The Filipino Nurse Stereotype & Why It Makes You Uncomfortable
For college students, choosing a major can be a difficult, confusing process. Multiple factors are in consideration when deciding a career path such as: personal strengths, education level, salary, job availability, as well as one’s own passion. For most Filipino-Americans, nursing is either a primary pursuit, a fallback plan, or at the least, a nagging stereotype. The perpetuation that all Filipinos are nurses negatively affects those Filipino-Americans who are currently in the profession, are aspiring to be, as well as those who are pursuing other careers. This stereotype assumes that the occupation functions as the default setting for Filipinos, thus degrading the passion and hardwork of nurses while also discouraging Filipino-Americans from choosing a different career path since they face microaggressions such as: “All the Filipinos I know are nurses, why aren’t you becoming one?”
There are about 150,000 Filipino nurses working in the United States, and they make up about 20% of the nursing force in California (Lee McFarling, 2020). As highlighted during the recent COVID-19 pandemic, nursing is an honorable occupation that is dedicated to selflessly providing care for others. In April of 2020, Disney’s Pixar posted a tribute on Instagram to all frontline workers. It is a drawing depicting a young boy offering mano po, a Filipino gesture of respect and honor, to a health care worker (Pixar, 2020). Obviously, nursing is considered to be a noble profession received with admiration. So why is there still a feeling of discomfort associated with the stereotype that all Filipinos are nurses?
When Jo Koy, the renowned Filipino-American comedian, jokes about his mother and ‘all your aunties and cousins’ being nurses, we laugh because it is relatable (“‘Follow Your Dreams’ | Jo Koy : Live from Seattle” 01:36–01:45). When a Filipino-American college student explains their nursing major to friends (which is often accompanied by the phrase “typical Filipino” by either the speaker or the listeners) we shrug it off in designation as acknowledgement to the cliché. We do all these things as a form of coping with discomfort.
Stereotypes, while some may seem positive, are, at their root, harmful because of their potential for discrimination. While the Filipino nurse stereotype, in and of itself, is not harmful, its foundation of imperialism and racial prejudices are. If the stereotype were to suddenly disappear, the material conditions of the prejudice remain. The infrastructure of this stereotype resides in the mass migration of Filipino nurses to the United States, which can largely be attributed to colonial exploitation and racialization of the Philippines that began in the early 20th century.
When the United States took over imperial rule over the Philippines from Spain, new occupations for Filipinos were introduced, particularly for women. The introduction of American medicine was both “liberating and exploitative” because while it did provide new opportunities for Filipinas, it was also part of the larger US colonial agenda that racialized Filipinos and Americans under the “pretense of benevolent reform” (Choy 19–20). Nursing was shown to be a prestigious career. Nursing students were often selected and recommended by their American teachers, despite knowing nothing about the profession. Those who were recruited were most often women from respectable families of rural areas who were told of distinguished opportunities in the city within the safe haven of the hospital. Professional nursing provided opportunities previously unavailable to young Filipino women such as higher education, invitations to interact with government officials, and attendance at government functions. As a result, nursing became known as a desirable career.
In 1967, the United States experienced a shortage of about 125,000 nurses (Choy 111). This was in addition to the increased demand generated by the newly established Medicare and Medicaid insurance plans. With a desperate need for healthcare workers, the United States turned to foreign graduates. All the education and tutelage of American medicine provided to the Philippines was not simply done because of the White Man’s Burden. The investment the United States had made in training the health care workers of the Philippines is yet another example of the exploitation of racialized immigrants through proletarianization (Lowe, 16).
