2013 - April

Topic: Social Construction of Filipino Foreign Educated Nurses in the US

Leo-Felix Jurado

The US healthcare systems have consistently resorted to foreign nurse recruitment to address its cyclical nursing shortages. The Philippines tops the list in supplying foreign educated nurses (FENs) to the US and many other countries in the world. Mass emigration of nurses from the Philippines has created a brain drain because of shortages of skilled nurses and nursing educators.

Purpose of Study: Examine the social construction of Filipino nurses in the Philippines and as foreign-educated nurses (FENs) in the US.  Study objectives include: a) Describe the historical events contributing to mass recruitment of nursing graduates from the Philippines to the US, b) Analyze the political and economic factors underlying the unidirectional flow of foreign-educated nurses from the Philippines to the US, c) Examine the impact of large scale nursing recruitment from the Philippines to the U.S., and d) Analyze the influence of socially constructed forces on conditions of employment and perceived value of FENs in the US.

Conceptual Framework: Social Critical Theory explains the dynamics of social change and social conditions in order to uncover hidden structures. It emphasizes the importance of historical context in understanding the lived experience of the people.

Study Design: Qualitative using historical research and focus group interviews. The data sources include archived data and secondary sources. Historical events in the US and the Philippines were examined to create a holistic and contextual interpretation of events. Four separate focus groups were conducted with specific cohorts of Filipino FENs. Findings from historical data and focus groups were triangulated in analyzing linkages and significance of events in the phenomenon of interest. .

Sample:Purposive sample for focus groups comprised of 21 FENs who entered the U.S. under different visas for training or employment between 1948- 2006. Historical data collected between 1900 – 2013.

Findings: Mass emigration of nurses from the Philippines to the U.S. is facilitated by nursing shortages that brought changes in immigration laws easing entry of nurses to the US. The fusion between the subjective and objective reality constructed nursing and migration to the US as key to improving the economic well-being and social status of FENs and their families. Filipino families, schools and government take an active role in promoting this social reality. The American benevolent assimilation agenda, US-based public education, and nursing education and practice perpetuated American superiority and dependence of Filipinos on Americans.

Significance of study: Findings provide understanding of institutionalized structures perpetuating global inequalities in nurse migration and distribution that impact differentially sending and receiving countries. Study has potential implications in policy development to promote retention of nurses in their home countries and foreign countries where they immigrate





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