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Part 1: Filipino American nurses, reflecting on disproportionate Covid toll, look ahead

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Part 1: Filipino American nurses, reflecting on disproportionate Covid toll, look ahead

Picture of Agnes Constante

This is the first story in a three-part NBC Asian America series, “The Impact of Covid-19 on Filipino Americans,” supported by the University of Southern California Annenberg Center for Health Journalism 2020 Data Fellowship.

Her other stories include:

Part 2: 85% of Filipino Americans reported Covid mental health issues, more than any Asian group

Part 3: To address Filipino American health disparities in future, experts look to past inequality

Courtesy Catherine Rubio
Courtesy Catherine Rubio
NBC News
Monday, June 7, 2021

LOS ANGELES — Catherine Rubio had planned on retiring from a 30-year full-time nursing career in the second half of 2020.

But shortly after stay-at-home orders were issued in Los Angeles County because of the coronavirus pandemic, she decided to leave her full-time job in July and work in the field part time.

She remembers struggling — especially in the earlier months of the crisis — with the possibility of contracting the disease because of her exposure to it on the job.

“It was challenging, because, of course, I was afraid of if I get it, how would I survive this? Then I will be leaving my family behind,” said Rubio, president of the West Los Angeles subchapter of the Philippine Nurses Association of Southern California. “There was a lot of fear and anxiety.”

Catherine Rubio, president of the Philippine Nurses Association of Southern California - West Los Angeles subchapter.Courtesy Catherine Rubio

Her decision to leave sooner than she had planned was largely rooted in a shift in her perspective while she worked during the pandemic. As she cared for Covid-19 patients who didn't have families or were uninsured or homeless, she thought about how fortunate she was to be worrying about others rather than herself. She also had to care for her elderly parents, who are at risk of severe illness if they contract Covid-19.

“I needed to prioritize what's important now, and I have the opportunity to be with my family,” she said.

As the country turns the corner on the pandemic, with more people getting vaccinated and cities reopening, Filipino American nurses, who account for nearly one-fifth of nurses in California, spoke with NBC Asian America about the emotional and physical toll it has taken, how the experience affected decisions about their careers, families and health — and how they ultimately feel a sense of resilience and optimism. 

Filipino Americans have been highlighted in the media throughout the past year because, while they are 4 percent of registered nurses nationwide, they account for about 25 percent of registered nurses who have died of Covid-19, according to data the union National Nurses United had gathered as of May 28.

paper published in the journal Gender, Work & Organization found that Filipino nurses are more likely than white nurses to work in wings like intensive care units, which increases their exposure to patients with severe Covid-19 symptoms.

The past year was a challenging one for Filipino American nurses, many of whom have pre-existing medical conditions that put them at high risk of severe illness from Covid-19, said Zenei Cortez, president of the California Nurses Association and National Nurses United. They also worried about becoming infected because of their exposure on the job and about bringing the virus home to elderly family members.

According to data from the 2017-18 California Health Interview Survey, an annual self-reported survey that offers insight into the health and health care needs of Californians, Filipino Americans have higher rates of diabetes and hypertension and of being overweight compared to Asian Americans overall, as well as higher rates of diabetes and hypertension compared to non-Hispanic whites.

“That's another add-on stress, that they're thinking that they need to be careful because they are at a much higher risk than their counterparts,” Cortez said.

Compounding the heightened risk was the fact that nurses had to fight for the protective equipment they needed to do their jobs safely. They were also left to take on increased workloads when California Gov. Gavin Newsom changed nurse-to-patient ratios, requiring nurses to treat three patients instead of two.

Judy Sastrillas, a registered nurse at Kaiser Permanente Los Angeles Medical Center, said the possibility of contracting Covid-19 caused her anxiety, especially after the death of a Filipino American nurse who had helped a code blue patient while wearing a surgical mask, she said.

The experiences of Filipino American nurses throughout the pandemic have led an increasing number to consider leaving the profession, Cortez said. She said three of her colleagues have expressed a desire to retire from nursing earlier than they had planned — a trend she didn’t see before the pandemic.

“It’s concerning, because these are seasoned nurses, and if more and more nurses like them quit or leave the profession, then I am worried about what will happen in the future,” she said.

It’s not just because of the physical demands of the job.

“It's also the everyday struggle, the everyday discussion with hospital management about defending your practice, advocating for the patient, begging for more staff, asserting a right to do what's right and good for the patient,” she said. “Those are the kinds of things that are really pushing the nurses to the limit and pushing us out sooner.”

Another source of concern for nurses throughout the last year, particularly those with at-risk family members, has been the heightened possibility of infecting others.