For this nurse, his vocation is an extension of his culture 00:00

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For this nurse, his vocation is an extension of his culture

Nurse and historian Ren Capucao reflects on how his Filipino identity motivated him to study the history of Filipino nurses in the U.S. In doing so, he came to better understand himself and his mother’s journey into the nursing field.

Ren Capucao 
My parents never really talked about their past when I was growing up. They didn’t really share their past with me until I mostly started asking about it. And that wasn’t really until graduate school. With my teenage angst, I just didn’t really want to understand my parents at the time. I felt in my mind, there’s no way they could understand how I feel, being a second-generation Filipino American, being also gay. 

So my name is Ren Capucao. I live in Richmond, Virginia. I currently go to the University of Virginia, and I’m a Ph.D. student in nursing over there. And I also work as a pediatric nurse. 

My parents, they’re both first-generation immigrants from the Philippines. And they both arrived here around the late 1980s. My mom went first to the United States and my dad followed a couple years after, and I was born here in Virginia, in 1992. 

Ren Capucao and his mother, Jolly, pose together in May 2019, on the day of his professional entry into nursing through the University of Virginia’s masters program. (Photo courtesy of Ren Capucao)

I have one sister, and she’s also in the healthcare field. My mom has been a nurse for over 40 years, she retired the same year that I graduated from nursing school. And my dad, he’s not in the healthcare field. He’s into technology and stuff, but he currently works at a factory. 

I think, for both me and my sister, we both had a somewhat form of cultural dissonance. I think for both of us, we’re not really entirely sure what being Filipino-American means. I didn’t really learn much about Filipino culture, where what was mostly passed on, it seemed, was more superficial-like. It was very much grounded around, you know, large family gatherings, Catholicism, and you know, the food. The food is so important in Filipino culture. But I didn’t actually, like, learn about what does it mean to be Filipino? What’s the history? What’s the culture? Like, the actual, I don’t know, depth of the culture, I didn’t really learn that from my parents, or from my surrounding family, or the community. 

And with this idea of the Filipino nurse, I know amongst Filipino culture, it’s pretty common to suggest nursing as a profession. But, for me, I don’t think I ever really considered being a nurse until much later in my life. Like, I remember, I was age 10, where I listed the top three professions of what I would want to do in the future. And the three were “a doctor,” “a history teacher,” and — I always reluctantly put “nurse” at the bottom. Even though I didn’t want to be a nurse at that time, I felt kind of … it’s supposed to be there. Even if I didn’t want it. 

I think becoming a nurse was reluctant for me growing up because I honestly just found nursing an extension of Filipino culture. There was just so much tension I feel between myself and my parents and the culture that we shared, that I didn’t know about. And, you know, all the things that I had to go through growing up. From hearing about Catholicism — it’s not okay to be gay. Like all of it kind of meshes together to kind of formulate what my idea was of Filipino culture. And so I pushed almost everything away that associated itself with Filipino culture. And so I distanced myself from nursing. Like, there were positives to nursing, like I did see the value of — my mom did raise me well, she cared for me. She’s one of those compassionate, empathetic people I know. She passed on those values on to me. It’s just — those traits that she had, I didn’t exactly connect it with nursing, I connected it to her as a person. Eventually, when I did make the connection of those values that she had — and I actually did research on what the nursing ideology is — it made it pretty clear that out of all the healthcare professions that I wanted to become, being a nurse was the obvious choice. 

Ren Capucao and his mother, Jolly, on his 3rd birthday in August 1995, in his hometown of Virginia Beach, Virginia. (Photo courtesy of Ren Capucao)

I actually supplemented my master’s education, which was clinical based — had nothing to do with history. I cold-emailed this professor who was the director of the Nursing History Center at the University of Virginia, and she agreed to be my mentor. So I was learning the history of nursing. At the same time, I was learning how to become a nurse. My advisor pushed me into the field of historical research pretty fast. So I was already conducting oral histories within, like, nine months. 

I think what the goal of those oral histories — they were more open-ended and broad just wanting to understand these nurses’ own experience. And so, when I asked my mom about her life as a nurse … she was very hesitant in speaking about it. But that’s because she’s also a very guarded person. 

She’s probably the best nurse that I know. But I’m biased, of course. But, it’s because she’s been a nurse for her entire life — from when her mom died when she was 14. Back in the Philippines, she had eight other siblings. And so when her mom died, she had to take care of her six younger siblings. She had become the maternal figure of her family at a very young age, like, she had to learn how to grow up very fast. I remember she said that she didn’t like high school, because she had to take care of everyone, and there’s a lot of stress that was on her. So finally being liberated, going to nursing school, away from her hometown, was very emotional, and I was nervous to interview my mom, to be honest, because she doesn’t really talk about her past. But when we did do it, it was interesting to hear her talk about herself and her experience. And be vulnerable, I suppose, in telling her story. 

