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Clinical TeamManagers’PlaybookThe Philippines Recruitment Initiative (PRI)

Supervisory Requirements andRecommendationsOnboarding and Orientation ConsiderationsPhilippines Healthcare OverviewPre-arrival OverviewIntroductionTable of Contents21191431

IntroductionIn support of the provincial Health Human Resource Action Plan torecruit, retain, and train health-care workers for Manitoba, thePhilippines Recruitment Initiative (PRI) launched in February 2023. Sincethen, over 300 internationally educated health professionals haveaccepted job offers to work in various locations across the province asnurses (on the pathway to becoming Registered Nurses and LicensedPractical Nurses) and health care aides.We are in a pivotal period with these newcomers as they prepare fortheir arrival in our beautiful province and settle into their newcommunities. Moving from the Philippines is a significant change. It is anincredible opportunity but does come with challenges—leaving friendsand family behind, stepping into a different culture, and having tonavigate an unfamiliar environment. While we have assistance in placeto help with this transition, your support as a leader is integral to theirsuccess.We can all continue building a work environment where newcomersthrive, grow through coaching, and excel in their new roles. To assist, weinvite you to review the Clinical Team Managers’ Playbook whichincludes pertinent information, tools, resources, and planning guidelines.It is recommended to bookmark or download this document for easyaccess. We are grateful candidates chose Manitoba to build their future and lookforward to what is to come. We are appreciative of the effort you areinvesting to guide and support these enthusiastic new hires as theybecome valued contributors to the health care system in Manitoba.Thank you for your leadership and dedication. Page 1

Our Filipino recruits embark on an incredible journey to start their new life in Manitoba,Canada. Recruitment to arrival can be up to 295 days—almost a year! Candidates andtheir family members have many processes to navigate before landing at the WinnipegJames Armstrong Richardson International Airport and traveling to their new home.Recruitment:After a careful and diligent screening process, candidates are grouped into pathways thatalign with their skillset and career goals, respectively:Health Care Aide (HCA)Internationally Educated Nurse - Undergraduate Nurse Employee (IEN-UNE) tobecome a Registered NurseSupervised Internationally Educated Nurse (SIEN) to become a Licensed PracticalNurse Each candidate is presented with a Letter of Offer from their Service DeliveryOrganization (SDO) employer. The Letter of Offer contains stipulations the candidatemust meet before becoming eligible for immigration and employment in their designatedpathway. All candidates must pass an English language proficiency test. Screening by theNational Nursing Assessment Service and a Clinical Competence Assessment is alsorequired for those pursuing a nursing pathway.Immigration:Once English language proficiency testing is passed and nursing assessments areunderway for those in the nursing pathway, the candidate can begin the immigrationprocess with the assistance of an immigration lawyer. The candidate must work with theimmigration lawyer to:Submit an Expression of Interest to the Government of Manitoba Immigration Office.Apply to the Manitoba Provincial Nominee ProgramApply for their work permitComplete medical and police background checks that later fulfill the SDO employerrequirement for the criminal background checkSubmit the request for an Overseas Employment Certificate (i.e., exit visa) from thePhilippines government via the Immigration, Refugee and Citizenship Canada federalofficePre-arrivalOverviewPage 3

