Scholarly Letter to the Editor

To the Editor

In your article, Immigrant Nurses Face New Hurdles with Ontario’s’ Licensing Changes, you assert that about 75% of immigrant nurses fail new screening exams for registered nurses because they have gaps in their careers, yet they do not find bridging programs to fill these gaps. Your assertion reflects the experiences that immigrant nurses undergo before integrating into the Canadian health care system. Currently, Canada is experiencing a significant shortage of nurses, which threatens the existence of pediatric hospitals and hinders the provision of pediatric care. As projection shows that Canada will have a 100,000 shortage of nurses by 2016, Canadian Nurses Association recommends immigration as a relevant policy lever in alleviating the shortage (Little, 2007). The immigration policy envisions that the immigration process of nurses would occur without undue delays in the assessment of their professional qualification and integration into the Canadian health care system. However, the experiences of immigrant nurses are shocking because the regulatory body takes years to recognize them as registered nurses, the new Objective Structured Clinical Exam (OSCE) unfairly fails about 75% of the nurses, and there are no remedial programs, which enable them to bridge gaps in their careers. According to Keung (2014), a veteran nurse from Iran aged 35 with 11 years of experience as a registered nurse failed OSCE, after waiting for three years. Such an experience reflects the experiences that immigrant nurses undergo as they strive to register and integrate into the Canadian health care system.

After reading your article, I support the assertion that immigrant nurses grapple with a considerable number of challenges in Ontario as they seek professional recognition and employment in the health care system. The nursing regulatory body has come up with new regulations, which require immigrant nurses to undertake OSCE for them to operate as registered nurses in Ontario. Although OSCE aims to improve the professional standing of nurses and promote the quality and safety of healthcare services, it does not consider the nature of professional training that immigrant nurses underwent in their native countries. Although Canada is experiencing shortage of nurses, the restrictions they impose on immigrant nurses, who have appropriate qualifications and experiences from their native countries, continue to worsen the state of nursing shortage. Nelson, Verma, Hall, Gastaldo, and Janjua (2011) state that most immigrant nurses, who used the standard point system to migrate to Canada, live as dependents and survive in caregiver program instead of working as nurses, and hence, negates the essence of immigration in alleviating the shortage of nurses. Fundamentally, immigrant nurses waste a great deal of their time and resources as they go through rigorous assessment, which unfairly fails them in the end. The existence of amorphous regulations, imposition of non-standardized exams, and the absence of specific remedial programs have complicated registration of nurses and delayed their licensure in Canada. Higginbottom (2011) examined the experiences of immigrant nurses and found out that inconsistent training policies are not only discouraging, but also destructive for they promote discriminatory practices in the recruitment process of nurses in Canada. Therefore, the aforementioned arguments effectively support the assertion that immigrant nurses experience tough challenges as they seek professional recognition and licensure in Canada.

To improve the experience of immigrant nurses in Canada, the health care system in conjunction with relevant stakeholders needs to undertake a number of reforms in the aspects of accreditation, registration, and recruitment of nurses. To prevent immigrant nurses from undergoing a haphazard accreditation process, the health care system should establish a standard accreditation process, which considers professional qualifications and experiences of nurses in their respective native countries (Little, 2007). Regarding the aspects of registering and recruitment of immigrant nurses, Nelson et al. (2011) propose that policy makers in the healthcare systems, immigration departments, and regulatory bodies, in both Canada and native countries of immigrant nurses, should create an integrated policy framework, which solves accreditation issues. Higginbottom (2011) recommends that curriculum for remedial programs should be available and the place of their issuance should be specific so that immigrant nurses, who require further training, can access them. Hence, if the Canadian health care system acts on the proposed recommendations, it would greatly alleviate tough challenges that immigrant nurses undergo as they strive to gain recognition by their regulatory body as registered nurses, and eventually get licenses to operate in various healthcare centers.

Overall, immigrant nurses in Ontario experience discouraging challenges as they strive to build their careers in nursing. Given that the regulatory body of nurses does not recognize professional qualifications and experiences of immigrant nurses that they gained in their respective native countries, it compels them to take OSCE so that they can qualify as registered nurses. The process involved in taking OSCE is amorphous because it has no curriculum, and thus, fails 75% of immigrant nurses. Moreover, the process wastes time and resources for immigrant nurses because it takes several years. Lack of appropriate remedial programs also complicates how immigrant nurses could bridge their careers by filling gaps in their trainings. As recommendations to solve these issues in nursing, the health care system should develop a standard accreditation process, create an integrated policy framework, and avail remedial programs.

Yours sincerely,

Insert your name here_____________________________

References

Higginbottom, G. (2011). The Transitioning Experiences of Internationally Educated

Nurses into a Canadian Health Care System: A focused Ethnography. BMC Nursing, 10(14), 1-13.

Keung, N. (2014, November 11). Immigrant Nurses Face New Hurdles with Ontario’s

Licensing Changes. The Star. Web.

Little, L. (2007). Nurse Migration: A Canadian Case Study. Health Services Research, 42(3), 1336-1353.

Nelson, S., Verma, S., Hall, L., Gastaldo, D., & Janjua, A. (2011). The Shifting Landscape of Immigration Policy in Canada: Implications for Health Human Resources. Health Policy, 7(2), 60-67.