Imagine a group of White nurses sitting at the nurses’ station talking about their Black colleagues. One says the Black nurses stick together. Another says they always look out for their own. Someone mentions how many Black nurses have moved into leadership and wonders aloud whether they are helping other Black nurses get promoted. Eventually, someone gives this supposedly powerful network of Black nurses a nickname, one that connects their race with secrecy, collusion, influence and criminality.
Would anyone be uncomfortable yet?
Now change the room. A group of Black nurses is talking about their Indian colleagues. They complain that Indian nurses seem to hire other Indians, recommend one another for opportunities and always seem to know somebody who can get them through the door. Someone jokingly gives this network of Indian nurses a name associated with organized crime.
Now make the nurses Latino and the colleagues they are discussing Korean. Or Asian nurses talking about Middle Eastern nurses. The particular combination almost does not matter. Most healthcare professionals would recognize when that conversation had crossed into uncomfortable territory. At some point, the discussion stopped being about the conduct of individual nurses and started assigning behaviors, motives and power to an ethnic group.
Yet there is a version of this conversation that has become so familiar in nursing that it can be said publicly, casually, and sometimes without much hesitation: the “Filipino Mafia.”
The phrase has circulated in healthcare for years. Sometimes it is said with a laugh. Sometimes it is used affectionately. Sometimes Filipino nurses use it themselves. I have also heard non-Filipino colleagues use it almost admiringly to describe how connected Filipino nurses are and how fiercely they can look after one another. But the phrase can take on a very different meaning when it is used to explain why there are “so many Filipinos” in a workplace, why Filipino nurses supposedly get other Filipinos hired, why they hold leadership positions, why they protect one another or why someone believes opportunities are controlled by an inside group.
I am both Black and Filipino, and perhaps living at the intersection of those identities makes the contradiction particularly difficult for me to ignore. I know how a conversation would sound if non-Black nurses described Black nurses as a racially organized network that helps its own get ahead and then attached a nickname associated with criminality to that group. We would hear the racial tension. Yet as a Filipino woman, I have watched “Filipino Mafia” move through healthcare conversations with remarkably less friction.
So I find myself asking two questions: Who gets to say “Filipino Mafia,” and when does saying it cross a line?
The Answer Is More Complicated Than It Seems
It would be easy to declare the phrase offensive, tell everyone to stop using it and end the discussion there. I don’t think that adequately reflects how the term actually functions within nursing or within the Filipino community.
Filipino nurses themselves have different reactions to it. Some find “Filipino Mafia” offensive or uncomfortable. Others use it humorously, affectionately and even proudly. Within the community, the phrase can be shorthand for something Filipino nurses recognize immediately: we are connected. We know one another. Someone always knows someone, and when somebody needs help, somebody usually shows up.
Popular culture may have helped normalize the idea, too. St. Denis Medical has played with the “Filipino Mafia” as part of its comedy, while The Pitt has brought other recognizable aspects of Filipino nursing culture to the screen, including Filipino nurses speaking Tagalog around people who may not understand them. Representation like this can be funny precisely because there is something recognizable behind the joke. But it can also blur the boundary between observing a culture and feeling entitled to label it. When “Filipino Mafia” becomes a punchline on a mainstream television show, audiences may reasonably take away another message: apparently, this is okay to say. Hollywood didn’t create the phrase, but popular culture can help give people permission to repeat language they might otherwise stop and question. Seeing an inside joke on television, however, doesn’t necessarily make everyone watching part of the inside.
That distinction matters. Communities develop their own language, humor and inside references. Words used among people who share a culture and experience can carry meanings that are different from those same words spoken by someone outside the group. I am not interested in policing how Filipino nurses talk about themselves, nor do I think one Filipino person can decide what every other Filipino person should find acceptable.
But Filipinos are not the only people who use the phrase.
I have heard non-Filipino nurses use “Filipino Mafia” positively, too. If you have worked around a close Filipino community, you may recognize what they are trying to describe. Someone brings food to work and somehow there is enough for everybody. A colleague has not eaten during a long shift and someone notices. A new nurse needs help getting acclimated and an experienced nurse takes that person under their wing. Someone is looking for another job and a coworker knows a former colleague, cousin, classmate or friend at another hospital who may be able to help.