Page 4Once the immigration process is complete, candidates are granted an OverseasEmployment Certificate which supports their exit from the Philippines and entrance intoCanada.Once the candidate's work permit application is approved, the SharedHealth Settlement Team connects with the designated SDO HR Lead(or delegate) to conduct an arrival planning and coordination meeting.The meeting addresses:Potential start date and limitations around the start dateHousing options, limitations, and support required from NetworkCanada (PRI's partner organization for accommodation andsettlement)Air travel to ManitobaSystem and network accessEmployee communication regarding SDO, site, and programcontactsCommunity settlement supports (varies by SDO)Winnipeg accommodations and transportationAirport arrival welcome and welcome basket planningReminder for Uncertified Health Care Aid (UHCA) or Nurse Re-entry/ bridging program registrationNext steps, timelines, and follow-up communicationSettlement planning:Settlement planning with the SDO employer and our partner settlement organizationsbegins when the candidate is near the completion of their immigration process. SDOs arenotified of their candidate's arrival, and a start date is selected. Candidates are givencustomized support to book flights and transportation from Winnipeg to their destination.They are provided options to choose long-term housing that best suits their needs.Candidates also receive the following support to prepare for their immigration journey:Pre-departure orientation session and briefings from their Philippines-basedimmigration lawyer and recruiting agencyWelcome to Manitoba orientation and guide (link)Virtual pre-arrival candidate seminars before candidate travelPre-arrival guide (link)Once the candidate's travel is confirmed, the Shared Health SettlementTeam connects with the designated SDO HR Lead (or delegate) toconduct an airport arrival and settlement preparation meeting. Thismeeting confirms and finalizes the following: System and network accessEmployee communication: SDO/site contacts, program contactsWinnipeg accommodations and transportationAirport welcome planning and the site guestlistHousing report by Network Canada and candidate's housingdecisionReminder for Uncertified Health Care Aid (UHCA) or Nurse Re-entry/ bridging program registrationCommunity settlement supports (varies by SDO)Any other topics pertaining to arrival and settlement

Welcome to Manitoba:After candidates arrive, they have a comfortable two- to three-day stay in a Winnipeghotel where they will be assisted to:Obtain their Social Insurance Number (SIN) through Service CanadaProcess their Manitoba Health card applicationsComplete their core new employee paperworkAttend an orientation to Manitoba that includes a welcome presentation from thePhilippines communityNow, it's time for the candidate to travel to their new home and community withinManitoba, where they are greeted by the SDO employer and local settlement servicesrepresentatives, who will support the candidate's adjustment to their new chapter of life.Page 5Shared Health coordinates the candidate'sarrival at YWG International Airport.Candidates are welcomed in a true"Friendly Manitoba" fashion by programand SDO representatives on a Philippines-inspired "Hug Rug" (a genuine Manitobawelcome mat). For those familiar withWinnipeg's James Armstrong RichardsonInternational Airport, the "hug rug" is awelcoming sign as you descend theescalator into the arrivals lounge. Therecruit also receives a basket of goodiescurated by local Manitoba vendors.MB Health Card Process and Coverage:If a candidate requires emergency health servicesbefore they receive their health card, the hospitalor clinic should be able to see the candidate’srelevant information in iREG to provide services. If they’re unable to find it there, please considerthe following: Contact the PRI team and they will flag thecase to MB Health for immediate health cardprocessing Alternately, request deferred hospital billingas per the direction of MB Health

Onboarding and OrientationConsiderationsOnce the candidate arrives in Manitoba,they will have approximately a week tosettle into their community and completetasks that include obtaining a SIN cardand Manitoba Health card, opening abank account, and arriving in theircommunity, among others. They will alsosettle into their new accommodations andbecome familiar with their new town orcity. The first day of work will be coordinatedthrough the employer’s HR departmentand clinical manager and/or director. Itwill be approximately one week from theday of their arrival. Please ensure thecandidate knows their work schedule, theaddress of their new workplace,appropriate work attire, and where tomeet their manager upon arrival on thefirst day.It would be helpful for the site to identifyspecific individuals to provide formal peersupport to help integrate the newemployee into their work environment.For example, pair the new employee witha former IEN who has previously beenthrough a similar experience. The peersupport person may or may not be theirassigned buddy; however, the role isintended to include support related toclinical questions and adjusting to theirnew workplace, a new health care system,and overall life in Manitoba. This role isintegral to integrating the employee intothe workplace and community.As part of provincially coordinatedplanning for the PRI, the ProvincialClinical Orientation and OnboardingWorking Group was created to develop astandardized approach to clinicalorientation across all SDOs. Educatorrepresentation from all regions helpeddetermine the best options for anorientation plan and required educationthat could be tailored to meet the needsof each SDO. Orientation content from across each SDOwas reviewed, and additional content andoptions to better meet the needs of ourPRI candidates based on current bestpractices for IEN integration weredeveloped to ensure the candidates havea smooth transition into the workplace.Page 14

