For most internationally educated nurses (IENs), Canada & United States are the top destinations for a nursing career in North America. With the high demand of health care and very favourable wages, it’s undeniably “too appealing”. Equipped with various skill sets and experiences, internationally educated nurses migrate to Canada as the country’s warmth and multicultural workforce invites each aspiring nurse to pursue their career and live the Canadian dream.
In 2013, according to Canada’s Regulated Nurses: A Look at Internationally Educated Nurses in Ontario and Canada publication, the top countries of internationally educated nurses in Ontario were from the US, UK, Poland, India, China and the Philippines. There was a significant decrease of the growth in the supply of IENs in Ontario from 2009 to 2013. Additionally, in 2013 about 64.6% of internationally educated registered nurses (RNs) were employed at a hospital compared to Canadian educated nurses which was 63.4%. Moreover, internationally educated registered practical nurses (RPNs) who were employed at a hospital was 25.1% as opposed to Canadian educated nurses which was 43.5%.
Now, let’s go back to the part where there was a decline of IENs growth in Canada. The reason being was the assessment process became more expensive, lengthy and biased. The launch of the National Nursing Assessment Service (NNAS) added a fair amount of difficulty to IENs who were willing to reciprocate their international licenses to a Canadian nursing license and integrate into the workforce. In fact, the proficiencies of these professionals are wasted instead of getting utilized as a work force asset in Canada. For those who are unfamiliar, NNAS is an assessment body that evaluates the equivalency of IENs’ education with that of the Canadian nursing degree. In short, they will tell you if your education is up to par or not. With a fee of $650 for the main application, IENs have to pay this amount upfront and fulfill the documentations needed for the assessment of their international nursing degree. Let me tell you, that’s just the beginning of never-ending fees. Along with this application comes a huge number of requirements such as English test, licensure verification and transcripts certification. UNDERSTANDABLE. They have to protect the public and that’s just fair.
What doesn’t sink in to me is for the price that the applicants have to pay, they’re not getting their money’s worth. What’s worse is the lengthy wait times. The application process came to a point when IENs have to wait 2-5 years of completion. RIDICULOUS! And after years of waiting, unfortunately, a few received an offensive evaluation such as, YOUR EDUCATION IS NON COMPARABLE OR SOMEWHAT COMPARABLE TO THAT OF THE CANADIAN EDUCATION, enough to crush one’s spirit trampled the years of professional experiences in highly acute areas and disregarded their almost perfect English test. By the time they receive their result, they have been stagnant for years from their practice waiting for a process that’s cocktailed with ineffectual arbitration.
I have met various IENs who have worked in ICUs and highly acute areas overseas who received a non-comparable result. Some of them have master’s degrees, numerous years of experiences and specialized skill sets. Surprising, isn’t it? The inconsistencies with the process to obtain a Canadian nursing license have to be terminated. I’m not complaining but it’s certainly a case of unfairness in plain sight and one has to speak up. I understand that the gaps for knowledge can be corrected by refresher programs and they’re setting the bars high however, when does this systemic unfairness stop? Systemic unfairness or systemic racism? Internationally educated nurses are discriminated because English is not their first language despite the fact that they have passed the NCLEX, met the requirements, have worked in highly acute areas and PASSED AN ENGLISH EXAM. What are we missing here?
I bumped into an open letter by the canadian-nurse.com where it tackled some few interesting points. It says that regardless where we came from, we are all Canadian nurses and opening up about racism in nursing and healthcare must be addressed. Systemic racism education is omitted in the nursing curriculum and workplaces. I agree. While cultural sensitivity is greatly emphasized, systemic racism among health care staff and fellow nurses are not discussed. It is a touchy subject that most people fail to address and even refuse to acknowledge. It exists and it is real. So, how can we tell that each application from an IENs is not viewed by an adjudicator without discrimination and prejudice? There is no valid proof to this claim but there should be a better system of transparency and open communication between the applicant and assessment bodies. Be more accessible, perhaps? After all, they’re not paying for cheap fees.
Additionally, I also understand that each province have standards of their own. I’m not saying to make it easier, MAKE IT FAIR. One does not realize that these IENs have a life to live. The emotional turmoil and stress of waiting for result is too much to fathom. This is unacceptable on all levels. Stop wasting their time. Stop making the application processes a money grab. Shorten the wait times. Establish a pathway so each case can be dealt with appropriately. Develop an effective system where applicants and nursing bodies can benefit from each other. We are in need of more nurses!
The questionable processes, amounts and timelines are the problems we have to solve as it strains the applicants financially and emotionally. To add, I don’t think anybody has questioned this because of possible repercussions. And I doubt change will happen soon because of extreme red tapes. It’s a life altering process for the applicant’s end and some lose their hope and confidence on what this country has to offer.
And as the pandemic continues to hit, the shortage of nurses is obvious. The health care system is overwhelmed with patient overflow and short staffing issues. This is the time to expedite applications. On the contrary, I still think that the standards have to be maintained to protect the public at all cost. After all, we’re all in this together. Or, are we really?