There can also be a strong protectiveness within those relationships. Filipino nurses may advocate for one another, mentor younger nurses, help newcomers navigate unfamiliar workplaces, share professional opportunities and open doors for people coming behind them. A non-Filipino colleague who has been welcomed into that circle may use “Filipino Mafia” affectionately, almost as a compliment to the strength of the network.
So does being non-Filipino automatically make using the phrase wrong? I don’t think the conversation is quite that simple.
Intent matters. Relationship matters. Context matters. And impact matters.
A non-Filipino nurse laughing while describing how Filipino coworkers have adopted her, fed her and made sure she never has to navigate the workplace alone is not having the same conversation as someone complaining that the “Filipino Mafia” controls hiring, protects incompetent nurses or prevents outsiders from advancing.
The words may be identical, but the message is not.
When Does It Cross a Line?
For me, the line becomes much clearer when Filipino identity stops being descriptive and starts becoming the explanation for negative behavior.
If a manager repeatedly hires unqualified friends or relatives, that is a legitimate concern about hiring practices. If nurses protect a colleague from accountability after an error, that deserves attention. If employees are being excluded from opportunities because they are not part of an inner circle, leadership should examine it. If there is bullying, favoritism, nepotism or discrimination, those behaviors should be identified and addressed.
But none of those behaviors is inherently Filipino.
There is a difference between saying, “This manager practices favoritism,” and saying, “The Filipinos take care of their own.” There is a difference between saying, “I feel excluded by this particular group of coworkers,” and saying, “The Filipino Mafia runs this place.”
The first identifies conduct. The second makes ethnicity part of the explanation for the conduct.
That is where the phrase crosses a line for me.
Mafia is not a culturally neutral word. It is associated with organized crime, secrecy, corruption, intimidation, collusion and loyalty to one’s own group. When that word is paired with an ethnicity and then used to explain hiring, promotion, leadership, influence or workplace power, we should recognize that the conversation has changed.
The fact that some Filipino nurses use the phrase themselves does not automatically make every use of it equivalent. An inside joke does not necessarily become culturally interchangeable when spoken by someone outside the community, particularly when it is being used to criticize the community.
What Are We Actually Trying to Describe?
There is another question worth asking before we decide that everything being called the “Filipino Mafia” is problematic behavior.
What if some of what people are describing isn’t misconduct at all?
What if Filipino nurses are mentoring other Filipino nurses, sharing job opportunities, recommending qualified colleagues, helping newly arrived nurses understand an unfamiliar healthcare system, making professional introductions, advocating for one another or simply making sure someone does not have to struggle alone?
In almost every other professional context, we have positive words for those behaviors. We call them networking, mentorship, sponsorship, advocacy and community.
Nursing actively encourages them. We tell nurses to build professional networks, find mentors and join professional organizations. We encourage experienced leaders to sponsor emerging talent and tell successful nurses to reach back and create opportunities for those coming behind them.
So when Filipino nurses do these things particularly well, why does mafia enter the vocabulary?
Filipino culture already has language that helps explain some of what people may actually be witnessing.
Bayanihan speaks to communal unity, cooperation and people coming together to help one another. The traditional image associated with bayanihan is members of a community gathering to help a family move its bahay kubo, or nipa hut, carrying the structure together. The underlying principle is simple: when someone has something heavy to carry, other people help carry the load.
Then there is malasakit, a deep sense of care and concern for another person’s well-being. It goes beyond simply feeling compassion. It reflects care that moves people toward action.
Those concepts provide a very different lens through which to view Filipino professional solidarity. What someone casually calls the “Filipino Mafia” may sometimes be bayanihan: nurses sharing knowledge, connections, opportunities and support so another person does not have to navigate the journey alone. What looks like an unusually protective group may sometimes be malasakit: seeing someone who needs help and feeling a responsibility to do something.
There is, of course, an important difference between looking out for someone and protecting someone from accountability. There is a difference between recommending a qualified colleague and manipulating a hiring process. There is a difference between mentorship and favoritism. Community does not excuse misconduct.
But neither should we mistake community for misconduct simply because the people practicing it share an ethnicity.
Why Are There So Many Filipino Nurses in the United States?
To understand the strength of Filipino nursing networks in the United States, it helps to understand how they developed.
The large presence of Filipino nurses in American healthcare did not happen by accident. It is connected to more than a century of complicated history between the United States and the Philippines.