Health Care Aide ConsiderationsAdditional EducationPRI candidates starting in a Health Care Aide position are trained as Registered Nurses inthe Philippines. These individuals have additional education that will be helpful in theirnew role as an HCA. To further build on their skills and knowledge, their orientationshould include participation in: Uncertified HCA (UHCA) course offered through Red River College Polytechnic(RRCP), and/orExisting orientation explicitly created for HCAs in specific SDOs It is up to each SDO to determine the orientation option utilized for its candidates.The UHCA course includes the following content (link). The course will also evaluate thefollowing critical elements (link).The courses are seven days long (five in-class and two skills days). Skills labs for PRIcandidates outside Winnipeg may be arranged at a regional satellite site to accommodatecloser-to-home education. Red River College is responsible for organizing this optionwhen possible.The process for registration is outlined here (link). Registration may be completed by theunit manager or the HR lead. Please contact your HR lead if you require furtherinformation about the UHCA course and to plan for registration.Additional relevant content will be added to the orientation plan and may include:Indigenous Cultural AwarenessOrientation to Canadian Healthcare: Building Intercultural and CommunicativeCompetenceNursing in the Rural ContextPalliative CareMedical Assistance in Dying (MAiD)Dementia (offered once per month, usually the second week of the month, toaccommodate PRI arrivals)PRI HCAs will also require site-specific Safe Patient Handing education. Please registernew employees for this training as soon as possible. Many of these courses are availableon SDO-specific Learning Management Systems (LMS). Buddy SupportA provincial recommendation to promote consistency for buddy shifts has been endorsedby the Provincial Nursing Leadership Council (PNLC). The recommendation is to includeone of the following in new PRI-employee orientation:10 x 12-hour buddy shifts, or 15 x 8-hour buddy shiftsHaving a consistent buddy is preferable and will assist in integrating the candidate intotheir new role and the healthcare team. It is recommended that sites utilize acompetency-based checklist and assess how the new staff member is progressing in theirorientation. Orientation can be extended at the discretion of the site/region.Page 15

IEN/NREP-UNE ConsiderationsPRI candidates are trained as nurses in the Philippines. During the hiring process,candidates were assessed based on educational requirements, recent clinical experience,and an in-person interview by the Manitoba recruitment team who travelled to Manila inearly spring of 2023. Successful candidates were identified and then accepted a Letter ofOffer for a full-time IEN/NREP-UNE position in a specific organization determined by therecruitment team. The candidates have all successfully completed and passed an Englishlanguage test at the standards required by the College of Registered Nurses of Manitoba(CRNM). These candidates are on the pathway to becoming registered nurses in Manitoba.Additional EducationAll candidates have completed a clinical competence assessment (CCA) to identify gapsin knowledge or entry level competencies. CRNM has reviewed the CCA report and basedon the report, each candidate is referred to the Nurse Re-entry Program at Red RiverCollege Polytech (RRCP) for specific courses that will bridge the gaps identified. Once the candidate’s travel date is confirmed, the CNO at the site/region where thecandidate will be employed will be provided:CCA report CRNM decision letter listing the courses the candidate is required to complete throughthe Nurse Re-entry Program to proceed with their Registered Nurse pathwayThese documents can be requested directly from the candidate by the employer. They canprovide insight into the additional orientation requirements that may be required for theIEN/NREP-UNE. The Nurse Re-Entry Program has specific intake dates, currently September and January.An additional intake date in May 2024 is being considered. Candidates will be enrolledwhen they arrive in Winnipeg. The process for registration through RRCP is outlined here (link).Every candidate will have different courses depending on the assessment by CRNM.Some candidates will take longer than others to complete all required curricula whileworking full-time (working a minimum of 30 hours per week). Once candidates areenrolled in the NREP program, it is the candidate’s responsibility to register for courseseach term until they have completed all required courses. Candidates are encouraged todiscuss course availability and course planning with RRCP.Ongoing Assessment An assessment of the IEN/NREP-UNE’s level of skill and knowledge will be required on anongoing basis and a plan developed in coordination with the candidate. The use of acompetency checklist and frequent check-ins are important tools to ensure the candidateis receiving the support they need and may identify any gaps in orientation or clinicalexperiences they require. Page 16

