OVATION FOR MIRIAM'S SENATE STAY

Over 3,000 nurses gave Sen. Miriam Defensor Santiago a standing ovation when she declared that she will not resign from the Senate until she is called to duty in the International Criminal Court.

"I was elected in 2010 for a six-year term. I am duty-bound to serve as long as I can. The ICC itself advised me not to resign until I am called to The Hague," she said.

Santiago was keynote speaker at the opening ceremonies of the two-day annual national convention of the Operating Room Nurses Association of the Philippines (ORNAP), held yesterday, July 7, at the Manila Hotel Fiesta Pavilion. After her speech, Santiago tried to leave the ballroom, but she was mobbed by the hysterical crowd, and had to hold on to a security guard in order to keep her balance.

At a press conference, Santiago said that the developing alignment of political forces between the administration party led by President Benigno Aquino III, and the opposition party led by former President Joseph Estrada, "is totally predictable." She said that the reason for the shifting of political parties among candidates is the lack of an ideological or philosophical distinction between parties.

"We should have a two-party system which should give the Filipino voter a choice between conservatives and liberals on the role of government in society," she said.

The senator said that the choice should be include on the one hand, a conservative party that will concentrate only on peace and order, and allow the free market to operate.

She said on the other hand, that a liberal party should advocate a more active role for government in society, including the economy.

"Normally, the result is that the rich gravitate to a conservative party, while the middle and lower classes gravitate to a liberal party," she said.

The standing ovation for Santiago was a second, after the first ovation given to her at a ballet performance. "I am happily surprised at this ovation. I think the Filipinos are expressing their appreciation and wishing me well in my career abroad," she said, in trying to explain the phenomenon.

In her speech, Senator Miriam Defensor Santiago pushed for the passage of two nursing bills she filed in the Senate.

Senate Bill No. 1565, also known as "An Act Limiting the Consecutive Hours of Work by Nurses," and Senate Bill No. 1589, also known as the "Nurse Faculty Higher Education Act," seek to solve the flight of nurses to other countries and to address the current faculty shortage in nursing, respectively.

"In both the previous and present Congress, I have filed at least two bills with respect to the nursing profession. The first is S.B. No. 1565, which provides that a nurse should not be required to remain on duty for a period longer than eight consecutive hours, or 40 hours in a seven-day work week. The second is S.B. No 1589, which mandates the Department of Health to encourage programs that will engage the cooperation of private institutions in raising the level of nursing education," Santiago explained.

According to the senator, the first bill also provides that a nurse should not be required to work more than her regularly scheduled work hours except in cases of health care disasters, a declaration of emergency in the region, or an emergency determined by the hospital. The second bill, meanwhile, proposes the creation of five pilot programs to provide scholarships to qualified nurses in pursuit of an advanced degree, with the goal of becoming faculty members. It also seeks to provide grants to partnerships between nursing schools and hospitals to fund release time for qualified nurse-employees.

"Nursing has been one of the fastest rising professions in our country. Due to the increase in opportunities to work abroad, nursing graduates have steadily increased over the past few years. Our nursing education system, therefore, is hard pressed to catch up with the demand," the senator said.

Santiago noted that unlike in the United States, all registered nurses in the Philippines should have a bachelor's degree pursuant to the Philippine Nursing Act of 2008. This example is now being followed in the United States, under the U.S. "RN to BSN" program.

"We can proudly say that in nursing, Filipino nurses hold a decided educational advantage over American nurses. Filipino nurses serve as role models to their American counterparts. However, the U.S. is catching up. It is therefore imperative that our nurses pursue further studies in order to acquire more knowledge that will improve the nursing profession here in the Philippines," Santiago said.

The senator added that in the United States, nurses with bachelor's degrees will become the largest segment of the profession and one of the best paid. Santiago laments, however, that her two bills have yet to be acted upon.

"My two bills have not been acted upon. If the nursing community thinks they are worthwhile, then they could pass a resolution, write a letter, or visit the chair of the Senate health committee, urging that these bills be given priority," the senator said.

Santiago said that she is willing to co-sponsor these bills and defend them on the Senate floor during the debates. -End-

TWO NURSING BILLS

By

SENATOR MIRIAM DEFENSOR SANTIAGO (Keynote speech at the annual convention of the Operating Room Nurses Association of the Philippines [ORNAP] on 7 July 2012, at the Manila Hotel Fiesta Pavilion)

Perioperative Nursing

The term "perioperative" pertains to the period extending from the time of hospitalization for surgery, to the time of discharge. In other words, the term means the nursing care given before, during, and after surgery. The prefix "peri" comes from the Greek word peri, which means around. Thus, when we use the prefix "peri," we mean near or around the surgery. Your annual convention and scientific meeting, of which this is No. 38, is intended to help achieve the objective to promote the highest professional standards of perioperative nursing practice for the optimum care of patients. The continuous goal of perioperative nursing is to furnish excellence in taking care of the patients - in the preoperative, intraoperative, and postoperative phases.

Operating room nursing is the oldest specialty on record, dating back to 1875. Nursing is unique in the operating room: it ensures a specialty service, emphasizing the need for continuous individual care, specific to the patient. Thus, the operating room is a specialized high-quality area of nursing. It is entirely possible that a perioperative nurse could become the first assistant to the surgeon, on a level with the resident, intern, or physician's assistant. If you are the first assistant you would assist in retracting, hemostasis, suturing, and any other task required by the surgeon to facilitate speed, while maintaining quality during the procedure.

