Canada desperately needs nurses. So why does it take so long for internationally trained nurses to get licensed?

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Canadian Lisa Conebear endured tragedy every day as a nurse on a COVID-19 floor at a Los Angeles hospital and after months of seeing the patient as she died, she decided she needed to come back to Ontario , where she was born, and helped fight. Epidemic here.

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“I worked on COVID for five or six months and thought, ‘Canada needs me,'” said Conibear, who has a master’s in clinical nursing and another as a nurse practitioner from both UCLA and California State University in Los Angeles. is in. ,

What she was unprepared for, however, is that she would still remain in the US as Canada endured the second and third, and now fourth, waves of the pandemic, which has exacerbated the country’s shortage of registered nurses. .


Hundreds of potentially foreign-trained nurses wishing to work in Canada, including ConeBear, are trapped in a backlog at the National Nursing Assessment Service, a Canadian not-for-profit that certifies and certifies their academic credentials. Is.

Its executive director Gail Waxman said in an email that the delay was due to an “abnormally high volume of applications” for the evaluation service. “This has delayed the review of minority applications. The NNAS has notified applicants whose applications have been affected.

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“We certainly apologize for the delay and hope this will be resolved in the near future,” Waxman said.

Appraisal Services is a Canadian non-profit that contracts work to an American company. Waxman said the service received about 7,000 applications from foreign-educated nurses who want to work here in the fiscal year ending March 31, 2021, up 11 percent from a year ago.

But assessment is only one of the many obstacles foreign applicants face when trying to be licensed by a provincial college, most of them pursuing permanent residency through Canadian immigration in a separate, unrelated process. .

The result, experts say, is that thousands of potential nurses come to Canada as live-in caregivers or permanent residents hoping to make their dreams come true.

But they work as individual support workers or caregivers to support their families because of the time it takes to get a license, the fees associated with it, or the cost of bridging programs at school and upgrading their education. is used to.

Joan Atlin, director of strategy, policy and research for World Education Services, said: “Once they get here, they face a different and costly journey trying to obtain a license to practice. ” “Many people give up on effort along the way and our health care system loses its skills.

“The players responsible for immigration, evaluation, bridging and licensing need to be tied together in a coherent system,” she said.

The World Education Service, a non-profit that helps international students, immigrants, and refugees achieve their career goals in the US and Canada, estimates that it would take a foreign-trained nurse to obtain a license here. 16,000, which includes expenses such as the NNAS academic assessment, nursing exams, application fees to the provincial nursing college, and academic bridging programs.

The Education Service was one of 50 organizations that signed an open letter during the federal election calling for a national strategy to address barriers to licensure faced by internationally educated health professionals.

“Right now, we don’t even have an accurate picture of how many health care professionals students, permanent residents, or temporary workers — including caregivers — visit Canada each year,” Atlin said.

Data from Immigration, Refugees and Citizenship Canada shows that no temporary foreign workers, including caregivers, declared their intended occupation as licensed practical nurses in Ontario between 2015 and 2021. And only 205 new permanent residents in Ontario declared nursing as their desired occupation at the Department of Immigration in 2019.

Nevertheless, that year more than 4,500 internationally educated nurses applied to the Ontario College of Nursing, which requires applicants to be citizens, permanent residents, or have valid work/study permits, suggesting that most of them Applicants must already be in the country.

The differences in the data are probably immigrants with nursing backgrounds who come to Canada through the Caregiver Program. They will record on immigration documents their intended occupation as a health care or personal support worker, working in a long-term care setting and not as a nurse, “as this is the focus of the immigration stream through which they enter Canada.” Naomi Lightman, assistant professor of sociology at the University of Calgary, said.

The forms aren’t really supposed to be aspirational. It’s supposed to be quite practical. It’s administrative. They’re just filling out where they think there’s a best chance for them as anyone would. So I guess It certainly doesn’t speak to the human capital of those immigrants,” said Lightman, whose research has shown that caregivers are typically highly skilled and more than half have bachelor’s degrees.

Applicants applying to the College of Nurses must have Canadian citizenship, permanent residency or a valid work/study permit to practice nursing in Ontario. But according to the College of Nurses of Ontario, work permits are not recognized for a specific type of employment, such as a live-in caregiver.

Lightman’s research also shows that many caregivers begin training again, but are unable to finish “due to cost or family obligations.”

“There are too many barriers to upgrading their skills or actually transferring their credentials out of their home country,” Lightman said.

For those who remain on the way, Ontario’s College of Nurses says it can take up to 18 months to obtain a license, although Samantha Moore, a registered nurse who has purchased a nurse recruitment company called PRN Staffing Solutions, says it can take up to 18 months to obtain a license. Says it’s the same. for three years.

His company recruits internationally educated nurses for rural hospitals in northern Ontario and other parts of the country.

Some are so desperate for nurses that they offer a $20,000 relocation reimbursement package to cover moving expenses, paid housing, and in the case of Newfoundland and Labrador, attract staff. Nurses do not need a work permit or permanent residency in that province to obtain an active nursing license.

“Since COVID, it has been very difficult,” Moore said. “I have four nurses with whom we’ve actually signed offer letters that are dealing with immigration. And they’ve had job offers for over six months. But unfortunately with COVID immigration is extremely slow, so They have not been able to do the paperwork to come to the country.”

Moore thinks the process can be streamlined.

“There are so many complications that come from everything. Immigration needs one thing, the NAS needs another. Each province requires the other,” said Moore, who worked in England for some time and said the process of granting licenses there was very simple.

“As a nurse, it is not like I want someone uneducated or low-level to come in and get a license. It just needs to be made a streamlined, fast process.”

The Government of Manitoba recently recognized the barriers that internationally educated nurses face and provided those in the province with access to clinical competence assessments, bridge training and other expenses such as a living allowance and child care. Announces initiative to provide up to $23,000 in financial aid.

The Ontario government recently announced a program similar to Manitoba to entice nurses to work in long-term care, as well as plans to add 500 enrollments to bridging programs.

Qualified registered practical nurses, who usually have a diploma, will have access to $10,000 per year to upgrade their education to become a registered nurse, which requires a degree. An additional $5,000 will be available to candidates annually to cover expenses such as course materials, tuition and child care.

Internationally trained nurses who are eligible can access up to $6,000 per year in financial aid to gain the credentials needed to work in Ontario.

In return, the government expects applicants to commit to long-term care work for the same amount of time as they received funding under the program.

When Manitoba offered incentives, the government said it did not know how many internationally educated nurses were in the province, but the program announced on July 8 received 1,210 online applications in the first week.

For Conebear, the process has already dragged on for so long that she quit her job in Los Angeles and moved to Virginia Hospital Center in Arlington in June to be closer to her daughter, who attends school there.

It took her months to gather all the documents required by the NAS, including transcripts from both the schools she attended and the syllabus for each course she took.

In December of 2020, she says that the NNAS told her it was reviewing her file, but then in June she received a request for more transcripts, which she says she has already sent. The NAS does not begin a review until it has every document it needs and says it typically takes about nine months to collect all the documents. From that point onwards the review takes at least 12 weeks.

She eventually received her NNAS evaluation on November 8 and said in an email that she had been told she should be registered (licensed) for evaluation by the Ontario College of Nurses in less than half the time.

The process is rigorous, well, as Coneybear says, but it has made it difficult to make any plans to move to Canada.

“If I trusted the process and said, ‘Oh, well, you know, great, I’ll be licensed and I’ll be able to start applying for jobs 12 weeks after December 1st 2020,'” then I would have was applying for…

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