SIEN ConsiderationsPRI candidates are trained as nurses in the Philippines. During the hiring process,candidates were assessed based on educational requirements, recent clinical experience,and an in-person interview by the Manitoba recruitment team, who traveled to Manila inearly spring 2023. Successful candidates were identified and accepted a Letter of Offerfor a full-time SIEN position in a specific organization determined by the recruitmentteam. The candidates have all completed and passed an English language test at thestandards required by the College of Licensed Practical Nurses of Manitoba (CLPNM). Additional EducationAll candidates have completed a clinical competence assessment (CCA) to identify gapsin knowledge or entry-level competencies. CLPNM has reviewed the CCA report, andbased on the report, each candidate is referred to either the Practical NursingQualification Recognition Program (PNQR) and/or specific continuing education coursesthrough Assiniboine Community College (ACC) as outlined by CLPNM to bridge any gapsidentified in the CCA. Once the candidate’s travel date is confirmed, the CNO at the site/ region where thecandidate will be employed will be provided:CLPNM decision letter indicating gaps identified and courses that the candidate isrequired to complete through the PNQR Program to proceed along the registrationpathway This document can also be requested directly from the candidate by the employer. TheCLPNM decision letter may provide additional insight into orientation requirements forthe SIEN. Please utilize the decision letter as a guide for orientation plans and check forany restrictions on the SIENs practice through the CLPNM registration system.Every candidate will have different courses to take through ACC, depending on theassessment by CLPNM. The PNQR through ACC has specific intake dates. Currently, theintake dates are August and April. Candidates will be enrolled once they arrive inWinnipeg. Further information about applying to ACC is pending.Some candidates will take longer than others to complete all required courses whileworking full-time. Managers must plan work schedules to allow the SIEN to attend theirrequired courses.Page 17CCA reports will not be provided to the candidate, and CLPNMwill not release the report to the employer.Additional information is provided in the decision letter thatfurther outlines gaps in knowledge and competencies. If thereare further restrictions due to unmet competencies during theCCA, these will be noted as a flag on the CLPNM registration.There is also additional information provided on the CLPNMwebsite (link).

SIEN Considerations (cont‘d)Supervised Clinical Practice In addition to the required courses, and as part of the registration pathway requirements,every SIEN must complete at least 360 hours of supervised clinical practice. However, thePRI SIENs will continue to be supervised while working full- time until they become fullylicensed and transfer into a licensed practical nursing position. Ongoing Assessment An assessment of their level of skill and knowledge will be required on an ongoing basis,and a plan will be developed in coordination with the candidate. A competencyassessment and frequent check-ins are essential tools to ensure the candidate receivesthe support they need. They may identify any gaps in orientation or clinical experiencesthey require. Regular formal evaluations of the SIEN are required per CLPNM and willalso assist in identifying any additional learning needs or support they may need. Student Registry RestrictionsAn SIEN is registered as a Student Practical Nurse (SPN) with CLPNM and their name islisted on the CLPMN registry as a student.Please refer to the CLPNM registry to view any restrictions on their registration (link).Page 18

