Not Just Nannies nor Ass-wipers

(On the Finer Details of Nursing as a Profession)

by aLfie vera mella

A friend of mine turned my attention to this video that is currently becoming viral, which features a Philippine politician, Cynthia Villar, who is a former chairperson of Committee on Education, who was suggesting that the four-year-degree profession of Nursing be demoted to a two-year program.

Here is my commentary article about it.

The Limitations of TV-show Interviews

Before anything else, I just want to commentate on the manner of the interview itself. The segment was obviously very time-constrained, so Villar understandably didn't have time to expound on the ideas/concept about that so-called room nursing that she was talking about. I could imagine, if the interview was allotted a longer time, then Villar could have explained better her positions. Serious and technical issues like that demand a longer time for participants to be able to hammer the finer points; a 30-minute or even a one-hour TV program with lots of commercials is not enough for such a discourse or question-and-answer segment, making the points unresolved and more vague rather than making them clearer.

I could imagine if I get to be interviewed about atheism or about my beliefs on a TV program in which the interview portion is just a part of the whole show, I'd surely be unable to expound on what I want to express; and many viewers would certainly misinterpret me or lambast me for that.

Opposing Villar’s Myopic View

First, Villar was generalizing. She said that "gusto lang nilang maging 'room nurse...'" That is the problem when speakers or writers generalize, they encapsulate a whole population of diverse individuals into one single entity, assuming that all these individuals share the same ideas and intentions. For sure, there are some aspirants of the nursing profession who just wanted to be simple bedside nurses, just like there are doctors who are contented into becoming only general practitioners of medicine. But, never generalize and never underestimate the entire population as a whole; of course, there remain so many nursing students who intend to pursue nursing as a degree and not just a certificate course, to be able to work in specialized nursing areas.

"Yung parang mag-aalaga...." – this is very ignorant. This is insufficient information about nurse aides or licensed practical nurses or even caregivers. "Care-giving" has a bigger scope than what this term means; it includes the feeding, morning care, evening care, washing, assisting with medication, exercising, etc.

I think I knew what Villar was getting into. The problem was, she still lacked the necessary information to be able to expound on the concept she was trying to talk about. So, aside from the lack of information, she also lacked the skills to use proper lingo in tackling the issue; she lacked communication skills as well, so she ended up getting misunderstood.

Good thing on my part, I was able to read between her crooked lines because I'm familiar with the nursing curricula available—I being a nurse myself (but working now only as a nurse aide). I surmise that what she was referring to when she used "room nurse" is the two-year Licensed Practical Nursing Program (LPN) as opposed to the four-year bachelor of science degree in nursing (BSN, or BN here in Canada). Maybe she just lacked the interview time (so she was pressured to squeeze into the limited time everything that she wanted to say about the two distinct nursing programs.

Expounding on Villar’s Seeming Ideas

I somehow side with her if the idea that she was really trying to expound on was the idea that I think I was able to grasp from the short interview.

Licensed Practical Nursing

LPN is a two-year nursing program. Many nurses here in Manitoba are only LPNs. They could still get jobs, but the limitation is, they could get jobs usually only in personal care homes (nursing homes), in which their primary tasks are limited to acting as assistant to BNs. They usually just give out medication prescribed already by physicians, they could do wound dressing, they could do simple physical assessment, and they could write nursing reports. The problem is, most hospitals here don't hire LPNs; they require BNs; after all, there are already nurse aides (or health care aides) to do the so-called dirty work—washing, dressing up, feeding, ordinary range-of-motion exercises, and reporting simple input-output measurement.

Bachelor of Nursing

Bachelor of Science in Nursing is a four-year degree. Aside from the tasks of an LPN, the significant tasks of BNs include the administration of IV meds (intravenous medications) [LPNs are not allowed to do that], drawing of blood (for blood analysis), and working in specialized areas like emergency wards, psychiatric institutes, operating and delivery rooms, and dialysis centers.

BNs get higher salaries and have greater job opportunities compared with LPNs.

So, in the above, the distinction between the two-year LPN and the four-year BN becomes clear.

If I am unmistaken, this could be the idea that Villar was trying to talk about but was just unable to articulate the whole concept either because she lacked the time to expound on it, given the nature of an interview segment on a TV show; or because her information about the subject matter was insufficient so she was spitting half-baked ideas.

Final Note

Here in Canada, because job opportunities are higher and the resources more abundant—add to that, health care is shouldered by the government—LPNs could still be a good option for those who don't have the time and money to finish a four-year course. Anyway, they could upgrade into BN whenever they feel that they are ready.

Unfortunately, in the Philippines, where the circumstances are very different and the opportunities scarce, LPN seems unnecessary. Besides, finishing the four-year BN (or BSN) would make the person more marketable and competitive in North American and European countries in which nurses are viewed as highly skilled and high-salaried healthcare professionals who could work independently with minimal collaboration with physicians; unlike in the Philippines and other economically challenged countries where nurses are often derogated as "mga alalay ng doktor at mga tagahugas ng puwet ng mga pasyente."

Disclaimer

I am yet to update my knowledge on the current status of the LPN and BN programs here in Canada, so the descriptions I gave about the programs might be a bit outdated. But I think I was able to make the issue a bit clearer.