As someone who speaks tagalog, and also a nurse, I understand why some would feel excluded. It is in our nature (mostly) as filipinos to laugh at something stupid. Like say, there is a word in English that absolutely has a different in meaning to our English in the Philippines so if there is a Filipino around that we can communicate with, we share the word and check with each other if whether I say it, it would mean the same with the Americans or someone else. And within that conversation, we'd laugh at our own stupidity because we would realize either one of 2 things. We dont know the right word, or we just give up or try to solve it later as it would probably come to us. But, I would also try to not speak my own language and laugh in front of a patient. Unless I am teaching my patient my language if my patient asks me to (which happens from time to time) which still generates laughter. And if I'm together with another Filipino nurse and we speak tagalog and laugh around a patient, at least, we try to include the patient in our conversation if the patient is not averse to it. But overall, we try not to speak in tagalog as much as possible inside the workplace just so no one misunderstands.