SupervisoryRequirements andRecommendationsSupervision must support patient safety and competent care.UIEN/NREP-UNE or SIEN’s are unregulated care providers with a defined scope ofemployment that includes the performance of reserved acts when supervised by a RN,RPN, and in specific circumstances, an LPN. Legislation requires this supervision, and it isimportant to ensure the IEN/NREP-UNE or SIEN applies the requisite skills for safe clientcare. Assign the same supervising nurse(s) as often as possible. This provides consistentsupport for the IEN/NREP-UNE or SIEN and clarity for the supervising nurses. Maintainingthe same supervising nurse for each shift will help improve the understanding of the fullscope of the new employees capabilities and not just tasks, particularly in the beginning.Also consider the following when planning supervisory supports:IEN/NREP-UNEMust be supervised by an RN or RPN.Cannot be supervised by an agency nurse.Having a consistent buddy during orientation is recommended.SIENMay be supervised by an RN, RPN, or LPN.Cannot be supervised by an agency nurse.Having a consistent buddy during orientation is recommended.Collaborative Care is an integral a part of supervision. Collaborative care and teamdecision-making to meet the client’s health care needs are required when determining thelevel of supervision. With a clear goal driving patient safety and competence in theprovision of care, consider:Duty to Provide CareCode of EthicsResponsibilities Related to Professional Practice IssuesAny other relevant CRNM, CRPNM, CRLPNM documentsEach SIEN must be assigned a supervising LPN, RN, or RPN in a direct or indirectsupervision relationship at the beginning of each shift. In collaboration with the SIEN, thesupervising LPN/RN/RPN is responsible for making a reasonable and prudent careassignment for the SIEN.The supervision does not always need to be direct one-on-one supervision for everynursing function if the supervising nurse assesses a lower level of supervision to be safein the context. It is the employing organization and supervising nurse’s sharedPage 19

responsibility to determine the level of supervision required for the safe provision of carebased on the individual’s competency assessment results, nursing experience, and prioreducational preparation; employer policy; the practice setting; patient complexity; level ofrisk; and the supervising nurse’s assessment of the SIEN’s competence after evaluatingtheir practice.Supervisors ResponsibilitiesIt is the responsibility of RNs, RPNs, and LPNs in Manitoba to understand their standardsand practice expectations. Every nurse is accountable to apply their standards andpractice expectations to their nursing practice, regardless of role or practice settings. Thepolicies of employers do not relieve RNs, RPNs, and LPNs of accountability for their ownactions or the primary obligation to meet Practice Directions. Learn more about thesePractice Directions here (link).Assigned supervisors must understand the IEN/NREP-UNE or SIEN’s position descriptionand the specific competency level of each employee they will supervise. Note, the RN, RPN, or LPN may only supervise a reserved act that is within theirlegislated scope of practice and for which the RN, RPN, or LPN is competent to perform. An IEN/NREP-UNE can only be supervised by an RN or RPN.Remember, direction and guidance are provided by answering questions, consultation,oversight, and constructive feedback.Page 20In addition to formal supervision, it isrecommended that the site identify specificindividuals to provide peer support to assistwith integrating the new employee into theirwork environment. Consider pairing the new employee with acurrent staff member who has been througha similar experience. The peer supportperson may or may not be their assignedsupervisor; however, the role is intended toinclude support to help adjust to their newworkplace, a new health care system, andoverall life in Manitoba. This role is integralto integrating the employee into theworkplace and community.

PhilippinesHealthcareOverviewCultivating a culturally sensitive environment has a significant impact on our team'ssuccess and the overall well-being of our employees. It is the foundation of effectivecommunication and collaboration in a diverse workplace. By understanding andrespecting the diverse backgrounds, traditions, and perspectives that our team membersbring, we can create a more inclusive work environment. This, in turn, leads to highermorale, improved team dynamics, and increased productivity.Lead by Example Your commitment to cultural sensitivity will inspire our team members to do the same.Here are a few proactive steps you can take:Engage with Team Members: Reach out to team members who belong to differentcultural backgrounds. Have open, respectful conversations with them to gain insightsinto their cultural perspectives. Ask about their experiences and be an active listener.Promote Inclusivity: Encourage open and inclusive discussions. Make sure everyone'svoice is heard and valued, irrespective of their cultural background. Also considercultural norms strongly influence communication styles. Understanding these normshelps in avoiding misunderstandings, misinterpretations, and miscommunications.Lead with Empathy: Approach situations with empathy, considering how culturaldifferences may affect perceptions and interactions. Acknowledging and respecting animmigrant's cultural norms demonstrates inclusivity and respect for their identity. Ithelps them feel valued and welcomed in their new community.To support you as we learn together, a number of resources have been developed asuseful reminders, tools, and conversation points. Learn more here.Page 21

