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THE LOCALIZED PRODUCTION and MIGRATION of FILIPINO NURSES by Megan Prescott

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THE LOCALIZED PRODUCTION and MIGRATION of FILIPINO NURSES by Megan Prescott Providers for the Household and Nation: The Localized Production and Migration of Filipino Nurses Item Type text; Electronic Dissertation Authors Prescott, Megan M. Publisher The University of Arizona. Rights Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. Download date 29/09/2021 05:15:36 Link to Item http://hdl.handle.net/10150/595977 PROVIDERS FOR THE HOUSEHOLD AND NATION: THE LOCALIZED PRODUCTION AND MIGRATION OF FILIPINO NURSES by Megan Prescott __________________________ Copyright © Megan Prescott 2016 A Dissertation Submitted to the Faculty of the SCHOOL OF ANTHROPOLOGY In Partial Fulfillment of the Requirements For the Degree of DOCTOR OF PHILOSOPHY In the Graduate College THE UNIVERSITY OF ARIZONA 2016 1 THE UNIVERSITY OF ARIZONA GRADUATE COLLEGE As members of the Dissertation Committee, we certify that we have read the dissertation prepared by Megan Prescott, titled Providers for the Household and Nation: The Localized Production and Migration of Filipino Nurses and recommend that it be accepted as fulfilling the dissertation requirement for the Degree of Doctor of Philosophy. _______________________________________________________________________ Date: 9/25/15 Mark Nichter, Chair _______________________________________________________________________ Date: 9/25/15 Susan Shaw _______________________________________________________________________ Date: 9/25/15 Sallie Marston Final approval and acceptance of this dissertation is contingent upon the candidate’s submission of the final copies of the dissertation to the Graduate College. I hereby certify that I have read this dissertation prepared under my direction and recommend that it be accepted as fulfilling the dissertation requirement. ________________________________________________ Date: 9/25/15 Dissertation Director: Mark Nichter 2 STATEMENT BY AUTHOR This dissertation has been submitted in partial fulfillment of the requirements for an advanced degree at the University of Arizona and is deposited in the University Library to be made available to borrowers under rules of the Library. Brief quotations from this dissertation are allowable without special permission, provided that an accurate acknowledgement of the source is made. Requests for permission for extended quotation from or reproduction of this manuscript in whole or in part may be granted by the copyright holder. SIGNED: Megan M. Prescott 3 Acknowledgements First and foremost, I am deeply indebted to the community that helped facilitate my research. I am grateful for the institutional administrators that welcomed me onto their campuses and allowed me to recruit students, nurses and faculty for participation, and I’m especially grateful for each person who participated, who opened up and shared their personal stories and experiences with me. I am so thankful to Zandro, Elaine, Ann, Gil, Yla, Ning-Ning, Lara, Gillian, and Cathy who befriended me, facilitated my research, helped me find housing and navigate the local area, included my husband and I in holiday celebrations and family vacations, and provided companionship during our stay in the Philippines. Beyond her friendship, Cathy also served as an excellent research assistant. I miss you all very much, will forever remember your kindness, generosity and humor, and look forward to seeing you all again, soon. I was supported intellectually by my advisor Mark Nichter and committee members Ana Alonso, Sallie Marston, and Susan Shaw, and I am grateful for the feedback, guidance, and challenges they offered throughout my coursework at the University of Arizona and supervision of this dissertation. I am also most grateful to my colleagues, Julie Armin, Lauren Penney, Sarah Raskin, Jennifer Jo Thompson and Sarah Trainer, for their immeasurable and invaluable intellectual and emotional support throughout writing this dissertation. I feel so fortunate for our weekly meetings, intellectual exchange, and the general life support you all have provided. Finally, I would not have been able to finish this dissertation without the support of my husband, Steve, who agreed to spend a year with me in the Philippines, spent hours solo-parenting our children—Penelope and Milo—so that I could write, and cheered me on when I was overwhelmed, discouraged, or intellectually stuck. My parents’ support throughout my life fostered my curiosity, commitment to life-long learning, and value and respect for difference. 4 Table of Contents List of Figures and Tables ............................................................................................................ 7 Abstract .......................................................................................................................................... 8 Chapter 1: An introduction to transnational nurse migration from the Philippines ............. 9 Nicole, 16 years old, first-year nursing student .................................................................................... 9 Dr. Ong, administrator at Eastern University ....................................................................................... 9 Abigail, 25 years old, first-year nursing student ................................................................................ 10 Jeffrey Tan, Chief Nurse at Florence Nightingale Hospital in San Luis City .................................... 11 Miguel Abalos, owner of an exam review center and nurse recruitment agency ............................... 12 Understanding nurse migration: the literature.................................................................................. 13 Growing nursing shortages, inequities, and market imbalances ........................................................ 13 Push/pull and brain drain: dominant frameworks in the literature ..................................................... 15 Sociocultural and political-economic studies ..................................................................................... 20 Situating the present study .................................................................................................................. 23 Global Nurse Care Chains .................................................................................................................. 24 Studying nurse production and migration in San Luis City, Philippines ........................................... 33 Methods ................................................................................................................................................. 39 Written surveys .................................................................................................................................. 39 In-depth interviews ............................................................................................................................. 41 Study participants................................................................................................................................. 48 Roadmap of the following chapters..................................................................................................... 51 Chapter 2: Boom and bust: the impact of nurse migration cycles on nurse training and labor ............................................................................................................................................. 55 A brief history of nurse migration from the Philippines ................................................................... 57 Creating the global market for nurses ................................................................................................ 65 Nurse migration and production: Boom and bust industries ........................................................... 72 The impact of nurse migration on nurse training: The recent past ................................................. 76 The proliferation of the training industry: Exam review centers .................................................... 85 Exploiting the market: Health system strategies capitalize on the overproduction of nurses ....... 87 Conclusion: nurses’ pathways to (un)employment ............................................................................ 94 Chapter 3: Obedience, obligation and care: the household production of migrant nursing labor ........................................................................................................................................... 105 “The white uniform” and other representations of the nursing profession .................................. 109 Becoming a nurse: narratives of choice ............................................................................................ 116 The dilemma of “choice” ................................................................................................................. 116 Nursing as vocation? ........................................................................................................................ 121 “I want to explore things and not just be stuck in here.” .................................................................. 126 “I’m a good boy. I obey the wishes of my parents.” ........................................................................ 129 “Actually, it was not my choice.”....................................................................................................
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