Three important preconditions were established under America’s colonial administration that prompted the mass migration of Filipino nurses (Choy 41). This ensured that the Filipino labor force was acclimated to the work culture of American hospitals, and would thus assimilate well once they immigrated. First, the Philippines received professional nursing training from American instructors that were brought to the Philippines. At first, Filipino textbooks emphasized diseases that were unique to the tropical climate like dengue fever, a mosquito-borne illness that is very common throughout the country. Their teachers were unfamiliar with such ailments, and instead emphasized the education of illnesses that were prominent in the United States. Second, learning the English language became a school requirement that began in grade school. School work such as essays, presentations, and communication with instructors had to be in English. Despite this, their first language of Tagalog remained. Third, the nursing work culture was Americanized. The medical procedures, terminology, and the chain of command of health care workers practiced in the United States was implemented in the Philippines. It is important to remember that this Americanization of the Philippines was shaped by the culture of US imperialism, and thus created racialized hierarchies. As instructors, the American health care workers were viewed as authoritative figures that had superior knowledge about the medical field with Filipinos, as the students, being inferior. This dichotomy of superiority and inferiority would persist outside the setting of school when Filipino nurses began working in the United States.
Studying abroad in the United States became, at first, an unsaid prerequisite for occupational mobility in the nursing profession in the Philippines (Choy 33). This contributed to the idealization of America and going abroad. Given the demand for nurses, the United States advertised work abroad as travel and adventure in order to attract Filipino nurses. For example, the New York Health & Hospitals Corporation released an advertisement that enthusiastically marketed:
We will help you cross the Bridge from where you are to where you want to be . . . New York City! No matter where you are — your nursing diploma can bring you to New York City . . . Imagine! Living and working in America’s most exciting city . . . where the world looks for the finest medical care!(Portes, 1989).
There were even US-sponsored programs at American universities for Filipino students with the intention that these graduates would return to work in the Philippines. However, as a collective, Filipino nurse immigrants talked about their aspiration to live in America and found a way to settle there upon arrival.
By 1989, 73% of foreign nurse graduates in the Unted States were Filipino (Choy 43). Through both the 1884 Exchange Visitor Program and the 1965 Immigration Acts, Filipino nurses were able to enter the United States. Most immigrated as cohorts as they applied for visas in groups and settled in cities where their friends or family members had also settled. These workers had motivation to leave their home country due to poor working conditions and little job opportunities. The aforementioned advertisements took advantage of this professional dissatisfaction and fostered a romanticized image of America in popularized media. This garnered a collective desire amongst Filipino nurses to widen their horizons only available outside of Philippine borders.
This idealization can be likened to the concept of snow. In the tropical climate of the Philippines, alternating periods of wet and dry seasons take place throughout the year. The changing colors of autumn and the snowfall of winter are only experienced through the media, and thus a dream of many Filipino citizens as they are often presented alongside joyful holidays. Autumn and winter would never occur in the Philippines, so it seemed as if going to the United States was the only mode to experience the magical weather first-hand. Similarly, it seemed that a successful nursing career was not plausible in the Philippines. The low wages, poor working conditions, and narrow network for opportunity deterred Filipino nurses from staying to work in their native country. With the tools Americanized education fostered, they had even more initiative to embark on the rewarding adventure that American media and advertisements promised them.
However, the perspective of the Filipino nurse in America shifted from a welcome exchange visitor to an alleged threat to the US healthcare system. As a result of xenophobic sentiments expressed by American nurses, Filipinos were motivated to form organizations that addressed exploitative recruitment practices, controversial licensing examinations, and the growing awareness of their complex and unique situation. Organizations such as the National Federation of Philippine Nurses Association in the United States, National Alliance for Fair Licensure of Foreign Nurse Graduates, Foreign Nurse Defense Fund were established (Choy, 167).
The dictator of the Philippines, Ferdinand Marcos, addressed the Philppines News Agency at the 1973 convention in Manila in light of the discrimination Filipino nurses faced in the United States. Most significantly, he emphasized the pay gap between Filipino students working abroad and American-born nurses. Marcos stated:
“It is our policy to promote the migration of nurses . . . We will allow them to go out, improve themselves, earn money but under the terms and conditions consistent with the dignity of the Filipino people and the Filipino worker in general and the fabled integrity, competence, and compassion of the Filipino nurses in particular” (Marcos, 1974).
