Commencement Speech

Lyceum-St. Cabrini College of Allied Medicine
3rd Commencement Exercises
April 16, 2008
Commencement Address

Ma Gan Dang Hapon to all of you. President Torres, members of the Board of Directors, Lyceum Technical Institute President Laurel, Executive Vice President Jimenez, nurturing and proud parents and grandparents, members of the family and friends, and a very hard working graduating class it is a great honor for me to be the Commencement Speaker for the 2008 graduating class of the Lyceum-St. Cabrini College of Allied Medicine Bachelor of Science in Nursing. I must confess when Ms. Jimenez the schools Executive Vice President first asked me to speak I mistakenly interpreted her invitation to be but one of several guest speakers and share maybe a few words about our Affiliation with St. Cabrini Medical Center. It was only on Monday when I learned that I was going to give the Commencement Address. You can imagine the honor I felt as commencement speakers are normally politicians, important citizens, and other noted speakers not hospital managers.

I am truly grateful for this honor. Somewhat overwhelmed, I immediately turned to the internet for research and guidance in fulfilling my duty as your Commencement Speaker. The research centered on the critical role in bridging the gap between your four years of dedicated study and the future that stands before you. The research also suggested length of the speech was very important, something which caught my attention as I recalled the many staff members who have commented on my tendency to engage in long winded speeches. Surprisingly, I noted the most remember and famous Commencement Speech given contained only 5 words. The speech was given at Oxford University one of England’s most prestigious universities by the nations treasured hero Sir Winston Churchill. Sir Churchill, himself a terrible student who took three years to finish the 8th grade simply directed the graduating class to, “Never, Never, Never Give Up!” The simplicity of this message holds true today and is at the center of all great success stories, rather they be of individual triumphs or those of organizations or great countries. With this message in mind, I will keep my speech short but relevant to what lies ahead as you leave your Alma Mater Lyceum-St. Cabrini.

While conventional wisdom suggest I should be politically correct and not venture into areas of controversy, this would not be the face of reality. Playing it safe and avoiding controversial issues does not meet the test of truth, and most importantly it does nothing to prepare you for meeting the challenges of Philippine and Multi-Cultural Nursing. Only through a brutal confrontation of the facts can we ever hope to improve both ourselves and our profession. So while my speech may be controversial it is designed to stimulate thought on solving the problems we all face and it is certainly not my intention to offend anyone.

Today’s message is not just for the graduate but also for her or his entire family as well. Getting to this point was the work of many people and I know the sacrifice and suffering many families have gone through to invest in your future. Please allow me to share with you experiences from my past and from our organization Kissito Healthcare in the hope that one of these experiences might give you guidance and be of benefit as your career begins.

But first we must face the Nursing Examination which most of you are planning to take in June. I want you to approach this examination with confidence. Lyceum-St. Cabrini has prepared you well! The results from the December examination were certainly disappointing with only 43.4 percent of the 67,000+ candidates achieving a passing score. To fully understand why the pass rates have been declining in the Philippines we need to look at the credentialing process for schools of nursing. In the 1970’s we had about 40 schools of nursing in the Philippines. This number has expanded rapidly to the point were we had 350 some schools by 2005. Then literally overnight the number mushroomed to today’s total of 460!

Today there are approximately 80,000 students in nursing schools in the Philippines. This compares with a current workforce of 128,000 nurses. As reported recently in the Manila Times, nursing schools have been selling dreams not education. The evidence is clear when 7.2 percent of all schools did not even have a single graduate who passed the December 2007 examination. It is simply not possible to expand the number of nursing schools in the Philippines that rapidly while maintaining the standard of excellence in education. The number of qualified faculty and staff members simply does not exist. Furthermore, the clinical practice sites do not exist in sufficient number to ensure each student has the hands on experience which is so critical in developing nursing judgment and knowledge.

Here at Lyceum-St. Cabrini the facts are very different. First, Lyceum as an organization has been engaged in education for over 6 decades and the school of nursing has been in existence for 6 years now. More importantly the founders of the school had the foresight to affiliate with St. Cabrini Medical Center to ensure each student had the critical exposure to clinical nursing practice. As a result Lyceum Alumnae have exceeded the national median pass rates. So consider yourself well prepared to sit for the examination at this point compared with many of the graduates around the country.

