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A nurse stands by in the COVID-19 intensive care unit at St. Paul's hospital in Vancouver, on April 21, 2020.JONATHAN HAYWARD/The Canadian Press

Peter Karanja Githang’a had worked nearly five years as a registered nurse in Kenya by the time he arrived in British Columbia in 2018 intent on broadening his nursing skills and gaining international working experience.

But he spent years waiting in B.C.’s licensing and registration process, which he says almost crashed that dream. “It was a setback after setback,” he said. “The more you’re staying outside the practice, the more you’re losing your skills.”

When Mr. Githang’a was told he needed another year of education before he would be eligible to work in B.C., he gave up his plans to settle in the province. He moved to New Brunswick in March of last year; four months later, he was licensed.

“I was feeling like this is not dreaming, because everything was just aligning well for me,” he said of his move.

Mr. Githang’a’s long and frustrating efforts to be certified in B.C. underscores the challenges facing internationally trained nurses who relocate to Canada. It’s a problem that several provinces are attempting to solve by streamlining the process and making it easier for new arrivals to work in a field where there is a shortage of trained workers.

Last week, the B.C. government announced $12-million in spending to make it easier and cheaper for foreign-trained nurses to get registered and licensed in the province. It is the latest jurisdiction over the past few months to introduce enticements to attract and retain those professionals within their systems, amid a looming nationwide nursing shortage exacerbated by the COVID-19 pandemic.

Mr. Githang’a is an alumnus of Omni College, a school based in Richmond, B.C., that focuses on preparing internationally educated nurses for work in Canada. Nearly all of its current students plan to work elsewhere in Canada.

Omni’s program director, Louise Levinson, said the college has 78 nurses enrolled, and 70 of them have chosen to register for nursing licences outside of B.C. Ms. Levinson said many of Omni’s students decided to pursue their registration in the Maritimes, and some in Ontario.

She described the B.C. announcement as a “wonderful start,” which she hopes will encourage more internationally educated nurses to purse their career in the province.

However, Ms. Levinson said the testing system needs to be improved, as well, to expand testing options and ensure results come in more quickly.

“We just are hoping that this process can be more streamlined,” she said. “People can be encouraged and actually get the registration in B.C.”

In a statement, B.C.’s Ministry of Health acknowledged the high demand of nurses across the country and every jurisdiction’s efforts to recruit them and other health care providers.

The Ontario government has recently offered several incentives for internationally educated nurses, or IENs, including more seats in bridging programs, and supervised practice experience to help applicants get the recent experience to meet licensure requirements.

Last month, the Ontario Internationally Educated Nurses Course Consortium, led by nursing faculty at York, Windsor, Trent and Ryerson universities, received $1.5-million in funding from the provincial government for its competency-bridging program of study for IENs.

At Toronto’s Sunnybrook Health Sciences Centre, 46 IEN externs are gaining paid experience through a program funded by the Ontario government, said Ru Taggar, the centre’s executive vice-president and chief of nursing.

These IENs are aiming to meet their registration requirements and be recruited by Sunnybrook, said Ms. Taggar. “It’s a great pipeline.”

Jennifer Lopez, president of the Integrated Filipino Canadian Nurses Association, which provides support for nearly 2,000 nurses trying to be certified in Canada, said Ontario has become more attractive to IENs because of these enticements, especially with the launching of the “supervised practice experience partnership” by the College of Nurses of Ontario and Ontario Health in January.

The partnership provides an opportunity for applicants, currently going through the registration process, to participate in a work experience to help complete their practice and language proficiency requirements.

The Alberta government set aside money in its 2022 budget to fulfill a commitment under the labour agreement reached with nurses.

As part of the agreement, a new Rural Capacity Investment Fund will provide $5-million a year for three years to support recruitment and retention strategies in rural and remote areas. Funding for international hiring is included.

The government is also working with the College of Registered Nurses of Alberta to streamline accreditation for IENs to complement the new recruitment fund, said Alberta Health spokeswoman Lisa Glover.

Manitoba, too, launched an initiative last summer providing financial and process support for IENs looking to become licensed there. The province said last week that 92 foreign trained nurses have received such assistance so far.

Ms. Lopez said she’s pleased with the announcements made in several jurisdictions, but measures need to be more aggressive.

“It’s not just a shortage right now – it’s a crisis,” she said.

Statistics Canada said the country has added more than 10,000 nursing vacancies within the past two years. A 2009 report by the Canadian Nurses Association, or CNA, estimated Canada would be short almost 60,000 full-time equivalent registered nurses by 2022.

Ms. Lopez said for IENs who are already in Canada, their immigration process needs to be accelerated. “We’re ready to help anytime.”

According to the CNA, the assessment process for IENs starts with the National Nursing Assessment Service, which conducts a preliminary assessment. After that, applications will be sent to each regulatory body in the provinces and territories.

CNA president Sylvain Brousseau said the association is unaware of pan-Canadian data or studies that compare and explore which province or territory has the longest processing times for accreditation.

He said major barriers facing IENs include the complex licensing and assessment process, limited access to information, and lack of financial resources.

Registration and licensing of IENs can take an average of 18 months to two years, with some nurses waiting years. According to the BC Care Providers Association, it typically costs an IEN upward of $15,000 to become licensed in British Columbia.

Mr. Brousseau also warns governments to be careful when planning to recruit nurses overseas because the shortage is a global issue.

“That’s why the recruitment needs to focus on IENs that are already living in Canada,” he said.

Joan Atlin, of World Education Services, a non-profit that’s been addressing the underutilization of IENs in Canada, said when provinces and territories are working to attract nurses to address shortages, the issue then becomes retention.

“Will the working conditions in nursing and the inclusiveness of their new communities and workplaces be such that they will want to stay?” she asked.

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