warned that there is a syndicate
specializing in stealing kidneys from healthy
looking people, drugging them and performing the
surgery in a hotel/motel room. The kidneys are
then sold to wealthy people who need the organ
Organ Donor Card
• In the Philippines, this is only INTENT to
donate.
The Donation
Conversation
The Donation Conversation
The Donation Conversation
Questions?
Next AMAT Educational
Series Webinar
June 6, 2013, 2pm ET
Increasing Donor
Designations through
Partnerships in the
African American
Collegiate Community
2013 AMAT Annual
Conference