VOLUME  1 | ISSUE 9 | JUNE 2025

Resilience in Uniform: Thriving Against the Odds to Sustain Nursing in the Philippines

 Gerly Mark R. Redoble

Abstract

Nurse retention continues to be an issue in the Philippines. Even though there is a steady inflow of trained nurses, a considerable number of them—either choose to migrate out of the country or exit the profession—stop working. Here, there are competing phenomena, including economic forces, workplace policies and psychosocial factors that need to be understood together. The fact that nurses need to possess psychosocial coping strategies also termed 'resilience' has seemingly made an important difference in nurses’ intentions to stay or leave. This paper seeks to understand how resilience enables nurses to cope with the demands of their work, as well as the enabling conditions for resilience to thrive. In this context, local studies and more recent data are used to analyze how, for Philippine healthcare, improving resilience strategically to mitigate the crisis of retention in healthcare professionals.

Introduction

The Philippines has gained the reputation of producing of highly competent nurses. Every year, there are thousands of newly graduate pass the Nurse Licensure Examination, well-equipped to join the health care force. In 2024, over 37,000, newly licensed nurses added to the registry (Daily Guardian, 2024). Amidst this number, majority of the health facilities especially those who are in provinces continue to report lacking of workforce and a high attrititon rate of nurses. This irony begs the question: Why are we losing our nurses faster than we can replace them?

Among the various reasons cited- low salaries, lack of career mobility, and heavy workloads- there is also a deeper, more personal dimension to this crisis. How nurses managing emotionally? Are they equipped to cope with the daily adversity, trauma, and exhaustion that come with the job? Interestingly, researchers and hospital leaders are turning their attention to a concept known as resilience- he inner capacity of the individual to bounce back from difficulty, stay engaged, and persist to care, even in challenging situations.

This paper looks into the role of resilience in shaping nurse retention in the Philippines. Specifically, awe ask: what makes a nurse resilient, and how organizations support relience in a way that encourages nurses to stay?

Understanding Resilience in Nursing

Resilience is more than just the ability to “power through”. In nursing, it refers to the emotional and psychological recover from stress, remain optimistic, and find meaning in one’s work, even when faced with exhaustion and uncertainty (Jacson et., 2007). In more recent studies, resilience is described not as a fixed trait but as a dynamic and evolving capacity shaped by both personal and workplace factors (American Association of College of Nursing 2021; Cooper et al., 2020).

Resilience encompasses self-awareness, emotional regulation, optimism and the presence of strong support system. It also closely tied to a nurse’s ability to adapt and grow through difficult experiences. As Cooper et al. (2020) explained, resilience among nurses is not only an individual quality but also influenced by leadership, team culture, staffing levels, and organization support. These environment factors either nurture or hinder a nurse’s capacity to stay grounded and fulfilled in their role.

In the Philippine context, this concept takes on even deeper meaning. Filipino nurses, both in public and private hospitals, often work under pressure- long hours, insufficient resources, understaffed units, and at times delayed compensation (Manaloto & Listones, 2024). Despite, these systematic issues, many continue to show resilience-driven by a deep sense of duty, faith, family motivation, and the enduring spirit of “malasakit” (compassionate care).

Delos Santos et al. (2022) found that Filipino nurses with higher levels of resilience particularly in areas such as decompressing after shift and maintaining a sense of meaning in their work- showed greater engagement in their roles, even when assigned to critical or high-risk units. this supports the idea that resilience not only help nurses push through tough times but also allows them to grow, find fulfillment, and stay committed to their calling. 

Strengthening resilience, however, isn’t something nurses should be expected to handle alone. It is a shred responsibility. Hospital Institutions have a vital role in creating a workplace where resilience can flourish through simple but meaningful efforts like offering mentorship, recognizing hard work, promoting psychological safety, and ensuring manageable workloads. In a job that demands so much from the heart and mind, these kinds of support can make all the difference.

