Internationally Educated Nurses' Experiences Still Full of Challenges

A WEALTH OF KNOWLEDGE BCNU, along with the Canadian Federation of Nurses Unions and World Education Services, co-hosted an evening event for internationally educated nurses (IENs) on Feb. 29 to hear their stories and learn how we can better advocate for improvements to the registration process and support these nurses in their workplaces. IENs play a critical role in BC’s health-care system and the recruitment and retention efforts underway.

Hyeonjeong (Olivia) Lee knows the challenges internationally educated nurses face. She has encountered many of them herself. Lee studied nursing in her home country of South Korea, graduated in 2019, then immigrated to Canada with the aim of working in a variety of multicultural patient care settings. Upon her arrival in Vancouver, she attended Sprott Shaw College and Langara College, graduating in August 2022. Today, she works as a surgical RN at Vancouver General Hospital (VGH).

Lee was one of the attendees at a February dinner and discussion event for IENs that BCNU co-hosted together with the Canadian Federation of Nurses Unions and World Education Services. Many at the dinner shared their frustration with the lengthy delays and inexplicable inconsistencies while navigating the process of acquiring a licence to practise nursing in BC. Lee was one of the lucky ones – her process for becoming an RN was relatively smooth. But after she began practising at VGH she ran into unexpected obstacles.

Lee’s work experience in health care was minimal prior to immigrating, so she began looking at professional development opportunities. Other RNs told her she could enhance her skills and knowledge by taking workshops focused on a wide array of topics including Indigenous cultural safety, code blue and trauma-informed care. She was told, however, that such workshops were not open to IENs because of limited space and resources. Lee was frustrated with the way the system excluded her.

“You want IENs to come and take care of people,” she says. “But now that I’m registered, now that I’m here… you don’t have the same education sessions available to us as [you do for] the other locally trained nurses.”

Lee wouldn’t take no for an answer. She joined with her managers, clinical educators, regional practice liaison and colleagues to advocate for change. A year later, in late 2023, the workshops on the Provincial Health Services Authority LearningHub became available to all IENs in the province.

Lee feels heartened that the education sessions are now available for everyone who needs them. But she still sees the need for major changes. She emphasizes the importance of IENs to the successful functioning of the province’s health-care system, particularly in the context of the current staffing shortage. Registering more IENs is one of the critical recruitment tools the province has at its disposal, but the process for recognizing international credentials is fraught with delays and duplication, and certification is far more difficult than it should be.

BCNU has successfully pushed the government to take action, with changes in 2022 making it easier for IENs to enter the workforce sooner. But those who attended the February IEN discussion said problems still abound.

The process requires those seeking registration to do much of the navigating themselves, jumping through the hoops of several organizations, such as the regulatory college. IENs sometimes need to meet similar requirements multiple times for qualifications such as English language proficiency. Many said, with no standard procedure, they rely on each other to share by word of mouth how best to approach the process.

The major theme emerging at the gathering was the need to streamline the process of recognizing international credentials in a way that is fair and efficient. The shared aim across the organizations involved in the registration process must be to help IENs meet the requirements to obtain their licence and to get them working in BC’s health-care system as quickly as possible.

Indeed, the government’s agreement with BCNU to adopt minimum nurse-to-patient ratios means thousands more nurses are needed. In addition to bringing nurses back to the bedside and retaining nurses who are already working, recruiting new nurses is a pressing need. Ensuring IENs have a clear, quick and efficient path to putting their skills to work in our health-care system must be a top priority. •

UPDATE (Spring 2024)