The first wave came after the US began its colonization of the Philippines and needed local health care professionals to meet the health needs of the subject population which is why the US Army recruited Filipinos to work as Volunteer Auxiliary and Contract Nurses.
Under the Pensionado Act of 1903, Filipinos were sent to the US as government-funded scholars (pensionados) including those pursuing a nurse education. Some of those who stayed for employment as nurses in the US went on to form the Philippine Nurses Association of New York in 1928
Many other pensionado nurses returned back to the Philippines to help set up and manage the 17nursing schools that were established in the Philippines from 1903 until 1940.Large numbers of the graduates from these nursing schools thereafter immigrated to the US as, unlike with the Chinese and Japanese, there were no immigration restrictions against them since Filipinos were considered “US nationals” and even traveled with US passports.
One of the pioneer Filipino RNs was Isabel L. Mina who graduated with a nursing degree from the University of the Philippines in 1919 before working at the Mary Chiles Hospital in Manila. Together with two other Filipino nurses, Josefa Cariaga and Petra Aguinaldo, Isabel boarded a ship in 1921 to go to Hawaii where they worked in a hospital before moving to California.
The next big wave of nurses from the Philippines began in1948 when the US State Department set up an Exchange Visitor Program to “combat Soviet propaganda”. According to Catherine Ceniza Choy, associate professor of ethnic studies at the University of California, Berkeley, and author of Empire of Care: Nursing and Migration in Filipino American History (Duke University Press, 2003), owing to the “special relationship” between the mother country and its former colony, a large percentage of the exchange visitors came from the Philippines, and many of them were nurses or nursing students.
Among these nurses was Maria Guerrero Llapitan who came to the US in 1948 to take post-graduate nursing courses at Baylor University in Texas. Maria had served as the supervisor of the operating room of a hospital in Bataan before it fell to the Japanese invaders in 1942. After completing her postgraduate studies at Baylor, Maria moved to Chicago to work at the Cook County General Hospital where she met her fiance. She then went to Hunter College for Women in New York to get her nursing degree while working at Sloane-Kettering Memorial Hospital in New York
The third wave of Filipino nurse immigration to the US came after 1965 when US Immigration laws were liberalized to allow Filipino nurses and other professionals to immigrate to the US. It also allowed Filipino nurses to come to the US on tourist visas without prearranged employment and to then adjust their status in the US.
During this period, the number of nursing schools in the Philippines soared from 17 in 1940 to 170 in 1990 to more than 429 at the present time. Many of these nursing schools were diploma mills exploiting the desire of many Filipinos to enter the nursing profession.
Unfortunately, as a result of the only 15-20% of the Filipino nurses who immigrated to the US after 1965 could pass the state nursing board exams. This led to the establishment in 1977 of the Commission on Graduates of Foreign Nursing Schools (CGFNS) to help prevent the exploitation of graduates of foreign nursing schools who come to the United States to work as nurses but who can’t pass the nursing board .
Since 1977, CGFNS has administered more than 350,000 tests to approximately 185,000 applicants in 43test sites worldwide. While the demand for Filipino nurses may have waned in the US, the demand for Filipino nurses in the rest of the world did not diminish.
Is there a fourth wave of Filipino nurse immigration to the US?
Yes, but it hasn’t arrived yet. According to recent CNN report, “Demand for health care services is expected to climb as more baby boomers retire and health care reform makes medical care accessible to more people. As older nurses start retiring, economists predict a massive nursing shortage will reemerge in the United States.”
The CNN report adds: “We’ve been really worried about the future workforce because we’ve got almost 900,000 nurses over the age of 50 who will probably retire this decade, and we’ll have to replace them,” [economist and nurse Peter] Buerhaus said.