In nurturing resilience, we protect not just our nurses but the health system itself. After all, resilience nurses are the cornerstone of sustainable, high-quality care. Their strength is not in being invulnerable-but in their ability to rise, reflect, and continue caring with heart, even when circumstances are tough.

Why Nurses Leaves

One of the most pressing reasons nurses cite for quitting is due to financial hardships. A nurse in a government hospital may earn around 33, 575 pesos per month under Salary Grade 15, while nurses working in private hospitals earn between 8,000 to 15,000 pesos monthly barely enough to keep their family afloat (Philstar, 2024). Given these circumstances. It is not surprising that many seek jobs abroad where salaries are higher.

Moreover, the burden of financial insecurities also affects resilience. When basic needs are not met, it become harder for individual to focus on emotional coping or job satisfaction. Herzberg’s motivation-hygiene theory supports this- poor compensation is a hygiene factor that can demotivate, even if other parts of the job are fulfilling.

In addition to financial insecurities, a nurse-patient ration of 1:12 is the recommended in many countries, however in the Philippines, nurse can be assigned to 30-50-40 patients per shift (PMC, 2023). This workload not only increases the risk for medical errors and burnout, but also drains emotional energy.  Even the most passionate nurse can feel defeated in such setting.

With persistent exposure, this undermines resilience. Emotional exhaustion one of the key components of burnout-sets in when nurses can no longer feel they can make a difference or when they feel constantly overwhelmed.

Equally important is career growth for nurses. The lack of continuing education programs, specialization pathways, or leadership training opportunities leads to feelings of being stagnant in one’s role.

As a result, when nurse see no opportunity to advance, their motivation declines. They may start to question their long-term future in the profession. On the other hand, nurses who feel they are growing in their careers are more likely to stay committed to work and resilient (Chato, 2024).

Building Resilience: What Works?

Nurses who work under leader who listen, encourage, and advocate for them tend to have higher morale. Transformational leadership- where managers inspire and motivate through positive relationships- has been shown to increase both resilience and retention (Chato, 2024). Leaders who recognize hard work, give constructive feedback, and protect their staff from unnecessary stressors create an environment where resilience can thrive.

On the other hand, passive leadership styles can add stress and confusion. What they truly need is clear direction, emotional support and reassurance their opinions are are valued when important decisions are made in the organization.

Furthermore, nurses tend to stay longer in their jobs when they feel that their work is meaningful. One study conducted by Central Philippines found that work engagement was an important indicator of job satisfaction and retention (PubMed, 2023). Nurses who said they were fully focused on their work and found purpose in caring for patient were also better at handling tough situations.

To support this, helping nurses reflect on their work, share patient success stories, and involving them in quality improvement can make their work feel more meaningful and impactful.

After all, no one understands a nurse like another nurse. Peer support is a powerful buffer against burnout. Creating strong, collegial teams where nurses can debrief, laugh, and support each other contributes greatly to resilience. Shared challenges feel lighter when they are faced together.

For example, programs such as peer mentoring, buddy systems, or regular team huddles can improve sense of belonging and emotional safety at work.

In addition, opportunities for further training can rekindle motivation. Platforms like Optum Health Education Global now offer free online training to Filipino nurses, allowing them to upgrade their skills without leaving their jobs (Philstar, 2024). These initiatives are especially important in provincial hospitals, where access to formal continuing education is limited.

To address nurse retention in sustainable way, resilience-building must be part of broader institutional and policy strategies. Here are four priority areas. Implement legislations ensuring fair compensation for both private and public hospitals. Secondly to strengthen human resources by ensuring safer nurse-to-patient ratios and adequate staffing. Third, institutionalize resilience program such as mental health services, reflective practice groups and stress debriefing. And lastly, invest in leadership development to train nurse managers in evidence-based leadership styles that foster supportive work environment.

