A Pinay’s Reflection

Contributor: Ashley M. Ruiz PhD, RN 

First off, I’m entitling this post “A Pinay’s Reflection”.  In submitting this piece I’ve been intentional in whether or not to explain this title to a dominantly white audience.  On the one hand, not explaining the title, and specifically the term “Pinay” may be a missed opportunity that leaves the reader uninformed, which could be interpreted as the responsibility of the writer.  On the other hand, in what I am emphasizing in this post is just this point.  The determination of value of a person’s existence based on their production for others to gain.  I believe that to create movement in decolonizing nursing requires active engagement, particularly when occupying spaces of privilege.  For this reason, I am intentionally not “defining” what “Pinay” means, and instead hope to encourage others that are not familiar with this term to critically reflect on what their reactions are to this decision, AND why their next actions (or inaction) are in response.  I would also encourage nurses to reflect on how these action(s) or inaction(s) will shape their knowledge bases that we utilize in informing our decisions as a nurse, and how that impacts the health and wellbeing of our patients and communities.  These are critical questions we need to be asking ourselves when we are making attempts to decolonize our actions, intentions, and impact as nurses. 

A Pinay’s Reflection

It’s Filipino American History Month.  And although the creation of this recognition emphasizes Filipinx contribution to “American” history (or dominant white American history), it’s important to express –or to at least stimulate some recognition or dialogue within nursing—nursing’s own role in perpetuating colonialism and racialization of Filipinx Americans (Choy, 2003).  Recognizing this history within nursing, and the perpetuation of present-day invisibility of Filipinx American voices within nursing knowledge generation (and existing health disparities within Filipinx American communities) forces us to reexamine our philosophy within nursing. 

The process of colonization for Filipinx/Filipinx Americans in the twentieth century started prior to first generation Filipinx Americans migrating to the States (Choy, 2003).  Due to shortages in labor after the abolition of slavery, colonial nursing education systems were developed and implemented in the Philippines with the primary purpose to serve the US mainland (Sabado-Liwag et al., 2022).  Immigration policies were enacted that highly encouraged Filipina women nurses to migrate to assist in addressing labor health care worker shortages. 

These strategic policies in connection to dominant ideologies, such as the model minority myth narrative that framed Filipinx American as possessing workforce traits (such as being “hard workers”, “loyal”, and “caring”) minimizes the value of Filipinx and Filipinx American existence and knowledge down to capitalistic terms of cheap labor that benefit the American economy. 

Today, the States employs more Filipinx-trained nurses than any other country (Oronce et al., 2021; Sabado-Liwag et al., 2022).  And during the COVID-19 pandemic, Filipino nurses were disproportionately assigned to care for COVID patients, which resulted in many deaths (Nazareno et al., 2021).  In addition, recent research is demonstrating the overlooking of disproportionate health disparities impacting Filipinx and Filipinx Americans due to aggregating race/ethnicity data (Oronce et al.,2021).   

Yet as nursing continues to address its role in perpetuating systematic racist legacies contributing to health inequalities, little discussion is recognized within our profession of this history and current reality impacting Filipinx and Filipinx American nurses (and patients). 

For this reason, I’m calling to hear from Filipinx and Filipinx American nurses themselves, with the intention of curating a space on Nursology.net that is specific to our voices in celebration of Filipinx American History Month.   Please feel free to direct your posts to Ashley.M.Ruiz@asu.edu

Maraming Salamat Po


Choy CC. Empire of care: Nursing and Migration in Filipino American History. Durham (NC): Duke University Press; 2003 

Nazareno, J., Yoshioka, E., Adia, A. C., Restar, A., Operario, D., & Choy, C. C. (2021). From imperialism to inpatient care: Work differences of Filipino and White registered nurses in the United States and implications for COVID-19 through an intersectional lens. Gend Work Organ, 28(4), 1426-1446. doi:10.1111/gwao.12657

Oronce CIA, Adia AC, Ponce NA. US Health Care Relies on Filipinxs While Ignoring Their Health Needs: Disguised Disparities and the COVID-19 Pandemic. JAMA Health Forum. 2021;2(7):e211489. doi:10.1001/jamahealthforum.2021.1489

Sabado-Liwag, M., Manalo-Pedro, E., Taggueg, R., Bacong, A., Adia, A., Demanarig, D., Sumibcay, J., Valderama-Wallace, C., Oronce, C., Bonus, R., & Ponce, N.  (2022).  Addressing The Interlocking Impact Of Colonialism And Racism On Filipinx/a/o American Health Inequities.  Health Affairs, 41(2), 289-295. 

About Ashley M. Ruiz PhD, RN

Dr. Ruiz is a Presidential Postdoctoral Research Fellow in the Edson College of Nursing and Health Innovation at Arizona State University.  Her current research focuses on examining the healthcare response to Black and Indigenous women sexual assault survivors, and examining interactions that cause secondary victimization by healthcare providers.  In the past, Ashley has practiced as a Sexual Assault Nurse Examiner in Milwaukee, Wisconsin.  This prior experience in nursing practice informed her identification of gaps where healthcare providers failed to address the needs of patients who experienced violence.  Based on this experience, Ashley began to pursue and completed a doctoral degree at the University of Wisconsin—Milwaukee, where she focused on advancing feminist theory in nursing science for the purposes of providing a theoretical foundation for addressing the problem of violence against women, particularly for Black and Indigenous women.  

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