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91��ɫ International has arranged an important resource for students coming to the University from abroad. It involves internationally educated nurses (IENs) completing their community placement with students to help demystify Canada's publicly funded health care system for both the nurses and students.

By Elaine Smith

Who better to understand the health concerns that international students might have than nurses who, themselves, are new to Canada? The team at 91��ɫ International realized having internationally educated nurses (IENs) would be a perfect match for the students they serve and have arranged to have 10 IENs do their community nursing placement assisting the students.

“It is a win-win situation for IENs and 91��ɫ International,” said Woo Kim, director, international student and scholar services with 91��ɫ International. “Our international students get to share their health concerns with nurses who have also had to adjust to Canada and its health care system, while the nurses gain Canadian experience in a community setting to complement their hospital work.”

The IENs are students in 91��ɫ’s Post-RN Internationally Educated Nurses (IEN) Program, a 20-month program to enable nurses who trained outside of Canada to transition to the Canadian health care system, earn a BScN degree and fulfil the requirements to take the provincial licensing exam that designates them as registered nurses (RNs).

For many of the students, who have practised in hospitals overseas, it is a frustrating roadblock on the road to being self-sufficient in their new country. Although the Canadian government has identified a labour shortage and worked to fill it through immigration, they have not lined up and coordinated the regulatory bodies and skills upgrading to support the transition to working in Canada. In fact, the hurdles often seem insurmountable. The College of Nurses of Ontario (CNO), for example, wants them to understand the Canadian health care system before allowing them to practice – including Canadian experience – which delays their ability to enter the workforce.

The community health course that pairs them with 91��ɫ International is designed to give them Canadian experience and an understanding of the system. Many of the IENs have worked solely in hospital settings, so this is their first community nursing experience.

“Community health in developing countries looks very different,” said Salwa Musa, the clinical course director for the Community Health course. “The IEN program works to demystify some of the complex nature of the Canadian health care system, how to navigate it and understand what patients can access.”

Nonetheless, IENs are itching to get on with their careers. Take Rosmy Mathew, for example. A native of India’s Kerala Province, Mathew obtained her three-year, hospital-based diploma in nursing and midwifery in Mumbai. She worked in an internationally accredited hospital there for four years, followed by three years in the ICU of a military hospital in Saudi Arabia, caring even for the war wounded. She immigrated to Canada in 2011 and 11 years later, she is still working toward the credentials that will allow her to practice in Canada.

“The CNO said I was eligible for the Registered Practical Nurse (RPN) exam, which I took in 2013, but I was missing a letter from the Saudi Arabian Nursing Council in my file,” Mathew says.

While she waited for the letter, she enrolled in the Centennial College year-long bridging program for nurses; she got her RPN credential just before graduation.

Finding work was also challenging because employers told Mathew she was overqualified. She eventually settled into an RPN job with the Scarborough Health Network, hoping she was on the road toward working as an RN again. In 2017, she registered for a year-long course through Carleton University that should have made her eligible to write the necessary licensing exam. She passed the Canadian national RN exam but discovered since she hadn’t worked as an RN for five years, she needed practice, not just theory, to obtain a license.

“I found 91��ɫ’s program that included a practicum component and a BScN upon graduation, but there are only 50 seats available in each class,” Mathew said. “Finally, in 2021, I was accepted.”

Mathew will graduate in August and finally be ready to practice as an RN.

“It has been a long journey, although I was well-supported by my family, my colleagues and my managers,” said Mathew, who has three young children. “I know many people who left the profession because of similar frustrations.”

Currently, Mathew’s placement with 91��ɫ International focuses on health promotion. She and her colleagues will be using online tools to answer international students’ questions about health issues. She is eager to become familiar with the tools and happy to help newcomers.

“I can relate to what international students are thinking about because I left home at the same age,” Mathew says.

Aagya Pokharel, an internationally educated nursing classmate from Nepal, will be working with 91��ɫ International on health promotion for international students. She and a couple of classmates will develop informational videos about the importance of taking COVID precautions amid the pandemic as well as strategies and tips for maintaining physical and mental health. “I’ve always worked in a hospital setting,” she said. “This is a different story and it’s interesting and exciting.

“For me, it’s also an opportunity to develop my leadership skills. You must have that to advance in your career.”

It’s a career that she, like Mathew, plans to continue after graduating in August and taking the Ontario licensing exam. Pokharel, too, had her career interrupted by the need to obtain Canadian credentials. She earned her BScN in India in 2012 and worked as a nurse for two years in Nepal before moving to Finland to earn a master’s degree. When her husband was offered a job and permanent residency in Canada, the couple relocated.

“I thought I would be eligible to take the licensing exam right away to become a registered nurse (RN) in Ontario since I was an internationally licensed nurse with a master’s degree in nursing research. But I was told by the College of Nurses of Ontario that I am not eligible to become an RN after they assessed my nursing education and experience,” Pokharel said. “In the United States, it’s much easier to become licensed for internationally educated nurses (IENs) with the similar educational background. However, it is a lengthy process to get licensed in Canada and it seems a bit unfair for IENs who wish to practice as an RN. Perhaps a short refresher course with clinical practice would be ideal for IENs, given that CNO continuously updates its rules and protocols for RNs.

“I had hoped to pursue nurse practitioner studies myself, but I’m not sure if my master’s degree credits will transfer.”

Despite their frustrations and the disconnect between the federal government and the provincial licensing organizations, YI and Canada will only be richer for the varied experience they will bring to the nursing profession.

Originally published in YFile