Conclusion 

Nurses are the foundation of the Philippine healthcare system, but they are under immense pressure. Many have remained, not because the system is idea, but because of their resilience- the inner strength to carry on despite challenges. However, resilience should not be expected to compensate for the systemic failure. It must be supported, nurtured, and protected. 

If we are serious about retaining our healthcare workforce, then we must also be serious about building the conditions where resilience can thrive. Only then we can expect our nurses not just to stay- but to thrive.

References:

American Association of Colleges of Nursing (AACN). (2021). Developing nurse well-being and leadership toolkit: Resilience concept. https://www.aacnnursing.org/developing- nurse-well- being-and-leadership-tool-kit/tool-kit/resilience-concept

Cooper, A. L., Brown, J. A., Rees, C. S., & Leslie, G. D. (2020). Defining the influence of external factors on nurse resilience. Journal of Clinical Nursing, 29(19–20), 3597– 3599. https://doi.org/10.1111/jocn.15276

Chato, A. O. (2024). Leadership Style and Job Satisfaction on Retention among Nurses in a Healthcare Facility. International Journal of Research and Scientific Innovation, 11(10), 444–473.

Daily Guardian. (2024). PH Produces 37,000 New Nurses in 2024, Faces Retention Issues. https://dailyguardian.com.ph/ph-produces-37000- new-nurses-in-2024-faces-retention-issues

Delos Santos, M. R., Sumpay, A., Reyes, M. S., Gatchalian, M. C., Gamboa, M. L., & Garma, P. F. (2022). Resilience and work engagement of Filipino nurses working in COVID-designated units in a national university hospital. The Philippine Journal of Advanced Nursing, 1(1). https://philjan.online/index.php/PhilJAN/article/view/4

Jackson, D., Firtko, A., & Edenborough, M. (2007). Personal resilience as a strategy for surviving and thriving in the face of workplace adversity: A literature review. Journal of Advanced Nursing, 60(1), 1–9.

Manaloto, A., & Listones, N. (2024). Resiliency among Filipino nurses in the face of nurse to- patient ratio. Globus: Journal of Medical Research, 3(2), 25 35. https://ww.researchgate.net/publication/390569634

Philstar. (2024). Where have all the nursegone? https://www.philstar.com/opinion/2024/03/10/233938 5/where-have-all- nursesgone

Philstar. (2024). Optum Philippines champions continuing education as key to solving nursing crisis. https://www.philstar.com/lifestyle/business- life/2024/10/22/2394168

PubMed. (2023). Relationship of Work Engagement with Nurse Work and Patient Outcomes in Central Philippines. https://pubmed.ncbi.nlm.nih.gov/39618981

PMC. (2023). Nurse Staffing and Outcomes in Philippine Hospitals. https://pmc.ncbi.nlm.nih.gov/articles/PMC10424539

The Impact of Influencer Marketing on Gen Z Purchase Behavior

Chona S. Sigue, Ph.D.

Abstract

Influencer marketing has become a dominant force in digital advertising, particularly among Generation Z (Gen Z) consumers. This paper explores how influencers affect Gen Z's purchasing decisions, focusing on the roles of trust, authenticity, and social media engagement. Using recent studies and consumer behavior models, it demonstrates that influencer marketing is more than a trend—it is a critical strategy for reaching a generation that values relatability and ethical alignment in brand communication.

Introduction

Generation Z, born between 1995 and 2010, represents a demographic that has grown up in a hyper-connected digital environment. Their heavy reliance on mobile devices and social media platforms has significantly reshaped traditional marketing approaches. Influencer marketing, where brands collaborate with individuals who have built social credibility, is particularly influential among Gen Z due to their preference for peer-driven and authentic content (Williams et al., 2022). This paper investigates the mechanisms through which influencer marketing impacts Gen Z purchasing behavior and offers insights for brands aiming to engage this segment effectively.