But ordinarily, the perioperative nurse performs two major roles: as circulator, and as scrub nurse. The circulator is a perioperative nurse who manages the nursing care of a patient during surgery. The circulator observes for breaches in surgical asepsis, and coordinates the needs of the circulating team. A scrub nurse is a perioperative nurse who works directly with the surgeon, in the sterile field. The scrub nurse passes instruments, sponges, and other items needed during the procedure. In the United States, there is a high premium for perioperative nurses, because you are considered specialty nurses. By 2006 standards, you could probably earn over $83,000 annually at that time; and certainly more, by this time.

Philippines Ahead of US

Under the Philippine Nursing Act of 2002, only the holder of a bachelor's degree in nursing is allowed to take the nursing licensure examination. Thus, in the Philippines, all registered nurses are holders of a bachelor's degree. This example is now being followed in the United States, under the U.S. "RN to BSN" program. Therefore we can proudly say that in nursing, Filipino nurses hold a decided educational advantage over American nurses. Filipino nurses serve as role models to your American counterparts.

But the U.S. is catching up. Today, in the United States, there is a surge in enrolment in nursing courses at four-year colleges. More than 600 schools in the U.S. have opened so-called "RN to BSN" programs. These are people who are already registered nurses, but want to earn bachelor's degrees. According to the American Association of Colleges of Nurses, fueled by the growth in online courses, enrolment this year 2012 is almost 90,000. The nurses with bachelor's degrees will become the largest segment of the profession and one of the best paid.

In the U.S., an added incentive for hospitals to hire nurses with baccalaureate degrees is a project of the American Nurses Association. The ANA awards the so-called "magnet designation" to about 400 hospitals. The ANA awards magnet status, depending, among others, on the nursing staff's level of education. In 2008, the U.S. federal government survey showed that the U.S. had 3 million registered nurses. But half or 1.5 million registered nurses already had a bachelor's or master's degree in nursing.

 In 2010, the U.S. Institute of Medicine called for raising the proportion to the total number of registered nurses to 80% with the bachelor's or master's degrees for 2020. Even if a bachelor's program has stiff requirements, American nurses consider it as second career. In the U.S., the typical starting age is around 30 years old. American nurses are emulating the Philippine system, because of your influence on serious treatment decisions.

Nursing Bills

In both the previous and the present Congress, I have filed at least two bills with respect to the nursing profession. The first bill limits the consecutive hours of work by nurses. The second bill is known as the Nurse Faculty Higher Education Act.

I filed the first bill, because the Philippine Overseas Employment Administration (POEA) issued reports that in 2001, some 13,500 Filipino nurses went overseas, but only some 4,400 students passed the nursing board examination. The statistics show that the Philippines is steadily losing nurses, and therefore we have to solve the problem of the flight of nurses to other countries. My bill focuses on the factor of the hours of work.

Under my bill, a nurse should not be required to remain on duty for a period longer than eight consecutive hours, or 40 hours in a seven-day work week. Further, a nurse should not be required to work more than her regularly scheduled work hours.

The bill allows exceptions in cases of health care disasters, a declaration of emergency in the region, or an emergency determined by the hospital. If there is an emergency, the hospital should make a good-faith effort to have overtime covered on a voluntary basis, including calling per diems, agency nurses, assigning floats, or requesting an additional day off work from off-duty employees. The bill does not prohibit a nurse from voluntarily working overtime.

Under my second bill known as the Nurse Faculty Higher Education Act, I took note of the current faculty shortage in nursing. This bill mandates the Department of Health to encourage programs that will engage the cooperation of private institutions, not only in producing better nursing faculty, but also in raising the level of nursing education. The purpose of the bill is to create five pilot programs to provide scholarships to qualified nurses in pursuit of an advanced degree, with the goal of becoming faculty members. It also seeks to provide grants to partnerships between nursing schools and hospitals to fund release time for qualified nurse-employees. Thus, the nurse-employee can earn a salary while obtaining an advanced degree in nursing, with the goal of becoming nurse faculty.

Under my bill, the Health Secretary, on a competitive basis, may award grants to partnerships composed of a nursing school and a hospital. The grant shall be awarded for a period of three to five years. In awarding grants, the health secretary shall consider the following factors: geographical distribution; rural and urban areas; range and type of institution; and prior experience or exceptional programs. My bill includes the proper appropriation from the National Treasury.

My two bills have not been acted upon. If you think they are worthwhile, you could either pass a resolution, write a letter, or visit the chair of the Senate health committee, urging that these bills should be given priority. This means that the bills should be scheduled for a public hearing, where ORNAP would be entitled to participate. The committee chair should then issue a committee report recommending that the bills should be passed. This will be followed by her sponsorship speech during the Senate plenary session. If you request it, I could be co-sponsor, so that I could help to defend the bills during the floor debates. The bills are identified as follows:

1. Senate Bill No. 1565, "An Act limiting the consecutive hours of work by nurses;" and

2. SBN 1589, "An Act to create a pilot program to increase the number of graduate educated nurse faculty to meet the future need for qualified nurse," with the short title of "Nurse Faculty Higher Education Act."

Conclusion

 Florence Nightingale, English nurse and medical reformer, said that the very first requirement in a hospital is that it should do the sick no harm. She also said that nursing should put the patient in the best condition for nature to act upon him. Finally, she said that a nurse deserves a better definition than simply being devoted and obedient.

This is presumably why the poet Henry Wordsworth Longfellow wrote of Florence Nightingale:

 A lady with a lamp

Shall stand

In the great history of the land,

A noble type of good,

Heroic womanhood.