History of Nursing in the Philippines

Nursing in the Philippines did not start in a classroom. It started in homes, war camps, and mission dispensaries, and the profession you practice today was built one hospital and one law at a time. Knowing that lineage tells you why the system looks the way it does. Here is the timeline that matters.

Early Beliefs and Practices

Early Filipino ideas about health ran on mysticism and superstition. Disease was blamed on an enemy, a witch, or evil spirits, so people stayed careful not to provoke either. Spirits were driven off by those believed to hold power over demons. Healing also came through special gods, with the priest-physician (the "word doctor") acting as intermediary. Healers who worked with leaves and roots were the herb doctors ("herbolarios"). When someone fell sick, female family members or friends cared for them at home.

Early Care of the Sick

Herb men were called "herbicheros," meaning one who practiced witchcraft. Illness with no clear cause was blamed on the "mangkukulam" or "manggagaway," and difficult childbirth and certain diseases ("pamao") were attributed to "nunos." Midwives handled childbirth. During labor the "mabuting hilot" (good midwife) was called in, and if the birth turned difficult, witches were assumed to be the cause. To break their influence, gunpowder was set off from a bamboo cane near the head of the sufferer.

Health Care During the Spanish Regime

Care meant basic nutrition, wound care, and tending a sick family member, with interventions from the babaylan (priest-physicians) or albularyo (herb doctors). In 1578, male nurses were recognized as Spanish friars' assistants caring for the sick in hospital. They were called practicante or enfermero.

The religious orders built hospitals across the islands. The earliest were:

Hospital Real de Manila (1577). Founded by Gov. Francisco de Sande, mainly to care for the Spanish king's soldiers, but it also admitted Spanish civilians.

San Lazaro Hospital (1578). Founded by Brother Juan Clemente and administered for many years by the Hospitalliers of San Juan de Dios. Built exclusively for patients with leprosy.

Hospital de Indios (1586). Established by the Franciscan Order, supported largely by alms and contributions from charitable persons.

Hospital de Aguas Santas (1590). Established in Laguna near a medicinal spring, founded by Brother J. Bautista of the Franciscan Order.

San Juan de Dios Hospital (1596). Founded by the Brotherhood of Misericordia and administered by the Hospitaliers of San Juan de Dios. Supported by alms and rents, it gave general health service to the public.

Nursing During the Philippine Revolution

In the late 1890s, war between the Philippines and Spain produced heavy casualties, and many women stepped into the role of nurse to tend wounded soldiers. That work seeded the Philippine Red Cross.

Josephine Bracken, wife of Jose Rizal, set up a field hospital in an estate house in Tejeros and nursed the wounded night and day.

Rosa Sevilla de Alvero converted her house into quarters for Filipino soldiers during the Philippine-American War that broke out in 1899.

Dona Hilaria de Aguinaldo, wife of Emilio Aguinaldo, organized the Filipino Red Cross under the inspiration of Mabini.

Dona Maria Agoncillo de Aguinaldo, second wife of Emilio Aguinaldo, provided nursing care to Filipino soldiers during the revolution and served as President of the Filipino Red Cross branch in Batangas.

Melchora Aquino ("Tandang Sora") nursed wounded Filipino soldiers and gave them shelter and food.

Capitan Salome, a revolutionary leader in Nueva Ecija, nursed the wounded when not in combat.

Agueda Kahabagan, a revolutionary leader in Laguna, provided nursing services to her troops.

Trinidad Tecson ("Ina ng Biak-na-Bato") stayed in the hospital at Biak na Bato to care for wounded soldiers.

Hospitals and Nursing Schools

Americans began training the first Filipino nursing students in 1907. The students studied many of the same subjects as their U.S. counterparts, but the curriculum was never a mirror image of the American one and involved more than a simple transfer of knowledge. Filipino students also studied subjects relevant to their own patients, such as the nursing of tropical diseases and the industrial and living conditions in the islands, as described in Lavinia L. Dock's 1912 book A History of Nursing: From the Earliest Times to the Present Day with Special Reference to the Work of the Past Thirty Years.

Hospital School of Nursing's Formal Training (1901-1911)

Formal hospital-based training began when American missionary doctors and nurses found their own numbers insufficient and decided to train Filipino nurses to staff the hospitals Americans were building in the early 20th century.

The first hospital to train Filipino nurses, in 1906, was Iloilo Mission Hospital, established by the Baptist missionaries. There were no strict entry requirements at first, only a willingness to work, and the school marked the start of nursing education spreading across the country. In this period the Pensionado Act of 1903 (Act 854) let Filipino nursing students study in the United States.

Iloilo Mission Hospital School of Nursing (Iloilo City, 1906). Run by the Baptist Foreign Mission Society of America. Miss Rose Nicolet, a graduate of New England Hospital for Women and Children in Boston, Massachusetts, was the first superintendent for nurses. The school moved to Jaro Road, Iloilo City, in 1929. Miss Flora Ernst, an American nurse, took charge in 1942. In April 1944, graduate nurses took the first Nurses Board Examination at the Iloilo Mission Hospital.

