The Unlikely History of Filipino Nursing

Lots of kids’ parents urge them toward careers in medicine, law, or engineering. Reynaldo “Ren” Capucao’s family suggested those fields along with one more, too: nursing.

“Growing up Filipino, I noticed that other parents didn’t say that,” recalls Capucao, a nurse and PhD student raised in Virginia Beach, Va. “I always wondered: Why are so many of us nurses?”

The answer – which spans more than a century and hearkens back to the Spanish American War’s 1898 end, the Jim Crow South, and even the post-9/11 fear of immigrants – is a lesson in history, migration, the American nursing shortage, and the ever-shifting sands of healthcare.

"Growing up Filipino, I always wondered: Why are so many of us nurses?"

Nurse historian Ren Capucao, PhD student, who's created a traveling exhibit focused on FIlipino nurses in Virginia

It’s also the topic of Capucao’s dissertation and a forthcoming exhibit, “Culture to Care: The History of Filipino Nurses in Virginia,” which will be on view at the Philippine Cultural Center in Virginia Beach this August. Across dozens of interviews, Capucao’s oral history project tells the story of Filipino nursing in Virginia through collected photographs, filmed narratives, and migration maps.

Though Filipinos make up just one percent of the American population, they make up more than four percent of nurses practicing in the U.S. Since the 1970s, Filipino nurses have comprised the largest group of internationally educated nurses practicing in the U.S., movement that contributed to Filipinos becoming the third-most populous group of Asian Americans overall (comprising nearly 20 percent of Asian-Americans, behind Indian and Chinese Americans).

Filipino migration to the U.S., says Capucao, came in four waves: American colonialism to pre- World War II, roughly 1940 to 1965, from `65 to the present, and a final wave compelled through chain migration.

After the Spanish-American War ended in 1898 and the U.S. took control of the Philippines, the import of Western institutions, including nursing and medicine, and a series of subsequent legislative maneuvers (including the development of U.S.-led nurse training programs in the Philippines, the Hill-Burton Act of 1946, which fueled construction of new American hospitals, and the 1948 Exchange Visitor Program and Immigration Act of 1965, which opened up opportunities for thousands of Filipino nurses to work in the U.S.) created a growing demand for nurses and an established route toward opportunity for Filipinos, who were only too happy to fill the gap.

Once in the U.S., Filipino nurses imbalanced the clinical and racial hierarchy of nursing, and, being considered neither white nor black, encountered racism and, in some cases, hostility. Still, in most environments they were embraced and flourished, and in their adopted homeland created “a sense of community, a sense of familiarity, and a transnational linkage back to the Philippines,” explains Capucao.

The wave of Filipino nurse immigrants included Capucao’s mother, Jolly, one of eight children from a rural fishing town to whom “the nurse’s white cap became a symbol of her hopes and dreams.”

It wasn’t an easy journey. Motherless at 14, Jolly became a parental figure to six younger siblings and, after graduating from a Philippine nursing school, took a job as a public health nurse in her hometown while raising her younger siblings and putting them through school. It wasn’t until her eldest brother enlisted in the U.S. Navy and petitioned for her citizenship that Jolly arrived in the U.S., settled in Virginia Beach, part of the Hampton Roads region which today has the largest population of Filipinos on the East Coast.

By 1990, Jolly had passed her nursing board exam, was working as a nurse, and, in 1992, gave birth to Ren, who would carry on the family’s nursing tradition, becoming an RN in 2019 after graduating from UVA’s Clinical Nurse Leader master’s program.

In May, Capucao earned his nursing degree. This July, his mother Jolly will retire after more than 40 years of service as a nurse.

Capucao, who will continue his research as a doctoral student in nursing this fall, says the experience has also informed his understanding of Filipino culture, America’s sometimes fraught history with immigrants, the factors that compel migration, and deepened his knowledge of his own family’s backstory, as well as his trajectory into nursing.

He received support for the project from several Filipino nurse advisors, the Philippine Nurses Association of Virginia, the Filipino American National Historical Society, and was mentored by Barbra Mann Wall, director of UVA’s Bjoring Center for Nursing Historical Inquiry, and Aprilfaye Manalang, a professor of history and interdisciplinary studies at Norfolk State University.

“I’m not where I am because of chance, but because of a culmination of historical events,” says Capucao. “The reason why I want to become a nurse historian is to venerate my mom, and the stories of unknown nurses who forged the path that I'm able to take.”

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