This being said you still need to rigorously prepare yourself for the examination. I recommend attending the coaching courses and studying with a partner or group. You must be disciplined. Studying can never be accomplished in the final days of preparation. Set aside a certain number of hours each day starting tomorrow through the examination for studying. Remember the old adage, “The harder I work the luckier I get.” Your hard work will pay off in the end and the two months of preparation is nothing compared to the length of your career. I ask that parents and family be supportive during this process and to the best of their ability provide the time and structure needed for this preparation.

Please! Do not put undo pressure on yourself over the examination. We can only do our best and if we do not pass it the first time we will follow the advice of Winston Churchill, and never give up. Five years from now you will not even be thinking about rather you passed the examination on the first or the third attempt. Families and parents I know your expectations are high but you must support your daughter and son more than ever through this process. A student who does not pass the examination will need your support and reassurance more than ever. Remember, only through disappointments or outright failure can we truly learn as is demonstrated by people like Sam Walton who founded Wal-Mart the worlds largest employer after losing his first store and being turned down by bank after bank as he tried to promote his concept for retailing. But like Churchill demanded he never gave up!

The next critical path for you will be your first working position and building your experience. When we first interviewed candidates in Manila two years ago I was surprised at how many people had been unable to find nursing positions since graduating. With 80,000+ nursing students enrolled today this is easy to understand and I am sympathetic to the problem of finding your first setting to gain the experience everyone is demanding. Again, I challenge you that we have 359 hospitals in the Philippines. Until you have applied to each one of them then you can not say that you truly have not been able to find a first position. Look for the setting with the most needs. Government hospitals may pay less than private hospitals but the needs may be greater. Certainly rural locations have a greater need for nurses than urban. Again, the sacrifice of being away from home and friends will be but a small part of your career and will serve you well. Find a friend to go with you if you are seeking employment away from family. Study the hospital you are applying to. Discuss the benefit of your education at Lyceum and share with prospective employers the clinical experiences that you had at St. Cabrini, all of which will have meaning for any new employer. At Kissito Healthcare we value the candidate who has studied the data available on our company and brings knowledge to the interview process. Always be sure to send a thank you letter to anyone who interviews with you or assists you in the process of seeking employment. Build a network of contacts that will stay with you throughout your career. These will include your professors here at Lyceum-St. Cabrini and you classmates. Keep in contact with your network as together you will share information and support each other as you build your careers.

Because a hospital or other healthcare provider is not hiring, this should not stop you from applying! Our company and many like us value a passionate employee who has a desire to be a part of our organization and is assertive in asking to join us. Offer to volunteer with any health care organization. Remember the key to finding employment is having the right attitude and the aptitude to learn. Many employers will tell you if someone has the ability to learn we can teach them, what we can not do is change their attitude. Which brings us to what are the characteristics most desirable to an employer and us as health care professionals?

Nursing has a time honored tradition of patient Care and Compassion the two basic hallmarks of your chosen profession. I can not imagine a career, except maybe teaching, were you have at this early stage of your career the ability to change peoples lives through demonstrating your caring and compassion. At our hospitals I regularly receive letters and expressions of gratitude for the acts of a particular nurse who made the difference in a patient’s life or helped a family confront end of life issues in a caring and compassionate way. At your young age you have the ability to make a difference, use that ability. Truly, what a great calling you have been drawn to. The technical aspects of nursing demand sound judgment and articulation. These skills will only come through experience and questioning. I implore you to ask as many questions as you have. You want to be known as the nurse who will not stop asking questions. The charge nurse might joke about your ongoing questioning but inside she will be proud of your passion and interest. Physicians depend on the nursing staff for current and comprehensive assessments of all patients. Do not be reserved, always know the status of your patients and be ready to share your assessment and concerns with other members of the Interdisciplinary Team.

