Canada

As Ontario’s emergency services flex, nurses’ groups want international applicants’ licenses expedited

Razan Suliman has worked as a registered nurse and midwife in some of the world’s most difficult circumstances, from wartime hospitals to refugee camps.

But five years after starting the process to become a licensed nurse in Ontario, she’s still waiting.

“It’s very, very disappointing. You can’t imagine the pain I was going through because I really wanted to get my license and everything was just pushing me back,” said Suliman, 34, who lives with her husband and three children in Orangeville, Ontario.

Suliman, who arrived in Canada as a Syrian refugee in 2015, is one of thousands of internationally educated nurses looking to work in Ontario — and could help ease staffing shortages that are forcing some hospitals to temporarily close emergency rooms wards – but are left in the lurch due to an expensive and complicated registration system.

Nursing organizations and hospital networks have identified international recruitment as a long-term solution as the province struggles to retain workers, many of whom are burned out or leaving the profession in droves.

“Patient care is suffering”

Repeated calls by the Registered Nurses Association of Ontario and the Ontario Nurses Association for a faster licensing process for internationally trained nurses have taken on added urgency in recent weeks.

“The system is on fire. It’s burning and patient care is suffering,” said Doris Grinspoon, CEO of the Registered Nurses Association.

“These colleagues are ready for work. And they just had to be processed much faster.”

Suliman’s application process began in 2017, when she began gathering the necessary documents to prove her Syrian education and work experience to Canada’s National Nursing Assessment Service. The service reviews these applications and then sends a report to the provincial nursing regulator, which issues the applicant with a set of requirements he must meet — for example, education, language proficiency, practical experience — before he can be licensed.

Registered nurse Janelle Van Haltren prepares to serve a patient at the Humber River Hospital emergency department on Jan. 13, 2022. (Evan Mitsui/CBC)

Suliman, who says she left Syria with nothing, was trying to get documents in the midst of a civil war.

Her nursing school, she said, was bombed and her old hospital withheld her employment records. After many phone calls to the assessment office, she says her application has been accepted.

Suliman says her report was forwarded in 2019 to the Ontario College of Nursing, which told her to build on her education with 16 college courses. With the help of her husband, who works as a used car salesman, Suliman juggled caring for three children and taking classes at George Brown College before graduating last December. She is due to write her registration exam in August.

“I know these are the rules, but everything was hard to get,” she said.

14,633 international nurses are seeking licensure

A recent report from Ontario’s justice commissioner showed the province’s nursing regulator is facing some pandemic-related setbacks as it works through thousands of international applications.

The 2020 report found that 14,633 internationally educated nurses are actively seeking licensure through the Ontario College of Nursing. That same year, just over 2,000 international applicants became full members.

Christy Green, spokeswoman for the College of Nurses of Ontario, said the regulator does not have available numbers of applicants participating in the registration process or timelines for the entire application process “because they do not reflect the variations that are necessary to to ensure justice.”

A nurse at Humber River Hospital in Toronto prepares doses of Moderna’s COVID-19 vaccine. (Evan Mitsui/CBC)

The Registered Nurses Association says it has seen a growing number of applicants over the past decade and estimates the queue is close to 26,000.

The college recently took steps to speed up the process, including changes to language proficiency requirements and a partnership with the province to create more supervised practice opportunities.

Ruth Wojtyuk, head of professional practice at the nonprofit Center for Internationally Educated Nurses of Ontario, applauded the move. She says the recent work experience requirement “is one of the most difficult” for internationally educated nurses to meet because they are often left to compete with provincial nursing students who are connected to internships through college programs.

A record year for candidates

The college says it’s been a record year, with nearly 4,000 applications processed by the end of June, more than double what it processed by this point last year. It also says it is considering updating policies on evidence of practice, education and criminal record checks to streamline the process.

But Grinspoon of the Registered Nurses Association says there’s still room for improvement. Instead of treating each applicant individually, she says the college can look for ways to bring together applicants who graduated from the same cohort at an international nursing school.

Gloria Baker, 55, has been trying for 14 years to get a nurse’s license in Ontario.

She says she first applied in 2008 while working in Jamaica and was told she had five years to get a work permit if she wanted to enroll in college.

She arrived in Canada two years later as part of the caregiver program, but says she didn’t get permanent residency before the college break because of what she described as failed immigration paperwork from a recruitment agency and problems with employers .

For 10 years, Baker says she didn’t see her daughter in Jamaica while she stayed in Canada trying to get permanent residency. He had to miss his father’s funeral.

“I couldn’t see my daughter, so it was a sacrifice. And at one point I said to her, ‘You know what, I’m coming home,’ and she said, ‘No, Mom, no, you went for a reason,'” she said. “It was just like working and hoping and we pray, let us work and hope and pray.’

She eventually received permanent residency in 2018, at which time she reapplied to the Ontario College of Nursing. She works with Purolator during the day and attends college nursing courses at night as she prepares to write her exams in August.

“We are nurses and we came here to be nurses to be useful here. We also served our country. And we came to serve this country as well,” she said. “Make the process smoother for us so we can get along.”