(Archival tape from interview with Ren’s mother)   
Ren: Was there a reason why you wanted to be a nurse?
Jolly: Well, sorry— 
Ren: No, no, it’s fine. Take your time.
Jolly: Yeah, because … I always like, fascinated with their white uniform, with their cap in their head. I said — I said, oh, I want to be a nurse. This looks like it’s nice. And then a lot of opportunities going abroad, that’s what they say.

Ren Capucao 
And it helped a lot when the community helped fund her education to go to nursing school.

(Archival tape of interview with Ren’s mother)
Jolly: And of course, we’re not really rich, so I said, ‘Oh, I have to finish my school.’ And then your Uncle Alven joined the navy, so he’s really the one who helped me with my studies, aside from your Grandma Soling.
Ren: And you were the first nurse in her family, correct? 
Jolly: Yes I am.

Ren Capucao 
This was her childhood dream to become a nurse, to travel the world. And I think her mom passing and not being able to do anything about it also helped my mom further strengthen her resolve. Being able to take care of all her younger siblings too — also strengthened her resolve. And I don’t blame her considering the history of American nursing in the Philippines.

It dates back to the beginning of the 20th century. It was a way for Filipino women to move outside of the domestic sphere, to travel abroad to the United States at a very early time. And knowing how patriarchal Philippine and American culture were at that time, you can imagine how liberating nursing was for these women. 

So, by the 1920s, we see that there is a beginning oversupply of Filipino nurses and an underwhelming amount of employment opportunities, so we start just seeing a build-up of nurses. And by 1934, the Tydings–McDuffie Act limits immigration to the United States.

But this changes by the midcentury where there’s a huge expansion of health care going on. The Hill-Burton Act supports the building of thousands of hospitals across the country. There’s a lot of trauma and death going on from post-World War II. And so there’s a need for nurses in that way. But at the same time, also biomedical advances are happening where we need more nurses who are capable of handling more critically ill patients. And by 1965 we also see the passage of Medicare/Medicaid, which allows for more coverage of Americans. So we see just the huge need for nurses in the United States. And I think it is rather serendipitous that the United States created an Americanized nursing workforce in the Philippines, because by the midcentury they do start recruiting more and more nurses from the Philippines. 

Like they’ve been recruiting nurses from Europe and such. But with the Exchange Visitor Program, which was created in 1948 — during the Cold War era — we first see the migration of Filipino nurses coming aboard. And by 1965, with also the Immigration Act, which expands migration from non-Western countries — which also favors professionals and educated persons. So then it just makes for this really strange formula for them to come abroad.

But my mom didn’t really know about this past, I would say. Just talking to nurses in the Philippines about nursing history, it’s not really a part of the curriculum to understand — to critically understand your own profession. 

Jolly Capucao (center), on her graduation day in 1976 from the baccalaureate nursing program at the University of Pangasinan in Dagupan, Philippines. (Photo courtesy of Ren Capucao)

I just thought that nursing would give me a way to better understand myself, but also, I just wanted a sense of grounding, a sense of knowing. And so with studying the history of Filipino nurses — I think for a lot of these Filipino nurses, belonging has also been a huge part of their meaning-making, in terms of where do they feel most comfortable? Where do they feel that they do belong? And so the pandemic has given another perspective on my work. Like the simple question of why are so many Filipino nurses dying? At least a minimum 4% of the American nursing workforce identifies as Filipino. And from reading the literature in the news, I keep seeing that Filipino nurses comprise about 30% of all nursing Covid-related deaths. Like, why — why are so many dying? I honestly can’t explain it to the full extent that people would want. 

A lot of people want an epidemiological or quantitative answer, but we have to also step back for a moment and realize, it’s a large socio-historical context that frames how these nurses went into nursing and how they end up in the places where they are. So in terms of my research, alongside the pandemic, I think it gives light to trying to understand these larger, broader processes and events that are happening. And eventually, when I chose to understand my parents, it’s also the same method that I have with them of trying to ask them questions about their lives and connecting it to the broader history of where we are now. 

(Archival tape of interview with Ren’s mother)
Ren: It’s amazing, you know, like, you’ve done nursing for like 40 years, and you’ve just, you know, still maintained it. What motivates you to keep doing your job?
Jolly: You guys (laughs). I have to work, so I can send you to school. And then I can give you all the things that you need. 
Jolly: But then, I like the job.

Sonia Paul
Thank you to Ren Capucao for sharing his family home videos and oral history interview with his mother to help make this story. For iPondr, this is Sonia Paul.

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Sonia Paul

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