Now we must turn our attention to a highly controversial part of Philippine nursing. The employment of Filipino nurses overseas. The Philippine Department of Health reports 85 percent of all nurses licensed in the Philippines are now practicing overseas. While 128,000 nurses are currently in the Philippine workforce another 100,000 are estimated to be working around the world. In fact nursing has become the most popular college degree in the Philippines. The so called Talent Drain has sparked a strong debate for mandatory service in the Philippines for graduates of government sponsored institutions. The so called Philippine National Health Service Act if implemented would require service in the Philippines for nurses graduating from these programs prior to having the ability to leave the Philippines. Despite these debates the numbers continue to rise with the most recent Philippine Overseas Employment Administration figures showing record employment of all classes of Pilipino workers exceeding 1,000,000 workers in 197 countries. Of this amount 317,000+ were new deployments of which nurses accounted for 8,528 new deployments.

Understandably economics is driving many of these decisions. The US Department of Labor recently published data suggesting that while the national average wage for RN’s was $48,000 USD annually, FNG actually earned a little more in Acute Hospitals at $49,000+ annually. But since this publication RN shortages have pushed the current wage of a US RN to over $60,000 annually for a 40 hour work week. The vast majority of nurses leaving expressed the need to support the education of a brother or sister or assist family members at home. Many nurses have little choice but to consider overseas employment. I would argue that Filipinos do not leave because they want to but because circumstances force them to.

Ironically, the two countries which draw a significant percentage of the Filipino nurses, the United States and Canada have over 9.0 nurses per population of 1,000 while the Philippines have 1.69 nurses per population of 1,000. A factor of 5.3 times more nurse staffing. The health impact is clear with the probability of a Pilipino female age 15-60 being 2.9 times more likely to die than a Canadian. The infant death rate is even greater with a Pilipino infant 5.5 times more likely to die than a Canadian infant in the first five years of life. While the funding to hire more nurses in the Philippines may not exist and therefore outmigration does not truly affect our health status, clearly when the more experienced and knowledgeable nurses leave all Filipinos suffer. An even more disturbing trend reported recently in the San Francisco Chronicle was the presence of over 3,000 physicians in Philippine schools of nursing. This represent 6.8 percent of the countries physicians and surgeons and should they leave their profession it would be critical for the countries already low ratio of .58 physicians per 1,000 population again an indicator which is a mere 22.7 percent of the US ratio.

I share all of this not to dampen the spirits of this great day but to implore you the new class of graduates to take action both for yourself and also for your country. The needs for Multi-Cultural nursing will continue to expand. The US alone projects the shortage of 111,000 RN’s in 2000 will grow to 275,000 by 2010 and 800,000 by 2020. FNG licenses issued in the US represented 10 percent of all licenses in 1995 and have climbed to 14 percent in 2003 despite major increases in the number of US nursing school graduates. The percentage of Filipino FNG has however declined in the US from 75 percent in the mid 1980’s to 43 percent as of 2000. This in part is due to the US recruitment of Canadian, UK, Korean, Nigerian, and Indian nurses on a larger scale with Filipinos just as likely to be migrating to Saudi Arabia, UAE, Hong Kong, and Kuwait.

We believe the growth in Multi-Cultural nursing will continue to expand due to the globalization of the world. Kissito Healthcare has taken a unique approach to the dual problems faced in the Philippines and in the US. Through our affiliation with St. Cabrini Medical Center we are structuring our own form of National Health Service Act. Our candidates will have extensive training and support in preparation for immigration to a Kissito Healthcare facility in the US. But in exchange, candidates must commit to returning to the Philippines for specified periods of time to share their knowledge and experience. This is but a baby step which we hope will ensure the rotation of skilled and experienced nurses back to St. Cabrini. We of course are hopeful other hospital systems in the US and other benefitting countries will adopt similar practices. But most importantly we hope you the next generation of Philippine leaders will have the conviction to venture out as circumstances may dictate but that you will return to meet the needs of this great Nation.

As we leave today lets remember the great calling and profession we have chosen. With the responsibility of caring for the sick and infirm comes the duty of service and self sacrifice. A consensus among histories great philosophers holds that happiness is highly correlated with the gaining of knowledge and service to others. Through service to those in need and a deep relationship with your family and God you will experience joys that will last your entire life. May God Bless you and guide you in your new career as a nurse!