2. The Technological Explosion 

The rapid growth in information technology has already had a radical impact on health care delivery and the education of nurses. Advances in processing capacity and speed, the development of interactive user interfaces, developments in image storage and transfer technology, changes in telecommunications technology, and the increased affordability of personal computers have contributed to the explosion of information technology applications. Advances in digital technology have increased the applications of telehealth and telemedicine, bringing together patient and provider without physical proximity. Nanotechnology will introduce new forms of clinical diagnosis and treatment by means of inexpensive handheld biosensors capable of detecting a wide range of diseases from miniscule body specimens. 

Dramatic improvements in the accessibility of clinical data across settings and time have improved both outcomes and care management. The electronic medical record will replace traditional documentation systems. Through the Internet, consumers will be increasingly armed with information previously available only to clinicians. Electronic commerce will become routine for transacting health care services and products.

Nurses of the 21st century need to be skilled in the use of computer technology. Already, distance learning modalities link students and faculty from different locales and expand the potential for accessible continuing professional education. Technically sophisticated preclinical simulation laboratories will stimulate critical thinking and skill acquisition in a safe and user-friendly environment. Faster and more flexible access to data and new means of observation and communication are having an impact on how nursing research is conducted. 

3. Globalization of the World's Economy and Society

Globalization has been brought about by many factors, including advances in information technology and communications, international travel and commerce, the growth of multinational corporations, the fall of communism in Eastern Europe and the Soviet Union, and major political changes in Africa and Asia. With the "death of distance" in the spread of disease and the delivery of health care, there are both extraordinary risks and extraordinary benefits. Along with the potential for rapid disease transmission, there is potential for dramatic improvements in health due to knowledge transfer between cultures and health care systems.

Nursing science needs to address health care issues, such as emerging and reemerging infections, that result from globalization. Nursing education and research must become more internationally focused to disseminate information and benefit from the multicultural experience.

Our Philippine nurses are in high demandglobally due to our standardized and unified BSN curriculum. Sadly, this globalized demand is driving the academe to come up with new programs that also fit the modern age and needs. This poses a threat to the image of Philippine nursing abroad, in relation to our economic status as a third-world country. In addition, this also exacerbates the quality of the nursing and health service in our own country. 

When one looks into the current state of nursing schools in our country, one could see the trend that there is a continuous increase in the number of newly opened nursing schools. From 175 in the early 1990s, it has ballooned to a current 450 registered schools and colleges of nursing. This mushrooming of new schools is attributed to the high demand and high-paying jobs that nurses have in developed countries like the United States and the United Kingdom. Yet when one examines the quality of the program schools and colleges offer, a feeling of shock and bewilderment comes. For instance, out of 2,392 faculty surveyed in 2003, only 1,157 [58%] are BSN with MA units; 539 [22.53%] have MAN and 198 [8.28%] have MAs in other fields. 

This alone shows that a majority of nursing faculty still lack advanced education and training. Alas, this is also reflected in their salaries, because in spite of having a high demand for clinical instructors, most faculty members [64%] are paid P15,000 and below. Half of them are paid less than P10,000 a month.

These two factors affect nursing education as new schools open without qualified deans and faculty members. Less than 1% of the deans of colleges of nursing have doctorate degrees, and due to the influx of nursing students, hospitals accept more than the required affiliate nursing students. Sadly, this translates to a high patient-to-nurse ratio of one patient to two nursing students in the 1990s, to one patient to 15 nursing students. How then could nursing students afford a quality experience in their practice when there are too many of them attending to one patient? Even the patient might feel exasperated by the sheer crowd of nurses attending to him or

Another appalling statistic is the decrease in the number of passers in the nursing board examination; from 54% in 2001, it has steadily declined to 46% the following year, and in 2003 it was 43%. Although in the more recently concluded exam, the number of successful board examinees increased, this is not an entirely reliable statistic because of the fact that there are many doctors who took up nursing as a second course; which also translates into the loss of qualified doctors who could serve in different community and regional hospitals in our country. 

These are, as the cliché goes, “the tip of the iceberg” on the state of nursing education in the Philippines. We have much to work for, as nursing professionals and auxiliary staff, to improve the quality of nursing education. There is much misinformation that goes about nowadays, as more students and professionals take up nursing as a second course. When logistics and economics become the primary motivation, then service and focus on patient care lose out. The challenge then is how to balance these things, so that we could further improve the quality of the educators in the different programs, and also reinstate the sense of service that the profession is all about, which is just a start in our long journey to overhaul nursing education in our country. 

It is, however, heartening to note that the UERMMMC College of Nursing has been a consistent top performing school in the country, as cited in a recent press release of the Commission on Higher Education (CHED) together with the Professional Regulation Commission, Board of Nursing (PRC-BON)