Every time someone finds out I’m from the Philippines, I often get asked the same question: “How different is nursing back home compared to the US?”
As someone who had stepped away from nursing for a while and then returned to the profession after moving here, I thought I had an idea of what to expect. I was wrong.
Going back to nursing wasn’t just about refreshing my skills—it was a complete adjustment in how care is delivered, communicated, and documented. From language barriers to fast-paced, technology-driven workflows on the floor, everything felt unfamiliar at first.
What I thought would be a simple return turned out to be one of the most challenging transitions of my career.
First is the language barrier. I’m not even talking about English since I understand and speak the language—I mean Spanish. Where I live, it’s predominantly Spanish-speaking, especially among the older population.
Twice, patients asked for a different nurse because I couldn’t speak Spanish. What I appreciate now is that we have 24/7 interpreter services on our phones, which helps a lot. I do know how to introduce myself in Spanish, but honestly, it’s like playing tennis—I can serve, but I’m not confident I can return the ball after that.
Even small things added to the adjustment. There was a moment when my charge nurse asked if a Villareal had rounded, and I said no because I read it as “Vil-ya-ri-yal.” Here, it’s pronounced “Vi-ya-ri-yal.” Small things like that already showed me how different everything was.
That communication challenge didn’t stop at language—it extended into daily workflow. I found it really stressful at first to constantly talk to everyone, in person and especially on the phone. Even now, every time my phone rings, I still get a bit of tachycardia. We didn’t have work phones in the Philippines, so that alone was a big adjustment.
Back home, communication with doctors was more direct. They would pop in, you’d round with them, briefly discuss the patient, and then place mostly paper-based orders.
Coming here, I realized how structured everything is—from work phones to electronic documentation, everything is digital. It was my first time using a computer on the floor.
Medication systems like Pyxis was also new to me. I knew nurses could still make mistakes, but after using it, I could see why so many hospitals rely on it. It definitely adds another layer of safety.
No Pyxis, just me and my bestfriend figuring it out one medication pass at a time. 😅
Beyond workflow, the healthcare system itself was very different. The US has more resources overall, but insurance plays a big role in access and care. In the Philippines, access often depends more on location and how much you have. I remember a time when a patient’s family had to buy IV fluids outside the hospital because supplies weren’t always available in government facilities.
Looking back, I’ve seen and worked in two very different sides of nursing.
Working here taught me a lot about structure, technology, and how different healthcare can be. But my roots in the Philippines taught me resilience and how to make the most of what you have.
I don’t carry these experiences to compare which one is better. If anything, they just remind me of where I started and how much I’ve grown since then.
Bisaya Word of the Post
pagpahiangay (pag-pa-hee-a-ngay) - learning to adjust to a new environment
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