He promoted the idea of Filipino nurses earning for the country as well as themselves, and in this way, those workers would build the Philippine national economy by depositing their earnings abroad in Philippine banks. Although this inspiring rhetoric seems noble, Marcos’ intention was that of monetary gain of foreign currency accumulation through the earnings of workers abroad. Instead of channeling this money towards the improvement of the Philippines, Marcos used it for his own personal financial gain.
Not only were Filipino nurses used for domestic production by satisfying the American demand for nurses, but they also functioned as a means of international consumption by their home country. The expansive community of Filipino nurses working abroad in the United States was utilized as an object of exploitation by both their respective governments.
Given its history, it makes sense why this stereotype would make someone feel uncomfortable. The origins of Filipino-American nurses is that of manipulation under the guise of benevolence. Despite the many hardships that were, and continue, to be experienced by Filipino nurses, there have still been many good outcomes. The most significant of these is that of the great nobility associated with the profession and the enduring diligence that has aided millions of American patients. This can be most evidently understood through both the AIDS epidemic as well as the recent work of front liners during the COVID-19 pandemic.
To all Filipino-American nurses past and present : Don’t let this stereotype degrade the nobility of the work of Fil-Am nurses past and present. You are more than just your occupation. You are even more than your title of national and cultural identity. Although all these things can shape you through experiences, they should not define who you are, confine you to a certain perspective, nor set of opportunities. You are allowed, and even expected, to feel angry about the origins of the stereotype. This stereotype, however, does not negate the work that Filipino people have done in the professional setting of nursing. Not only has this occupation benefitted many Filipinos seeking financial stability outside their native country, but it also work of great dignity, respect, and admiration.
Works Cited
Choy, Catherine Ceniza. Empire of Care: Nursing and Migration In Filipino American History.Duke University Press, 31 Jan 2003.
Capucao, Raynaldo. “For the Love of Family: The Filipina/o Nurse Diaspora.” Routed, 14 Feb2020, https://www.routedmagazine.com/filipino-nurse-diaspora.
“‘Follow Your Dreams’ | Jo Koy : Live from Seattle” Youtube, uploaded by Jo Koy, 13 Apr 2017,https://www.youtube.com/watch?v=gYjVZ14eb0c.
Umandap, Kach Medina. “How to Travel and Work in the USA Legally — Complete Guide onGetting a J1 US Visa.” Mr. and Mrs. Howe, https://mrandmrshowe.com/lifestyle-blog/guide-j1-us-visa-application-filipino.
Lee McFarling, Usha. “Nursing ranks are filled with Filipino Americans. The pandemic is taking an outsized toll on them.” STAT, 18 April 2020, https://www.statnews.com/2020/04/28/coronavirus-taking-outsized-toll-on-filipino-american-nurses/.
Lowe, Lisa. “Ch. 1: Immigration, Citizenship, Racialization: Asian American Critique.”Immigrant Acts, Duke University Press, 1996, pp. 1–36.
Marcial, Araceli. Photo of Chinese General Hospital School of Nursing in Manila.
Marcos, Ferdinand E. ‘‘Address of His Excellency, President Ferdinand E.Marcos.’’ PJN, March 197, pp. 13–23.
Ngo, An. Photo of Snowglobe. 500px, 23 Dec 2011, https://500px.com/photo/6133508/Snowglobe-by-An-Ngo/.
Pixar [@pixar]. Photo of Mano Po to Frontliners Drawing. Instagram, drawing by Bobby Rubio,22 April 2020, https://www.instagram.com/p/B_QyMDNI1SW/.
Portes, Alejandro and József Böröcs. ‘‘Contemporary Immigration: Theoretical Perspectives on Its Determinants and Modes of Incorporation,’’ International Migration Review 23.3–4 (1989).