Saint Paul's Hospital School of Nursing (Manila, 1907). Established by the Archbishop of Manila, Jeremiah Harty, under the Sisters of St. Paul de Chartres in Intramuros, providing general hospital services. Its training school opened in 1908 with Mother Melanie as superintendent and Miss Chambers as principal.

Philippine General Hospital School of Nursing (Manila, 1907). PGH began in 1901 as a small dispensary for civil officers and employees in Manila and later grew into a Civil Hospital. In 1906, Mary Coleman Masters, an educator, pushed the idea of training Filipino girls for nursing and, with government approval, opened a dormitory for girls enrolled at the Philippine Normal Hall and the University of the Philippines. In 1907, with support from Governor General Forbes and the Director of Health, she opened nursing classes under the Bureau of Education. Admission ran on an entrance exam, and applicants had to have completed elementary education through the seventh grade. Julia Nichols and Charlotte Clayton taught nursing subjects, and American physicians lectured. In 1910, Act No. 1976 reorganized the school under the Department of Health, the Civil Hospital was abolished, and the Philippine General Hospital was established.

St. Luke's Hospital School of Nursing (Quezon City, 1907). An Episcopalian institution that began as a small dispensary in 1903. The school opened in 1907 with three girls admitted, who spent their first year in combined classes with the PGH School of Nursing and St. Paul's Hospital School of Nursing. Miss Helen Hicks was the first principal, Mrs. Vitaliana Beltran the first Filipino superintendent of nurses, and Dr. Jose Fores the first medical director.

Mary Johnston Hospital and School of Nursing (Manila, 1907). Started as a small dispensary on Calle Cervantes (now Avenida), called the Bethany Dispensary and funded by the Methodist Mission to relieve suffering among women and children. In 1907, Sister Rebecca Parrish, with registered nurses Rose Dudley and Gertude Dreisbach, organized the Mary Johnston School of Nursing. The training course began with three Filipino girls fresh from elementary school.

Philippine Christian Mission Institute Schools of Nursing. The United Christian Missionary Society of Indianapolis, Indiana, a Protestant organization of the Disciples of Christ, operated three schools of nursing.

Sallie Long Read Memorial Hospital School of Nursing (Laoag, Ilocos Norte, 1903).

The Start of Nursing Practice (1911-1921)

Act No. 2493 amended the Medical Law (Act No. 310) to allow regulation of nursing practice. In 1919, the first true nursing law was enacted through Act 2808, and the Board of Examiners for Nursing was created. The first nursing board examination was given in 1920. The first executive officer of the Board of Examiners for Nurses was a physician.

Mary Chiles Hospital School of Nursing (Manila, 1911). Established by Dr. WN Lemon in a small house on Azcarraga, Sampaloc, Manila. In 1913, Miss Mary Chiles of Montana donated a large sum that bought the present building at Gastambide. The Tuason Annex was donated by Miss Esperanza Tuason, a Filipino philanthropist.

Frank Dunn Memorial Hospital (Vigan, Ilocos Sur, 1912).

San Juan de Dios Hospital School of Nursing (Manila, 1913). In 1913, through the initiative of Dr. Benito Valdez, the board of inspectors and the executive board passed a resolution to open a school of nursing. The Daughters of Charity have run it since, with Sister Taciana Tinanes as the first directress.

Emmanuel Hospital School of Nursing (Capiz, 1913). In 1913, the American Baptist Foreign Mission Society sent Dr. PH Lerrigo to Capiz to open a hospital, assisted by Miss Rose Nicolet. The school offered a 3-year training course for an annual fee of Php 100.00. Miss Clara Pedroso was the first principal.

Southern Islands Hospital School of Nursing (Cebu, 1918). The hospital was established in 1911 under the Bureau of Health. The school opened in 1918 with Anastacia Giron-Tupas as organizer and Miss Visitacion Perez as the first principal.

A More Established Professional Organization (1921-1931)

The precursor to the country's accredited professional organization took shape in this period. The Filipino Nurses Association was established on October 15 and began publishing the Filipino Nurse Journal, later renamed The Philippine Journal of Nursing. In 1922, Act 3025, passed by the 5th Legislature, amended certain sections of Act 2808. Titled An Act Regulating the Practice of Nursing Profession in the Philippine Islands, it required all practicing nurses to register yearly. In 1929, the organization became a member of the International Council of Nurses.

Through the 1930s, Philippine schools of nursing kept adopting the aspects of American professional nursing they judged relevant, such as higher admission standards and the specialization of public health nursing.

Public Health Nursing Development (1931-1941)

In 1933, nursing schools raised their requirements: an applicant now had to complete secondary education to enter nursing. The first collegiate nursing graduates in the Philippines finished from the University of the Philippines School of Public Health Nursing in 1938.