Page 22It is also crucial to invest time in learning about the various cultures represented in yourteam. Understanding their values, customs, and communication styles will go a long wayin fostering positive relationships. Learning about a person's cultural background canfacilitate their integration into their new Manitoba community. It can help them navigatethe local culture and customs more smoothly, reducing the sense of isolation. Use the information below as a springboard to build your understanding. This self-education not only benefits you as a manager but also sets a positive example for theentire team.Healthcare in the Philippines Healthcare in the Philippines is a vital aspect of the country's infrastructure:Public and Private Healthcare: Healthcare services in the Philippines are provided byboth the public and private sectors. Public healthcare facilities are often moreaffordable, but private healthcare facilities may be preferred by those who can affordthem.Healthcare System: The public healthcare system in the Philippines follows a tieredstructure. At the primary level, you have barangay health centers and rural healthunits (note, a barangay in the Philippines is the smallest administrative division and isthe native Filipino term for a village or district, with about 2000 to 5000 members orinhabitants). At the secondary level, there are district and provincial hospitals. Tertiarylevel facilities are found in major cities and include specialized medical centers andlarge hospitals.Hospitals and Facilities: Major cities, such as Manila and Cebu, have well-equippedhospitals and medical facilities that meet international standards. These facilitiesoften cater to medical tourism as well.Healthcare Financing: Healthcare in the Philippines is funded through a combinationof government funding, private health insurance, and out-of-pocket payments bypatients. Some government programs provide health coverage for specificpopulations, but universal coverage is not guaranteed. The Philippines has adopted aUniversal Healthcare law, which aims to provide equitable access to qualityhealthcare services for all Filipinos. This law, signed in 2019, seeks to make healthcareservices more accessible and affordable.Health Insurance: The Philippine Health Insurance Corporation (PhilHealth) is thegovernment agency responsible for providing health insurance to Filipinos. PhilHealthcovers a portion of medical expenses, making healthcare more affordable for insuredindividuals.Traditional Healing Practices: In some regions, traditional healers or "albularyos" areconsulted alongside or instead of Western medicine. These practices often involve theuse of herbal remedies and rituals. The services of an albularyo are sought for bothphysical and spiritual healing, and they play a significant role in the healthcarelandscape of the Philippines, particularly in rural and remote regions.To learn more about healthcare in the Philippines, review this resource (link).It is imperative to recognize, respect, and appreciate the diverse backgrounds, beliefs, andtraditions of individuals and communities. Approach interactions with an open mind and awillingness to understand and embrace the unique perspectives and values of others.

