In the late-night quiet of the hospital, there was always a knock on the call room door. It wasn’t an urgent consult — it was Tito Fedy, a senior dialysis nurse. With a gentle voice, he would ask, “Have you eaten yet?”

Tito Fedy wasn’t just any nurse. He was a father figure to us fellows in training, a fellow Filipino who brought a sense of warmth and humanity to the sterile hospital corridors in the US. He checked on us not because it was part of his job but because he cared. His presence made the long, exhausting nights feel a little lighter.

Returning home to the Philippines, I couldn’t help but notice the stark contrast in how nurses and other healthcare providers are treated here. In the US, Tito Fedy’s skill and dedication were well-compensated. Back home, many nurses work tirelessly under far more challenging conditions, for salaries that barely allow them to make ends meet. And yet, Filipino nurses aren’t asking for much.

In 2015 or 2016, I found myself in a position to do something about it. At the time, the attrition rate at one of the largest hospitals in the country was staggering — 20 to 30 nurses resigning every month. The hospital was bleeding talent, and it was only a matter of time before the quality of patient care would suffer irreparably.

I was young, relatively new to administration, and not in a position of major influence. But I had seen enough to know that silence wasn’t an option. Without informing the CEO or the CMO, I wrote a letter directly to the board members — the most powerful people in the hospital. I laid out the facts: the attrition rate was threatening patient care, and the nurses weren’t asking for much — just enough to feel that their work was valued.

That letter sparked an emergency board meeting. To my surprise, the board approved a cost-of-living allowance of P6,000 for the nursing staff. It wasn’t a monumental sum, but it sent a powerful message. Attrition rates dropped from 20-30 nurses per month to just 8. It wasn’t just about the money — it was about recognition, about letting nurses know that their voices mattered.

One of my first roles in hospital administration was as the head of the Center for Renal Disease. At the time, we prided ourselves on teamwork. Our Viber group was called Team Renal, and our hashtag was #RenalFamily. That sense of camaraderie made the hard work feel lighter, and it fostered loyalty among the team. Now, about a decade later, I barely recognize the place — or most of the people who work there. It’s a sobering reminder of how transient healthcare teams can be when we fail to invest in people and foster connections.

Unfortunately, many hospital administrators default to the excuse that “we can’t compete with other countries.” This mindset, as far as I’m concerned, is a cop-out. It assumes that money is the only reason Filipino healthcare workers leave, ignoring the other factors that matter just as much — respect, working conditions, career growth, and the simple acknowledgment of their contributions.