Providers for the Household and Nation: The Localized Production and Migration of Filipino Nurses

Abstract

In the context of increasing nursing labor shortages around the world, the Philippines has become a major producer and exporter of nurses, with 85 percent of employed Filipino nurses working outside of the Philippines. Based on 12 months of ethnographic research in a provincial center for nursing education and healthcare in Northern Luzon, Philippines, I utilize a global nurse care chain (Yeates 2004a, 2009a) framework to explore transnational nurse migration out of the Philippines through the experiences of nurses, nursing students, their families and other stakeholders in nurse production and migration. As a more local GNCC analysis, the present study traces the production and provision of nursing care labor through the family and local and transnational household, to formal training and nursing experiences in educational and health institutions, and through other encounters with state, private, and international agencies that facilitate and shape the experiences and subjectivities of migrant nurses. Chapter 2 traces the relationship between the production and migration industries and between these industries and the state, exploring the ways that both the healthcare landscape and experiences of new nursing graduates (as consumers and laborers) has been shaped by migration booms and busts. Chapters 3 and 4 examine the household as a site of nurse production and the role of the household's moral economy and structures of feeling (Williams 1977). In Chapter 3, I examine nursing students' narratives of choice in the decision to study nursing and argue that obligation to family and reciprocal financial and emotional relationships underlie nurse production. In Chapter 4, I explore the ways that nurses and students imagine their future lives and identities as migrant nurses, illustrating how subjectivities are shaped by a legacy of transnational migration, imagination, and family moral economy. In Chapter 5, I use the narrative of a returned migrant nurse to illustrate the long-term impacts of past and temporary migration, and the ways that returned migrants may construct their identities through remembering. The final chapter explores the nurse migration industry through recruitment agents and nurses navigating this privatized industry as they pursue migration opportunities. Beyond an ethnography of nursing students', nurses' and their families' experiences of nurse training and migration processes, this dissertation focuses the roles of the state, private industry, and family in the mobilization of gendered and filial subjectivities to stimulate nurse production and migration, and explores the complex effects of unregulated nurse migration industries on students, nurses, and families as consumers and laborers.