Following U.S. colonization of the Philippines at the turn of the 20th century, American influence helped shape professional nursing education in the country. Nursing programs adopted American-influenced curricula and English-language instruction, helping create a nursing workforce whose education aligned closely with American healthcare. That history laid part of the foundation for what would eventually become a significant nurse migration pipeline to the United States.
After World War II, American hospitals expanded while the United States faced nursing workforce shortages. Filipino nurses increasingly came to the country through programs such as the Exchange Visitor Program. Between 1956 and 1973, more than 12,000 Filipino nurses entered the United States through that program. The Immigration and Nationality Act of 1965 created additional pathways for skilled professionals from Asia, while American hospitals and recruiters increasingly looked to Filipino nurses to help meet workforce needs.
American hospitals did not simply wait for Filipino nurses to arrive. During periods of nursing shortage, healthcare institutions actively recruited nurses from the Philippines.
In other words, Filipino nurses didn’t simply show up in large numbers in American hospitals. American healthcare recruited them because American healthcare needed nurses.
That history matters.
Many Filipino nurses came thousands of miles from home, leaving behind extended families, established communities and familiar support systems while navigating a different country, immigration system and healthcare environment. So they found one another.
They shared information about jobs and housing. They helped newcomers understand American hospitals. They made introductions, mentored younger nurses, formed professional organizations, supported families and helped colleagues get established. Over generations, those relationships developed into networks stretching across hospitals, communities, states and countries.
Seen through that history, the strong connections among Filipino nurses look considerably less mysterious. They are part of a larger story involving migration, American workforce needs, adaptation, culture and community.
There is an irony worth acknowledging here. American healthcare helped create the pathway, recruited Filipino nurses to fill its shortages and benefited from their labor for generations. Yet the networks those nurses built to support one another can now be characterized, even jokingly, using language associated with secrecy and organized power.
Understanding that history doesn’t excuse inappropriate workplace behavior. It does, however, challenge us to think more carefully about what we are looking at before deciding what to call it.
Perhaps Nursing Could Learn Something From It
Instead of viewing strong Filipino professional networks primarily through the lens of suspicion, perhaps nursing should also ask what can be learned from them.
Our profession talks constantly about mentorship, sponsorship, belonging, leadership development and retention. We tell nurses to build networks and encourage leaders to create opportunities for the next generation. Yet many nurses still describe feeling professionally isolated, unsupported or unsure of how to advance.
Filipino nurses have been building many of those support structures, formally and informally, for generations. There is something worth celebrating about getting through a door and then turning around to hold it open for someone else.
Perhaps what some people have been trying to describe as the “Filipino Mafia” is sometimes something very different: bayanihan, malasakit, mentorship, advocacy, solidarity and community.
So, Who Gets to Say It?
I don’t believe there is a simple rule that will satisfy everyone.
Some Filipino nurses will continue to call themselves the “Filipino Mafia,” laugh about it and see nothing wrong with the phrase. That is their relationship with their own culture and community. Other Filipino nurses may hear the same words and feel stereotyped or diminished. Their reaction is equally real.
For people outside the Filipino community, I think the question deserves greater care. Before using the phrase, consider what you are actually trying to communicate and whether ethnicity needs to be part of it.
If you mean that your Filipino coworkers welcomed you, fed you, mentored you and made you part of their community, perhaps say that.
If you admire how Filipino nurses network, advocate for one another and help colleagues advance, say that.
If you are alleging favoritism, nepotism, exclusion or misconduct, say that, document it and address the people responsible.
There is no shortage of accurate language available to us.
What concerns me is when “Filipino Mafia” becomes a shortcut that allows an ethnic identity to carry assumptions we would hesitate to attach publicly to other racial groups.
Nursing is a profession that asks us to practice cultural humility. That responsibility should extend beyond how we care for patients. It should influence how we speak about one another, particularly when race, ethnicity and culture enter the conversation.
So, who gets to say “Filipino Mafia,” and when does it cross a line?
Perhaps there isn’t one answer every Filipino nurse will agree on. But there is a question every healthcare professional can ask before using it:
What exactly am I trying to describe, and why do I need the word “Filipino” to describe it?
Sometimes the answer may be misconduct, in which case we should call the misconduct what it is. Sometimes the answer may be something far more admirable: a community that feeds one another, mentors one another, advocates for one another, shares opportunities and makes sure the next person does not have to figure everything out alone.
If that’s what we’re seeing, Filipino culture already has better words for it.
Bayanihan. Malasakit.