Influencer Marketing and Gen Z Psychology

Gen Z consumers are known for their skepticism of traditional advertising and strong preference for authenticity. Unlike earlier generations, they are more likely to respond to user-generated content and peer reviews than to polished brand campaigns (Fromm & Read, 2018). Influencers, especially micro-influencers, often appear more relatable and trustworthy than celebrities, which positions them as credible voices in shaping opinions and purchase decisions.

The parasocial interaction theory suggests that audiences develop one-sided emotional bonds with media figures, which can lead to increased persuasion (Horton & Wohl, 1956). For Gen Z, these interactions often occur through daily vlogs, Q&A sessions, and unfiltered storytelling on platforms like TikTok and YouTube.

Platform Dynamics and Purchase Behavior

TikTok, Instagram, and YouTube are among the most influential platforms for Gen Z consumers. According to a Morning Consult (2023) report, 72% of Gen Z follow at least one influencer, and 50% report purchasing a product based on influencer recommendations.

TikTok, in particular, leverages short-form video content that blends entertainment with product exposure. Viral trends under hashtags like #TikTokMadeMeBuyIt showcase the direct link between influencer content and consumer action (Smith, 2023). The platform's algorithm amplifies reach beyond follower count, enabling even micro-influencers to impact large audiences quickly.

 Authenticity, Trust, and Ethical Expectations

Gen Z values transparency, ethical behavior, and brand alignment with social issues (Francis & Hoefel, 2018). Influencers who consistently demonstrate these values earn long-term trust, while those who promote products they do not genuinely use risk being labeled inauthentic.

Disclosure of paid partnerships (e.g., via #ad or “sponsored” tags) is critical. Failure to disclose sponsorships may lead to distrust and diminish the perceived integrity of both the influencer and the brand (Evans et al., 2020). Therefore, authenticity is not only a marketing advantage—it is a requirement for success with this demographic.

Risks and Limitations of Influencer Marketing

While influencer marketing can yield high returns, it is not without limitations. Overexposure to promotional content can lead to "influencer fatigue," where audiences become desensitized to endorsements (Djafarova & Rushworth, 2017). Additionally, misalignment between influencer values and brand identity can result in reputational risks and consumer backlash.

To mitigate these risks, brands must conduct due diligence when selecting influencers and foster long-term relationships built on mutual value alignment.

Conclusion

Influencer marketing is a powerful and evolving strategy that resonates deeply with Generation Z. Its success lies in leveraging authenticity, trust, and platform-specific engagement to shape consumer behavior. As Gen Z's purchasing power continues to rise, brands that embrace genuine influencer partnerships and align with social values will be best positioned to succeed in a competitive digital marketplace.

References

• Djafarova, E., & Rushworth, C. (2017). Exploring the credibility of online celebrities' Instagram profiles in influencing the purchase decisions of young female users. Computers in Human Behavior, 68, 1–7. https://doi.org/10.1016/j.chb.2016.11.009

• Evans, N. J., Phua, J., Lim, J., & Jun, H. (2020). Disclosing Instagram influencer advertising: The effects of disclosure language on advertising recognition, attitudes, and behavioral intent. Journal of Interactive Advertising, 20(2), 1–14. https://doi.org/10.1080/15252019.2020.1769513

• Francis, T., & Hoefel, F. (2018). ‘True Gen’: Generation Z and its implications for companies. McKinsey & Company. Retrieved from https://www.mckinsey.com

• Fromm, J., & Read, A. (2018). Marketing to Gen Z: The Rules for Reaching This Vast--and Very Different--Generation of Influencers. AMACOM.

• Horton, D., & Wohl, R. R. (1956). Mass communication and para-social interaction. Psychiatry, 19(3), 215–229.

• Morning Consult. (2023). The Influencer Report: What Influences Gen Z's Buying Decisions. Retrieved from https://morningconsult.com

• Smith, A. (2023). The power of #TikTokMadeMeBuyIt: How social media is changing shopping habits. Marketing Week.