Letter to the Editor by Dalmacito Cordero to “Registered Nurses Leaving the Profession in the First Two Years”

December 3, 2025

Response by Dalmacito Cordero to “Registered Nurses Leaving the Profession in the First Two Years” by Stephanie Tate, PhD, RN (May 31, 2024)

Dear Editor,

I read with interest the published article titled “Registered Nurses Leaving the Profession in the First Two Years” (Tate, 2024). The esteemed author highlighted that registered nurses are leaving the profession within the first two years of practice at rates as high as 33%. She also identified why novice nurses have left their positions within this timeframe, including being overworked, family obligations, management, and not completely gone, among others. With this, she concluded that efforts to address the shortage have focused heavily on recruiting more nurses into the profession. This study not only represents the shortage of health and care workforce (HCWF) in many countries that pose a serious challenge to the healthcare system but also exacerbates the unfortunate impact of nurses' migration from their home countries to address the reasons for leaving their jobs. Thus, I aim to elaborate on the impact of nurses' migration using the context of the Philippines during the COVID-19 pandemic to call for an intensified global response and an enhanced focus on policy implementation to ensure a fair and balanced global distribution of HCWF and maintain the quality and efficiency of healthcare services (Kuhlmann, et al., 2025).

During the COVID-19 pandemic, many healthcare workers (HCWs), like nurses, decide to migrate and leave their home countries for various reasons, leaving a depleted workforce in their home country. For example, there were 951,105 licensed Filipino nurses in the Philippines in 2023. Still, only 509,297 are considered "active," the 316,415 migrated abroad, most notably in Austria, Canada, Germany, Japan, Saudi Arabia, Singapore, and the United States (US). With this, the Department of Health (DOH) suggests that the country needs an additional 127,000 licensed nurses, which is expected to increase to 250,000 by 2030, to provide optimal health care. With the current graduation rate would take 12 years to close this gap (PIME Asia News, 2023).

Migration was perceived to impact the healthcare system negatively by depleting the pool of skilled and experienced health workers. For example, the loss of senior nurses is a challenge since their replacements must undergo more training, which may affect the quality of care and add expenses to human resources (Lorenzo et al., 2007). Hospitals in the country have already started to downsize their operations, not because of the lack of facilities or health equipment but because of the lack of HCWs (Alibudbud, 2022). Aside from higher pay, some HCWs decided to leave because of burnout, unreasonable workload, unpaid incentives and benefits, and even being stigmatized as virus spreaders.

Similarly, while host countries addressed the lack of HCWF through the nurse migrants, some faced issues of deskilling where the nurses are assigned to sectors that they are not trained for (sectoral deskilling) or in tasks that are way below their qualifications (hierarchical deskilling). The lack of formal recognition of the nurses' credentials represents the regulatory bodies' devaluation of their cultural capital. Thus, some feel they cannot utilize their professional skills to the fullest, and others fear lagging and losing confidence in their professional skills (Gotehus, 2021).

Global health will not be achieved if only several nations can address the challenges their respective health care system poses while others suffer due to unaddressed and unfair policies. We all live together on one planet, and everyone must not only have the right to receive but be responsible to give regardless of racial differences, especially during difficult times.

Respectfully,

Dalmacito Cordero Jr., PhD
Department of Theology and Religious Education
De La Salle University, 2401 Taft Avenue, 1004 Manila, Philippines
dalmacito.cordero@dlsu.edu.ph