Nurses who were educated outside of Canada and want to work within our country can face a labyrinth of application procedures and a wait in limbo of two years or more, an Irish nurse said.
“I’m part of an ever-expanding group of internationally qualified nurses being forced to wait an inordinate amount of time for our qualifications to be recognized,” Lisa McGowan said. “I will have waited three years come May.”
Foreign nurses wanting to work in Canada begin their licensing or registration process with an application to the National Nursing Assessment Service (NNAS).
The body was formed in 2012 by 21 Canadian nursing regulatory bodies, including the colleges for licensed practical nurses, registered nurses and registered psychiatric nurses in B.C.
If a nurse’s credentials are verified and they receive an advisory report, they can then apply to their provincial regulatory body for registration to practise.
According to the NNAS annual report for the 2016-17 fiscal year, 5,488 internationally educated nurses from more than 180 countries submitted applications. The top five countries were the Philippines, India, the U.S., Nigeria and the U.K.
The report states that the average processing time — from receipt of all documents to issuing an advisory report — fell from 12 weeks the previous fiscal year to 10 weeks in 2016-17. The entire process takes an average of eight months.
McGowan called those numbers “laughable” and a “ridiculous charade.”
“And it’s a near impossibility to contact (NNAS) after applying,” she said.
The initial application costs $650 and the file will remain open and active for a year. If the application expires, then the applicant must pay $180 to reactive it.
Raquelle Forrester, interim executive director for NNAS, said delays are most often caused by problems with documentation, because the service doesn’t accept copies and needs the information about applicants directly from universities, regulating bodies and workplaces in their home countries.
“Ultimately, the reason that we take these precautions is to make sure that everything is done in a certain fashion. At the end of the day it’s about patient safety,” Forrester said.
Everything is done on a case-by-case basis and some can take longer than others, she said. If a nurse’s case is taking longer than it should, Forrester said the nurse should contact the NNAS Toronto office and make an inquiry. In some cases, an application’s time can be extended for a month or more depending on the circumstances.
Forrester said she found the prospect of people waiting two years to receive an answer concerning: “That is something I would want to hear about personally.”
She said the service has renewed its focus on quality improvement and dealing more quickly with files that have been escalated.
“It’s a huge priority for us. We’re focusing on that,” she said. “They were definitely acting on things (before), but I’m not sure they had all of the staffing complement and that’s the important piece.”
According to the College of Registered Nurses of B.C., as of Dec. 31, 2017, there were 5,658 nurses practising in B.C. who were processed as internationally educated applicants. This is out of a total of 41,100 practising registrants.
The B.C. Nurses Union has heard complaints of long waits for years, both from its members and others who haven’t become accredited but are working elsewhere in the health field, and has been advocating on behalf of internationally educated nurses to the government and the colleges.
“This is not news to us, and it’s becoming of greater concern,” said Christine Sorensen, the union’s acting president. She described the process as long, expensive, “very arduous and difficult to navigate.” She has heard of nurses waiting up to two years for their applications to be approved.
“That’s extremely hard on our nurses financially and psychologically,” she said.
The applications process is also a concern because B.C. is in the midst of a nursing shortage — particularly critical-care and specialty nurses. Sorensen said it’s leading to heavy workloads, short staffing, congestion in hospitals and an inability to discharge because nurses aren’t available in the community.
“It becomes a significant issue for the system,” Sorensen said. “We have a looming nursing shortage and we need to make this province accessible.”
McGowan, meanwhile, sits and waits, overqualified and underpaid (compared with nursing wages) in her job as office manager at a private clinic in Vancouver.
“It’s at the point now of what is the point?” she asked.