McMaster University

McMaster University

Faculty of
Health Sciences

Foreign-trained nurses in Canada wasted during shortage

By Suzanne Morrison
Published: September 25, 2008
Andrea Baumann
Andrea Baumann, director, NHSRU McMaster site, and associate vice-president, international health of the Faculty of Health Sciences

Researchers in McMaster University’s Nursing Health Services Research Unit (NHSRU) have identified what could be termed a ‘brain waste’ of foreign-trained nurses in Canada.

The McMaster researchers found most internationally educated nurses (IENs) are not eligible to practice on arrival. They also discovered many foreign-trained nurses abandon the idea of ever re-entering the nursing profession because of the length of time it takes to become eligible to write examinations, pass national exams and find professional employment. At the same time, the country has a projected shortage of 78,000 nurses within three years.

The research was led by Andrea Baumann, director, NHSRU McMaster site, and associate vice-president, international health of the Faculty of Health Sciences, and Jennifer Blythe, senior scientist, NHSRU, and associate professor in the School of Nursing.

"In Canada, it is evident that greater support, resources and appropriate information are necessary at each stage of the migration process," said Baumann. "If receiving countries such as Canada ensure that migrants understand national licensing processes and job markets before migration, potential nurse migrants can decided what to do and will know what documents they need to speed their registrations."

Baumann will discuss workforce issues affecting foreign-trained nurses when she speaks in Toronto on Saturday, Sept. 27 as a panellist at the Health Human Resources Migration International Policy Symposium organized by the nursing and medical faculties at the University of Toronto.

The McMaster research on obstacles foreign-trained nurses face in re-establishing their professional careers in Canada is documented in three different studies: 

  • Nurses Migration to Canada: Pathways and Pitfalls of Workforce Integration
  • Profiling a Multicultural Workforce: Diversity Among Internationally Educated Nurses in Ontario, Canada
  • Globalization of Higher Education in Canada

The research undertaken by Baumann and Blythe is timely as the federal government announced in mid-August that it is creating a new fast-track immigration route for skilled foreign workers, including nurses, who have already proved employable in Canada.

McMaster’s Nursing Health Services Research Unit is currently evaluating a Ministry of Health and Long-Term Care demonstration project on recruiting, hiring and retaining internationally educated nurses. This project is underway in two Hamilton hospital systems — St. Joseph’s Healthcare and Hamilton Health Sciences. Hamilton having the third highest population of new immigrants in Canada. This project’s recruitment strategies for IENs may serve as a provincial or national model to others.

In 2006, there were 325,299 nurses in the Canadian nursing workforce of which 21,395 were internationally educated nurses.  Most arrived from the Philippines, Britain, India, the United States, Iran, USSR, Poland, Yugoslavia, China and Romania.  More than half of the foreign-trained nurses in Canada are practicing in hospitals in Ontario, primarily in central Toronto and surrounding cities.

Although the number of internationally educated nurses in Ontario’s workforce increased during the past decade, the growth was modest.  Between 1997 and 2006, 6,832 IENs entered the Ontario workforce and 6,024 left.  In the late 1990s and in 2001, more left the workforce than joined.  Consequently, only 824 more IENs were in the workforce in 2006 than in 1997.

Some of the barriers foreign-trained nurses face include: insufficient practical information about jobs before coming to Canada, long absences from practicing nursing, the need to take upgrading courses to meet new entry-to-practice requirements (four-year baccalaureate degree) and poor communication skills.

Among the solutions suggested by the McMaster researchers are: Group and individual counselling on educational needs; upgrading in stages; development of a mandatory adaptation program; and the establishment of international nursing education standards.

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