Internationally educated nurses face roadblocks to working in Ontario

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There are thousands of qualified health care workers in this province being kept from work by various bureaucratic logjams.


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Internationally trained nurses need to jump through several hoops before they can start nursing jobs in Canada, and none of the hoops — immigration, the National Nursing Assessment Service, provincial licensing colleges — seems to know what the others are doing.

Each step through the maze can take enormous amounts of time and money.

On Tuesday, Health Minister Christine Elliott announced that internationally educated nurses registered with the College of Nurses of Ontario (CNO) will now be permitted to work in hospitals and nursing homes.

Some 1,200 have expressed interest. For the time being, 300 internationally trained nurses will be available to the hospitals that so desperately need them.

And that’s a drop in the bucket, said Dr. Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario (RNAO).


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“That is nothing. A bed is 4.2 nurses,” said Grinspun, so 300 now for 50 hospitals equals one bed per hospital. It’s nothing.”

The reality, she said, is that 15,000 RNs are waiting for jobs in Ontario, and what they’re waiting for is for CNO to process their paperwork.

“They processed only 1,400 in 2021,” said Grinspun.

“CNO needs to get their processes in order. Omicron is not waiting. Those lined up for surgery can’t wait either.”

And all the ICU beds Elliott said were available?

“Beds without nurses are just furniture,” said Grinspun.

Nurses are currently dealing with triple the usual workload. They’re leaving the profession in droves.

“They are stretched to the limit, they’ve gone flat out for two years with no relief, with vacation days and days off cancelled, and now many are out ill — ill with Omicron and ill with stress.


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The CNO is one major bottleneck to more nurses, said Grinspun. Immigration is another.

“But Bill 124 is the No. 1 reason nurses are leaving,” she said.

That wage-limiting bill, passed in 2019, is an insult to nurses and must be repealed, Grinspun said.

“That’s what Health Minister Elliott should have announced today. ‘Nurses, we need you. Bill 124 is gone.’ That’s the message we needed.”

Birgit Umaigba (RN) teaches internationally educated nurses and sympathizes with their plight. The process for them being permitted to work as nurses in Ontario is unclear and expensive.

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The U.S. has made it much easier to start working, said Umaigba, and that’s where many nurses are headed.

“Some of these students are actually more experienced than I am. They’ve been nurses for years in Saudi Arabia, in the U.K., in America. They have tons of experience. They have tremendous knowledge and skills. Their credentials are overlooked or disregarded,” Umaigba said.


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Little is done to show support, she said, or to help these nurses integrate.

“They make it unnecessarily difficult. For students from Africa, the transition is hell, she said.

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Asked for comment, a spokesperson for the CNO said in a statement that they protect the public by promoting safe nursing practice and registering nurses.

“There are eight registration requirements: education; police criminal record check; evidence of practice; language proficiency; registration examination; health and conduct; authorization to work; and past offences and findings.”

The statement concedes that even before the pandemic, CNO was aware their registration process needed improvement, particularly for internationally educated applicants. They recently announced policy changes to help move things along.

“We have prioritized modernizing applicant assessment to respond to the needs of the health care system.”


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