Page 23Nursing in the Philippines Education and Training: In the Philippines, nursing education follows a Bachelor ofScience in Nursing (BSN) program, which takes four years to complete. The curriculumoften includes a focus on theory and clinical practice. Nursing education followsUnited States standards. As such, there are some differences in their experience withterminology and lab values (e.g., units of measure for fasting blood glucose in Canadais mmol/L in Canada and mg/dL in the Philippines).Licensing and Regulation: Nursing graduates in the Philippines need to pass theNurse Licensure Examination (NLE) to practice as registered nurses. The ProfessionalRegulation Commission (PRC) regulates nursing practice and is responsible foroverseeing the licensing and regulation of nurses in the Philippines. PRC plays apivotal role in ensuring that nurses meet the necessary standards for practice.Scope of Practice: Filipino nurses may work in a variety of healthcare settings, buttheir roles can be more specialized due to the demand for overseas nurses:Clinical Roles: Filipino nurses have a wide scope of clinical practice, with a focuson providing direct patient care. They are involved assessing patients, planningcare, patient education and support, carrying out interventions, and evaluatingoutcomes.Specialization: Filipino nurses often become specialists through furthereducation and certification. Common specializations include critical care,pediatric, perioperative, and obstetric nursing. Some also pursue careers inareas like forensic nursing and flight nursing.Patient Interaction: Communication and patient interaction are essential skillsfor Filipino nurses. They work closely with patients and their families to providesupport and education about their health needs.Patient Education: Nurses educate patients and their families about variousaspects of healthcare, including disease management, lifestyle modifications,and post-treatment care. They provide guidance on nutrition, exercise,medication management, and other health education.Collaboration: Collaboration with other healthcare professionals, such asphysicians and allied health workers, is crucial in the Filipino nursing scope ofpractice. Nurses are key members of the healthcare team.Limited Autonomy: Filipino healthcare system does not have an equivalent toCanada’s Nurse Practitioner designation. Nurses in the Philippines generallyhave less autonomy in clinical decision-making compared to their counterpartsin Canada. Medical decisions are typically made by physicians. Consistent tointernational studies, nurses in the Philippines demonstrate moderate levels ofprofessional autonomy. Nurses who had higher levels of autonomy tended tobe high performing, satisfied, and committed in their jobs.Community Health: In the Philippines, nurses are often involved in communityhealth programs. Filipino nurses provide nursing services to individuals,families, population groups, and communities promoting health, diseaseprevention, and improvement of physical and social environments.Work Environment: Nurses in the Philippines often work in government-run publichospitals, private hospitals, clinics, and may also seek opportunities abroad due to thehigh demand for Filipino nurses internationally.Labrague LJ, McEnroe-Petitte DM, Tsaras K. Predictors and outcomes of nurse professional autonomy: Across-sectional study. Int J Nurs Pract. 2019 Feb;25(1):e12711. doi: 10.1111/ijn.12711. Epub 2018 Nov 13.PMID: 30426592.11

Page 24Public and Private Hospitals: Nurses in the Philippines work in a range ofhealthcare settings, including both public and private settings. These clinicalsettings provide various levels of care, from primary care to specialized tertiarycare facilities.Community Health: Some Filipino nurses work in community health settings,providing healthcare services and education in local communities, rural, andunderserved areas. They are involved in public health programs and initiatives.Urban vs. Rural: Work environments can vary significantly between urban andrural areas. Urban nurses have access to better-equipped facilities, while ruralnurses face resource limitations.Cultural Sensitivity and Communication: Filipino nurses often have strong culturalcompetence given the need to interact with patients from various culturalbackgrounds.Language: Philippines English follows US English spelling and grammar.Canadian slang may not register right away.Ethnic Diversity: The Philippines is known for its ethnic diversity, with over 180distinct ethnolinguistic groups, many of which are classified as indigenouspeoples under the country's Indigenous Peoples' Rights Act of 1997. Due to thecountry's linguistic diversity, Filipino nurses often have strong language skillsand may be multilingual. This helps them communicate effectively with patientswho speak different languages or dialects. Filipino nurses are accustomed toworking with patients from diverse cultural backgrounds.Patient-Centered Care: Filipino nurses provide patient-centered care, takinginto account cultural beliefs and practices. They respect patients' culturalvalues and traditions.Respect for Traditions: Nurses in the Philippines are trained to respect thecultural traditions of their patients. They may accommodate religious practices,dietary preferences, and other cultural considerations.Family-Centered Care: Filipino culture places a strong emphasis on family.Nurses often involve family members in care decisions and provide support toboth the patient and their family.Respect for Elders: Respect for elders is a deeply ingrained cultural value in thePhilippines, impacting healthcare decisions for the elderly. Family membersoften play a crucial role in the care of elderly relatives.Ethical Considerations: The Philippines is secular, and its constitutionguarantees freedom of religion. The Philippines is predominantly Catholic (78%as of 2020). Religious beliefs often influence healthcare decisions, includingend-of-life care, birth control, and vaccination. Work Environment (cont’d):Continuing Education: Once licensed, nurses in the Philippines are required to engagein continuing education to maintain their licensure. This ensures that they stay up todate with the latest healthcare practices and standards. Continuing education forFilipino nurses is encouraged, but resources and opportunities can be limited. Somenurses pursue further education and specialization abroad.

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