Bodies of work: skilling at the bottom of the global nursing care chain

ABSTRACT

In the midst of a growing global market for migrant care work, there is a need to investigate not only how such labour is consumed but how ‘ideal’ care workers are also produced. This paper investigates how schools within migrant-sending countries produce nurse labour through body work or the testing and honing of hospital procedures on patients’ bodies. Focusing on the case of the Philippines, this paper shows how the education of nurses for export creates a paradoxical impact on care work within local healthcare institutions. Aspiring nurse migrants provide much-needed manpower to understaffed public hospitals yet, treat poor patients as docile bodies to enhance their skills for future foreign employers. This practice creates an inherent inequality in the actual skilling of aspiring nurse migrants, where the poorest bodies allow nurse migrants to provide better care to more privileged bodies in wealthier nations.

KEYWORDS:

• Global care chain
• body work
• care work
• nursing
• labour migration
• Philippines

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Yasmin Y. Ortiga http://orcid.org/0000-0003-1740-0521

Jenica Ana Rivero http://orcid.org/0000-0002-2944-6933

Notes

1. Interest in body work has led to different strands of research. One focuses on the labour of working on one’s own appearance; another investigates the management of one’s own body and feelings in the workplace; and a growing field looks at the embodied experience of different social groups. In this paper, we focus specifically on the paid labour of working on others’ bodies. Gimlin (2007) provides a comprehensive review of these different studies.

2. The first author also sent invitation letters to public university organizations but did not get a response. When it came to the question of preparing students for overseas work, instructors from public institutions were not very different from the private school counterparts. In all, Author 1 conducted interviews in schools in Metro Manila, Rizal, Laguna, Cebu, Palawan, and Cagayan de Oro.

3. Catherine Ceniza Choy (2003) provides a detailed discussion of the history of nursing education in the Philippines.

4. Previous studies have discussed the expansion and contraction of Philippine nursing programmes in line with perceived overseas opportunities. (see Ortiga, 2018).

5. Clinical exposure during one’s nursing education is different from the work experience required after graduation, where the duration and setting for nursing experience varied depending on aspiring migrants’ desired destination countries. Most nursing graduates needed to obtain at least two years of hospital experience in order to qualify for jobs in the US, Canada, and Australia. Beginning 2009, different government programmes have attempted to bring nursing graduates to the provinces by offering contractual positions in rural health centres. However, many nursing graduates did not see this experience as an ideal for leaving the country. The first author discussed these issues in previous work (see Ortiga, 2018).

6. There were some interclass tensions in public hospital wards as well. Nursing students and instructors (many of whom may be middle class or lower middle class) were sometimes critical of charity ward patients who had no money for medicine and treatment, but owned ‘impractical’ things like new cell phones or branded sneakers. Such critiques do reveal the uneasy relations that Filipino healthcare workers negotiate in public hospitals, yet they also reflect the broader moral politics of Philippine society. Wataru Kusaka’s (2017) work provides a rich analysis of this issue.

7. Janet Taylor’s (2014) work raises the question of whether the pursuit of such ‘useful’ cases discussed in Boys In White remains relevant in medical education today, given an increasing move towards the use of ‘standardized patients’ to simulate illnesses and symptoms for medical students. In this paper, we argue that this still holds true for nursing students in the Philippines.

Additional information

Funding

This work was supported by Japan Society for the Promotion of Science [grant number 15H05171].

Notes on contributors

Yasmin Y. Ortiga

Yasmin Y. Ortiga is an Assistant Professor of Sociology at the School of Social Sciences, Singapore Management University. She investigates how ideas about ‘skill’ define migration pathways, and how this then affects local institutions within both sending and receiving countries.

Jenica Ana Rivero

Jenica Ana Rivero is a Clinical Instructor, College of Nursing, Our Landy of Fatima University, Philippines.