Other Schools of Nursing

1. Zamboanga General Hospital School of Nursing (1921)
2. Chinese General Hospital School of Nursing (1921)
3. Baguio General Hospital School of Nursing (1923)
4. Manila Sanitarium Hospital and School of Nursing (1930)
5. St. Paul School of Nursing in Iloilo City (1946)
6. North General Hospital and School of Nursing (1946)
7. Siliman University School of Nursing (1947)

Nursing During World War II

The largest, most violent armed conflict in history reopened the need for nurses and spurred new programs to recruit women into training. In the U.S., the government pushed women to contribute, more women worked outside the home, and opportunities for nurses multiplied.

In the Philippines, the war sent Manila's public health nurses into devastated areas to attend the sick and wounded. A year later, 31 nurses taken prisoner by the Japanese army and held at Bilibid Prison in Manila were released to the Director of the Bureau of Health. As in the U.S., many public health nurses joined the guerrillas or hid in the mountains.

In 1946, postwar Bureau of Health records showed 308 public health nurses and 38 supervisors, down from the prewar 556 public health nurses and 38 supervisors. That same year, Mrs. Genera De Guzman, technical assistant in nursing of the DOH and President of the Filipino Nurses Association, recommended creating the Nursing Office in the Department of Health.

The Bachelor of Science in Nursing Degree (1941-1951)

A nursing curriculum based on the thesis of Julita V. Sotejo, a Philippine General Hospital School of Nursing graduate, laid out nursing education within a university-based College of Nursing. That thesis became the foundation for making the country's nursing program a baccalaureate course, and the College of Nursing was created in this period.

When the Japanese occupied the Philippines in 1942, training and practice at Manila's hospital schools of nursing were violently disrupted. U.S. colonial patterns in Philippine nursing education returned after the U.S. reclaimed the country in 1945 and persisted even after the Philippines gained independence on July 4, 1946.

The First Colleges of Nursing in the Philippines

University of Santo Tomas College of Nursing (1946). In its first year, it enrolled students from various nursing schools whose studies were interrupted by the war. In 1947, the Bureau of Private Schools let UST grant the title Graduate Nurse to 21 students of advanced standing. Sor Taciana Trinanes was its first directress.

Manila Central University College of Nursing (1947). The MCU Hospital first offered BSN and Doctor of Medicine degrees in 1947 and served as the clinical field for practice. Miss Consuelo Gimeno was its first principal.

University of the Philippines Manila College of Nursing (1948). The idea came out of a conference between Miss Julita Sotejo and the UP President. In April 1948, the University Council approved the curriculum, and the Board of Regents recognized the profession as equal in standing to Medicine and Engineering. Miss Julita Sotejo was its first dean.

Proliferation of Nurses as a Workforce (1951-1971)

The Philippine Nursing Law was approved under Republic Act No. 877 on June 19, 1953. A 1966 amendment limited practice to nurses 21 years old and above. The growing number of nurses brought Nurses' Week, proclaimed by President Carlos P. Garcia under Proclamation No. 539. It also drove the first wave of migration, mainly to the United States: between 1966 and 1985, about 25,000 Filipino nurses migrated there.

Nursing Profession Development (1971-2001)

Presidential Decree No. 223 regulated health care providers and established the Professional Regulation Commission. The Philippine Nursing Act of 1991 was amended under Republic Act No. 7164, expanding nursing practice into management, teaching, decision making, and leadership, and updating the qualification for nurses and academic faculty to a Master's Degree in Nursing or equivalent. In 1999, the Board of Nursing created the Nursing Certification Council through Resolution No. 14 to oversee new programs run by Specialty Certification Boards, which launched Advanced Practice Nursing (APN) in the Philippines.

Further Changes in Nursing Law (2001 to Present)

The Philippine Nursing Act of 2002 was enacted under Republic Act No. 9173, revising policies under Republic Act No. 7164. The changes tightened requirements for faculty and the Dean of Colleges of Nursing and set the conduct of the Nursing Licensure Exam.

At a Glance

Colleges of Nursing

1. UST College of Nursing, 1st College of Nursing in the Philippines: 1946
2. MCU College of Nursing, June 1947 (1st to offer the BSN, a 4-year program)
3. UP College of Nursing, June 1948
4. FEU Institute of Nursing, June 1955
5. UE College of Nursing, Oct 1958

1909

• 3 female graduated as "qualified medical-surgical nurses"

1919

• The 1st Nurses Law (Act #2808) was enacted, regulating the practice of nursing in the Philippine Islands. It set the nursing exam for the 2nd Monday of June and December each year.

1920

• 1st board examination for nurses, conducted by the Board of Examiners. 93 candidates took the exam, 68 passed, with the highest rating of 93.5% going to Anna Dahlgren.
• The theoretical exam was held at the UP Amphitheater of the College of Medicine and Surgery, the practical exam at the PGH Library.

1921

• Filipino Nurses Association established (now PNA) as the national organization of Filipino nurses.
• PNA 1st President: Rosario Delgado. Founder: Anastacia Giron-Tupas.

1953

• Republic Act 877, the "Nursing Practice Law," was approved.

Nursing was not always treated as a profession, but it has existed here for centuries, and its standing today rests on that long record of care, regulation, and contribution to Philippine society.